Therapeutic hypothermia after cardiac arrest: why and for how long? - editorial

J. Bělohlávek, O. Šmíd

Vnitr Lek 2011, 57(1):23-26  

Genes and osteoporosis - editorial

V. Palička

Vnitr Lek 2011, 57(1):27-28  

Obesity, body mass index, waist circumference and mortality - editorial

M. Kunešová

Vnitr Lek 2011, 57(1):29-30  

Obesity, body mass index, waist circumference and mortality - editorial

J. Pařízková

Vnitr Lek 2011, 57(1):31-32  

Characterization of residual coronary sinus-related tachycardia during ablation of longstanding persistent atrial fibrillation

M. Fiala, J. Chovančík, D. Wojnarová, V. Bulková, J. Pindor, H. Szymeczek, R. Lábrová, O. Toman, J. Januška, J. Špinar

Vnitr Lek 2011, 57(1):33-42  

Purpose:The aim was to characterize the coronary sinus (CS)-related tachycardia that occurred as the last residual arrhythmia and required ablation within the CS or great cardiac vein to restore sinus rhythm (SR) in patients with primary longstanding persistent AF. Methods:The study included 23 patients in whom stable SR was restored by ablation inside the vein during the first or repeat ablation. Results:The 23 subjects represented 23% of the 99 patients in whom SR was restored by ablation. A reentry tachycardia confined to the CS musculature was suggested in 8 (35%) patients, and a peri-mitral reentry circuit...

Acute heart failure and early development of left ventricular dysfunction in patients with ST segment elevation acute myocardial infarction managed with primary percutaneous coronary intervention

J. Pařenica, P. Kala, J. Jarkovský, M. Poloczek, O. Toman, M. Pávková Goldbergová, J. Maňoušek, K. Prymusová, L. Kubková, M. Tesák, L. Elbl, Z. Čermáková, J. Špinar

Vnitr Lek 2011, 57(1):43-51  

Background:Acute heart failure during ST elevation myocardial infarction (STEMI) makes worse prognosis. The aim of the work was to find independent factors with relationship to acute heart failure (AHF) and the early development of left ventricular dysfunction within the prospective followed patients with STEMI. Methods:A total of 593 patients with STEMI treated by primary PCI (164 patients with AHF) were the study population. The activity of BNP and NT-ProBNP were measured at hospital admission and 24 h after MI onset. Left ventricular angiography was done before PCI; echocardiography was undertaken between the third and...

Contribution of whole-body magnetic resonance in the diagnostics of monoclonal gammopathy of undetermined significance, multiple myeloma, and the assessment of Durie-Salmon Plus staging system

V. Ščudla, M. Heřman, J. Minařík, T. Pika, J. Hrbek, J. Bačovský, V. Heinzová

Vnitr Lek 2011, 57(1):52-60  

Background:The aim of the study was to assess the contribution of the whole body MRI (WB-MRI) in the diagnostics of monoclonal gammopathy of undetermined significance (MGUS) and initial, asymptomatic form of multiple myeloma (MM), as well as the evaluation of practical usefulness of the Durie-Salmon Plus staging system (D-S Plus). Materials and methods:The analyzed 86-patient cohort consisted of 28 patients with MGUS and 54 patients with newly diagnosed multiple myeloma and 4 patients with solitary plasmocytoma (SP). WB-MRI was evaluated using Magnetom Avanto 1.5 T with the use of virtual whole body coil with sequential acquisition...

The influence of some factors on presence of varices and variceal bleeding in liver cirrhosis patients

L. Husová, P. Husa, P. Ovesná

Vnitr Lek 2011, 57(1):61-71  

Study aim:The aim of the study was to identify non-invasive investigations that would provide a sufficiently reliable prediction of the presence of varices in patients with liver cirrhosis (LC) and identification of patients in a risk of variceal bleeding. Patient sample and methodology:As part of a prospective evaluation, 165 patients with alcoholic LC admitted to the Department of Internal Hepatology and Gastroenterology of the Medical School, Masaryk University in Brno between 2007-2009 were divided according to the presence of varices and variceal bleeding into three groups: I. patients with LC and varices with no variceal...

Therapeutic hypothermia after non-traumatic cardiac arrest for 12 hours: Hospital Karlovy Vary from 2006 to 2009

R. Sýkora, R. Janda

Vnitr Lek 2011, 57(1):72-77  

Introduction and aims:Therapeutic hypothermia is a standard part of post-resuscitation care. Here we present cohort patients after non-traumatic cardiac arrest and their neurological outcomes who underwent 12 hours of therapeutic hypothermia. Moreover, we focused on examining the results of particular subgroup of patients with initial ventricular fibrillation (VF) with acute myocardial infarction with ST-elevation (STEMI) who underwent coronary intervention (PCI). Methods:We evaluated retrospectively the patients with non-traumatic out-of- and in-hospital cardiac arrest (IHCA, OHCA), admitted to our intensive care unit (ICU)...

