MUDr. Jana Lacinová - 65 let

Richard Češka

Vnitr Lek 2011, 57(9):669  

Prim. MUDr. Milanu Tržilovi k 60. narozeninám

Petr Svačina

Vnitr Lek 2011, 57(9):670-671  

Czech angiology and its transformation

M. Bulvas

Vnitr Lek 2011, 57(9):672-680  

Over the last 25 years, Czech angiology has changed dramatically with respect to the diseases and conditions managed by angiologists as well as available therapeutic modalities. Such developments also required substantial expansion of the extent and character of specialist knowledge required from angiologists. Angiology manages to effectively correlate a clinical profession with non-coronary endovascular therapy and this has brought about a significant improvement in treatment efficacy and comfort. Physicians thus crossed a boundary of purely conservative treatment and focus on life and organ-threatening vascular diseases. Recent years have also seen...

Irritable bowel syndrome

J. Dolina, A. Hep, M. Mišejková

Vnitr Lek 2011, 57(9):681-683  

Irritable bowel syndrome is a frequent functional disorder of gastrointestinal tract. Its high incidence represents an important socioeconomic concern. The diagnosis of irritable bowel syndrome is indirect and requires exclusion of an organic lesion within as well as outside the gastrointestinal tract. No algorithms - so called treatment guidelines - are available for pharmacological or non-pharmacological treatment of the irritable bowel syndrome. Long-term and comprehensive care of patients with functional diseases is an important component of the management of patients with irritable bowel syndrome.

Biological treatment in dermatology - psoriasis

K. Ettler

Vnitr Lek 2011, 57(9):684-692  

Psoriasis is a chronic, relapsing skin disease affecting 1-2% of the population. Genetically-determined autoimmune inflammation is initiated by an infection (e.g. streptococcal). T-lymphocytes, producing a number of cytokines, mainly of the Th₁ profile, including TNFα, play a key role. The role of Th₁₇ and its interleukin IL-23 has recently been confirmed. It contains p40 protein, also a component of IL-12. TNFα and p40 blockade appear to be an effective biological treatment of severe lesional psoriasis. Further research and new drug development is to assure modern individualized treatment of psoriasis as well as other...

Prokinetic agents - their contribution to practice of gastroenterology

A. Hep, J. Dolina

Vnitr Lek 2011, 57(9):693-696  

Motility plays a fundamental role in the functioning of the gastrointestinal tract. Prokinetic agents are thus an important treatment modality in patients with functional and certain organ diseases with underlying functional modifications. Gastro-oesophageal reflux disease is frequently associated with a disorder of oesophageal motility, an alteration of gastric evacuation may manifest as an atypical dyspeptic complaint. Prokinetic agents may also be effective in other disease states, such as diabetic gastroparesis, malignant conditions associated with nausea and vomiting, motility disorders in preterm babies etc.

Liver diseases in internal medicine outpatient clinics

P. Husa

Vnitr Lek 2011, 57(9):697-701  

Patients with a suspected or confirmed liver disease are frequent attendees at internal medicine outpatient clinics. Metabolic and toxic liver lesions are presently much more prevalent than infectious liver diseases. Liver steatosis and drug-induced liver impairment are the most frequent. The main task for internal medicine specialists in primary care with respect to chronic viral hepatitis B and C is to keep these diseases in mind and when an increased alaninaminotranspherase activity is detected, to perform blood tests for the presence of HBsAg as well as anti-HCV antibodies. Epidemiologically high-risk patients should always be tested for the presence...

Arrhythmology today: risks associated with anti-arrhythmic therapy in an internal medicine outpatient clinic

J. Kautzner

Vnitr Lek 2011, 57(9):702-708  

Arhytmology that is focused on diagnostics and therapy of heart rhythm disturbances and their complications has undergone dramatic development in last 2 decades. Widespread use of catheter ablation, introduction of implantable cardioverter-defibrillators for prevention of sudden cardiac death and finally, development of cardiac resynchronization therapy have lead to decreased importance of drug treatment. Antiarhythmic drugs remain therapy of choice in management of atrial fibrillation and in some ventricular arrhythmias, especially in patients with implantable cardioverter-defibrillator backup. Therefore, this review deals predominantly with a strategy...

Treating stable chronic obstructive pulmonary disease (COPD) and its potential cardiovascular risks (a basic overview)

V. Koblížek

Vnitr Lek 2011, 57(9):709-720  

Chronic obstructive pulmonary disease (COPD) is a highly prevalent clinical syndrome. It affects a significant proportion of world population, including non-smokers. The number of COPD patients continues to grow. For many reasons, COPD is often associated with a heart disease. In some patients, a heart disease is the primary pathology, in others COPD develops first, while sometimes heart and pulmonary involvement occur more or less simultaneously. As yet we are unable to repair damaged pulmonary parenchyma or to restore capillary destruction occurring around pulmonary alveoli. Furthermore, the disease development cannot be completely suppressed. However,...

Criteria for perioperative risk evaluation - non-cardiac surgery

L. Kotík

Vnitr Lek 2011, 57(9):722-727  

The paper presents criteria used to evaluate surgical risks associated with non-cardiac surgical procedures.

