Jak a proč změnily staré léky prognózu nemocných s primárním lymfomem CNS? - editorial

M. Klabusay

Vnitr Lek 2010, 56(8):785-786  

Problematika primárních lymfomů centrálního nervového systému - editorial

J. Vaníček

Vnitr Lek 2010, 56(8):787  

Changes in NT-proBNP levels in patients with atrial fibrillation related to heart failure

V. Pokorná, O. Jurkovičová, J. Kalužay, A. Stecová, P. Ponťuch

Vnitr Lek 2010, 56(8):788-794  

Introduction:NT-proBNP, a well-established diagnostic and prognostic marker in clinical practice, is significantly elevated in individuals with atrial fibrillation (AF), even in absence of heart failure or major structural heart disease. Objectives:The aim of this study was to determine the cut-off value of NT-proBNP for diagnosis of heart failure in individuals with atrial fibrillation. Methods:We compared 44 patients (25 male/19 female) with AF and concomitant overt heart failure [age 76 (62-82) years; median (interquartile range - IQR)] versus 29 patients (16 male/13 female) with AF with no signs of heart...

Primary central nervous system lymphomas

M. Hrudková, D. Belada, L. Smolej, P. Žák, J. Malý

Vnitr Lek 2010, 56(8):795-800  

Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal lymphoma (nearly always non-Hodgkin's) and accounts for approximately 3 to 4% of primary brain tumors. PCNSL typically affects patients older than 60 years. Clinical features are variable and reflect the location of central nervous system lesion. Magnetic resonance imaging and stereotactic biopsy are the most important tools for diagnostic assessment. Chemotherapy based on high-dose of methotrexate (HD-MTX) and whole brain radiotherapy are the cornerstones of treatment. Radiotherapy is usually omitted in individuals older than 60 years because of high risk of unacceptable...

Care for patients on mechanical ventilation from the perspective of an internal medicine physician

Y. Staňková, P. Štourač, J. Skřičková

Vnitr Lek 2010, 56(8):801-809  

At times of respiratory insufficiency, mechanical ventilation (MV) provides support for or a substitution of certain components of the respiratory system. The aim of ventilation therapy is to achieve appropriate ventilation and oxygenation parameters and to minimize adverse events of MV. The main examples of non-invasive ventilation (NIV) are Continuous Positive Airway Pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP). The main benefit of NIV is a minimal need for tracheal intubation. To perform invasive mechanical ventilation, it is necessary to secure the airways with intubation or tracheotomy. We aim for the shortest possible duration...

Successful treatment of angiomatosis with thalidomide and interferon α. A description of five cases and overview of treatment of angiomatosis and proliferating hemangiomas

Z. Adam, L. Pour, M. Krejčí, E. Pourová, O. Synek, L. Zahradová, M. Navrátil, M. Mechl, T. Nebeský, J. Neubauer, J. Feit, J. Vokurková, Z. Král, O. Bednařík, P. Šlampa, H. Doležalová, R. Hájek, J. Mayer

Vnitr Lek 2010, 56(8):810-823  

Our paper describes 5 patients with a vascular malformation - angiomatosis. In the first patient, a young man, angiomatosis affected the stomach, intestine, the area of mesenterium and retroperitoneum as well as mediastinum. Angiomatous mass had invaded pelvic bones and vertebrae. Treatment was initiated with interferon α in a maximum tolerated dose of 3 million units 3 times a week. Because of low efficacy of interferon α, thalidomide was added at a dose of 100 mg per day. Bone pain disappeared following a few applications of zoledronate administered in regular monthly intervals. After 3 years of concomitant administration of interferon...

Immunoglobulin G4-associated cholangitis

P. Dítě, L. Husová, Z. Lukáš, M. Přecechtělová, S. Štěpánková

Vnitr Lek 2010, 56(8):824-826  

Autoimmune IgG4- associated cholangitis is a new entity among the liver and biliary tree disorders, classified among the so-called IgG4-related diseases. Even though prognosis of this disease is unclear, this type of sclerosing cholangitis is not being linked to a carcinoma. Clinical and laboratory data differ slightly from the findings associated with the usual primary sclerosing cholangitis and it is mainly the high IgG4 level and hyperbilirubinaemia that supports the diagnosis of autoimmune disease. Unlike primary sclerosing cholangitis, this disease is not associated with a malignant prognosis and steroids represent an effective treatment. Combination...

Šobrův den, XXV. konference o hyperlipoproteinemiích. Praha, 9. června 2010

Vnitr Lek 2010, 56(8):889-892  

K významnému životnímu jubileu prof. MUDr. Jindřicha Špinara, CSc., FESC

Vnitr Lek 2010, 56(8):829  

K životnímu jubileu prof. MUDr. Jindřicha Špinara, CSc., FESC

Jiří Vítovec

Vnitr Lek 2010, 56(8):830-831  

Risk profile of hypertensive patients

J. Bulas, M. Ilčík, K. Kozlíková, J. Murín

Vnitr Lek 2010, 56(8):832-837  

Introduction:Arterial hypertension is an important component of global cardiovascular risk profile of an individual patient. Estimation of global cardiovascular risk besides the blood pressure level incorporates all risk factors (RF), preclinical cardiovascular diseases (hypertension - induced target organ disease - TOD) and associated clinical conditions, and it should influence the therapy and long-term patient management. A group of metabolic risk factors comprizes several modifyable risk factors, detection of which influences the antihypertensive drug selection. The main goal of antihypertensive therapy is to achieve maximum reduction...

