Doporučení pro diagnostiku a léčbu chronického srdečního selhání ČKS 2006

J. Špinar, J. Hradec, J. Meluzín, J. Špác, L. Špinarová, J. Vítovec, P. Lupínek, I. Málek

Vnitr Lek 2007, 53(7-8):877-908  

Z odborné literatury

Vnitr Lek 2007, 53(7-8):874-875  

K sedmdesátinám profesora Klenera

Jan Evangelista Dyr

Vnitr Lek 2007, 53(7-8):865  

Profesor MUDr. Miroslav Mydlík, DrSc., sedemdesiatpäťročný

Katarína Derzsiová, Viera Spustová

Vnitr Lek 2007, 53(7-8):866-868  

Za prof. MUDr. Janem Němcem, DrSc. (11. 8. 1932 - 21. 4. 2007)

Václav Zamrazil

Vnitr Lek 2007, 53(7-8):869-870  

Odešel profesor MUDr. Miroslav Vykydal, DrSc.

Karel Trnavský

Vnitr Lek 2007, 53(7-8):871  

Spomienka na prof. MUDr. Mikuláša Takáča, DrSc., pri jeho nedožitých 80. narodeninách

Miroslav Mydlík, Katarína Derzsiová

Vnitr Lek 2007, 53(7-8):872-873  

132. internistický den - XXII. Vanýskův den, Brno 2007

Vnitr Lek 2007, 53(7-8):788  

Quo vadis, hypophysis? Some news and prospects

J. Marek

Vnitr Lek 2007, 53(7-8):789-794  

Knowledge of hypophysis could hardly stagnate in a context of general progress in medical science as such. New knowledge in physiology, pathology and treatment of hypophysis diseases is vast and only some of it could be included in the article. New regulators of hypophysial secretion have been discovered. Among them are hypothalamic chemokines and the KISS-1 gene product - kisspeptin. Impulses coming to the hypophysis from the brain centres and the periphery need to be integrated. This is provided by a system of folliculo-stellate cells, paracrine mechanisms and hypophysial microcirculation. Are there stem cells in the hypophysis, too? It seems there...

Subclinical thyroids disease

V. Zamrazil

Vnitr Lek 2007, 53(7-8):795-798  

Subclinical thyroids disease (STD) is recently defined term in clinical thyroidology, which includes mainly functional disorders. Basic diagnostic signs are: normal values of thyroid hormones (fT₄, fT₃) and elevated TSH level (subclinical hypothyroidism) or suppresed TSH level (subclinical hyperthyroidism). In a category of STD may be included subclinical autoimunne thyroiditis (elevated level of thyroid antigens antibodies and/or hypoechogenity in sonographic screen, increased volume of the thyroid without clinical symptoms and/or autoimminity) and microscopic lesions of papillary thyroid carcinoma. Subclinical hypothyroidism...

Aspiration cytology of the thyroid

J. Čáp, A. Ryška

Vnitr Lek 2007, 53(7-8):799-803  

Fine needle aspiration cytology is a basic type of examination in thyreology today. It is primarily indicated for thyroid node to exclude a malignant tumour. The presence of multiple nodes or of one node only has shown to be indicative of the same amount of risk of a malignant tumour for the patient. Ultrasound characteristics are insufficient for the determination of the nature of the focus and all the existing nodes greater than 10 mm are an indication for puncture. As for other diseases, aspiration cytology is indicated in granulomatose thyreoiditis, while in Hashimoto thyreoiditis it is usually indicated only if a node is present. In addition to...

Autoimmune polyglandular syndromes: clinical aspects

K. Vondra

Vnitr Lek 2007, 53(7-8):804-806  

The history of autoimmune polyglandular syndromes (APS) and the basic characteristics of types 1 and 2 are briefly introduced. The clinical aspects of the more common type 2 are discussed in more detail from the point of view of the endocrinological and diabetological practice. The diagnosis aspects of preclinical, subclinical and manifestation stage of the main diseases occurring along with APS are briefly mentioned as well as the treatments and their challenges cause by the combination of various endocrine and non-endocrine autoimmune diseases. It is emphasized that care for there patients is a life-long process and that the health condition of these...

Endocrinology and nuclear medicine aspects of the treatment of thyroid tumours

P. Vlček

Vnitr Lek 2007, 53(7-8):807-811  

Thyroid tumours belong among the most frequent malignant tumours in endocrinology. The rate of incidence of new carcinomas has increased dramatically in recent years; the rate of thyroid tumour incidence, in particular of its less advanced papillary forms, sextupled in the Czech Republic in the previous decade. The article brings an overview of the factors involved in the development of thyroid tumours, and the classification and clinical assessment of their different types. Recombinant human TSH has started to be used in the Czech Republic as part of preparation of patients for radioiodine treatment. Also discussed is the relevance of tumour markers...

Hypopituitarism - substitution therapy

V. Olšovská

Vnitr Lek 2007, 53(7-8):812-815  

Hypopituitarism is a condition linked with insufficient function of the adenohypophyse and occurs in the case of destruction of its greater part. It may take the form of an isolated deficit or a combined disorder - panhypopituitarism. The most common cause is an expansion in the region of sella turcica, irradiation, traumas, inflammations, bleeding, puerperal ischemic necrosis (Sheehan syndrome) or an affection of the hypothalamus. The cause remains unclear in the case of idiopathic hypopituitarism. Clinical picture: the most common case in children is the deficit of the growth hormone, manifested by retarded growth. Sometimes it is combined with the...

