Erdheim-Chester disease - the rare and under-diagnosed disease - editorial

Martin Mistrík

Vnitr Lek 2014, 60(5-6):410-411  

Closed pleural biopsy in the diagnostics of malignant pleural involvement - editorial

Jana Skřičková

Vnitr Lek 2014, 60(5-6):412-413  

Impact of natriuretic peptides in current clinical practice - editorial

F. Málek

Vnitr Lek 2014, 60(5-6):414  

Sentinel biopsy, a short outline - editorial

Vuk Fait

Vnitr Lek 2014, 60(5-6):415-416  

Adherence to the guidelines for treatment of mild biliary acute pancreatitis in the setting of tertiary center in the Czech Republic

Oldřich Stibůrek, Jan Trna, Michal Šenkyřík, Vladimír Procházka, Zdeněk Kala, Aleš Hep

Vnitr Lek 2014, 60(5-6):417-422  

Introduction:Cholecystectomy (CCX) represents the crucial procedure in preventing relapses of biliary acute pancreatitis (BAP). Endoscopic papilosphincterotomy (EPST) represent an acceptable alternative in patients unsuitable for surgery. Current guidelines recommend patients with mild BAP to undergo CCX in 2 maximally 4 weeks following discharge from the hospital, ideally during the same hospital stay. Adherence to the guidelines differs significantly between particular countries and institutions. Aim:To evaluate adherence to the guidelines of BAP management in conditions of tertiary hospital in the Czech Republic. Methods:Retrospective...

Closed pleural biopsy in the diagnostics of malignant pleural involvement

Petr Jakubec, Vítězslav Kolek, Aleš Václavík, Jaromír Zatloukal, Stanislav Losse, Ladislava Kučerová, Tomáš Tichý, Kateřina Musilová

Vnitr Lek 2014, 60(5-6):423-430  

Introduction:Pleural effusion is a frequent reason for a pulmonologist's investigation. The cornerstone is to distinguish transudative pleural effusion from exudative pleural effusion. In the case of the exudative pleural effusion the next step is detection of malignant etiology of pleural effusion. We have a variety of any non-invasive or invasive examinations. The pleural biopsy is one of the most important methods for diagnostics of malignant pleural effusion. Material and methods:Two hundred and twenty-two closed pleural biopsies (CPB) were performed in 208 patients with pleural effusion, where the cytologic examination...

Význam EKG u pacientov s resynchronizačnou liečbou

Pavol Murín, Peter Mitro, Gabriel Valočik, Peter Spurný, Branislav Stančák

Vnitr Lek 2014, 60(5-6):431-436  

Background:Cardiac resynchronization therapy (CRT) improves symptoms and survival in patients with chronic heart failure. The presence of electrocardiographic (ECG) signs of electrical dyssynchrony during ventricular contractions are an essential criterion for the implantation of CRT. Nevertheless, 1/3 proportion of patients who undergo CRT do not seem to respond favorably. Aim of study was to investigate the relevant ECG parameters prior to CRT (as well as their postimplantation changes) and to determine their relation to predicting favorable response to CRT. Methods:52 symptomatic patients (age 62.2 ± 10.5 years,...

Management of angioedema. Guidelines of the Angiology Section of Slovak Medical Chamber (2013)

Peter Gavorník, Ľudovít Gašpar, Andrej Dukát

Vnitr Lek 2014, 60(5-6):490-498  

Angioedema is defined as a vascular reaction of the deep dermis/mucous and/or subcutaneous/submucosal tissues with localized vasodilatation and increased permeability of blood vessels resulting in tissue swelling. Angioedema can be mediated by bradykinin or mast cell mediators including histamine. Bradykinin-mediated angioedema can occur either on a hereditary (HAE) or acquired (AAE) basis, due to a deficiency/defect of C1 inhibitor (C1-INH) or not. Three forms of HAE have been defined: HAE due to C1-INH deficiency (type 1 HAE, HAE-1), characterized by low antigenic and functional C1-INH levels; HAE due to C1-INH dysfunction (type 2 HAE, HAE-2), characterized...

