Pandemická chřipka A/H1N1 2009 - reálný problém - editorial

R. Sýkora, R. Janda

Vnitr Lek 2009, 55(12):1116-1117  

Symmetrical phlebothrombosis of lower extremities resulting from congenital malformation of vena cava inferior

A. Halčín, E. Kováčová, F. Mikla, A. Reptová, J. Bedeová

Vnitr Lek 2009, 55(12):1189-1192  

Agenesis/atresia of vena cava inferior is a rare congenital anomaly, caused by an aberrance of embryonal venous system development. This is in most cases asymptomatic, because of well developed collateral venous circulation. However, in some cases, it can be manifested with occurence of deep thrombosis in area of pelvis and lower limbs. In this case report, we repon a 21 year old male with painful swelling of both lower limbs. Ultrasonographic examination revealed a bilateral thrombosis in deep venous system of lower limbs and pelvis. Subsequent CT angiography showed atresia of infrarenal segment of vena cava inferior. According to the CT image thrombotic...

The programme of managed ambulatory rehabilitation for patients after heart valve defect surgery

S. Nehyba, V. Chaloupka, R. Souček, Š. Chaloupková, R. Vysoký, F. Štětka, E. Skřičková

Vnitr Lek 2009, 55(12):1118-1125  

The aim of our research was to evaluate the impact of 8-week comprehensive rehabilitation programme on circulatory parameters, left ventricular (LV) function and functional capacity of patients after aortal (ao) and mitral (mi) heart defect surgery. Patient sample and methodology: The rehabilitation programme was completed by 54 patients (exercising, RHB+) following valve defect surgery (13 women/41 men), aged 27-83 (56 ± 16) years. The majority were patients with aortal (ao) stenosis (39), the remainder had a combined ao defect (7), ao regurgitation (3) or mitral (mi) regurgitation (5). Myocardial revascularisation was concomitantly performed...

Liver transplantation and peri-operative changes to renal function

E. Kieslichová, O. Schück, I. Smrčková, J. Granátová, J. Skibová, D. Merta, P. Trunečka

Vnitr Lek 2009, 55(12):1126-1134  

The aim of the study:Was to analyze in detail perioperative changes of renal function during orthotopic liver transplantation (OLT) and to identify risk factors, that were associated with the need of renal replacement therapy (RRT) during the first week after liver transplantation. Methods:Prospective study of 50 consecutive patients undergoing OLT was performed. Selected laboratory and clinical parameters were monitored prior to the procedure, after reperfusion, at the end of the procedure, and at 12 hours after the procedure. In the first post-transplant week, necessity to use RRT in the presence of acute kidney injury was...

Nuclear receptors gene polymorphisms and risk of restenosis and clinical events following coronary stenting

P. Neugebauer, M. Goldbergová-Pávková, P. Kala, O. Boček, P. Jeřábek, M. Poloczek, M. Vytiska, J. Pařenica, R. Mikulík, J. Jarkovský, B. Semrád, J. Špinar, A. Vašků

Vnitr Lek 2009, 55(12):1135-1140  

Introduction:Hereditary factors connected with inflammation and fibroproliferation may play important role in restenotic process after coronary stenting. Peroxisome proliferator-activated receptors (PPAR) and retinoic X receptors (RXR) regulate the transcription of crucial genes involved in the glucose and lipid metabolism, inflammation and cell differentiation. Methods:In our angiographic and clinical study we assessed the association of gene polymorphisms of L162V for PPAR-α, C161T for PPAR-γ and A(39526)AA for RXR-α with the risk of restenosis and cardiac events after coronary stenting. Primary endpoint...

Impact of pandemic H1N1 2009 influenza virus on critical care in Australia: A single centre case series

N. Kloth, L. Weisbrodt, A. McLean, M. Nalos

Vnitr Lek 2009, 55(12):1141-1144  

Introduction:In late May 2009, an outbreak of the novel swine - influenza A virus (H1N1) was identified in the Southern hemisphere. We describe the clinical and epidemiologic characteristics of patients infected with H1N1 requiring intensive care (ICU) admission at a Sydney University Hospital. Methods: We retrospectively reviewed medical charts and laboratory results of all patients who tested positively for H1N1 by viral polymerase chain reaction (PCR) on nasopharyngeal smear or endobronchial secretions. Results: From June 1st until August 31st, 2009 a total of 17 patients required admission to the Intensive Care Unit at Nepean Hospital,...