Randomly discovered enlargement in the region of sella turcica

V. Hána, Z. Seidl, M. Vaněčková, P. Diblík, V. Weiss, V. Masopust, M. Kršek, J. Marek

Vnitr Lek 2007, 53(7-8):816-820  

Computer tomography (CT) and magnetic resonance imaging (MRI) quite often detect unexpected cases of enlargement in the hypothalamus-hypophysial region, without the above methods being indicated for clinical manifested symptomatology provoked by the tumour. This is not surprising if we consider that autopsies show the presence of hypophysial adenomas of 10-15 % of population on an average. X ray, CT or MRI are indicated in the case of head traumas, lateral nasal cavity inflammations, headaches, strokes, neurological diseases and other disorders. A number of tumours of diverse etiology occur in the hypothalamus-hypophysial region, but hypophysial adenomas...

Adrenal incidentalomas

M. Kršek

Vnitr Lek 2007, 53(7-8):821-825  

Adrenal incidentalomas are called as a disease of modern technology because increased availability and accuracy of imaging techniques lead to increased incidence of incidentally discovered adrenal masses. Adrenal incidentalomas are found in about 0.35-4.36 % of abdominal CT scans performed for purpose other than suspicion of adrenal diseases. However, in autoptic studies the percentage of incidentally discovered adrenal tumours in much higher, in some of then being even more than 20 %. Important component of differential diagnosis is endocrinological examination aimed to reveal potential autonomous hormonal overproduction. Approximately more than 10...

Differential diagnosing of hypercalcemias

P. Broulík

Vnitr Lek 2007, 53(7-8):826-830  

Primary hyperparathyreosis and tumour diseases are the two most frequent causes of hypercalcaemia. Surgical removal of parathyroid adenoma is the permanent solution for hypercalcaemia. Hypercalcaemia may occur in 20-30 % of patients with cancer in the course of the disease. It causes progressive deterioration of the overall condition of the patient which culminates in a coma-like state with renal failure and means a bad prognosis for the affected person. Evaluation of clinical condition and obtaining the immunoreactive parathormone level data are of extreme importance for correct diagnosis. Normal or even low parathormone levels almost surely exclude...

Glucocorticoids and osteoporosis

V. Zikán

Vnitr Lek 2007, 53(7-8):831-840  

Treatment with glucocorticoids (GC) has no alternative in many medical disciplines for their anti-inflammatory and immunosuppressive effect. However, osteoporosis and the related fractures are a serious complication brought about by long-term GC therapy. The risk of fractures, especially of the vertebras and the ribs, becomes higher as early as in the first months of oral GC therapy. It grows in proportion to the daily dose of GC, and is present even if low doses are administered (2.5-7.5 mg of prednisone per day). Decreasing bone density (BMD) is not accountable for the higher risk of fractures in GC therapy and fractures occur with higher values...

Mineral-bone disorder with chronic kidney disease

D. Sobotová, A. Zharfbin, M. Neobálková, J. Svojanovský, M. Souček

Vnitr Lek 2007, 53(7-8):841-851  

Mineral-bone disorder in chronic kidney disease is a clinical syndrome provoked by the combination of three factors: abnormal laboratory results, bone morphology disorder and extra-bone calcification. Its onset in adult age is linked with a decrease in glomerular filtration (GF < 1 ml/s). Fully developed forms occur in the course of regular dialysis treatment. The use of the traditional denomination "renal osteodystrophy" is currently restricted to the bone morphology finding. As there are two threshold types of bone turnover (low and high) and two degrees of mineralisation (low and normal), there is a total of four basic variants of mineral-bone...

Prohlášení výboru České společnosti intenzivní medicíny

Vladimír Černý

Vnitr Lek 2007, 53(7-8):851  

Oral treatment of type 2 diabetes mellitus

J. Olšovský

Vnitr Lek 2007, 53(7-8):853-858  

The article informs about current views of the ethiopathogenesis of type 2 diabetes mellitus (DM). It presents diabetes as a disease which is chronic and progressive, therefore requiring a dynamic approach to treatment. Based on the above concept, the article lists the current armamentarium of oral antidiabetic drugs and the possibilities of their combining. In addition to the existing therapeutic options, it also brings information about innovative drugs from the above group to be made available in the near future.

Transplantation in the treatment of diabetes

F. Saudek

Vnitr Lek 2007, 53(7-8):859-864  

Diabetes mellitus continues to be the most common cause of chronic kidney failure, blindness acquired in adulthood, non-traumatic amputations and severe forms of neuropathy. Therefore it is necessary to look for new forms of therapy capable of achieving long-term normalisation of blood sugar levels. The only standard method so far is pancreas transplantation. Most often, it is performed in combination with kidney transplantation and only exceptionally as an isolated procedure. A new and considerably less invasive option is transplantation of isolated Langerhans islets. While the number of pancreas transplantations in IKEM has exceeded 300, the program...