Výskyt agranulocytózy po tyreostaticích v kohortě pacientů s Gravesovou nemocí léčených radioaktivním jodem ¹³¹I v průběhu 14 let - editorial

Zdeňka Límanová

Vnitr Lek 2014, 60(10):815-816  

Czech TAVI Registry. Potrebujeme registre? - editorial

Viliam Fridrich

Vnitr Lek 2014, 60(10):817-818  

Léčba obezity u osob s diabetem 2. typu - editorial

Zdeněk Rušavý

Vnitr Lek 2014, 60(10):819-820  

Bortezomib-based therapy in patients with light chain deposition disease

Jiří Minařík, Tomáš Tichý, Tomáš Pika, Jaroslav Bačovský, Dagmar Adamová, Karel Srovnalík, Karel Krejčí, Josef Zadražil, Vlastimil Ščudla

Vnitr Lek 2014, 60(10):821-826  

Light chain deposition disease (LCDD) is a rare systemic condition caused by monoclonal proliferation of terminally differentiated B-lymphocytes with production of free light chains and their deposition in kidneys or other organs. The aim of our study is to show the pitfalls of the diagnostics, and to demonstrate the effect of bortezomib-based therapy on a series of 4 patients with LCDD, from the point of hematological and organ therapeutic response. We include that bortezomib based treatment provides rapid and effective hematological response. It is, however, often accompanied by adverse events, especially within intensive treatment schedules. The...

Infective endocarditis in Tabor district in years 2009-2013

Rudolf Koubek

Vnitr Lek 2014, 60(10):827-831  

Aim:To find out an average incidence of infective endocarditis (IE) in Tabor district in a monitored period of time and compare the obtained data with previously published national study. Methods:Retrospective monocentric observational study monitoring occurence and characteristics of infective endocarditis in a defined region in years 2009-2013. Only patients with proved and treated infective endocarditis and patients whose diagnosis was revealed by autopsy were involved. Results:In the monitored time 39 cases of infective endocarditis occured, which means that the average incidence was 7.8 cases on 100 000...

The occurrence of agranulocytosis due to antithyroid drugs in a cohort of patients with Graves' disease treated with radioactive iodine ¹³¹I during 14 years

Jitka Čepková, Filip Gabalec, Ioannis Svilias, Jiří Horáček

Vnitr Lek 2014, 60(10):832-836  

Introduction:Agranulocytosis is a serious complication of antithyroid drugs (ATD) treatment of thyrotoxicosis. The aim of our work was to assess the occurrence of agranulocytosis in Graves' disease (GD) patients admitted for radioactive iodine ¹³¹I (RAI) treatment to our thyroid unit. Patients and methods:We analyzed retrospectively a cohort of 603 GD patients (500 women and 103 men; mean age 51.5 ± 12.7 years) who received RAI between 1999 and 2012. Of them, 327 (54 %) patients were originally treated with carbimazole (CBZ), 215 (36 %) with methimazole (MMI) and 61 (10 %) with propylthiouracil (PTU). Results:Agranulocytosis...

Aktualizované stanovisko České společnosti pro hypertenzi k provádění renálních denervací u rezistentní hypertenze

Jan Filipovský, Václav Monhart, Jiří Widimský jr

Vnitr Lek 2014, 60(10):908-910  

The user's reporting from the national registry of catheter aortic valve implantations (Czech TAVI Registry): the possibilities of the analytical reports based on the database system TrialDB2

Milan Blaha, Petr Kala, Daniel Klimeš, Ivo Bernat, Marian Branny, Pavel Červinka, Jan Horák, Viktor Kočka, Martin Mates, Petr Němec, Ladislav Pešl, Roman Štípal, Josef Šťásek, Michael Želízko

Vnitr Lek 2014, 60(10):837-845  

Assessment of the treatment procedures and their results is increasingly important in current medicine. The emphasis is put on an effective use of the health technologies (HTA). Unlike randomised studies, which involve strictly selected groups of patients who meet inclusion and exclusion criterias, the multicentre clinical registries provide a real-life picture of the treatment safety and effectiveness. Well prepared registries involve both research database and a friendly user interface enabling collection of parametric and easily analyzable data. Although there are some technological aspects aiming to ensure a maximum quality of entered data, cooperation...

Therapeutic monitoring of vancomycin in routine clinical practice

Ivana Kacířová, Milan Grundmann

Vnitr Lek 2014, 60(10):846-851  

Therapeutic drug monitoring (TDM) is specific method of clinical pharmacology for monitoring of the therapy using measurement of drug serum concentrations followed interpretation and good cooperation with clinician. TDM help clinicians to quickly optimize vancomycin dosing regimens to maximize the clinical effect and minimize the toxicity of the drugs. Minimum serum vancomycin trough concentrations should always be maintained above 10 mg/L to avoid development of resistance, neverthelles trough concentrations > 20 mg/L are not recommended because of the risk of nephrotoxicity. For serious infections vancomycin trough concentrations of 15-20 mg/L...

