Influence of spontaneous ventricular premature beat coupling interval on the value of heart rate turbulence

M. Kozák, L. Křivan, M. Sepši, P. Trčka, J. Vlašínová

Vnitr Lek 2008, 54(9):803-809  

The heart rate turbulence is promising marker of a sudden cardiac death. The aim of the study is to evaluate the influence of the ventricular premature beat (VPB) coupling interval on the values of turbulence onset (TO) and turbulence slope (TS) parameters in the three groups of patients - "healthy" with ventricular premature beats, pts post myocardial infarction (MI) and pts with chronic heart failure with the left ventricle ejection fraction (LVEF) < 0.35. Patients and methods:382 pts were examined: healthy - 149, post MI - 123 and LVEF < 0.35 - 110. The distribution of VPB was analyzed and the values of TO and TS...

Coronary artery disease with premature manifestation in young patients

O. Toman, M. Poloczek, J. Pařenica, P. Kala, R. Jenyšová, L. Dostálová, J. Špinar

Vnitr Lek 2008, 54(9):810-816  

Introduction:Coronary artery disease (CAD) affects in lower percentage even younger individuals. This paper describes group of young patients aged 40 years or less with premature manifestation of CAD, including analysis of risk factors, severity of coronary arteries affection, management and follow-up lasting up to 7 years. Patients and methods:There were 98 patients included retrospectively, in whom macroscopic affection of coronary arteries was diagnosed by coronary angiography within the years 2000-2007. 68 of the patients were indicated to coronary angiography urgently due to acute coronary syndrome (ACS), 44 of them due...

The relation between nutritional risk category identified by the modified Nutritional Screening 2002 and mortality in metabolic intensive care unit

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

Vnitr Lek 2008, 54(9):817-820  

Introduction:The presence of malnutrition is connected with the significantly higher mortality and morbidity. Its early detection is very important for the institution of nutrition intervention that has favourable impact on patient's prognosis. The nutrition screening is the simple and fast way of nutrition risk assessment. The aim of our study was to evaluate the relation of the modified Nutrition Risk Screening 2002 (NRS 2002) with mortality of patients admitted to metabolic intensive care unit (MICU) in prospective study. Methods:Nutrition screening has been examined in all the patients admitted to MICU over half year period...

Inflammatory reaction and its importance in the course of tumour process

D. Hlávková, O. Kopecký, Š. Lukešová

Vnitr Lek 2008, 54(9):821-826  

This article gives basic information about the formation and the course of the inflammatory reaction, which is the important adaptation mechanism of the organism on the various external and internal injurants. The main attention is fixated on the role of the immune system in the course of the inflammatory reaction. It deals with the presence and the sense of the inflammatory reaction in the tumour environment in more detail. It gives the short information about the mechanisms of the antitumour defence. The influence of the inflammatory reaction on the genesis, the course and the progression of the tumour disease is discussed in the third chapter.

Hypertension in dialysis patients

M. Nedbálková, M. Souček

Vnitr Lek 2008, 54(9):827-834  

Hypertension in long term dialysis patients has a significant effect on cardiovascular morbidity and the mortality of such patients. Important factors in the pathogenesis of hypertension in dialysis patients include retention of sodium and water, activation of the rennin-angiotensin system and the sympathetic nervous system, disorders of calcium and phosphate metabolism with osteogenic differentiation of vascular smooth muscle cells and calcification of arteries, vasoactive substance imbalance, endothelium dysfunction and erythropoietin therapy. The basis of treatment is diet with limited salt and fluid intake, restriction of phosphorus in the diet...

BK viral infection after renal transplantation

E. Novotná, O. Viklický

Vnitr Lek 2008, 54(9):835-841  

Viral infections have been a subject of great interest in patients after organ transplantations. Post-transplant immunosuppressive therapy is often associated with transfenction or reactivation of viruses. The human polyomavirus type I, also called BK virus (BKV), causes polyomavirus-associated nephropathy (PVAN) in 1-10% of renal transplant recipients. Thanks to increased PVAN awareness and improved diagnostic techniques, the rate of graft loss has lowered, more consistently in centres with active screening and intervention programs. The risk factors for PVAN are not conclusively defined and likely involve complementing determinants of recipient,...

