Prevalence of rheumatic manifestations and non-organ specific autoimmunity in patients with autoimmune thyreopathy - editorial

V. Zamrazil, K. Vondra

Vnitr Lek 2010, 56(2):95-96  

A few comments on the issue of infected myxoma - editorial

B. Fischerová

Vnitr Lek 2010, 56(2):97-98  

Analysis and comparison of cohorts of patients with implantable cardioverter-defibrillator in primary and secondary prevention

L. Křivan, M. Kozák, M. Sepši, J. Vlašínová, P. Lokaj, J. Špinar

Vnitr Lek 2010, 56(2):99-105  

Objective:The aim of this study was an analysis of patients with ICD implanted in primary prevention (PP) in long term follow-up and comparison with data obtained in secondary prevention patients (SP). Patients and methods:We assessed 73 patients with PP ICD and 138 patients with SP ICD. Males were in majority with 88% in PP group and 78% in SP group. The average age was 63 years. Majority of patients suffered from coronary artery disease. The mean ejection fraction (LV EF) was 28% in PP patients and 38% in SP patients. The number of affected coronary arteries and medication were similar in both groups. We compared the occurrence...

Prevalence of rheumatic manifestations and non-organ specific autoimmunity in patients with autoimmune thyreopathy

K. Benhatchi, I. Lazúrová, D. Kozáková, J. Rovenský

Vnitr Lek 2010, 56(2):106-110  

Introduction: A variety of rheumatic manifestations (RM) has been described in association with autoimmune thyroiditis (AIT). In the past, most of these manifestations were attributed to the underlying thyroid dysfunction, in particular hypothyroidism. AIT is often associated with non-organ specific autoimmunity. Increased prevalence of non-organ specific autoantibodies in patients with AIT without any evidence of rhemautic manifestations is clinically unclear. Aim of this study was to find out the frequency of apperance of non-organ specific antibodies in serum in patients with AIT and prevalence of RM (arthralgia/arthitis). Patients and methods:...

Probiotics in acute pancreatitis - a randomised, placebo-controlled, double-blind study

J. Lata, J. Juránková, O. Stibůrek, V. Příbramská, M. Šenkyřík, T. Vaňásek

Vnitr Lek 2010, 56(2):111-114  

Introduction:Infections accompanying pancreatitis, particularly pancreatic necroses, represent a serious complication associated with worsening of the disease prognosis. The aim of our study was to explore whether this complication could be prevented by administering a probiotic. Methods:The probiotic was administered to 7 patients and placebo to 15. The study was discontinued early following the release of the Propatria study results. Results:There was no death in our patient sample and there was no difference between the two groups in microbial colonisation or the length of hospitalization. However, a reduction...

Risk of long-term antisecretory treatment with proton pump inhibitors

R. Kroupa, J. Dolina

Vnitr Lek 2010, 56(2):115-119  

At present, pharmacotherapy leading to a reduction in hydrochloric acid production in the stomach constitutes the core treatment strategy for the majority of the upper intestinal tract diseases. Proton pump inhibitors (PPIs) are the predominant therapeutic group. Gastroesophageal reflux disease is the main indication for the long-term PPI use. Chronic use might be associated with adverse reactions. Potential risks take a form of malabsorption of certain food nutrients with their consequent deficiency, bacterial overgrowth and increased incidence of infections as well as altered regulation of proliferation of gastric as well as other mucosas. Individual...

Direct renin inhibitor aliskiren in the treatment of cardiovascular and renal diseases

K. Horký

Vnitr Lek 2010, 56(2):120-126  

The role of renin-angiotensin-aldosterone system (RAAS) in regulating the volume and composition of extracellular fluid, blood pressure (BP) as well as onset and progression of cardiovascular and renal diseases has been studied for more than 150 years. The compounds that block the vital stages of the RAAS cascade, such as ACE-inhibitors (ACEI), AT₁-receptor blockers (ARB) and aldosterone receptor antagonists, importantly extended our treatment options. However, the positive therapeutic effects of these compounds also have certain negative consequences. Administration of ACEIs and ARBs interrupts physiological feedback for renal renin release...

