Rifaximin v léčbě chronické divertikulózy

Martin Vaněk

Vnitr Lek 2013, 59(7):643-644  

K životnímu jubileu prof. MUDr. Marie Brodanové, DrSc.

Karel Horký

Vnitr Lek 2013, 59(7):544-545  

Flavonoidy vážně i nevážně

Kristína Čilíková

Vnitr Lek 2013, 59(7):645-646  

K významnému životnímu jubileu prof. MUDr. Marie Brodanové, DrSc.,

Vnitr Lek 2013, 59(7):543  

Liver disorders in diabetic patients

R. Brůha, K. Dvořák, J. Petrtýl

Vnitr Lek 2013, 59(7):546-550  

There is a mutual relationship between diabetes and liver disorders. Diabetic patients suffer from liver disorders more frequently and, vice versa, patients with liver disorders are at a higher risk of developing diabetes. Diabetes is probably the most common cause of chronic liver disorders in developed countries. Liver disorders related to diabetes include a wide spectrum of conditions, from a simple steatosis related to a slight elevation of liver tests through non-alcoholic steatohepatitis with various degrees of fibrosis up to cirrhosis, hepatocellular carcinoma and acute liver failure. Non-alcoholic liver steatosis is the most common pathological...

Effects of GLP-1 (glucagon-like peptide-1) on liver

J. Fontana, Z. Červinková, M. Anděl

Vnitr Lek 2013, 59(7):551-558  

Effects of glucagon-like peptide 1 (GLP-1) on liver cells are very intensively studied. In the metabolism of saccharides GLP-1 stimulates synthesis of glycogen and reduces glucose production - thus acting like insulin. In the lipid metabolism it enhances fatty acid oxidation and lipid transport from hepatocytes while reducing de novo lipogenesis - effects more similar to glucagon action. Some studies suggest beneficial effects of GLP-1 on oxidative stress, endoplasmic reticulum stress, production of inflammatory mediators and dysfunction of biliary secretion. Current results suggest that drugs affecting incretin system could be used in the treatment...

Digestive tract polyposes

V. Jirásek

Vnitr Lek 2013, 59(7):559-565  

The article provides an overview of hereditary polyposis syndromes of the digestive tract and genetic mechanisms in greater detail. A brief summary of the basic symptoms of the condition, including extra-gastrointestinal signs, is given. Significant diagnostic procedures are listed. The therapy for these disease conditions is either operative or endoscopic.

Neonatal hyperbilirubinemia and molecular mechanisms of jaundice

M. Jirsa, E. Sticová

Vnitr Lek 2013, 59(7):566-571  

The introductory summarises the classical path of heme degradation and classification of jaundice. Subsequently, a description of neonatal types of jaundice is given, known as Crigler-Najjar, Gilbert's, Dubin-Johnson and Rotor syndromes, emphasising the explanation of the molecular mechanisms of these metabolic disorders. Special attention is given to a recently discovered molecular mechanism of the Rotor syndrome. The mechanism is based on the inability of the liver to retrospectively uptake the conjugated bilirubin fraction primarily excreted into the blood, not bile. A reduced ability of the liver to uptake the conjugated bilirubin contributes to...

Cystic tumors of the pancreas - our experience with diagnostics

T. Krechler, J. Ulrych, M. Dvořák, D. Hoskovec, J. Macášek, T. Švestka, J. Hořejš

Vnitr Lek 2013, 59(7):572-577  

Number of newly diagnosed cystic pancreatic tumors is permanently increasing. This fact is primarily related to the development of new diagnostic methods. The main representative ones are: serous cystadenoma, mucinous cystic neoplasm, intraductal papillary mucinous neoplasm and solid pseudopapillar tumor. Because of the malignant potential of these lesions, proper indication of surgical treatment is extremely important. The article highlights and describes our experience in diagnostics and therapy of cystic pancreatic tumors diagnosed in the General Teaching Hospital Prague in the period: 1/2008-12/2012. All patients were investigated by computerised...