Current perspective of treating hypertension in pregnancy

M. Koucký

Vnitr Lek 2011, 57(9):728-731  

The author deals with the contemporary perspective on treatment hypertension in pregnancy. The article highlighted that hypertension treatment should be conducted not only with regard to the mother, but also to the possible negative impact on supply to the fetus. New information, particularly in the pathophysiology of pregnancy related hypertension show that in these diagnoses is vasoconstriction in placental microcirculation quite common. Inadequate treatment may have adverse effects on uteroplacental flow with potential risks to the fetus. The treatment of choice in pregnancy relatedy hypertension are methyldopa, calcium antagonists and labetalol.

New antithrombotics in the prevention of venous thromboembolia and new anti-platelet drugs

J. Malý, M. Pecka, R. Malý

Vnitr Lek 2011, 57(9):733-739  

We first present a brief overview of new antithrombotic agents that are assumed to replace coumarines and heparin in many indications; this overview provides information on pentasaccharides, direct thrombin inhibitors and direct factor Xa inhibitors. Secondly, since the new drugs with antiplatelet effect act through blockade of the reactions involved in blood platelet activation, we review and discuss the substances that interfere with this process. The current antiplatelet therapy focuses mainly on an inhibition of platelet aggregation stimulated by ADP, reducing the risk of arterial occlusions.

Targeted biological treatment of solid tumours

L. Petruželka

Vnitr Lek 2011, 57(9):740-744  

Clinical use of targeted biological treatment was initiated in 1970s following a discovery of hormonal receptors and targeted clinical use of tamoxifen. Deeper understanding of molecular principles of the process of metastasizing and cell communication and signalling have contributed to the development of targeted molecular biological treatments based on direct impact on the key target structures of a tumour cell. Clinical effectiveness of targeted biological treatment has been shown in phase III clinical studies in advanced and metastasising solid tumours and importantly expanded our armamentarium of pharmacotherapeutic treatment options in breast...

Proteinuria in primary care

R. Ryšavá

Vnitr Lek 2011, 57(9):745-750  

Proteinuria is one of the main symptoms of renal impairment. It may manifest itself as a small amount of albumin in the urine (microalbuminuria) or as the nephrotic syndrome. Testing strips results should be considered as preliminary; a negative result does not exclude renal disease. At present, proteinuria is assessed as a total protein waste in the urine collected over 24 hours with up to 150 mg/day being considered a norm. Lately, the protein (albumin) to creatinine ratio in a sample of morning urine is being preferred (protein//creatinine ratio - PCR or albumin/creatinine ratio - ACR). More detailed nephrological examination should be performed...

The importance of antihypertensive therapy in subclinical brain damage

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

Vnitr Lek 2011, 57(9):751-754  

Older patients are often affected by impaired cognitive function and high blood pressure. Damage to microcirculation of the brain is closely related to changes in large vessels. High blood pressure and vascular stiffness might lead to a damage in microcirculation of the brain and, consequently, to worsening of the patient's cognitive function and dementia. We discuss early diagnosis of subclinical brain damage using magnetic resonance and its preventive management with antihypertensive therapy.

Plypharmacy and drug interactions

J. Suchopár, M. Prokeš

Vnitr Lek 2011, 57(9):755-759  

The growing consumption of drugs and other numerous factors relates to the increasing incidence of polypharmacy. The proportion of patients currently treated with 5 or more medicines at the elderly population in particular is 30-60% of patients. Repeatedly has been proven the dependence between the number of concomitant drugs and occurrence of adverse effects, patients requiring hospitalization, or incidence of moderate and serious drug interactions. Some works show that it is possible to satisfactorily address the issues of polypharmacy, but it requires great courage and an interdisciplinary approach involving modern information technology.

Is there any relation between diabetes tharapy and cancer risk?

Š. Svačina

Vnitr Lek 2011, 57(9):760-763  

Type 2 diabetes is associated with increased risk of cancer. This risk is related to HbA_1c increase and this influence is present also in prediabetes and in nondiabetics with HbA_1c in upper normal range. In last 2 years, it was concluded that that the specific antidiabetic therapy could influence the cancer risk. In this review we show that reduction of HbA_1c does not change cancer risk. Most important is the risk reduction of cancer risk by metformin. Insulin therapy and the use of sulphonylurea related drugs, increases the risk of cancer. This risk can be eliminated in the combination with metformin. Other published...

Combined exercise training in men with metabolic syndrome after acute coronary event

H. Svačinová, V. Mrkvicová, J. Pochmonová, B. Rosenbergová, J. Siegelová, P. Dobšák, J. Vítovec

Vnitr Lek 2011, 57(9):764-771  

Introduction:Favourable effect of exercise training on cardiovascular prognosis in patients with metabolic syndrome have been documented in lot of studies. Less information exist about results of cardiovascular rehabilitation in patients with different forms of coronary heart disease and associated diseases and abnormalities within metabolic syndrome. Methods:The present article evaluates a benefit of combined, aerobic-resistance training in two groups of patients after percutaneous coronary intervention for acute coronary syndrome: with [group MS(+), n = 42] and without [group MS(-), n = 53] metabolic syndrome. The changes...

