Poznámky k problematice akutní embolizace do tepen splanchnického řečiště - editorial

B. Fischerová

Vnitr Lek 2008, 54(11):1029-1030  

The safety of long-term administration of losartan in current clinical practice: a non-intervention NCT-CZ 14/04/LOZ study

J. Krupička, K. Ceypová, P. Kristenová, T. Hauser

Vnitr Lek 2008, 54(11):1031-1038  

Introduction:Losartan is the longest used angiotensin II receptor blocker in clinical practice [1]. It is one of the first-line drugs for the treatment of hypertensive disease and there is enough data available today about its use in the treatment of the disease, including some specific situations (left ventricular hypertrophy, cerebrovascular accidents) and cases when the hypertension disease combines with another disease (e. g. diabetic nephropathy) [2]. The primary objective of the non-intervention multicentre prospective observational open clinical assessment NCT-CZ 14/04/LOZ was to verify on a large sample of patients the safety of...

Prolactin - a marker of the activity of connective tissue systemic disease?

Ž. Macejová, D. Trejbal, M. Oetterová, I. Lazúrová

Vnitr Lek 2008, 54(11):1039-1044  

The ethiopathogenesis of auto-immune diseases has not yet been fully explored. Auto-immune diseases develop in individuals with a genetic pre-disposition. Among the endogenous factors, also sexual hormones play a role, especially prolactin. The objective of the study was to use basal exam and TRH test to determine stimulated prolactin values in patients with a systemic connective tissue disease: systemic lupus erythematosus (SLE), systemic sclerosis, Sjögren's syndrome, dermatomyositis. Patient group and methods:The authors examined 43 patients with systemic connective tissue diseases: 20 patients with SLE, 7 patients with Sjögren's...

Relationship between familial combined hyperlipidemia and insulin resistance

D. Jackuliaková, H. Vaverková, D. Karásek

Vnitr Lek 2008, 54(11):1045-1053  

Background and aims:Familial combined hyperlipidemia is the most frequent hereditary dyslipidemia, usually associated with insulin resistance. Recently, the diagnostic criteria of familial combined hyperlipidemia were redefined: There should be at least two 1st degree hyperlipidemic relatives with both triglycerides ≥ 1.5 mmol.L^-1 and apolipoprotein B ≥ 1.20 g L^-1. The aim of this study was to evaluate the relationship between this lipoprotein phenotype and the presence of insulin resistance and to assess the presence of metabolic syndrome. Methods:Lipid parameters and parameters associated with...

Subclinical acute rejections in protocol biopsies at 3 months after kidney transplantation

I. Matl, E. Honsová, A. Lodererová, V. Lánská, O. Viklický

Vnitr Lek 2008, 54(11):1054-1058  

Aim:The primary aim of the study was detection of subclinical acute rejection and borderline changes in protocol biopsies at 3 months after transplantation, and assessment of possible clinical and laboratory associations. Methods:Biopsy was carried out in 194 patients with stabilized graft function. Patients were treated with immunosuppressive regimen based on cyclosporine A (n = 34), tacrolimus (n = 152), or sirolimus/everolimus (n = 10). Samples were processed by standard paraffine technique, and stained according to laboratory protocol. All samples were tested by immunofluorescence or immunohistochemical procedures for...

Place of inhibin B investigation in clinical andrological praxis

I. Poršová-Dutoit

Vnitr Lek 2008, 54(11):1059-1062  

Inhibin B is a gonadal dimeric peptide, produced in men in testicular Sertolli cells. Inhibin B blood level knowledge can be a useful tool in the management of difficult diagnostic problems, such as ambiguous genitalia, the distinction between cryptorchidism and anorchidism and the hypogonadotrophic hypogonadism/delayed puberty differential diagnosis. Inhibin B measurements can help in gonadal dysgenesis evaluation, androgen insensitivity management and also in the diagnosis of some gonadal tumors. In adult men, inhibin B evaluation is helpful in the investigation of male infertility, especially in the judgment of the pro-gnosis of testicular biopsy...

Langerhans cell histiocytosis in adult patients - a disease with many faces. Experience of a centre and an overview of the disease symptoms

Z. Adam, L. Pour, M. Krejčí, J. Neubauer, J. Vaníček, V. Vašků, R. Hájek

Vnitr Lek 2008, 54(11):1063-1080  

Over a period of 18 years, 17 patients with proven Langerhans cell histiocytosis (LCH) were treated at the Haematological Clinic in Brno. In 13 of them, the disease was diagnosed at adult age, and 4 patients were referred to the centre with LCH diagnosed at early child age. One of these 4 patients suffered from repeated recurrences of the disease at adult age and was diagnosed with progressive neurodegenerative damage of the CNS at the age of 25 which in its terminal phase resulted in the patient's immobility, loss of sphincter control, incapacity to communicate and death at the age of 32. LCH was diagnosed at adult age in 13 patients. The form with...

