Pulmonary hypertension - unusual complication of the bacterial overgrowth syndrome - editorial

P. Jansa

Vnitr Lek 2010, 56(6):486-487  

Is there circadian variation of big endothelin and NT-proBNP in patients with severe congestive heart failure?

O. Ludka, J. Špinar, Z. Pozdíšek, V. Musil, L. Špinarová, J. Vítovec, J. Tomandl

Vnitr Lek 2010, 56(6):488-493  

Introduction:Circadian rhytmus have long been recognized to occur in many biologic phenomena, including secretion of hormones as well as autonomic nervous system. There is increasing evidence that circadian rhythms have been also found in cardiovascular events, for example, myocardial infarction, sudden cardiac death as well as stroke have shown a circadian pattern of the distribution. The pathophysiology and the mechanism underlying these variations are the focus of much investigation, while i tis not full understood up to date. Heart rate, blood pressure, neurohumoral vasoactive factors, such as plasma norepinephrine levels and renin activity,...

The normalized smoothness index and parametric population RDH index of telmisartane in patients with newly diagnosed hypertension and metabolic syndrome

I. Řiháček, P. Fráňa, D. Schwarz, M. Plachý, M. Souček

Vnitr Lek 2010, 56(6):495-502  

Introduction:Ambulatory blood pressure monitoring provides an opportunity to evaluate 24-hour efficacy of once daily preparations. Aims of the study:To evaluate 24-hour efficacy of telmisartane in patients with newly diagnosed hypertension and metabolic syndrome using the parametric population RDH index and normalized smoothness index. Patient sample and methodology:Thirty newly diagnosed hypertonics with metabolic syndrome, sufficiently responding to blood pressure therapy with telmisartane, assessed using sphygmomanometer. Twenty six men, 4 women, mean age of 44 years, body mass index of 31.4 kg. m^-2,...

Essential thrombocythaemia and other myeloproliferative disorders with thrombocythaemia treated with Thromboreductin. A report from the database of Register for the 1st quarter of 2010

M. Penka, J. Schwarz, P. Ovesná, A. Hluší, Z. Kořístek, M. Doubek, P. Dulíček, D. Pospíšilová, J. Kissová, A. Buliková, T. Pavlík, kolektiv České pracovní skupiny pro myeloproliferativní choroby (CZEMP)

Vnitr Lek 2010, 56(6):503-512  

In the Czech Republic, anagrelid is used according to the recommendations of the Czech Working Group on Myeloproliferative Disorders for treatment of thrombocythaemias associated with chronic myeloproliferative disorders - mainly essential thrombocythaemia and, regularly, reports are being presented from the Register of Patients Treated with Thromboreductin®, most recently last year (Vnitř Lék 2009; 55: I-XII). The Register commenced in 2005 and from then it aims to determine detailed clinical and laboratory profiles of the patients. The structure of the Register has changed significantly in the course of its existence, reflecting the reports from...

Pulmonary hypertension - unusual complication of haemolysis and the bacterial overgrowth syndrome

V. Kojecký, M. Lukaštíková

Vnitr Lek 2010, 56(6):513-516  

The authors describe a case of a patient with celiac disease in whom a secondary bacterial overgrowth had developed in the small intestine. Vitamin B₁₂ and folic acid consumption deficiency resulted in a development of macrocytary anaemia and non-immune haemolysis. Subsequently, within a few weeks, a significant pulmonary hypertension has developed, the cause of which was first unclear. Haemolysis as well as pulmonary hypertension ceased following bacterial overgrowth treatment and B₁₂ and, later on, folic acid substitution. Retrospectively, the authors infer that this could have been the haemolytic anaemia-associated pulmonary...

Prim. MUDr. Petr Svačina - významné životní jubileum

M. Souček

Vnitr Lek 2010, 56(6):522-523  

Můj život s prim. MUDr. Petrem Svačinou

Z. Adam

Vnitr Lek 2010, 56(6):524-525  

Hyperlipoproteinaemia and dyslipoproteinaemia I. Classification, diagnostics, cardiovascular, cardiometabolic and residual risk

R. Češka, M. Kvasilová, R. Procházková, G. Šmelková, M. Vrablík

Vnitr Lek 2010, 56(6):526-531  

Cardiovascular diseases remain the most important cause of death worldwide. The situation in the Czech Republic is one of the best when compared to the other countries of the former socialist block; on the other hand, we significantly lack behind when the comparison is made to south and southwest European countries. The concept of risk factors (RF) and multifactorial character of atherosclerosis as the main cause of cardiovascular diseases (CVD) is fully accepted at present. Hyperlipoproteinaemia (HLP) and dyslipidemia (DLP) are a group of high incidence metabolic diseases characterised by increased levels of lipids and lipoproteins in plasma or, in...