Diagnostic of secondary hypertension in clinical practice

Z. Šomlóová, J. Rosa, O. Petrák, B. Štrauch, T. Zelinka, R. Holaj, J. Widimský jr.

Vnitr Lek 2011, 57(9):772-776  

Arterial hypertension is a common worldwide disease with a prevalence of approximately 26%. Secondary cause is known in 5-10% of patients with hypertension. We should think of secondary hypertension in all patients with resistant hypertension, in patients with sudden deterioration in the control of hypertension and in patients with laboratory and clinical signs of diseases associated with secondary hypertension. It is important to distinguish between secondary hypertension and pseudo-resistance (noncompliance to treatment, white coat syndrome). Secondary causes of hypertension can be divided into endocrine (primary aldosteronism, pheochromocytoma,...

FARIM - FARmakoterapie po Infarktu Myokardu (Post-Myocardial Infarction Pharmacotherapy study)

J. Špinar, J. Vítovec, L. Špinarová

Vnitr Lek 2011, 57(9):778-784  

A total of 2,500 patients with an anamnesis of myocardial infarction at least 1 month prior to inclusion in the study who visited a general practitioner or an internal medicine or cardiology specialist were examined. Through an internet-based portal, physicians entered patient data, their complaints, treatment, blood pressure, heart rate and main biochemical parameters. There were more men (1 787 vs. 713) and patients under 70 years of age (1 491 vs. 1 009) in the cohort. Eighteen percent of patients had more than one MI. Mean age at the first infarction was 59.2 years in men and 64.9 in women (p < 0.001). NYHA breathlessness category higher than...

Thyreopathy in primary care

P. Vlček

Vnitr Lek 2011, 57(9):786-790  

Thyroid gland disorders, as the core of all endocrinopathies, affect 5-7% of the population of the Czech Republic, with women being affected 6-8 times more often than men. Clinically, thyreopathies are divided into hormonal production disorders and morphology disorders. Thyroid hormones fT₃, fT₄ and TSH serum levels determine the diagnosis of a thyroid gland disorder. Primary hypothyreosis is characterized by reduced fT₄ and increased TSH. Low T₃ syndrome is a protective reaction of the organism and is associated with conversion of T₄ into hormonally inactive triiodothyronine (rT₃)....

Zemřel prof. MUDr. Vladimír Pacovský, DrSc., emeritní předseda Československé internistické společnosti

Š. Svačina, P. Sucharda, R. Češka

Vnitr Lek 2011, 57(9):791  

Prof. MUDr. Bohumil Fišer, CSc., zemřel (Osobní zprávy)

prof. MUDr. Jarmila Siegelová, DrSc.

Vnitr Lek 2011, 57(9)

Prínos prof. MUDr. Jana Broda, DrSc., v oblasti hypertenzie a nefrológie (Z historie medicíny)

prof. MUDr. Miroslav Mydlík, DrSc.

Vnitr Lek 2011, 57(9)

Kožní změny u interních onemocnění (Z odborné literatury)

prof. MUDr. Vladimír Vašků, CSc.

Vnitr Lek 2011, 57(9)

XXX. Dny mladých internistů České republiky a Slovenska v Olomouci (Zprávy z odborných akcí)

doc. MUDr. Pavel Horák, CSc.

Vnitr Lek 2011, 57(9)

Zajímavosti ze sjezdu Evropské skupiny pro transplantaci krvetvorných buněk (European Group for Blood and Marrow transplantation), 3.-6. dubna 2011 v Paříži, týkající se pacientů s ledvinami poškozenými mnohočetným myelomem (Zprávy z odborných akcí)

prof. MUDr. Zdeněk Adam, CSc.

Vnitr Lek 2011, 57(9)

Diabetická nefropatie. Průvodce ošetřujícího lékaře (Z odborné literatury)

Petr Žák

Vnitr Lek 2011, 57(9)

Praktická podiatrie. Základy péče o pacienty se syndromem diabetické nohy (Z odborné literatury)

Petr Žák

Vnitr Lek 2011, 57(9)

Hypopituitarismus a diabetes insipidus centralis (Z odborné literatury)

MUDr. Karola Balšíková

Vnitr Lek 2011, 57(9)

Farmakoterapie neuropatické bolesti (Z odborné literatury)

MUDr. Marek Hakl, Ph.D.

Vnitr Lek 2011, 57(9)

Anémie, diagnostika a liečba v praxi (Z odborné literatury)

Štefan Hrušovský

Vnitr Lek 2011, 57(9)

Klinická a radiačná onkológia. 2. diel (Z odborné literatury)

prof. MUDr. Zdeněk Dienstbier, DrSc.

Vnitr Lek 2011, 57(9)

Novinky z Acute Leukemias XIII. International Symposium, Mnichov, SRN, 28. 2.-2. 3. 2011

MUDr. Petr Lemež, CSc.

Vnitr Lek 2011, 57(9)