Acute embolization into the veins in the splanchnic bed - an overview of current methods of diagnosis and therapies

R. Miklík, P. Kala, J. Maňoušek, M. Poloczek, J. Pařenica, P. Lokaj, J. Špinar

Vnitr Lek 2008, 54(11):1081-1086  

Acute mesentery artery embolization is a rare diagnosis. In case of late recognition the mortality may reach up to 93%. Acute abdominal pain, vomitus, rapid and sudden bowel evacuation with or without blood are the typical symptoms of the disease. Unfortunately, the symptoms do not often correlate with clinical findings. Plain X-ray of abdomen or CT tomography may show no signs of intestinal ischaemia. The diagnostic method to choose is either spiral CT angiography or contrast angiography, respectively. The most common therapeutical approach is surgical revascularization but in selected cases it is feasible to perform local thrombolysis with a microcatheter...

The use of positron emission tomography (¹⁸F-FDG PET) in diagnosing chronic periaortitis

P. Němec, Z. Řehák, P. Fabián, M. Souček

Vnitr Lek 2008, 54(11):1093-1099  

Chronic periaortitis involving idiopathic retroperitoneal fibrosis, inflammatory aneurysm of the abdominal aorta and perianeurysmal retroperitoneal fibrosis is a rare disease characterised by the development of an inflammatory fibrotising process surrounding large vessels and organs of the retroperitoneum. According to some authors, chronic periaortitis results from a systemic autoimmune inflammation with vasculitis affecting aortal vasa vasorum and medium and small calibre retroperitoneal vessels. The disease is assumed to have immunopathogenetic background. Chronic periaortitis is diagnosed with the use of ultrasonography, computed tomography or...

Hypoglycaemic periodic paralysis in hyperthyroidism patients

J. Kratochvíl, J. Masopust, V. Martínková, J. Charvát

Vnitr Lek 2008, 54(11):1100-1101  

Hypokalemic periodic paralysis (HPP) is a rare disorder characterised by acute, potentially fatal atacks of muscle weakness or paralysis. Massive shift of potassium into cells is caused by elevated levels of insulin and catecholamines in the blood. Hypophosphatemia and hypomagnesemia may be also present. Acidobasic status usually is not impaired. HPP occurs as familiar (caused by ion channels inherited defects) or acquired (in patients with hyperthyroidism). On the basis of two clinical cases we present a review of hypokalemic periodic paralysis in hyperthyroid patients. We discuss patogenesis, clinical and laboratory findings as well as the principles...

Newly diagnosed Churga-Strauss syndrome in a female patient with suspect acute coronary syndrome

R. Husár, J. Václavík, J. Lukl

Vnitr Lek 2008, 54(11):1102-1105  

We present a case of 60 years old patient with the history of repeated sinusitis and bronchial asthma, who developed Churg-Strauss syndrome (CSS) with mononeuritis multiplex, skin laesions on the head and acute perimyocarditis, which led to suspicion on myocardial infarction. Diagnosis of CSS was based on clinical manifestations, blood hypereosinophilia and histological examination of nasal mucous membrane biopsy. Subsequent immunosuppressive therapy led to regression of symptoms and improvement of temporarily decreased left ventricular function.

Persistent diarrhoea, hypotension, polyneuropathy

R. Sýkora, J. Raděj, I. Novák, A. Kroužecký, J. Mareš, I. Irová, Š. Hadravská, J. Chvojka, T. Karvunidis, T. Maňáková, M. Matějovič

Vnitr Lek 2008, 54(11):1106-1110  

We present a case report of a 59-year-old man with a history of arterial hypertension and excision of malignant melanoma. He was admitted to the hospital because of two months history of diarrhoea, weight loss and circulatory collapse. In addition, the patient suffered from marked vegetative instability with symptomatic hypotension, polyneuropathy and progression of renal insufficiency, without proteinuria. Complex examination did not reveal neoplasms, endocrine, autoimmune, infectious or neurodegenerative disorders. A serial biopsy of colon failed to provide a clue to the diagnosis. However, AA amyloidosis was found on the kidney biopsy. Neither chronic...

Z odborné literatury

Vnitr Lek 2008, 54(11):1117-1118  

Prof. MUDr. Ivo Dvořák, DrSc. - 80 let

Miroslav Souček, Petr Svačina

Vnitr Lek 2008, 54(11):1113  

K životnímu jubileu prof. MUDr. Bořivoje Semráda, CSc., *7. 11. 1938

Bohumil Fišer

Vnitr Lek 2008, 54(11):1114  

Emeritní primář a bývalý předseda Spolku lékařů ČLS JEP MUDr. Karel Staněk letos 65letý

Jindřich Charouzek

Vnitr Lek 2008, 54(11):1115-1116  

Informace, které jsou zásadní i pro volbu diagnostického a léčebného postupu, a úloha léčebných doporučení (guidelines)

Z. Adam, P. Svačina

Vnitr Lek 2008, 54(11):1087-1092  

Ohlédnutí za Kongresem České internistické společnosti České lékařské společnosti J. E. Purkyně v Brně

Richard Češka

Vnitr Lek 2008, 54(11):1111-1112