Pulmonary hypertension - disease mechanisms

Martin Helán, Anna Konieczna, Martin Klabusay, Vladimír Šrámek

Vnitr Lek 2014, 60(10):852-858  

Pulmonary hypertension (PH) is known for its variable etiology. PH pathophysiology is very complex and our therapeutic options are limited. Most of known underlying disease mechanisms play a role across all etiological groups of PH, and they are followed by the same morphological and functional changes of pulmonary vasculature. Mostly, we are not able to determine whether one particular mechanism works as a cause or consequence in the chain of events. An imbalance between vasoconstriction and vasodilation becomes the major functional change of pulmonary vasculature in PH. The main morphological changes (termed together as "remodeling") include cell...

Monoclonal gammopathy of undetermined significance and asymptomatic multiple myelom in the year 2014

Zdeněk Adam, Marta Krejčí, Luděk Pour, Eva Ševčíková, Andrea Křivanová, Zdeněk Řehák, Renata Koukalová, Zdeňka Čermáková, Jiří Vaníček, Sabina Ševčíková

Vnitr Lek 2014, 60(10):861-879  

Presence of monoclonal immunoglobulin in serum or urine is a relatively common event affecting about 3.2 % of people over 50. Isolated increase of only one type of free light chain, either κ or λ, is detected in 0.7-0.8 % of people over 50. Most people with monoclonal immunoglobulin meet the criteria of the so-called "monoclonal gammopathy of undetermined significance (MGUS)". MGUS is defined by concentration of monoclonal immunoglobulin in serum < 30 g/l, number of plasma cells in the bone marrow < 10 % and the absence of symptoms of multiple myeloma and other lymphoproliferative diseases. A proportion of people with MGUS gradually...

The Association of atherothrombosis and thrombophilias - genetic aspects

Tomáš Kvasnička

Vnitr Lek 2014, 60(10):880-884  

Thrombosis in the arterial or venous vascular systems is preceded by a complex interplay between environmental and genetic factors, and it is the underlying cause of several common complex diseases. The genomewide association approach has proved successful in identifying loci associated with cardiovascular disease and related risk factors. However, much work remains to identifyning the culprit genes and causal variants as well as the mechanisms whereby they influence disease development and progression. In-depth studies of previously identified disease-associated loci are expected to improve our understanding of the pathophysiology of cardiovascular...

Optimal way of administration of high dose intravenous furosemide - continuous infusion or bolus?

Jana Gallusová, Milada Halačová, Dalibor Černý

Vnitr Lek 2014, 60(10):885-892  

Introduction:Furosemide is a loop diuretic used in states of volume overload. The need for high doses is due to its reduced efficacy caused by lower concentration of furosemide achieved at the site of action in the renal tubule lumen and adaptation mechanisms. High doses have been associated with the development of ionic dysbalance, direct toxicity and intravascular volume fluctuations. The way of furosemide administration (intermitent versus continuously) to influence efficacy and safety is contradictory evaluated in EBM. Aim:The aim of this study is to analyze the available data for evaluation of the efficacy and safety...

Gout and cardiovascular risk

Petr Němec

Vnitr Lek 2014, 60(10):893-901  

Gout represents a heterogeneous group of metabolic disorders characterized by production and deposition of sodium urate crystals in various tissues. The consequence of this deposition in musculoskeletal system causes gouty arthritis often presented by acute recurrent attack and development of chronic tophi. The most important risk factor is hyperuricemia which means higher level of acid uric in blood. Gout or hyperuricemia alone represents significant independent risk factor of all-cause and cardiovascular morbidity and mortality. Many patients with hyperuricemia and gout have risk factors typical for metabolic syndrome or suffer from other diseases....

How are changing the therapy options in obese diabetic type 2 patients

Štěpán Svačina

Vnitr Lek 2014, 60(10):902-907  

Classical consequence of treatment with anti-diabetic agents, including insulin, is weight gain which enhances insulin resistance and leads to a further increase in drug dose. This creates an unwanted cycle. Administration of weight neutral anti-diabetic drugs has broken this scenario. Another option is to use anti-obesity agents, but actually many of them are not available. However, in the United States, two new drugs have been used in past two years. The most important change in the treatment of obese type 2 diabetes patients is administration of anti-diabetic agents that reduce weight. These agents are well-known incretin analogs characterized by...

Jiří Gallo. Osteoartróza. Průvodce pro každodenní praxi

Pavel Horák

Vnitr Lek 2014, 60(10):911