BRNO Register 2: post-myocardial infarction pharmacotherapy

J. Špinar, O. Ludka, M. Sepši, J. Schildberger, L. Dušek, J. Jarkovský

Vnitr Lek 2010, 56(6):533-540  

We assessed 850 patients with a history of myocardial infarction > 1 month ago who attended outpatient clinics of the Clinic of Internal Medicine and Cardiology at the Faculty Hospital Brno between 1st September 2009 and 31st December 2009. There were more men (650 vs. 200) and patients under 70 years of age (576 vs. 264) in the cohort. 87.8% of patients experienced one myocardial infarction only and the mean age at the first infarction was 59.0 years in men and 65.5 in women (p < 0.001). 75.8% of patients had been prescribed all recommended pharmacotherapeutic groups according to guidelines (RAAS blockers, beta-blockers, statins, antiagregation...

Different courses of recurrent or multisystem Langerhans cells histiocytosis in adults - description of 22 cases from one centre

Z. Adam, M. Krejčí, L. Pour, P. Szturz, J. Neubauer, T. Nebeský, Z. Řehák, R. Koukalová, J. Mayer, J. Vorlíček

Vnitr Lek 2010, 56(6):542-556  

Since its establishment in 1990, a total of 22 patients with confirmed Langerhans cell histiocytosis (LCH) have been monitored and treated at the Clinic of Internal Medicine Haemato-Oncology in Brno. In 5 patients, the disease was diagnosed in childhood and 2 of these 5 patients had late neurodegenerative changes in the CNS with a typical picture on MR and a typical PET-CT imaging fluorodeoxyglucose hypometabolism in the cerebellar area. In 5 patients from the cohort of 22, the disease had unifocal form, dominant in the area of skeleton with no recurrence after the treatment. However, in 12 patients, the disease affected a number of organs simultaneously...

Sepsis and the septic shock in oncological or other immunocompromised patients

M. Navrátil, M. Tomíška, Z. Kořístek, J. Vorlíček, J. Mayer

Vnitr Lek 2010, 56(6):557-569  

Sepsis and the septic shock and the up to date knowledge about them represent a marked drifting for diagnostics and the treatment of this complications. Their application in patients with the oncological disease or the other immunocompromised patients represents further extension in the specific group of patients with several unique properties. In despite of the improving results in the oncological treatment there are only few reports in literature about this group of patients and this one is steadily growing due to the progressive improving of the supportive care in oncology. This group of patients with the febrile neutropenia and the sepsis (the...

A psychological perspective on the problems faced by the oncology patients and their care teams

L. Kalvodová, J. Vorlíček, Z. Adam, P. Svačina

Vnitr Lek 2010, 56(6):570-581  

Survey of the history and study of the psychical expressions of the oncology patients, the rules of communication of oncologist and his patient. Personality of oncology patient and a Model of Kübler-Ross, then a decalogue of speaking about the oncology diagnosis. Clinical psychologict as an integral part of the medical team, which brings a supportive care for the oncology patients, then the psychopatological behaviour appears iside a medical team. In the end there are the authentic patients stories with the psychologist commentary.

Antibiotics and probiotics in acute pancreatitis

J. Lata, O. Stibůrek

Vnitr Lek 2010, 56(6):582-584  

Severe acute pancreatitis is serious disease. High mortality is also due to infection complications. If we will be able to prevent the infection, it could diminish mortality. The role of prevention of infection with antibiotics and probiotics is discussed in the paper.

The value of various imaging techniques in diagnosing and monitoring the disease activity of multiple myeloma

J. Vaníček, P. Krupa, Z. Adam

Vnitr Lek 2010, 56(6):585-590  

Imaging techniques such as RTG, CT, MR and PET are key in diagnosing multiple myeloma. Their selection, combinations and sequence of their application are important for early and correct diagnosis. It is the clinical experience with this condition complemented by suitable imaging diagnostics that leads effective treatment.