Role of genetics in prediction of osteoporosis risk

I. Žofková

Vnitr Lek 2011, 57(1):78-84  

Osteoporosis is in 60-80% a hereditary disease with a characteristic multifactorial pathogenesis during which the effects of many "weak" genes interact with external factors. To date, most information relating to the correlations between genes and bone parameter variability (density, quality and metabolism) has been provided by association studies of candidate genes for osteoporosis. The best known genes related to bone density have been identified as the genes for the vitamin D, estrogen and calcitonin receptor, LRP5 and LRP6. The genes for IL-1α and osteoprotegerin are responsible for the parameters of bone remodeling. Recently discovered genes...

Obesity, body mass index, waist circumference and mortality

M. Berková, Z. Berka

Vnitr Lek 2011, 57(1):85-91  

Obesity belongs to civilization diseases with its incidence and prevalence increasing all over the world. Complications of obesity represent a serious socioeconomic problem. Obesity is a part of the metabolic syndrome and an independent mortality risk factor in all age categories, however, this relation is twice as strong in individuals under fifty years of age. Slight overweight in old age is associated with reduced total mortality risk. Simple evaluation of obesity via calculation of body mass index and measurement of waist circumference can be carried out in every medical consulting room.

Why there is atrial fibrillation after cardiac operations?

M. Jakubová, Ľ. Družbacká, B. Stančák, P. Mitro, F. Sabol, A. Hermely, P. Olexa, P. Török

Vnitr Lek 2011, 57(1):92-96  

Atrial fibrillation (AF) is the most frequent arrhythmias after cardiac operations. Its incidence ranges from 10-65 %. Often there is a patient discomfort, prolongs hospitalization, increases costs of operation and may be permanent or recurrent course. The cause of postoperative AF is multifactorial. The prevention of non-pharmacological and pharmacological interventions. The conventional treatment strategies include monitoring ventricular rate, restoration of sinus rhythm and prevention of thromboembolic events. The development of effective therapies designed to decrease the high incidence of postoperative AF may be important in the future.

Schnitzler syndrome: case report, the experience with glucocorticoid and anakinra (Kineret^TM) therapies and monitoring of systemic cytokine response

P. Szturz, Z. Adam, M. Klabusay, Z. Fojtík, Z. Kadaňka, O. Stehlíková, J. Chovancová, L. Kalvodová, D. Čorbová, K. Starý, J. Neubauer, J. Prášek, R. Koukalová, Z. Řehák, R. Hájek, J. Mayer

Vnitr Lek 2011, 57(1):97-112  

Schnitzler syndrome is a rare idiopathic disease characterized by chronic urtica, presence of monoclonal IgM immunoglobuline and further, less common symptoms. This case report describes another case of this disease affecting a male adult born in 1963. The first symptoms, eruptions of non-pruritic urticarial rash, appeared in this patient at the age of 43. In addition, bone pains (mainly tibias) and joint pains (mainly knees) were present. Later on however, severe attacks of fever, chills and shaking together with bone and joint pains were added to during which new urticarial eruptions appeared. Primarily, the man was followed up without any substantial...

A delay in the HELLP syndrome diagnosis

J. Záhumenský, E. Menzlová, H. Hermann, B. Zmrhalová, O. Šottner, I. Vašíčka, M. Halaška

Vnitr Lek 2011, 57(1):113-116  

HELLP syndrome is a serious obstetrical complication that tends to occur in the second half of pregnancy that complicates six promiles of pregnancies. The term HELLP syndrome is derived from the beginning letters of the English words indicating laboratory changes, which is occurs as a specific illness in pregnancy. There is hemolysis, elevated liver enzymes and a decreased platelet count. It can present itself with preeclampsia or without it. The most serious complications are disseminated intravascular coagulation, liver rupture or various organ failures. The pathogenesis at the moment is not completely known. The basic approach to care is delivery...

A case of a flapping infected thrombus in the internal jugular vein, septic pneumonias and heparin-induced thrombocytopaenia

P. Majdák, J. Kubík ml., L. Harmátová

Vnitr Lek 2011, 57(1):117-121  

We present a case of a 54 years old female patient after anterior wall left ventricular myocardial infarction in 2005 who underwent coronary artery bypass graft (CABG) surgery requiring cannulation of the right internal jugular vein (IJV). She was admitted to a Department of Pulmonary Diseases with left bronchopneumonia (BPN) following 7 day treatment, with hemoptysis, dyspnoea and fevers. Duplex ultrasound (DUS) was used to diagnose flapping thrombus in the right IJV, severe thrombocytopenia and, in addition, progressing multiple infiltrates on X-ray a few days later. We empirically adjusted the treatment initiated in primary care and observed deterioration...

MUDr. Václav Jedlička se dožil 85 let

Miroslav Souček

Vnitr Lek 2011, 57(1):122  

Diagnosis and treatment of acute pulmonary embolism in 2010

J. Widimský

Vnitr Lek 2011, 57(1):5-21  

Diagnostic approaches in acute pulmonary embolism include evaluation of clinical likelihood, D-dimers, echocardiography and spiral CT angiography and pulmonary scintigraphy. Determination of D-dimers is only meaningful in patients with low or intermediate clinical likelihood. It is safe not to initiate anticoagulation treatment (or to discontinue such treatment) in patients with low clinical likelihood of acute pulmonary embolism and negative D-dimer test (only if methods with 99-100% sensitivity are used). Duplex sonography and pulmonary scintigraphy are only necessary at the centres with a first generation spiral CT and not those with multidetector...