Wilson's disease

Z. Mareček, R. Brůha

Vnitr Lek 2013, 59(7):578-583  

Wilson's disease is an autosomal recessive genetic disorder in which copper accumulates in tissues, especially in the liver and the brain. The genetic defect affects the P type ATPase gene (ATP7B). More than 500 mutations causing Wilson's disease have been described. The most common mutation in Central Europe concerns H1069Q. The symptoms of Wilson's disease include hepatic or neurological conditions. The hepatic condition is manifested as steatosis, acute or chronic hepatitis or cirrhosis. The neurological conditions are most often manifested after the age of 20 as motor disorders (tremor, speech and writing disorders), which may result in severe...

Effect of liver cirrhosis on pharmacokinetics and pharmacodynamics of drugs

F. Perlík

Vnitr Lek 2013, 59(7):584-586  

Metabolic liver functions are significantly involved in the total clearance of a number of drugs. In liver cirrhosis the reduced drug elimination is a result of the blood flow through the liver, hepatocytes function and volume of hepatic tissue. Pharmacokinetic and pharmacodynamic changes depend on the nature and degree of hepatic impairment and on the characteristics of the dosed drug. Hepatocytes have a different extraction ability with respect to the individual drugs. The following are examples of drugs with high hepatic extraction: anodyne, propranolol, metoprolol, verapamil and lidocaine. These drugs are significantly dependent on the first passage...

Hepatic vein catheterisation - selected assessment aspects

J. Petrtýl, R. Brůha, P. Urbánek, Z. Mareček, M. Kaláb

Vnitr Lek 2013, 59(7):587-590  

Introduction:Hepatic vein catheterisation and portal hypertension assessment using the value of portal hepatic gradient (HVPG) is currently a method of choice. Methodology:In our paper we shall compare HVPG with the so-called direct gradient - using the difference in pressure in the portal vein and free hepatic vein in 5 groups of patients with liver cirrhosis. Results:Hepatic vein catheterisation is reliable for assessing the portal hypertension in the group of patients with liver cirrhosis of ethylic etiology. In patients with liver cirrhosis resulting from hepatitis B, Wilson's disease or primary biliary...

Reactivation of chronic hepatitis B

J. Šperl

Vnitr Lek 2013, 59(7):591-596  

Hepatitis B (HBV) is a DNA virus, which cannot be eradicated completely from the organism by treatment, only its replication can be suppressed to low levels. The pathogenesis of liver damage due to HBV is immune-mediated, the infected hepatocytes represent the target structures of immune reaction. In individuals who spontaneously achieved the state of inactive carriage of the virus or even achieved HBsAg negativity, we deal only with immune control of viral replication. Chemotherapy or immunosuppressive treatment disrupt the immune control of HBV infection, the virus replication substantially increases and hepatitis B reactivates. HBV reactivation...

Acute pancreatitis - new developments in treatment

J. Špičák

Vnitr Lek 2013, 59(7):597-605  

Acute pancreatitis continues to be a potentially very severe disease. According to new classification schemes, a severe pancreatitis (up to 20%) is conditioned by structural changes and organ failures. The first critical moment concerns a fast development of pancreatic necrosis, followed by delayed infection. The most common complications of pancreatitis include infections, bleeding, compartment syndrome and decompensation of comorbidities. At the early stage the most important measure concerns the active expansion of blood volume and treatment of organ dysfunction. General antibiotic prophylaxis has been rejected; it is indicated only if there are...

Hepatic involvement in patients with non-Hodgkin's lymphoma

M. Trněný, J. Šálková, J. Dlouhá, J. Stříteský

Vnitr Lek 2013, 59(7):606-611  

Non-Hodgkin's lymphoma (NHL) represent the most frequent hematological malignancy with frequent extranodal involvement. We have identified 79 pts (4.6%) out of 1,712 patients with NHL, who were diagnosed in our center between 1999-2010. Five cases were primary extranodal lymphomas and we have observed one primary hepatic lymphoma (0.015%). The most frequent (61.3%) NHL subtype in our cohort was diffuse large B-cell lymphoma. B-NHL formed 92.4% of all lymphomas. We have observed high number of HBsAg positive patients (10%). The whole group have poor prognostic features with high number of patients (85%) with intermediate-high and high risk according...

