Endokrinní disruptory - neviditelná hrozba - editorial

B. Bendlová

Vnitr Lek 2013, 59(5):334-336  

Koncept spondyloartritid - editorial

K. Pavelka

Vnitr Lek 2013, 59(5):337-340  

Maligní nádory srdce - editorial

P. Gregor

Vnitr Lek 2013, 59(5):342-343  

Distribution of Lipoprotein-Associated Phospholipase A2 in Czech Population and its interaction with conventional cardiovascular risk

O. Mayer jr., J. Seidlerová, P. Wohlfart, L. Trefil, J. Bruthans, J. Filipovský, R. Cífková

Vnitr Lek 2013, 59(5):344-351  

Introduction:Lipoprotein-associated phospholipase A2 (Lp-PLA₂) represent new cardiovascular risk factor and potential treatment target. We aimed to analyze the epidemiological situation of this factor in Czech population. Methods and Results:The study population consisted from 1 962 subjects, a random samples of general population (postMONICA study), and from patients with manifest coronary or cerebrovascular disease (Czech samples of EUROASPIRE III survey). Lp-PLA₂ activity was estimated using commercial kits by diaDexus Inc. in frozen samples. Increased activity (by definition, i.e. > 195 nmol/min/ml)...

Possible influence of genetic polymorphism in the area of GSTs genes on the serum PCB level

M. Tajtáková, A. Pidaničová, M. Kmeťová-Sivoňová, A. Kočan, B. Drobná, M. Javorský

Vnitr Lek 2013, 59(5):352-356  

Objective:To find out whether the serum PCB level depends on genetic polymorphism in the area of GSTs genes. Material and methods:In the group of 147 men (112 with an average age of 59.1 ± 10.1 and serum PCB level > 1,000 ng/g lipid - PCB1, and 35 with an average age of 56.2 ± 12.9 and serum PCB level < 700 ng/g lipid - PCB2), the PCR-RLFP analysis of DNA was used to determine the genetic polymorphism in the area of GSTs genes. Results:As regards PCB, an association was found between serum PCB concentrations and the null genotype of GSTT1 gene. Men above the median PCB levels displayed, with...

Comparison of MRCP a ERCP in Diagnosis of Choledocholithiasis

J. Vaníček, H. Kyselová, B. Kianička, R. Mikulicová, B. Bajgarová, J. Trna, M. Souček, I. Řiháček, J. Špác

Vnitr Lek 2013, 59(5):357-360  

Introduction:Choledocholithiasis is the most common cause of biliary obstruction. Each of the testing methods used in its diagnosis has its advantages and disadvantages. Objective of the study:The objective of this prospective study is to compare endoscopic retrograde cholangiopancreatography with magnetic resonance cholangiopancreatography in the diagnosis of choledocholithiasis on the basis of own experience and literature data. Set of patients and methodology:The set was studied from the beginning of 2007 to the end of 2012 (i.e. six years). The study assessed prospectively 45 patients (age range 28-72 years)...

The arrhytmias in patients with diabetes mellitus

M. Migra, F. Kovář, M. Mokáň

Vnitr Lek 2013, 59(5):361-365  

Cardiovascular disorders are the most common reason of morbidity and mortality worldwide. The prevalence of diabetes mellitus, which is strongly associated with cardiac and cerebrovascular events, is increasing during the last decades. Based on the results of clinical studies we summarize in the review article the risk factors and patomechanisms connecting diabetes mellitus to incidence of arrhythmias and sudden cardiac death. The paper analyzes influence of diabetes mellitus on atrial fibrillation and arrhythmogenic effect of antidiabetic drugs.

Combined therapy of arterial hypertension

H. Rosolová

Vnitr Lek 2013, 59(5):366-369  

For a successful treatment of arterial hypertension, in most patients it is necessary to prescribe at least two antihypertensive medicines. A well chosen fixed combination of antihypertensives improves lifelong compliance with treatment, another important approach to improving treatment compliance being regular education of the patient regarding the appropriateness of regular medicine taking in relation to the risks of untreated hypertension. Currently, when initiating treatment of uncomplicated hypertension, the combination of diuretics with beta-blockers is being abandoned, especially for their metabolic adverse effects. The most frequent combination...

Prevention of sudden death during sport activity in view of new recommendations

E. Sovová

Vnitr Lek 2013, 59(5):370-375  

The study deals with the prevention of sudden death in sportsmen. It analyzes the influence of ECG examination on reducing the risk of sudden death. It presents new recommendations for ECG assessment in sportsmen and a new algorithm for examination of middle-aged and senior subjects.

