Predikce neurologické prognózy po srdeční zástavě - editorial

P. Ošťádal

Vnitr Lek 2012, 58(4):259-260  

Význam biomarkerů NGAL a cystatin C u kardiovaskulárních onemocnění - editorial

F. Málek

Vnitr Lek 2012, 58(4):261-262  

Gastrin bez gastrinomu - editorial

O. Louthan

Vnitr Lek 2012, 58(4):263-265  

S-100B protein elevation in patients with the acute coronary syndrome after resuscitation is a predictor of adverse neurological prognosis

K. Helánová, J. Pařenica, J. Jarkovský, L. Dostálová, S. Littnerová, I. Klabenešová, Z. Čermáková, P. Lokaj, P. Kala, M. Poloczek, O. Toman, O. Gimunová, J. Maláska, J. Špinar

Vnitr Lek 2012, 58(4):266-272  

Introduction:The annual incidence of out-of-hospital cardiac arrest is around 90-190 cases per 100 000 inhabitants. The limiting factor for further prognosis of patients after out-of-hospital arrest is their neurological status. The S100B protein is mainly the nervous system cell's product, it's glial-specific and mostly expressed by astrocytes. It has been shown that after circulatory arrest its increased level correlates with the prognosis of patients. Work aims to determine the level of protein S100B in the group of patients with acute myocardial infarction without circulatory arrest, and compare it to the value in patients with acute...

Short-term prognosis and treatment of patients hospitalized for acute heart failure in a regional hospital without a cardiocentre

K. Zeman, L. Pohludková, J. Špinar, J. Jarkovský, S. Littnerová, L. Dušek, R. Miklík, M. Felšöci, J. Pařenica

Vnitr Lek 2012, 58(4):273-279  

Background:Heart failure is a syndrome with increasing prevalence and poor prognosis. The aim of the article is to describe the characteristics, etiology, treatment and short-term prognosis of consecutive patients hospitalized for acute heart failure (AHF) in a regional hospital without Cardiocentre. Patients and methods:From 1/2007 to 5/2009 in total 752 patients were hospitalized in Hospital in Frýdek-Místek with diagnosis of AHF, 18% of them were in that period re-hospitalized. Data collection was performed by doctors using the National registry of acute heart failure AHEAD. Systematic sorting of patients with heart failure...

Risk stratification in patients with Brugada syndrome

M. Bébarová, P. Lokaj

Vnitr Lek 2012, 58(4):280-285  

Brugada syndrome (BrS), one of the most frequently diagnosed inherited arrhythmogenic syndromes, is responsible for more than 4% of all sudden deaths and at least 20% of sudden deaths in patients with structurally normal hearts. The sudden death is often the first symptom of BrS and appears most often already during the fourth decade of life of BrS patients. Implantation of cardioverter-defibrillator was proved to be the only effective treatment, i.e. prevention of the sudden death, in BrS. Thus, it is uniquely determined to be used in case of symptomatic BrS patients. On the contrary, the individual risk of life-threathening arrhythmias has to be...

The importance of NGAL and cystatin C biomarkers in cardiovascular diseases

K. Helánová, J. Pařenica, V. Dlouhý, M. Pávková Goldbergová, Z. Čermáková, J. Gottwaldová, J. Špinar

Vnitr Lek 2012, 58(4):286-290  

Cystatin C is an inhibitor of lysosomal proteases and extracellular cysteine protease, it participates in the regulation of metabolism of extracellular proteins. It is fully glomerular filterable, completely absorbed and catabolised in proximal tubule cells. NGAL (neutrophil gelatinase-associated lipocalin) is an acute phase protein, participating in antibacterial immunity and his important feature is the formation of complex with metalloproteinase 9 (MMP-9), thereby increasing its activity and prevents its degradation. NGAL is freely filtered across the glomerular membrane and is reabsorbed by endocytosis in the proximal tubule. NGAL detected in urine...

New knowledge of the pathogenesis of Crohn's disease

B. Ambrůzová, M. Rédová, J. Michálek, M. Šachlová, O. Slabý

Vnitr Lek 2012, 58(4):291-298  

Crohn's disease is a complex chronic inflammatory disease of the gastrointestinal tract with multifactorial pathogenesis. Over the recent years, there has been rather a sharp increase in the incidence of Crohn's disease and, even though this disease had been known for some time, the cause remains unknown. Studies exploring genetic basis of Crohn's disease have provided new knowledge of the pathogenesis of this disease, suggesting that this may be associated with a failure of mechanisms behind symbiosis of gut microflora and intestinal mucosal immune system. Crohn's disease seems to be caused by inadequate immune response to intestinal flora in genetically...

Drug interactions in the elderly with diabetes mellitus

T. Hendrychová, J. Vlček

Vnitr Lek 2012, 58(4):299-304  

The elderly with diabetes mellitus are usually treated with many types of drugs. This, together with pharmacokinetic and pharmacodynamic changes connected with aging, can lead to an occurence of drug interactions. They are often manifested as hypoglycaemia, decompensation of diabetes or an increase of frequency of adverse effects of drugs used together. It is important to pay an attention especially to hypoglycaemia, which brings many risks in the elderly. An article is focused on probable drug interactions when combination of various antidiabetics, antidiabetics with antihypertensives or hypolipidemics is used. Despite ACE-inhibitors and beta-blockers...