Heart failure - can be treated by affecting cardiac metabolism?

Ján Murín, Miroslav Pernický, Soňa Kiňová

Vnitr Lek 2014, 60(5-6):437-441  

Chronic heart failure is a disease of epidemic extent and has a high mortality and morbidity. Etiology is multifactorial, but the issue is that heart does not have "enough fuel" to produce energy for its work or available fuel can't be properly utilized. Components of cardiac energy metabolism are substrate utilization, oxidative phosphorylation and ATP (adenosine triphosphate) transfer and utilization. The aim of article is to present the function of heart metabolism and how "metabolic dysfunction" contributes to heart failure. Perhaps, drug effect on heart metabolism is an approach to treatment of chronic heart failure.

Diffuse Idiopathic Skeletal Hyperostosis

Michal Scheinost, Kristýna Němejcová, Adam Pudlač, Tereza Budková, Denisa Janíčková Žďárská

Vnitr Lek 2014, 60(5-6):442-447  

Diffuse idiopathic skeletal hyperostosis is a progressive non-inflammatory bone and entheses disease which reduces the quality of life and self-sufficiency of patients. Despite significant prevalence is awareness of this disease still low and often leads to misdiagnosis. Therapeutic approach is different in diseases with similar symptomatology so it is important to raise awareness of this disease.

Why and how do insulin agents act on weight

Štěpán Svačina

Vnitr Lek 2014, 60(5-6):448-453  

The weight gain in insulin therapy is known phenomenon for decades. Different types of insulin and insulin analogues differ in many clinical effects, e.g. duration of action, risk of hypoglycaemia and effect on the weight as well. These effects vary with change of insulin for insulin analogues and vice versa. It has been unclear for a long time why some insulin analogues have positive effect on weight gain. Currently, it is obvious that several factors are crucial: binding to albumin, reduction of hypoglycaemia events, dissociation between hepatic and peripheral effects, influence on renal function and differences in action of insulin in brain. Therefore,...

Importance of taste in maintaining homeostasis and pathological impact of orosensory reflexes distraction in relation to sweet taste after non-caloric sweeteners consumption.

Jana Neuwirthová, Břetislav Gál, Pavel Smilek, Rom Kostřica

Vnitr Lek 2014, 60(5-6):454-457  

Taste signals and their reflexes have important signalling function in nature. They protect organism against toxic substances in food with help of taste aversion, they help to cope nutrition deficiencies through taste preferences, on the other hand, they act in many postprandial reflexes to maintain energy homeostasis. It is well-known that sweet taste is important oro-sensory stimulus for mammals. It acts as predictor of caloric food intake even before its entry into stomach and circulation. Taste and other oro-sensory signals from oral cavity affect not only the intake regulation, but also influence hormonal, neural and metabolic pathways to maintain...

Live style and risk of lifestyle diseases

Jan Kábrt

Vnitr Lek 2014, 60(5-6):458-461  

Metabolic syndrome included obesity, diabetes mellitus type II, hypertension and disorder of lipid metabolism are serious complication affecting many people of economic advanced countries. Unhealthy live style with limited physical activity and overfeeding are the main cause of this disorder. Adjustment of the live style with regular physical activity has the better result compared with a diet intervention alone.

The management of chronic diseases in international comparison

Miroslav Barták

Vnitr Lek 2014, 60(5-6):462-466  

The goal of this overview paper is to offer the international (European) evidence in the field of chronic diseases condition. Chronic conditions counting more that 60 % of all deaths worldwide and about 90 % of all deaths in the Czech Republic. Population development in developed countries is characterized by increasing live expectancy and by growing population in higher age groups namely in age more that 65 years. In the same time the population faced the consequences of unhealthy live style like eating's habit or physical inactivity. Thanks these factors as well as thanks increasing expectations and available medical technologies the costs of chronic...

