Neuroprotekce po srdeční zástavě a časná poresuscitační péče - editorial

J. Bělohlávek, O. Šmíd

Vnitr Lek 2009, 55(11):1011-1013  

Má tromboelastografie své místo v kardiochirurgii a kardiologii? - editorial

R. Hájek

Vnitr Lek 2009, 55(11):1014-1015  

The results of the of patiens with essentials thrombocythemia and other myeloproliferation-related thrombocythemia - a report of patients treated with Thromboreductin®

M. Penka, J. Schwarz, T. Pavlík, K. Indrák, M. Doubek, P. Dulíček, D. Pospíšilová, J. Kissová, A. Jonášová, P. Jelínková, A. Hluší, M. Schützová, O. Černá, Y. Brychtová, L. Nováková, Z. Kořístek, J. Segethová, V. Vozobulová, I. Hadačová, I. Hochová, J. Voglová, L. Walterová, C. Bodzásová, L. Dušek

Vnitr Lek 2009, 55(11):I-XII  

The registry of patients treated with Thromboreductin® (anagrelide) in the Czech Republic contains data concerning patients that have been treated using this drug since 2004. As of June 2009, the total number of patients was 549. The current analysis focused mainly on evaluation of anagrelide dosage needed to achieve a complete response in high-risk patients: reduction in platelet count to below 400 × 10⁹/l, which was also considered as reaching the therapeutic goal. The outcomes of the registry confirm that although anagrelide (Thromboreductin®) is a very effective platelet-reducing agent, the administration of which is related...

Long-term evaluation of patients with type 1 diabetes mellitus treated with insulin glargine

I. Haladová, S. Lacigová, D. Čechurová, Z. Jankovec, M. Krčma, Z. Rušavý

Vnitr Lek 2009, 55(11):1016-1021  

Aims of the study:To evaluate long-term effects of treatment with insulin analogue glargine in patients with type 1 diabetes mellitus and to follow up their further course of life. Patient sample and methodology: Retrospective evaluation of 114 patients who, from September 2004, had their basal insulin changed from NPH insulin to insulin glargine. Treatment was changed again in patients in whom a year-long treatment with insulin glargine did not bring improvement in diabetes control. The original sample was divided into 3 groups and the results compared. Compensation of diabetes (HbA_1c) after 1, 2 and 3 years and changes to basal...

Inflammatory bowel disease - familial and sporadic form

M. Pintér, M. Pintérová Kolesárová, S. Rejchrt, T. Douda, R. Repák, M. Kopáčová, J. Bureš

Vnitr Lek 2009, 55(11):1022-1029  

The aim:The aim of this thesis was to elucidate more differences between a familial and sporadic inflammatory bowel disease by comparing certain clinical data. Methods: We assessed 248 patients with inflammatory bowel disease (IBD) observed in 1994-2004 in the Academic Department of Gastroenterology at the Medical Faculty in Hradec Králové. To get information about the defined characters we obtained from the questionary and the hospital data. Results: We did not identify any relationship between the onset of the disease and a certain age group, yet males seem to be more prone to familial Crohn's disease. The more frequent familial form of...

Social, economic and psychological issues as cardiovascular disease risk factors

J. Spáčil

Vnitr Lek 2009, 55(11):1030-1034  

The highest mortality in developed countries is, according to the data from our as well as international literature, among people from low socioeconomic backgrounds. No recent data are available for the Czech Republic. We compared the estimated median life expectancy in 2001-2005 with the proportion of people with basic education only and with the proportion of unemployed in all regions within the Czech Republic. We confirmed significant negative correlation - people in regions with low socioeconomic status had lower estimated median life expectancy. Conclusion: Despite the decline in the total and cardiovascular mortality in particular in the Czech...