The complexity of interactions of the tumour growth process

Z. Valášková, S. Kiňová, Ľ. Danihel, I. Ďuriš, D. Markovičová, B. Mravec, I. Hulín

Vnitr Lek 2009, 55(12):1145-1158  

It was believed for rather a long time that the only components of tumour tissue are transformed cells characterised by hyper-proliferation, invasivity and immortalisation. Therapeutic strategies thus focused on autonomous proliferation and tumour cell survival. These result from oncogene activation and inactivation of tumour-suppressor genes. Research studies showed that tumour growth itself is a complex process. In addition, studies confirmed involvement of heterotypical multicellular interactions in tumour tissue. Complexity as a characteristic is one of the processes that do not demonstrate attributes of linear systems. The process of tumour growth...

Pre-eclampsia from the perspective of inter-professional collaboration

P. Janků, K. Janků, V. Unzeitig

Vnitr Lek 2009, 55(12):1159-1166  

Preeclampsia-eclampsia is a syndrome which covers the area of influence belonging to gynecologists-obstetricians. However the internists, especially those who work as consultants in obstetric departments, are interested in diagnostics and therapy of this problem as well. Though internists working in the outdoor-departments do not face the problems of preeclampsia so often, it will be usefull to inform them about the latest trends in diagnostics and therapy of this syndrome, which may be very risky in pregnancy. The physicians in general (except the gynecologists) consider preeclampsia mostely as one form of hypertension that appears sometimes during...

Gender differences in pharmacotherapy of chronic heart failure

A. Klabník, J. Murín

Vnitr Lek 2009, 55(12):1167-1172  

At this point, guidelines recommend the same care for patients with chronic heart failure (HF), regardless of gender. In the future, however, HF care may need to be tailored by sex, as the best way to optimize outcomes for both men and women. Because prior studies demonstrated sex-related differences in many aspects of HF care (in the appropriate use and dosing of evidence-based therapy and in the individual response to pharmacological treatment between women and men with HF). In general, benefit of beta-blockers, ACE inhibitors, angiotensin II receptor blockers (ARBs) and spironolactone in clinical trials was similar, regardless of gender. Women with...

Diabetes insipidus followed, after 4 years, with dysarthria and mild right-sided hemiparesis - the first clinical signs of Erdheim-Chester disease. Description and depiction of a case with a review of information on the disease

Z. Adam, K. Balšíková, L. Pour, M. Krejčí, P. Svačina, M. Dufek, L. Křen, M. Hermanová, M. Moulis, J. Vaníček, J. Neubauer, M. Mechl, J. Prášek, J. Staníček, R. Koukalová, R. Hájek, J. Mayer

Vnitr Lek 2009, 55(12):1173-1188  

In 2004, diabetes insipidus was the first clinical sign of Erdheim-Chester disease in our patient. Following introduction of substitution therapy with adiuretin, the patient had no further health complaints for four years until 2008 when he gradually developed dysarthria and, consequently, movement disorder in the form of mild right hemiparesis. The first CNS CT scan (2004) did not reveal any pathology. The first pathological MRI of the brain in 2006 - thickening of pituitary stalk by pathological infiltration to 4-5 mm. During the following year, further infiltrates were detected in the CNS. The number and size of CNS infiltrates increased gradually...

Pavelková A. Revmatoidní artritida a biologická léčba. Praha: Maxdorf Jessenius 2009. 125 stran. ISBN 978-80-7345-192-9

Zbyněk Hrnčíř

Vnitr Lek 2009, 55(12):1198  

Starosti s hypertenzí a krevním tlakem vůbec

P. Jerie

Vnitr Lek 2009, 55(12):1193-1195  

Zhodnocení dvouleté léčby Schnitzlerova syndromu (kopřivkové velkoplošné morfy, monoklonální IgM gamapatie a osteolyticko-osteosklerotické změny skeletu) preparátem anakinra (Kineret)

Z. Adam, M. Krejčí, L. Pour, R. Hájek

Vnitr Lek 2009, 55(12):1196-1197