Non-alcoholic steatosis and steatohepatitis - editorial

R. Brůha

Vnitr Lek 2010, 56(3):173-175  

Treatment of adult acute lymphoblastic leukemia according to GMALL 07/2003 study protocol in the Czech Republic - the first experience

F. Folber, C. Šálek, M. Doubek, J. Soukupová Maaloufová, T. Valová, J. Trka, N. Gökbuget, J. Vydra, T. Kozák, J. M. Horáček, P. Žák, P. Cetkovský, D. Hoelzer, J. Mayer

Vnitr Lek 2010, 56(3):176-182  

Introduction:We present two years' experience in the treatment of adult acute lymphoblastic leukemia (ALL) according to the German GMALL 07/2003 study protocol at CELL (Czech leukemia study group - for life) hematological centers in the Czech Republic. Methods:A total number of 37 patients were included in this analysis. We evaluated complete remission and molecular remission rate, incidence of relapse, patients' status at the end of the follow-up period, incidence of chemotherapy-related adverse events and causes of death. A statistical analysis of risk factors affecting survival was carried out. Results:Complete...

Prevalence of liver disease markers among patients with metabolic risk factors

T. Koller, J. Kollerová, T. Hlavatý, M. Huorka, J. Payer

Vnitr Lek 2010, 56(3):183-189  

Introduction:Non-alcoholic fatty liver disease is one of the most common liver diseases. It's prevalence among patients with metabolic risk factors (obesity, type 2 diabetes, hypertension, lipid disorders) without previously recognized liver disease is not completely known. Aim:Aims of our study were to determine the prevalence of liver lesions (elevated alanin aminotransferase (ALT), gamma glutamyl transpeptidase (GGT) above normal range and ultrasound signs of liver steatosis) among the study group of patients with at least one metabolic risk factor, to compare it with the control group with no risk factor, to investigate...

Treatment of AL-amyloidosis - results from one clinic and review of published experience with new agents (bortezomib, thalidomide and lenalidomide) in AL-amyloidosis

Z. Adam, L. Pour, M. Krejčí, L. Zahradová, A. Křivanová, J. Šmardová, L. Kovářová, S. Štěpánková, M. Moulis, L. Křen, K. Veselý, I. Svobodová, Z. Čermáková, M. Nedbálková, J. Mayer, R. Hájek

Vnitr Lek 2010, 56(3):190-209  

Patients:Fifteen patients with light chain deposits in the form of AL-amyloidosis and 2 patients with light chain deposition as amorphous matter (light chain deposition disease) were treated at our clinic as of 1999. Median age at the diagnosis was 63 (34-77) years. The light chain deposition caused: nephrotic syndrome in 12 (70%) patients, renal insufficiency with reduced filtration in 4 (23%) patients, cardiomyopathy in 4 (23%) patients, hepatosplenomegaly in 2 (12%) patients, manifest coagulopathy in 2 (12%) patients, periorbital hematoma in 2 (12%) patients, visceral and somatic neuropathy in 2 (12%) patients. Treatment with high-dose...

Combination therapy of hypertension in general clinical practice. The results of the KOHYBA study

J. Krupička, M. Souček, K. Chroust

Vnitr Lek 2010, 56(3):210-216  

Introduction:The aim of hypertension treatment is to achieve blood pressure target values; in the majority of patients this is achieved with combination therapy. ACE inhibitors and imidazoline receptor agonists have neutral effect on lipid metabolism and positive effect on glucose metabolism. They thus may significantly improve long-term prognosis of patients with hypertension and metabolic syndrome or hypertension and diabetes mellitus. The aim of our research was to evaluate physicians' approach to hypertension treatment and to ascertain the proportion of patients in general clinical practice who require combination treatment to control...

Contribution to differential diagnosis of chronic abdominal pain

P. Dítě, B. Kianička

Vnitr Lek 2010, 56(3):217-219  

Differential diagnosis of abdominal pain is a complex area of internal medicine. The present paper discusses possible aetiology together with characterisation of some other signs, pain localisation, its propagation and diagnosis. The approach to differential diagnosis of abdominal pain must always be comprehensive and span from targeted anamnesis to physical examination of the abdomen and rational application of available, mainly imaging and endoscopic methods. Therefore, we present the most frequent aetiologies of functional and organic impairments of the oesophagus, intestines and pancreatic and biliary area, including possible extra-abdominal causes...