The endocannabinoid system and interference with thrombogenesis

T. Kvasnička

Vnitr Lek 2010, 56(2):127-129  

The endocannabinoid system is an endogenous signaling system that plays a role in the regulation of energy homeostasis and lipid and glucose metabolism-all of which can influence cardiometabolic risk. The endocannabinoid system is normally a silent physiologic system that becomes transiently activated, that is, only when needed. Endocannabinoids may also be secreted by the endothelium. Accordingly, there has been interest in the interactions between endocannabinoids and blood cells. There is certainly evidence that endocannabinoids, especially 2-arachidonoylglycerol (2-AG), may promote platelet activation, indicating that they may participace in regulation...

Antithrombotic therapy in pregnancy

M. Procházka, J. Procházková, L. Slavík

Vnitr Lek 2010, 56(2):130-137  

Despite the fact of low prevalence of maternal death, deep venous thrombosis remains one of the most serious complication in pregnancy and puerperium. Virchows triad - vascular stasis, hypercoagulability, and vascular trauma plays the main role in the pathogenesis of deep vein thrombosis in pregnancy. Low molecular weight heparins and unfractionated heparins are the best treatment option. The aim of the treatment is to be effective in extension of thrombus and prevention of the postthrombotic syndrome and pulmonary embolism. Management of pregnant women with increased risk of venous thromboembolism can be stratified by determining whether the prior...

Central diabetes insipidus in adult patients - the first sign of Langerhans cell histiocytosis and Erdheim-Chester disease. Three case studies and literature review

Z. Adam, K. Balšíková, M. Krejčí, L. Pour, S. Štěpánková, P. Svačina, M. Hermanová, J. Vaníček, P. Krupa, J. Staníček, R. Koukalová, J. Neubauer, A. Křivanová, J. Mayer, R. Hájek

Vnitr Lek 2010, 56(2):138-148  

Central diabetes insipidus with an onset in adulthood is very rare. Unlike in children, central diabetes insipidus in adults is more frequently caused by inflammatory processes and neoplastic infiltrations that do not originate from the neuronal tissue than primary neuronal tissue tumours. Rare histiocytic neoplasias (Langerhans cell histiocytosis, xanthogranulomatosis and Erdheim-Chester disease) have a specific affinity to hypothalamus and the pituitary stalk not only in paediatric patients but also when occurring in adults. We describe 3 cases of central diabetes insipidus with an onset in adulthood. Diabetes insipidus was the first sign of Langerhans...

A case study of a young male patient with subacute constrictive pericarditis

M. Plachý, J. Špác, M. Souček, O. Hlinomaz, V. Feitová

Vnitr Lek 2010, 56(2):149-153  

Chronic constrictive pericarditis (CP) is a disorder affecting pericardium, that becomes inelastic, rigid and restricts filling of the ventricles. Most commonly CP evolves after acute pericarditis, typical is a long-lasting asymptomatic phase with development of right heart failure and low systemic output. The case report refers CP, which developed in 33 years old patient in a short period after acute idiopatic pericarditis. The patient suffered from severe congestive heart failure with oedema and pleural effusion. At first this diagnosis had not been thought of, the differential diagnosis was focused at primary lung disorder or autoimunne disease....

Infected myxoma as a cause of acute infective endocarditis

R. Surovčík, P. Jebavý, R. Feuereisl, P. Frídl, J. Pavlovič, D. Štěrba

Vnitr Lek 2010, 56(2):154-156  

Myxoma is the most frequent primary cardiac tumor. In the typical clinical picture mostly dominate signs of intracardial obstruction, embolisation or general signs of neoplastic process. The myxoma can mimic the course of acute endocarditis. Genuine proof of infection is rare. We report on a patient with familiar form of infected myxoma, who was treated succesfully with antiobiotic therapy and surgical extirpation of the tumor.

Z odborné literatury

Vnitr Lek 2010, 56(2):165-166  

Jubileum Ing. Kataríny Derzsiovej

M. Mydlík, V. Spustová

Vnitr Lek 2010, 56(2):162-164  

Reappraisal of guidelines on hypertension management

J. Špinar, M. Souček

Vnitr Lek 2010, 56(2):157-161  

We present the core information from the "Reappraisal of European Guidelines on Hypertension Management", an official document of the European Society of Hypertension updating the current guidelines of 2007 based on the new knowledge that became available over the last two years. The division of antihypertensive agents into 5 main groups remains unchanged. The key discussion is about whether the treatment of hypertension in high-risk patients should be initiated already at high normal blood pressure and whether the target value should be 130 mm Hg and less. Both objectives are just speculative at present as they have not been confirmed in a large clinical...