Risk factors and progression predictors of Barrett's oesophagus to adenocarcinoma

Pavel Svoboda, Petr Dítě, Pavel Klvaňa, Tomáš Kupka, Martina Bojková, Jana Žmolíková, Irena Urbanovská, Magdalena Uvírová, Petr Buzrla, Jana Dvořáčková

Vnitr Lek 2014, 60(5-6):467-473  

Gastroesophageal reflux disease is a quite common disorder, and the condition affects some 40 per cent of population in the course of their lifetime. Fortunately, about half of the patients examined due to clear symptoms do not manifest macroscopic damage of the oesophageal mucosa, and serious endoscopic findings (Barrett's oesophagus) are observed in only a small percentage of patients (10%). Barrett's oesophagus is a serious complication - precancerous condition with a 30-fold higher risk of development of oesophageal adenocarcinoma when compared with patients without this condition. The article presents risk factors and predictors of progression...

Impact of natriuretic peptides in current clinical practice

Eva Ganovská, Jindřich Špinar, Jiří Pařenica

Vnitr Lek 2014, 60(5-6):474-483  

Natriuretic peptides (NP) have been intensively studied and also used in clinical practice. Their use is important for diagnosis and risk stratification of heart failure, pulmonary embolism and acute coronary syndrome. For the correct interpretation of the results is necessary to know factors, which induce elevation of natriuretic peptides. The article shows an overview of the physiology of the NP, the factors that influence the levels of NP, like heart failure, acute coronary syndrome and pulmonary embolism etc. There is also mentioned possibility of using synthetic derivates of natriuretic peptides in therapy of heart failure.

Sentinel lymph node in malignant melanoma

Eva Rovenská

Vnitr Lek 2014, 60(5-6):484-489  

Melanoma is highly malignant tumor which arises through malignant transformation of melanocytes. Surgical treatment of primary cutaneous melanoma including radical excision and intervention in regional lymphatic drainage is irreplaceable. Sentinel node biopsy is a recognized method of defining the stage of disease. Performance of sentinel node biopsy in patients in clinical stage Ib and II may reveal clinically occult nodal disease and thereby help identify a group of patients with occult stage III disease who may thereafter undergo complete lymphadenectomy and systemic treatment. Sentinel node biopsy is beneficial in treatment of melanoma, but the...

PET-CT documented complete remission of Erdheim-Chester disease, lasting more than 4 years from treatment initiation with cladribine

Zdeněk Adam, Zdeněk Řehák, Renata Koukalová, Zbyněk Bortlíček, Marta Krejčí, Luděk Pour, Petr Szturz, Jiří Prášek, Tomáš Nebeský, Zdenka Adamová, Zdeněk Král, Jiří Mayer

Vnitr Lek 2014, 60(5-6):499-511  

Erdheim-Chester disease is a very rare histiocytic disease. It represents one form of juvenile xanthogranuloma in WHO classification of blood diseases. The disease often causes B symptoms, skeletal pain and also may cause diabetes insipidus and retroperitoneal fibrosis. Selection of therapy depends on published case reports and small clinical trials. There are no recommendations for treatment based on randomized studies. Interferon α is probably the most commonly used drug for this disease. Some remissions have been described after treatment. However, long-term interferon α application is needed which is associated with numerous side effects....

Purple urine bag syndrome - rare but substantial symptom of urinary infection

Ondřej Hloch, Daša Gladišová, Miroslava Horáčková

Vnitr Lek 2014, 60(5-6):512-513  

The urine colour change is an important clinical sign associated with patological process not only in the urinary tract. Apart from the commonest urine colour modifications due to metabolites of haemoglobin, myoglobin and bilirubin one may come accross with some less frequent changes. The violet urine coloration is very rare but represents the important clinical finding that is known as purple urine bag syndrome. The change of colour is made by indirubin and indigo. It is connected all the time with urine tract infection. In our presentation we describe a case where this sign was the only presentation of clinically important bacteriuria. Consequently...

