Co přináší našim pacientům katetrizační ablace u fibrilace síní? - editorial

R. Čihák

Vnitr Lek 2011, 57(5):434  

Co způsobuje pokles úmrtnosti na ischemickou chorobu srdeční? - editorial

R. Cífková

Vnitr Lek 2011, 57(5):435-436  

Co způsobuje pokles úmrtnosti na ischemickou chorobu srdeční? - editorial

L. Groch

Vnitr Lek 2011, 57(5):437-438  

Idiopatická retroperitoneální fibróza - editorial

M. Hermanová

Vnitr Lek 2011, 57(5):439-440  

Disturbance of synthesis of cholesterol and its precursors in clinically serious conditions

P. Vyroubal, R. Hyšpler, A. Tichá, J. Samek, J. Cerman, E. Havel, J. Bajnárek, Z. Zadák

Vnitr Lek 2011, 57(5):441-450  

Objective:The aim of the study was to elucidate the role and importance of hypocholesterolemia in clinically serious conditions. It was a monocentric, prospective clinical study. Material and Methods:Two groups of patients were recruited to the study - one group were patients with coronary heart disease (CHD), who underwent miniinvasive cardiosurgical operation without extracorporeal circulatio (n = 17) and one group of patients, who sustain polytrauma (n = 19). Thirty six patients were recruited into the study. We performed the determination of sterols (total cholesterol, HDL-cholesterol, LDL-cholesterol, triacylglycerols),...

Treatment of critical limb ischemia and diabetic foot disease by the use of autologous stem cells

M. Dubský, A. Jirkovská, R. Bém, L. Pagáčová, V. Fejfarová, M. Varga, J. Skibová, Š. Langkramer, E. Syková

Vnitr Lek 2011, 57(5):451-455  

Aim:The aim of our study was to assess safety and efectiveness of therapy of critical limb ischaemia by autologous stem cells and evaluation of potential adverse events. Methods:Fourteen patients were included into the study (11 men, 3 women, mean age 61.9 ± 9.6 years, mean diabetes duration 23.5 ± 11.1 years, mean glycated hemoglobin 6 ± 1 %). Eight patients were treated by bone marrow stromal cells, 6 patients by peripheral blood progenitor cells after stimulation by filgrastim. The suspension of stem cells was then applied into the muscles of ischemic limbs. We evaluated transcutaneous oxygen tension...

Improvement of quality of life after ablation of longstanding persistent versus paroxysmal atrial fibrillation: results of 2-year follow-up

V. Bulková, M. Fiala, L. Haman, J. Chovančík, L. Škňouřil, Š. Havránek, J. Pindor, J. Duda, J. Gorzolka, K. Ivanová, P. Pařízek

Vnitr Lek 2011, 57(5):456-462  

Aims:The purpose of the study was to assess quality of life and socio-economic parameters in patients after ablation of paroxysmal versus longstanding persistent atrial fibrillation (AF). Methods:The study included 89 patients with paroxysmal AF and 56 patients with longstanding persistent AF who underwent ablation within 1 year, and were afterwards prospectively followed up for 2 years. Quality of life was evaluated by the EQ-5D questionnaire before and every 6 months after ablation. Results:Objective, respectively subjective quality of life at baseline was lower in patients with longstanding persistent AF...

Blood lipid changes at long-term antiretroviral treatment

S. Snopková, J. Jarkovský, M. Matýšková, K. Povolná, P. Polák, M. Cvanová, P. Husa

Vnitr Lek 2011, 57(5):463-471  

The aim of study was to find the development trend of blood lipid concentration in a group of HIV positive patients treated by combination antiretroviral therapy (cART). We followed changes during the therapy and evaluated their aterogennic nature. Methods:The group included 118 patients stepwise allocated to the AIDS Centre of the Faculty Hospital Brno, with the monitoring period being up to 1 month as the minimum and up to 17 years as the maximum. The patients were divided into cART treated patients and not treated patients. The following parameters were analysed: total cholesterol, triglycerides, HDL-cholesterol, apolipoprotein...

Cardiotoxicity of cancer therapy

J. Marek, A. Linhart, Z. Rucklová, J. Haber, J. Kořínek

Vnitr Lek 2011, 57(5):472-484  

Due to advances in oncological care, the number of patients exposed to and surviving after anticancer chemotherapy is steadily increasing. Anticancer agents, however, are often associated with side-effects including cardiotoxicity which has been identified as one of the most serious and potentially life threatening complications. Cardiotoxicity manifestations range from asymptomatic alterations of heart and vasculature function to arterial hypertension, myocardial ischemia, arrhythmias (including QT-prolongation) and overt heart failure. Post-chemotherapy cardiovascular impairment has been associated with increased morbidity and may also contribute...