Examination of function and structure of respiratory cilia of adult patients suffering from chronic obstructive pulmonary disease (COPD) - comparison of nasal and bronchial mucosa (pilot of CILIARY STUDY)

V. Koblížek, T. Dobešová, F. Salajka, E. Čermáková, M. Tomšová, D. Pohnětalová, P. Papoušek, V. Bartoš, Z. Paráková, J. Ruta, V. Sedlák

Vnitr Lek 2009, 55(11):1035-1042  

Introduction:Borderline between upper and lower respiratory tract pathology is probably artificial (bronchial asthma). Also inflammation of bronchial mucosa during chronic obstructive pulmonary disease (COPD) is likely combined with inflammatory involvement of nasal mucosa. Ciliary edge of respiratory epithelium is very important part of mucosa layer. Aim:To investigate and compare nasal and bronchial ciliary beat frequency (CBF), degree of nasal and bronchial ciliary dyskinesia, presence of ciliary akinesia and incidence of spinocellular metaplasia in the both mucosa localities among of stable COPD patients (pts). Method:Nasal...

Endoscopic diagnostics and management of pancreatic-biliary disorders in patients after Billroth II gastric resection

B. Kianička, P. Dítě, P. Piskač

Vnitr Lek 2009, 55(11):1043-1050  

Aims of the study:The aim of this retrospective study was to analyse diagnostic and therapeutic success of endoscopic retrograde cholangiopancreatography (ERCP) in our sample of patients following Billroth II gastric resection, where, due to significantly modified anatomic ratios, this surgery represents a specific and often extremely difficult technical problem when performing ERCP. Materials and methodology: The sample was followed up for 13 years (November 1994 - December 2007). The data on 112 patients after Billroth II gastric resection were assessed retrospectively; indications for ERCP included cholestasis in 92 patients, acute biliary...

Neuroendocrine tumours of the appendix

O. Louthan

Vnitr Lek 2009, 55(11):1051-1055  

According to WHO, neuroendocrine tumors of the appendix (appendiceal carcinoids) are defined as 1. well-differentiated endocrine tumors with benign or uncertain behavior, 2. well-differentiated endocrine carcinoma and 3. goblet cell carcinoma. These tumors are usually diagnosed incidentally during appendectomy. Carcinoid syndrome is rare in appendiceal carcinoid. Tumor size greater than 2 cm is the most important parameter for prognosis. Most patients are cured by appendectomy (appendiceal tumors ≤ 2 cm), tumors with a diameter > 2 cm should be managed by right hemicolectomy.

Goblet cell carcinoid of the appendix

O. Louthan

Vnitr Lek 2009, 55(11):1056-1059  

Appendiceal goblet cell carcinoids are mixed tumors including neuroendocrine cells and intestinal type of goblet cells. Compared to typical carcinoids, goblet cell carcinoids are malignant tumors with degree of malignity differing from case to case. Carcinoid syndrom is not present. There is poor prognosis in larger tumors. Appendectomy is a sufficient therapeutical approach in small tumors, hemicolectomy should be performed in larger ones. There is limited experience with chemotherapy in metastasizing tumors and sporadic with somatostatin analogues.

Current cooling methods for induction of mild hypothermia in cardiac arrest survivors

R. Škulec, A. Truhlář, P. Ošťádal, P. Telekes, J. Knor, M. Ticháček, V. Černý, J. Šeblová

Vnitr Lek 2009, 55(11):1060-1069  

Induction of mild therapeutic hypothermia early after return of spontaneous circulation improves prognosis of cardiac arrest survivors. Rapid cooling of the patients and correct maintainance of the target therapeutic temperature followed by controlled slow rewarming can be achieved by several noninvasive and invasive methods of various efficacy. Elementary and the most frequently used methods are surface cooling via ice-packs and rapid intravenous administration of cold crystaloids. Mattress cooling systems and facilities for endovascular cathether-cooling are more sophisticated, manageable and ensure more precise titration of therapeutic temperature....

Is thromboelastography able to influence management of patients in cardiology and cardiosurgery?

I. Varga, I. Olejárová, E. Goncalvesová

Vnitr Lek 2009, 55(11):1070-1078  

Thromboelastography (TEG) is perceived as a non-specific test of hemostasis. It evaluates the global hemocoagulation, however by some modifications could be its diagnostic potential greater. With new inovations is TEG except more precise analysis of participation of blood components on final coagulation (for example rotational TEG) capable also to assess the antiplatelet drug nonresponsiveness (for example platelet mapping system). It gives more accurate information about prothrombotic conditions than routine laboratory techniques in state of ventricular assist device implantation.