Diabetes mellitus and dementia

I. Tůma

Vnitr Lek 2012, 58(4):305-308  

Patients with diabetes are at increased risk of developing cognitive impairment in comparison with the general population. Diabetes mellitus increases the risk of dementia (vascular and/or neurodegenerative). Diabetes accelerates the progression from mild cognitive impairment to dementia. It has been estimated that type 2 diabetes or impairment of glucose metabolism might be present in up to 80% of patients with Alzheimer disease. The cognitive dysfunction is associated with poorer ability in diabetes self-care and decreased adherence to antidiabetic treatment.

Specific diabetes education in children

J. Venháčová

Vnitr Lek 2012, 58(4):309-312  

Education is an integral part of diabetes care. The structured self-management education is the key to improve glycemic control, to reduce the risk of acute and long term complications and it is associated with improved quality of life. Type 1 is the most common type of diabetes in children and adolescents. Although the basic treatment principles are the same as in adults, the developmental characteristics during childhood need to apply age-appropriate, different teaching and learning techniques that should be adaptable to individual abilities, skills, needs and requirements of patients and parents, as well.

Interleukin-1 receptor blockade with anakinra provided cessation of fatigue, reduction in inflammation markers and regression of retroperitoneal fibrosis in a patient with Erdheim-Chester disease - case study and a review of literature

Z. Adam, P. Szturz, P. Bučková, I. Červinková, R. Koukalová, Z. Řehák, M. Krejčí, L. Pour, L. Zahradová, R. Hájek, Z. Král, J. Mayer

Vnitr Lek 2012, 58(4):313-318  

We describe a case of an Erdheim-Chester disease patient. First line chemotherapy treatment with 2-chlorodeoxyadenosine did not reduce fluorodeoxyglucose accumulation in pathological lesions. The patient had continuously increased CRP values of 17-20 mg/l. The disease continued to cause subfebrile temperatures and significant fatigue that made the patient to spend most of the daytime in bed. To manage the permanently increased inflammation markers, we decided to start treatment with anakinra, successfully used in some other autoinflammatory diseases (e.g. Schnitzler syndrome). We have now been able to evaluate the first 6 months of treatment. Daily...

Pervitin induced acute myocardial infarction

K. Salomonová, A. Hachová, H. Hrabáková, P. Kropáček, L. Lisa, V. Bufka

Vnitr Lek 2012, 58(4):319-321  

The case demonstrates how significant the effects of addictive drugs are for human organism, which may cause serious acute changes in the function of cardiovascular system and can end in permanent heart damage.

Hypergastrinaemia without detection of gastrinoma

Ľ. Cibičková, J. Janková, Ľ. Víchová

Vnitr Lek 2012, 58(4):322-324  

We present a case-report of a woman with persisting gastric ulcers, who had elevated gastrin blood levels. First of all, a rare cause of hypergastrinaemia was excluded - a gastrinoma. It was not found despite of extensive investigation. Ulcers were repetitively biopted and transition of high grade dysplasia to adenocarcinoma was detected. Gastrin levels normalised after surgical antrectomia. Afterwards pernicious anaemia was diagnosed as the underlining cause of hypergastrinaemia.

Acute copper poisoning by suicidal attempt

O. Hloch, J. Charvát

Vnitr Lek 2012, 58(4):325-328  

Voluntary copper poisoning is a rare mode of suicide. We report a case of patient admitted to Metabolic Intensive Care Unit who took fatal dose of copper oxichloride. In his clinical picture dominated gastrointestinal dicomfort with the profused diarrhoea leading to the excessive fluids loss exceeding 10 liters over 24 hours. The renal and liver damages typical for copper intoxication were prevented due to the early intensive treatment (2 hours after ingestion of copper oxichlorid) including the application of copper chelator Succicaptal.

Hidden cystic fibrosis in patient suffering from sarcoidosis

M. Doubková, I. Binková, J. Skřičková

Vnitr Lek 2012, 58(4):329-334  

We describe a case of an adult patient, whom sarcoidosis was diagnosed at first and cystic fibrosis was also discovered 2 years later on. Cystic fibrosis and sarcoidosis are uncommon diseases that only rarely occur together. On the other hand, the coincidence of sarcoidosis and cystic fibrosis is possible, and, moreover, one of the diseases can remain undiagnosed long time. Relationship between sarcoidosis and cystic fibrosis seems not to be probable, in accordance with recent medical reports, and the coincidence of both conditions appears as sporadic.

K významnému životnímu jubileu doc. MUDr. Jiří Neuwirtha, CSc. (Osobní zprávy)

prof. MUDr. Eva Topinková, CSc., Mgr. Eva Marková

Vnitr Lek 2012, 58(4)

Průvodce diagnostikou, diferenciální diagnostikou a léčbou pro praktické lékaře (Z odborné literatury)

prim. MUDr. Michaela Sosíková, Ph.D.

Vnitr Lek 2012, 58(4)

XXXI. dni mladých internistov s medzinárodnou účasťou. Martin, Slovenská republika, 24.-25. 5. 2012 (Abstrakta)

Vnitr Lek 2012, 58(4)