Sorafenib in the treatment of hepatocellular carcinoma

G. Suchánková, J. Špičák

Vnitr Lek 2011, 57(5):485-490  

Hepatocellular carcinoma (HCC) is the 5th most frequent tumour disease and, at the same time, the 3rd most frequent cause of death from cancer worldwide. More than 600 000 new patients are diagnosed every year and more than 80% are diagnosed at an advance stage where surgical treatment is not indicated and systemic chemotherapy does not provide longer survival time. Sorafenib is the first substance that provides proven significant prolongation of survival time of HCC patients. This is a multikinase inhibitor with anti-proliferative and anti-angiogenic properties. Its efficacy was shown in the SHARP study that enabled licensing of sorafenib for the...

Infectious complications in patients after cardiac arrest undergoing therapeutic hypothermia

R. Sýkora

Vnitr Lek 2011, 57(5):491-495  

Therapeutic hypothermia is currently recommended neuroprotective therapeutic measure for comatose patients after cardiac arrest. Hypothermia has been proven not only to affect the neurological outcomes but also the survival of patients after cardiac arrest. This communication summarizes the issue of early infectious complications in patients after cardiac arrest undergoing therapeutic hypothermia. Diagnosis of infectious events is complicated in patients after cardiac arrest not only by the physiological effects of therapeutic hypothermia but also by the consequences of reperfusion injury and development of postresuscitation disease associated with...

The decrease in morbidity and mortality of patients with chronic forms of ischemic heart disease is the result of conservative treatment

L. Kotík

Vnitr Lek 2011, 57(5):497-501  

Article presents actual comparison of therapeutic methods for patients with chronic coronary artery disease and their influence on morbidity and mortality. It calls attention to the insufficiently presented fact, that invasive methods, like percutaneous and surgical revascularization, despite great expectations, have not proved to lower morbidity and mortality in large randomized studies. In contrary several groups of drugs proved their efficiency many times. Paradoxically, the cheapest approach, life style intervention, seems to be the most efficient method for prognosis improvement of patients with chronic coronary artery disease.

Internal medicine and cognitive decline in seniors

H. Matějovská Kubešová, H. Meluzínová, P. Weber

Vnitr Lek 2011, 57(5):502-506  

Authors show the situation in diagnostics and treatment of cognitive deterioration in elderly. There are stressed chronic diseases influencing significantly influencing the development of dementia. Adequate treatment of these diseases was proved as a factor delaying the cognitive decline. The relationship between different groups of medications and cognitive performance are discussed. The importance of nutrition of elderly and possible microelements deficits are mentioned - specially group B vitamines, polyunsaturated fatty acids etc. Special part of the article show the importance of physical and psychical activities from the cognition point of view....

Sulodexid and nephrotic syndrome in patients with diabetic nephropathy

I. Valočiková

Vnitr Lek 2011, 57(5):507-510  

Diabetic nephropathy (DN) is the most serious, life limited complication of both types of diabetes mellitus. Therefore the early identification and intensive treatment of DN is very important. DN involves the thickening of glomerular basement membrane (GBM) and the depletion of glycosaminoglycan (GAG) in the GBM with resultant diminution in the physiological electrostatic charge barier. Additional mechanism in pathophysiology of DN is mesangial expansion. Sulodexide is glycosaminoglycan mixture of heparansulfate and dermatan sulfate. We present a 71-year old patient with severe nephrotic syndrome, probably caused by DN. AS patient refused renal biopsy,...

Morbus Ormond (idiopatic retroperitoneal fibrosis)

A. Michaligová, L. Plank, A. Ježíková, V. Maňka, P. Makovický, M. Mokáň

Vnitr Lek 2011, 57(5):511-515  

Idiopathic retroperitoneal fibrosis (IRF) is a rare condition characterized by the development of fibrotic tissue around the abdominal aorta and iliac arteries and often involves structures as ureters and the inferior vena cava. The age at onset of signs and symptoms is between 40-60 years, males predominane over females. In most cases the clinical manifestation is presented as compressive syndrom of ureters, therefore the first known cases were described by urologists. In this report we present the case of 37-years old male examinated for persistent fever about 38 °C and high inflammatory activity in spite of empiric antibiotic therapy. Positron emission...