High sensitivity cardiac troponin assays 2009: clinical potential, current practice and benefits, the future

M. Engliš, J. Šochman, R. Pudil, J. Franeková, A. Jabor

Vnitr Lek 2009, 55(11):1079-1084  

At present, determination of cardiac troponins (cTn) is the biomarker method of choice for diagnostics and risk stratification in patients with a myocardial injury. Past clinical practice had provided sound evidence that low cTn concentrations, measured with unacceptable imprecision by the currently used methods, hold important clinical, diagnostic and stratification potential. The new generation cTn assays, so called high-sensitivity assays, enable determination of very low cTn concentrations with satisfactory analytical precision and open the way to early identification of small but often prognostically important myocardial damage. Introduction of...

The results of the RE-LY study promise more effective, safer and easier prevention of embolic complications in patients with non-valvular atrial fibrillation

J. Vojáček

Vnitr Lek 2009, 55(11):1085-1088  

The RE-LY study compared dabigatran in the dose of 150 mg and 110 mg twice daily, without laboratory monitoring, with the conventional treatment with warfarin dosed according to INR in 18,113 patients with non-valvular atrial fibrillation and high risk of embolisation. The incidence of cerebrovascular events and systemic embolisation was 1.69% per year in the warfarin group, compared to 1.53% per year in the 110 mg dabigatran group (relative risk 0.91; 95% CI 0.74-1.11; p < 0.001 for non-inferiority) and 1.11% per year in the 150 mg dabigatran (relative risk 0.66; 95% CI 0.53 - 0.82; p < 0.001 for superiority). Major bleeding occurred in 3.36%...

Complete remission of nephrotic syndrome and improvement of renal function in a patient with light chain deposition disease following high dose chemotherapy with transplantation of autologous haematopoietic stem cells. A case study and review of literature

Z. Adam, M. Krejčí, L. Pour, S. Štěpánková, Z. Čermáková, L. Voska, V. Teplan, A. Křivanová, R. Hájek, J. Mayer

Vnitr Lek 2009, 55(11):1089-1096  

Light chain deposition disease (LCDD) damages most frequently kidneys, and less frequently other organs. The incidence of LCDD is lower than the incidence of AL-amyloidosis. Symmetric swelling of both legs was the first sign of nephrotic syndrome with renal insufficiency in our female patient. Renal biopsy specimen revealed the diagnosis of LCDD. Bone marrow biopsy contained 40% of plasma cells. Bone survey showed no osteolytic changes. These findings confirmed the diagnosis of multiple myeloma (MM) Durie Salmon stage IB with LCDD. The patient was initially treated with 4 cycles of VAD (vinkristine, adriamycine, dexamethasone) chemotherapy with no...

Recurrent unsustained ventricular tachycardia in pregnancy

K. Prymusová, O. Ludka, V. Musil, J. Špinar

Vnitr Lek 2009, 55(11):1097-1101  

The incidence of arrhythmias in pregnancy is more frequent. Arrhythmias can develop in women with structural heart disease as well as in healthy population. Palpitations, dizziness, vertigo or syncope are the most common symptoms of arrhythmias. Rarely life threatening arrhythmias requiring acute therapy occur. The treatment of the pregnant patient with cardiac arrhythmias requires important modifications of the standard practice. We describe pregnant patient in 33rd week of pregnancy with new onset of recurrent unsustained ventricular tachycardia, which did not regress after the pharmacological therapy. Patient was indicated to cesarean section, after...

Repeated local thrombolysis in a patient with axillary and subclavian vein injury and thrombosis

S. Šárník, I. Hofírek

Vnitr Lek 2009, 55(11):1102-1104  

Deep vein thrombosis (DVT) is a disorder with blood clot (thrombus) formation in deep veins. DVT of upper extremities (UE) is rare but serious, bearing in mind its possible complications, disease. UE DVT treatment involves subcutaneous injections of low molecular weight heparins and subsequent switch to oral anticoagulation or thrombolysis; thrombolysis by intravenous administration of a thrombolytic agent is used only if indicated (subclavian vein thrombosis). A case of a professional sportswoman is presented, who was treated for venous thrombosis of subclavian and axillary veins using local thrombolysis. Thrombosis emerged suddenly after a basketball...

Z odborné literatury

Vnitr Lek 2009, 55(11):1106-1107