Gluten induced diseases

P. Frič, M. Zavoral, T. Dvořáková

Vnitr Lek 2013, 59(5):376-382  

The introduction of cereals in human nutrition 10 000 years ago caused the occurrence of gluten induced diseases. This protein complex is involved in pathogenesis of wheat allergy, celiac disease, and gluten sensitivity. Wheat allergy and celiac disease are mediated by the system of adaptive immunity. Gluten sensitivity is a recently defined entity induced by innate immune mechanisms. These subjects present various intestinal and particularly extraintestinal symptoms. The differences between celiac disease and gluten intolerance include permeability of the intestinal mucosal barrier, histology of duodenal biopsy, and mucosal gene expression. The symptoms...

Spondyloarthritides: Current Perspective on Diagnosis and Classification

L. Procházková, P. Němec, M. Souček

Vnitr Lek 2013, 59(5):383-390  

Spondyloarthritides (SpA) are a heterogeneous group of chronic inflammatory diseases with common clinical features and genetic basis. They primarily affect the axial skeleton, especially the sacroiliac joint, other localizations of the affection being peripheral joints and entheses - typical of the group of spondyloarthritides. On the basis of the predominant affection of the axial or peripheral skeleton, they can be divided, according to the current classification criteria, into axial SpA and peripheral SpA. Apart from axial and peripheral articular manifestations, many patients also display extra-articular manifestations, which can thus become an...

Diastolic dysfunction in the elderly subjects. Disease or a physiological manifestation of ageing?

J. Meluzín, H. Podroužková, Z. Gregorová, R. Panovský

Vnitr Lek 2013, 59(5):392-396  

Aim:The purpose of this summary paper is to discuss the current knowledge of the impact of age on diastolic function of the left ventricle. Data from the literature:Reports published till this time have convincingly demonstrated a significant relationship of age to diastolic function of the left ventricle. Ageing is a physiological process accompanied by structural changes in both myocardium and arterial bed resulting in worsening of parameters characterizing the left ventricular diastolic function. This "physiological" diastolic dysfunction in the elderly subjects can be explained by the deterioration of passive left ventricular...

A fixed dose combination of telmisartan, and a thiazide diuretic in the treatment of hypertension

J. Vítovec, J. Slíva

Vnitr Lek 2013, 59(5):397-401  

The article gives an overview of the risk factors for hypertension and the appropriate indication for using a fixed combination of telmisartan and hydrochlorothiazide. It cites large, multi-centre clinical trials that demonstrate the efficacy and safety of telmisartan in patients with hypertension and also a meta-analysis of treatment with either telmisartan alone (TELMI) or in combination with hydrochlorothiazide (HCTZ) which shows that it is a very well tolerated and safe treatment for patients across a wide age range.

Paraneoplastic hypoglyacemia

I. Ságová, A. Klimentová, D. Prídavková, D. Kantárová, J. Sadloňová, P. Galajda, M. Mokáň

Vnitr Lek 2013, 59(5):402-406  

Paraneoplastic hypoglyacemia (PH) is a relatively rare phenomenon, which may be caused by insulinomas or non-islet cell tumours (NICT). Both types are among the major "fasting" hypoglyacemia as opposed to reactive postprandial hypoglyacemia. The most common group of non-islet cell tumours causing hypoaglycemia are large mesenchymal tumours, which account for over 50 % of all neoplasms associated with hypoglyacemia. Neuroglycopenic symptoms in patients with NICT may be present for months or years before the actual diagnosis of the underlying disease. Differentiation and correct diagnosis of this type of disease leads to significant improvement in the...

Acute coronary syndrome imitated by malignant melanoma or real acute coronary syndrome?

L. Gužiková, N. Hučková, M. Čaprnda, M. Bendžala, P. Babál, H. Mrázová

Vnitr Lek 2013, 59(5):407-411  

The article describes the case of 67-year-old woman, hospitalized at our department due to history of syncopes. At the time of admission the patient complained of back pain in the area of exophytic growing tumour. During the diagnostic process routine laboratory tests revealed severe normocytic hypochromic anemia, hypoproteinemia, elevation of inflammatory parameters (leukocytes, C-reactive protein) and imaging methods (ultrasonography, computer-aided tomography) helped to formulate suspicion of disseminated cancerous disease (metastases in spleen, skeleton and lymph nodes). Patient was subsequently operated at the surgical ward, where she had removed...

Spondylodiscitis and epidural empyema as a complication of diabetic foot

D. Čechurová, S. Lacigová, M. Žourek, J. Gruberová, I. Haladová, J. Tomešová, Z. Rušavý

Vnitr Lek 2013, 59(5):412-415  

Spinal column infection (vertebral osteomyelitis, discitis, epidural empyema/abscess) is a rare condition, albeit its incidence has been increasing in recent years. Staphylococcus aureus is the most frequent pathogen. The routes of infection are predominantly hematogenous. Any delay in making correct diagnosis increases risk of adverse outcome of the patient. The authors present 3 case reports of patients with diabetic foot syndrome, who were diagnosed with spondylodicitis in the period of 2009-2012, two patients had associated epidural empyema. Apart of a chronic neuropathic foot wound, the patients reported severe or deteriorated dorsal pain...