Comprehensive management of cardiovascular risk. Focusing on telmisartan

R. Češka, S. Krutská, L. Zlatohlávek, M. Vrablík

Vnitr Lek 2010, 56(8):839-844  

Cardiovascular diseases (CVD) represent a significant health problem in all countries world-wide and in the developed world, including the Czech Republic, in particular. The underlying cause in the majority of CVD patients is atherosclerosis and its complications, respectively. The present paper focuses on prevention and timely treatment of atherosclerosis. Management should be comprehensive and should target the risk factors (RF). Hypertension, hyperlipoproteinaemia and dyslipidemia (HLP and DLP), type 2 diabetes mellitus (T2DM), visceral fat obesity and cigarette smoking are the dominating RFs. Even though all RFs have to be managed simultaneously...

Characteristics and the prognosis of patients with acute heart failure in current clinical practice

E. Gonçalvesová, I. Varga, P. Lesný, B. Líška, M. Luknár, P. Solík

Vnitr Lek 2010, 56(8):845-853  

Purpose:Analysis of predefined characteristics and outcomes in a non-selected population of patients hospitalized for acute heart failure (AHF) in Slovakia. Methods:We conducted a nationwide prospective multicenter survey with 860 consecutive patients enrolled in 11 hospitals throughout Slovakia - two centres with a non-stop catheterization service, two central and 7 regional hospitals. Relevant data of 78 characteristics in 9 categories were collected during 3 months (between 1 May 2009 and 31 July 2009). There was a specific form designed for this survey. Collected data were then transferred into the electronic database...

Anaemia in chronic heart failure

J. Hradec

Vnitr Lek 2010, 56(8):854-859  

Anaemia is a relatively frequent co-morbidity of chronic heart as well as chronic renal failure. In both conditions, it represents a strong and independent predictor of increased morbidity and mortality. Aetiology of this anaemia is multi-factorial. A number of various factors play a role in its development, e. g. inadequate erythropoietin production in the kidneys, bone marrow inhibition, iron deficiency as well as haemodilution associated with fluid retention. Treatment strategies aim at two directions. One is the stimulation of erythropoiesis with recombinant human erythropoietin or its analogues such as darbepoetin α. The other involves iron...

Therapy with implantable cardioverter-defibrillators (ICD) in the early of third millenium

M. Kozák

Vnitr Lek 2010, 56(8):860-864  

The patients without ventricular arrhythmias with markers of high risk of sudden cardiac death are indicated for ICD implantation today. Last generation of ICD systems are equipped with high capacity batteries, with many automatic functions, capabilities of data sending and possibilities of prediction of worsening of heart failure. Nowadays ICD systems offers not only elimination of the risk of sudden cardiac death but reduction of symptoms of chronic heart failure through the resynchronization therapy, too.

The significance of fenofibrate in the therapy of atherogenic dyslipoproteinaemia

M. Kučera, S. Oravec, I. Očadlík

Vnitr Lek 2010, 56(8):865-870  

There are accepted the lipid levels goals in all world, which are needed to achievement in primary and secondary prevention. Despite efficacy of current standards of care (including achievement of LDL-C, blood pressure and blood sugar goals), patients with atherogenic dyslipidemia (DLP) (high TG levels, low HDL-C, high apolipoprotein B and small dense LDL-particles), which is common in patients with diabetes melitus (DM), metabolic syndrome or cardiovascular diseases (KVD), remain exposed to a high residual risk of major cardiovascular events and microvascular complications. Statin therapy does not adequately address vascular risk asociated with elevated...

Atrial fibrillation in the era of catheter ablation

R. Lábrová

Vnitr Lek 2010, 56(8):871-879  

Atrial fibrillation is the most frequent heart rhythm abnormality and is associated with increased morbidity and mortality. Trigerring ectopias and arrhythmogenic substrate that enable arrhythmia to sustain are both influenced by many modulating factors. Which risk factor is the most signifficant one remains unknown. Understanding pathophysiology of atrial fibrillation including molecular and genetic aspects is necessary to assign the most effective preventive measures as well as treatment of atrial fibrillation. Pharmacological treatment is the method of choice but "upstream therapy" that counteracts atrial remodelling has been more and more discussed....

Aortic pulse wave velocity in patients with metabolic syndrome and hypertension treated with sartans

J. Špác, M. Souček, I. Řiháček, H. Němcová, L. Pluháček

Vnitr Lek 2010, 56(8):880-883  

Introduction:The incidence of subclinical organ damage is higher in patients with hypertension (HT) and metabolic syndrome (MS). Increased aortic pulse wave velocity (PWV) is one the markers reflecting subclinical arterial damage. Treatment with sartans leads not only to a reduction of blood pressure but may also bring regression of the subclinical damage. Long-acting sartans (telmisartan) may be more effective than sartans with medium duration of action (losartan); the aim of this research was to compare the impact of hypertension therapy with losartan and telmisartan on aortic pulse wave velocity (Ao-PWV). Methods:We examined...

Heart transplantations - the past, the present and outlook into the future

L. Špinarová

Vnitr Lek 2010, 56(8):884-888  

We provide an overview of the history, current status and future perspectives of heart transplantations. We describe indication criteria and possible post-transplantation complications. Finally, we list the options that could, as an alternative, complement transplantations in the future. This is mainly the use of mechanical heart support devices.