Strategie dávkování antibiotik u kriticky nemocných s potřebou náhrady funkce ledvin - maximální účinnost při minimální toxicitě! - editorial

J. Raděj, M. Matějovič

Vnitr Lek 2012, 58(6):427-429  

Deficits in lipid lowering therapy and achieving target lipid concentrations in patients with high risk of a cardiovascular event

J. Petrus, F. Málek, J. Dvořák, M. Mates, P. Kmoníček, V. Skalníková, P. Neužil

Vnitr Lek 2012, 58(6):430-433  

Lipid concentrations were analysed in 529 consecutive patients, 190 females (34%) and 339 males (66%) with mean age 66 years, at high cardiovascular risk, undergoing elective coronary angiography between 1st January and 31st May 2010. LDL-cholesterol level < 2,5 mmol/l was identified only in 36% of patients in primary prevention, LDL-cholesterol level < 2,0 mmol/l was identified only in 28% of subjects in secondary prevention of cardiovascular events. The study proves inadequate control of dyslipidaemia in patients at high cardiovascular risk.

Catheter ablation of atrio-ventricular accessory pathways in the era of ablation therapy of complex arrhythmias: a changing perspective for oncoming generation of electrophysiologists

M. Fiala, J. Chovančík, D. Wojnarová, H. Szymeczek, J. Pindor, V. Bulková, R. Neuwirth, O. Jiravský, D. Vavřík, Š. Krawiec, J. Januška

Vnitr Lek 2012, 58(6):434-438  

Introduction:Catheter ablation of atrio-ventricular accessory pathways has become a routine treatment method. However, its perspective has been changing in the era of ablation of complex arrhythmias. This study was aimed at evaluating accessory pathways ablation efficacy within the last nine years at one center. Methods:From February 2002 to June 2011, catheter ablation of accessory pathways was performed in 247 patients (100 females, 42 ± 16 years). Elimination of accessory pathways conduction in both directions was the procedure endpoint. Results:Immediate accessory pathways conduction elimination at...

Disturbances of hemostasis in sepsis

J. Novotný, M. Penka

Vnitr Lek 2012, 58(6):439-447  

Immune system and hemostasis are closely bound together. When one of these systems is activated, another is set in motion too. This is especially noticeable in polytraumas, inflammation, shocks etc. The most important activator of immune system and hemostasis is sepsis. In sepsis there is a vigorous stimulation of immune response because of a liberation of a lot of cytokines and proinflammatory molecules. This may lead to an extrem picture of systemic inflammatory response syndrome. In systemic inflammatory response syndrome a downregulation of thrombomodulin and endothelial protein C receptor on the surface of intact endothel may be detected and there...

An effect of continuous and intermittent renal replacement therapy on antibiotic treatment in critically ill patients with sepsis - a practice-based perspective of vancomycin and gentamycin therapies

N. Petejová, A. Martínek, J. Zahálková, J. Ďuricová, J. Plášek, I. Valkovský, M. Grundmann, I. Kacířová

Vnitr Lek 2012, 58(6):448-454  

Sepsis and septic shock are common cause of hospitalisation in intensive care unit. Acute kidney injury is an accompanying manifestation of sepsis/septic shock leading to worsening of morbidity and also mortality and requiring use of intermittent or continual renal replacement therapy. Life saving effect is attributed to early and effective antibiotic therapy. Therapeutic drug monitoring and dosage adjustment is important for successful treatment. Despite therapeutic drug monitoring of both antibiotic agents vankomycin and gentamicin the treatment still rises many questions about the convenient use in septic patients due to their nephrotoxicity.

Cladribine is highly effective in the treatment of Langerhans cell histiocytosis and rare histiocytic disorders of the juvenile xanthogranuloma group

Z. Adam, P. Szturz, L. Pour, M. Krejčí, L. Zahradová, M. Tomíška, Z. Král, R. Koukalová, Z. Řehák, J. Mayer

Vnitr Lek 2012, 58(6):455-465  

Cladribine (2-chlorodeoxyadenosine) is metabolised and phosphorylated in a cell up to 2-chloroadenosine triphosphate which is the actual effective form of the drug. The greatest accumulation of 2-chloroadenosine triphosphate is in the most active cells, where activating (phosphorylation) enzyme, deoxycytidine kinase, has the highest activity, whereas inactivating enzyme (dephosphorylation), cytoplasmic 5-nucleotidase, has the lowest activity. A very good ratio of the both enzymes for high effectiveness of cladribine is in resting and proliferating lymphocytes. Therefore, cladribine is an effective medication for hairy cell leukemia, Waldenström macroglobulinemia...