Treatment of chronic hepatitis C virus infection at the beginning of a new era

P. Urbánek

Vnitr Lek 2013, 59(7):612-617  

After 2010 the therapy of chronic HCV infection entered a completely new era - the era that is marked with the gradual introduction of the so-called directly acting antivirals into treatment schemes of this serious disease. The term directly acting antivirals (DAA) covers low-molecular substances that inhibit viral non-structural proteins - enzymes involved in the HCV replication cycle. At present, the first 2 representatives of DAA, Boceprevir and Telaprevir, have been approved for chronic HCV infection indication. The synoptic article pays the greatest attention to these 2 representatives, along with mentioning some other substances that are under...

Relationship of bilirubin to diseases caused by increased oxidative stress

L. Vítek

Vnitr Lek 2013, 59(7):618-621  

Oxidative stress contributes importantly to pathogenesis of numerous civilization diseases, including cardiovascular diseases, cancer, as well as autoimmune and neurodegenerative conditions. Bilirubin is the major product of the heme catabolic pathway in the intravascular compartment. For long time, bilirubin was considered to be only a waste product, however, recent data from the last 2 decades have proved its important antioxidant properties, which contributes to defense against increased oxidative stress. Numerous experimental as well as clinical studies have demonstrated association between low bilirubin concentrations and cardiovascular diseases,...

Pokroky v onkohematologii v 21. století

R. Neuwirtová, H. Klamová, I. Špička, K. Benešová, P. Obrtlíková, A. Jonášová

Vnitr Lek 2013, 59(7):622-623  

Tyrosine kinase inhibitors - major change in the prognosis of chronic myeloid leukaemia

H. Klamová

Vnitr Lek 2013, 59(7):624-626  

Chronic myeloid leukaemia (CML) is an example of a tumour disease, in which the discovery of its molecular principle resulted in the development of the specific targeted molecular treatment with the first representative being imatinib. The introduction of other tyrosine kinase inhibitors, nilotinib and dasatinib, into the clinical practice meant not only a revolutionary change in the treatment approach to CML but literally an epochal improvement of the prognosis and quality of life. The disease with an originally fatal prognosis in patients diagnosed in the chronic stage has changed into a disease with the expected survival rate median estimated to...

Multiple myeloma

I. Špička, M. Klánová

Vnitr Lek 2013, 59(7):627-630  

Multiple myeloma is one of the most common hematological malignancies with increasing prevalence. Not until the introduction of 1 or 2 cycles of high-dose therapy with the support of hematopoietic cells meant a certain progress in the prognosis of patients. The radical change in the therapy efficiency was not made possible until the so-called new or targeting drugs - thalidomide, bortezomib and lenalidomide. The 2 latter preparations have particularly changed the approach to the disease itself from one of the least prognostically favourable hematological tumours to a long-term controllable malignancy with a potential to treat at least some of the patients....

Advances in the treatment of chronic lymphocytic leukaemia

P. Obrtlíková, M. Trněný

Vnitr Lek 2013, 59(7):632-634  

Chronic lymphocytic leukemia (CLL) is the most common forms of leukemia in the western world and is characterized by a highly variable clinical course. Some patients live for many years without treatment, whereas other have disease with rapid progression. The treatment of chronic lymphocytic leukemia has achieved extraordinary progress over the last years with the incorporation of monoclonal antibodies and combined chemoimmunotherapy. Despite these therapeutic successes, CLL is still considered to be an incurable disease. Only the allogenic transplantation is potentially curative but it is feasible only for selected group of younger patients without...

Myelodysplastic syndromes - therapy progress over the last two decades

A. Jonášová

Vnitr Lek 2013, 59(7):635-640  

Myelodysplastic syndrome is one of the most common hematology diseases in the age over the 60. Until recently the therapy of this disease was frustrating and often based only on supportive care. The last decade witnessed the emergence of promising drugs that represent a major breakthrough in the therapy and interest of decoding of the pathogenesis of this disease. In our work we summarize the evolution of MDS therapy with accent on the new drugs contribution.

Perorální antidiabetika, průvodce ošetřujícího lékaře (Z odborné literatury)

MUDr. Jana Pecová

Vnitr Lek 2013, 59(7)

Diabetes mellitus a doplňky stravy. Průvodce pro každodenní praxi (Z odborné literatury)

MUDr. Jana Pecová

Vnitr Lek 2013, 59(7)

Diabetes mellitus a mozek. Průvodce pro každodenní praxi (Z odborné literatury)

MUDr. Jana Pecová

Vnitr Lek 2013, 59(7)