Extraadrenal paraganglioma

Zuzana Teliarová, Jana Kollerová, Peter Jackuliak, Ján Breza, Juraj Payer

Vnitr Lek 2014, 60(5-6):514-519  

Various symptoms may be present in pheochromocytoma and paraganglioma. The tumor can imitate numbers of diseases and often leads to misdiagnosis. Current advances in laboratory techniques (determination of free plasma metanephrines), tumor localization (using positron emission tomography) and surgery techniques together with better understanding of pathophysiology and genetics (role of subunit B of succinate dehydrogenase) lead to earlier diagnosis, changes in strategy and treatment options. Authors introduce case report of retroperitoneal paraganglioma in 59 years old patient. In conclusion, interdisciplinary cooperation in diagnosis and treatment...

Adult-onset Still's disease - a difficult path to diagnosis through fever and effusions of unknown origin

Jana Malegová, Lukáš Koten, Pavel Horák

Vnitr Lek 2014, 60(5-6):520-526  

Fever of unknown origin, pleural and pericardial effusions can be caused by a variety of independent agents. On the other hand, we can identify a common causative condition in other cases. Infectious diseases, malignancies and autoimmune diseases are the most common etiological factors. Considering the pleural and pericardial effusion, we also have to think of cardiovascular and pulmonary diseases. The basis of every diagnostic process is thorough medical history and detailed clinical examination followed by laboratory and imaging methods. In spite of that, the right diagnosis sometimes stays long time hidden. One of such conditions is Adult-onset...

Liver rupture with hemoperitoneum as rare complication of cardiopulmonary resuscitation in young patient with acute myocardial infarction

Linda Vetešková, Petr Kysela, Šárka Bohatá, Jiří Pařenica

Vnitr Lek 2014, 60(5-6):527-530  

Rupture of the liver is a rare but a very serious complication of cardiopulmonary resuscitation. The presented case report describes a young patient with acute myocardial infarction with ST segment elevation treated by primary PCI. Just during admission to the hospital she had ventricular fibrillation with prolonged resuscitation. Subsequently due to a decrease of hemoglobine a liver rupture with hemoperitoneum was diagnosed by ultrasonography and computed tomography (CT). Conservative therapy with repeated ultrasonography and CT examinations was successful even without discontinuation dual antiplatelet therapy. Frequency of this rare complication,...

Near-infrared spectroscopy (NIRS), new intracoronary imaging technique of unstable coronary plaque

Tomáš Ondrúš, Jan Kaňovský, Martin Poloczek, Roman Miklík, Otakar Boček, Petr Jeřábek, Petr Kala

Vnitr Lek 2014, 60(5-6):531-534  

Acute coronary syndrome may develop in the background of hemodynamically non-significant coronary artery disease. It may be caused by the presence of "vulnerable plaque", which is characterized by the lipid rich core and thin fibrous cap content. NIRS - near infrared spectroscopy - is a morphological imaging method allowing determining atherosclerotic plaque cholesterol burden. Information about the chemical composition may contribute to "high risk" plaque early identification and subsequent optimal interventional strategy. The first experience with the clinical implementation of this novel method is demonstrated in a case report.

Z odborné literatury

Vnitr Lek 2014, 60(5-6):542  

Rozlúčka s profesorom Ďurišom, nestorom Slovenskej internej medicíny

Soňa Kiňová

Vnitr Lek 2014, 60(5-6):541  

Význam stanovení natriuretických peptidů a prokalcitoninu u akutního srdečního selhání

Antonín Jabor, Janka Franeková

Vnitr Lek 2014, 60(5-6):535-538  

XVII International Congress on Nutrition and Metabolism in Renal Disease

Miroslav Mydlík, Katarína Derzsiová

Vnitr Lek 2014, 60(5-6):539-540