Budd-Chiari syndrome - hematologists' part in the multidisciplinary approach

P. Dulíček, J. Malý

Vnitr Lek 2008, 54(9):842-845  

Budd-Chiari syndrome presents a serious disease with a complex etiology and clinical manifestations, which is associated with high morbidity and mortality. An early diagnosis and therapy is mandatory due to the severity of disease and therapy contains the treatment of underlying disorder, anticoagulation therapy and therapy of liver impairment. We discuss hematologists' contribution to the diagnostic approach and therapy of this syndrome.

Kidney damage in multiple myeloma and other monoclonal gammopathies

Z. Adam, L. Pour, M. Krejčí, S. Štěpánková, I. Svobodová, K. Veselý, R. Hájek

Vnitr Lek 2008, 54(9):847-861  

Multiple myeloma typically damages the skeleton in the form of osteolytic lesions or diffuse osteoporosis and causes a decrease in blood production. Renal insufficiency is diagnosed immediately at the onset of illness when establishing diagnosis in up to 20% of patients. Where patients suffer from an advanced form of the illness, it occurs in up to 40%. The predominant cause of damage to the kidneys is the monoclonal light chains. Most frequently, nephropathy is caused by the precipitation of light chains with the Tamm-Horsfall protein in the distal part of the loop of Henle and subsequent tubular ruptures and the creation of fibrous changes in the...

⁶⁷Ga-citrate SPECT imaging of the isolated right ventricle heart metastatic malignant melanoma in a patient with chest pain

J. Doležal, J. Vižďa, L. Klzo

Vnitr Lek 2008, 54(9):862-865  

Aim:to present a rare case report about a woman with a right heart ventricle malignant melanoma metastasis who presented with chest pain and that was successfully detected by ⁶⁷Ga-citrate single photon emission computer tomography (SPECT). Material and method:a 73-years-old woman with a past history of excision of a malignant melanoma from the right calf, 6 years later, was admitted to hospital with chest pain. The examination excluded myocardial ischemia. The chest CT and MR imaging detected a large tumour mass in the right heart ventricle. The CT and MR finding was evaluated as a suspect benign, mesenchymal intracardiac...

Acute pericarditis as an organic manifestation of the acute infection Chlamydia pneumoniae

M. Rýzlová, P. Gregor

Vnitr Lek 2008, 54(9):866-870  

The article presents the case of a 52-year-old patient who was treated in our clinic for very serious acute Chlamydia pericarditis (a Chlamydia pneumonia infection) with a large pericardial exudate. The clinical progression was that of an acute systematic illness. The article describes the differential diagnostic algorithm used during hospitalisation and the corresponding treatments provided. Similar cases are very rarely described in the literature. The discussion includes an analysis of the possible organic manifestations of acute and chronic Chlamydia pneumoniae infections. This bacterium most frequently attacks the respiratory tract...

Superior mesentery artery embolization as a complication of the primary angioplasty solved by local thrombolysis

R. Miklík, J. Maňoušek, P. Kala, J. Sedmík, J. Pařenica, M. Poloczek, O. Toman, J. Špinar

Vnitr Lek 2008, 54(9):871-875  

Acute mesentery artery embolization is a rare complication of invasive catheterizations. The incidence is unknown. In case of late diagnosis 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. Plain X-Rays 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 placed directly...

Z odborné literatury

Vnitr Lek 2008, 54(9):878-880  

Prof. MUDr. Vladimír Pacovský, DrSc., osmdesátiletý

Štěpán Svačina

Vnitr Lek 2008, 54(9):876  

Prof. MUDr. Juraj Payer, CSc. - 50-ročný

Jozef Rovenský, Zdenko Killinger

Vnitr Lek 2008, 54(9):877  

XV. kongres České internistické společnosti ČLS J. E. Purkyně. Brno, 24.-27. 9. 2008. Sborník abstrakt

Vnitr Lek 2008, 54(9):881-923