Contribution to the evaluation of serum levels of selected biological parameters in monoclonal gammopathy of undetermined significance and in individual clinical stages of multiple myeloma

V. Ščudla, P. Petrová, J. Minařík, T. Pika, M. Budíková, J. Bačovský, Š. Repovský, Česká myelomová skupina

Vnitr Lek 2010, 56(6):591-601  

Introduction:This study aimed to measure serum levels of 12 selected parameters in patients with monoclonal gammopathy of undetermined significance (MGUS) and initial, asymptomatic phase of multiple myeloma (MM) to assess their potential benefit in differentiating both conditions. Patient sample and methodology: The analysed sample of 131 patients consisted of 62 patients with MGUS and 69 patients with MM fulfilling the criteria of the International Myeloma Working Group (IMWG). The following techniques were used to assess serum levels: quantitative immunoradiometry (bone-type alkaline phosphatase - bALP and insulin-like growth factor-1...

Continuous monitoring of tissue glucose

M. Bendžala, I. Očadlík, B. Krahulec

Vnitr Lek 2010, 56(6):602-606  

Continuous glucose monitoring is technology revolution in diabetology similar to holter ECG monitoring in cardiology. With goal of the diabetes treatment to achieve almost normal glucose concentration in blood, continuous glucose monitoring can help in hypoglycemia risk reduction. Continuous glucose monitoring offers actual value of glycemia longitudinal whole day, with possibility of analyzing records and signalization when programmed thresholds are exceeded. It offers immediate patients reaction by modification of insulin treatment, food intake or physical activity, and also retrospective analysis of records. Subsequently it is possible to improve...

The value of baroreflex sensitivity for cardiovascular risk stratification in hypertensives

D. Čelovská, J. Staško, J. Gonsorčík, A. Dukát

Vnitr Lek 2010, 56(6):607-612  

Impaired baroreflex sensitivity (BRS) is a marker of autonomous dysfunction, which may play an important role in the long-term development of arterial hypertension, disease progression as well as complications related to global cardiovascular risk. The aim of the study was to evaluate the clinical significance of baroreflex sensitivity in hypertensives with/without major cardiovascular events. We found out that essential hypertension is associated with decreased BRS, and that grade of hypertension is inversely related to BRS values. Spontaneous BRS values in hypertensives with major cardiovascular event (stroke, myocardial infarction) were significantly...

Prevention and treatment of extremitovascular ischemic disease

P. Gavorník, A. Dukát, Ľ. Gašpar, S. Oravec, M. Čaprnda, I. Vacula, D. Čelovská, A. Uhrinová, M. Kováčová, T. Pišková, K. Letková, A. Teren

Vnitr Lek 2010, 56(6):613-619  

Extremitovascular ischemic disease (peripheral arterial disease of extremities - PAD) is an important manifestation of systemic atherosclerosis and other arterial diseases of vascular system. The lower the anklebrachial pressure index, the greater the risk of serious cardiovascular events (e. g. acute myocardial infarction, stroke). Prevention and treatment of extremitovascular disease is discussed in this article.

Changes in lipoprotein spectrum in patients with the diagnosis of extremito-vascular ischemic disease

S. Oravec, A. Dukát, P. Gavorník, M. Čaprnda, O. Reinoldová

Vnitr Lek 2010, 56(6):620-623  

New method of lipoprotein determination on polyacrylamid gel with Lipoprint LDL system quantifies non atherogenic and atherogenic plasma lipoproteins, including small dense LDL, the potent atherogenic lipoprotein subpopulations. According to majority of non atherogenic versus atherogenic lipoprotein in the whole lipoprotein spectrum, this method distinguishes a non atherogenic lipoprotein profile phenotype A from an atherogenic lipoprotein profile phenotype B. Definitely, the contribution of this method is focusing on the atherogenic lipoprotein profile phenotype B in 80% of patients with an extremito-vascular ischemic disease and on the existence...

Universities need to have high quality education as well as an effective quality control of their students' (products') knowledge and skill base

Z. Adam, M. Komenda, M. Doubek, M. Krejčí, M. Tomíška, D. Schwarz, J. Vorlíček

Vnitr Lek 2010, 56(6):624-628  

In order for the schools of medicine to produce high quality physicians, they have to provide high quality education as well as they must ensure that knowledge building is taking place in the course of the programme and that the students whose efforts and/or abilities do not allow achievement of the required criteria are eliminated. Exams used to be the standard quality control tool. However, current information technologies allow doubling-up of this control; retaining the traditional examinations but preceding them with the requirement to complete multiple-choice tests. The text summarizes our experience with examining the students' mental presence...

XXIX. dni mladých internistov Slovenska a České republiky v Martině

P. Horák

Vnitr Lek 2010, 56(6):518