Oxidative stress in patients on regular hemodialysis and peritoneal dialysis

J. Vostálová, A. Galandáková, P. Štrebl, J. Zadražil

Vnitr Lek 2012, 58(6):466-472  

Hemodialysis and peritoneal dialysis are methods of blood purification, which partially replaced excretory renal function in patients with chronic renal failure, which was depleted regime, dietary and pharmaco-therapeutic remedy, and who are not eligible for kidney transplantation. Both two methods are accompanied by increased oxidative stress. In peritoneal dialysis particularly the composition of dialysis solution contributes to oxidative stress. In extracorporeal hemodialysis the oxidative stress is associated with the character of hemodialysis membranes, non-specific loss of low molecular weight antioxidants, activation of leukocytes (oxidative...

Cardiac symptoms in a patient with Addison's disease and hypothyreosis on the basis of autoimmune polyglandular syndrome type II

A. Hachová, L. Brunerová, P. Gregor

Vnitr Lek 2012, 58(6):473-476  

In many endocrine diseases we can find a heart disorder. We present a case of a young patient aged 34 years, who was examined for non-specific ST-T abnormalities on ECG and a new-diagnosed left ventricle dysfunction with suspicion to the acute coronary syndroma. However, this diagnosis wasn't verified. Endocrinological examination detected the Addison's disease and a severe hypothyreosis. After the hormonal substitution therapy was given, the patient became asymptomatic and the ECG- and echocardiographic changes disappeared.

Teleangiectasia hereditaria haemorrhagica -Osler-Weber-Rendu syndrome. Case study and treatment experience

Z. Adam, G. Chlupová, A. Neumann, B. Jakubcová, J. Simonides, Z. Adamová, J. König, P. Krupa, P. Szturz, L. Pour, M. Krejčí, R. Hájek, Z. Král, J. Mayer

Vnitr Lek 2012, 58(6):477-489  

Hereditary haemorrhagic telangiectasy is an inborn disease with autosomal dominant transmission. Nose bleeding usually occurs during the 2nd decade of life as the first sign of the disease. Later, during the 3rd or 4th decade of life, typical subtle, pinhead-sized (1-2 mm in diameter) vascular arteriovenous malformations occur. These are usually found on the oral mucosa and in the stomach and small intestine. During later stages of the disease, nose as well as gastrointestinal bleeding causes severe anaemia requiring transfusions. Advanced stages of hereditary hemorrhagic telangiectasy are associated with a development of ateriovenous vascular malformations...

The viewpoint of an internal medicine at the issue of an aortoenteric fistula

I. Šturdík, T. Koller, V. Šišovský, Ľ. Danihel, J. Payer

Vnitr Lek 2012, 58(6):490-493  

Aortoenteric fistula is an uncommon life-threatening disease; it can be divided into primary and secondary one. Primary aortoenteric fistula is the result of ongoing disease in the aorta and the intestine, secondary one is iatrogenic. Typical symptoms are abdominal pain and gastrointestinal bleeding (two-stage process). The most appropriate diagnostic method is CT aortography, treatment is only surgical. 75-year-old patient was admitted to the 5th Department of Internal Medicine in Bratislava due to progression of renal parameters, the patient had undergone an aortofemoral bypass 4 years ago. During the fourth day of his hospitalization the patient...

Recurrent prosthetic endocarditis in a 21-year old patient with renal transplantation treated with allogeneic homograft

F. Sabol, M. Jakubová, A. Kolesár, B. Stančák, M. Beňa, J. Podracký, Ľ. Podracká, P. Čadník, J. Špatenka

Vnitr Lek 2012, 58(6):494-498  

Prosthetic infective endocarditis is a possible complication of implantation of a prosthetic cardiac valve. Without early and effective treatment, it can have fatal consequences. One treatment option is use of an allogeneic cryopreserved homograft. This case report presents a 21-year old patient after kidney transplantation due to hereditary nephrotic syndrome and aortic valve replacement with aortic conduits. After fever was noted in the patient, prosthetic infective endocarditis was diagnosed by echocardiography and also confirmed by CT-3D examination. The cryopreserved aortic homograft was implanted at the Department of Cardiac Surgery. This along...

Zpráva ze sympózia společnosti Abbott Laboratories na kongresu ČNS konaného dne 15. 6. 2012

Vladimír Tesař

Vnitr Lek 2012, 58(6):499  

Vliv aktivace receptoru pro vitamin D na albuminurii

Ivan Rychlík

Vnitr Lek 2012, 58(6):500  

Hrudní drenáže ...krok za krokem (Z odborné literatury)

MUDr. Anna Hrazdirová

Vnitr Lek 2012, 58(6)

Loketní kloub ortopedie a traumatologie. 2. rozšířené vydání (Z odborné literatury)

Jiří Vokurka

Vnitr Lek 2012, 58(6)