Myocardial dysfunction in sepsis - definition and pathogenetic mechanisms

K. Muriová, J. Maláska, F. Otevřel, M. Slezák, M. Kratochvíl, P. Ševčík

Vnitr Lek 2010, 56(3):220-225  

Sepsis is considered to be the major cause of morbidity and mortality of patients hospitalised in intensive care. It's defined as a systemic inflammatory response of organism to infection. Incidence of myocardial dysfunction in studies with severe sepsis patients is up to two thirds of patients. Cardiac dysfunction shows a continuum from isolated and mild diastolic dysfunction to combined severe diastolic and systolic failure of both ventricles mimicking even cardiogenic shock in some patients. Typical features of septic myocardial dysfunction (SMD) are decrease in ejection fraction (EF) with dilatation of ventricles, e. g. increase in end-diastolic...

Myocardial dysfunction in sepsis - diagnostics and therapy

J. Maláska, M. Slezák, K. Muriová, J. Stašek, P. Ševčík

Vnitr Lek 2010, 56(3):226-232  

Incidence of myocardial dysfunction in studies with severe sepsis patients is up to two thirds of patients. On the other side, patients with normal echocardiography have some type of myocardial injury, which can be detected by elevated serum levels of troponins and natriuretic peptides. Strong prognostic value of these markers regarding morbidity and mortality of septic patients indicates an important role of this "occult" myocardial injury. Therapeutical interventions should take place only in situation in that low cardiac output is not capable to ensure metabolic demands of tissues. Nowadays, because of detrimental effects of classical inotropes,...

Cardiovascular effects after hematopoietic stem cell transplantation

Ľ. Roziaková, B. Mladosievičová

Vnitr Lek 2010, 56(3):233-239  

Increasing numbers of patients now survive long-term following hematopoietic stem cell transplantation (HSCT). Hematopoietic stem cell transplantation can induce damage of various organs and tissues - from minimal potentially progressive subclinical changes to life-threatening conditions. These potential complications and effects include endocrine, respiratory, skeletal, neurological and other complications, as well as cardiotoxicity and secondary malignancies. Cardiovascular effects belong to life-threatening. There is a possibility of decreasing these effects - by their prevention, earlier diagnosis and treatment. It is necessary for the patient...

More than 10 years of complete remission of monoclonal gammopathy of undetermined significance and cessation of light chain deposition disease-associated nephrotic syndrome following treatment with vincristine, adriamycin and high-dose dexamethasone (VAD)

Z. Adam, M. Nedbálková, M. Krejčí, L. Pour, K. Hušek, K. Veselý, Z. Čermáková, A. Křivanová, J. Mayer, R. Hájek

Vnitr Lek 2010, 56(3):240-246  

Light chain deposits in the form of amorphous material (light chain deposition disease) damage most frequently kidneys and, less frequently, they affect other organs. The incidence of light chain deposition disease is much lower than that of AL-amyloidosis. Symmetrical swelling of both legs, swelling of the eye lids, erythrocyturia and nephrotic proteinuria were the first signs of light chain deposition disease in our patient. The disease was diagnosed from kidney biopsy performed at the stage of advanced nephrotic syndrome with reduced filtration. The bone marrow aspirate contained 0.8% of plasma cells, serum contained monoclonal immunoglobulin IgG-κ...

Persisting symptoms, diastolic dysfunction and decreased coronary flow reserve after succesful correction of aortic recoarctation

M. Šebo, T. Zatočil, A. Nečasová, T. Brychta, J. Černý, P. Kala, J. Špinar

Vnitr Lek 2010, 56(3):247-250  

We present a case of a 53-year-old woman undergoing successful surgical treatment of coarcation restenosis after patch grafting in childhood. Despite the optimal result of the operation, normal left ventricle systolic function and coronary angiogram, majority of symptoms, such as angina and dyspnea, persist 16 months after the intervention. In further investigation, pathological values of left ventricular end-diastolic pressure (LVEDP = 30 mm Hg) and coronary flow reserve (CFR = 1.3) were confirmed, implicating recoarctation to be the unusual cause of cardiac syndrome X.

In memoriam - za docentem MUDr. Zdeňkem Churým, CSc.

J. Jedličková

Vnitr Lek 2010, 56(3):260  

9. kongres Spoločnosti balkánskych miest pre nefrológiu, dialýzu, transplantáciu a umelé orgány (BANTAO), 18.-22. novembra 2009, Antalya (Turecko)

M. Mydlík, K. Derzsiová

Vnitr Lek 2010, 56(3):251-253  

V. jubilejný medicínsko-literárny memoriál Franza Kafku, 18. septembra 2009, Tatranské Matliare a Tatranská Lomnica, Vysoké Tatry

M. Mydlík, K. Derzsiová

Vnitr Lek 2010, 56(3):254-259