Ventilace plic u osob se silikózou a pneumokoniózou uhlokopa - editorial

Jiří Chaloupka

Vnitr Lek 2015, 61(12):998-1000  

Fosfátová homeostáza při selhání ledvin je draze vykoupená maladaptivními systémovými důsledky extrémně vysokých koncentrací fosfatoninů - editorial

Sylvie Dusilová Sulková

Vnitr Lek 2015, 61(12):1001-1003  

ST2 a srdeční selhání: pouze další marker z rodiny nebo přeci jen něco více? - editorial

Radek Pudil

Vnitr Lek 2015, 61(12):1004-1005  

Karotická stenóza - diagnostika a léčba - editorial

Petr Štádler

Vnitr Lek 2015, 61(12):1006-1007  

Fallotova tetralogie dříve a dnes - editorial

Jana Rubáčková Popelová

Vnitr Lek 2015, 61(12):1008-1009  

Regional registry of pulmonary embolism

Mária Záňová, Zdeněk Monhart

Vnitr Lek 2015, 61(12):1010-1014  

Introduction:Pulmonary embolism (PE) together with coronary heart disease and arterial hypertension are most common diseases of cardiovascular system. Due to its high mortality rate it is worth of attention. Aim:to describe characteristics of patients with PE, provide data about treatment and inpatient mortality rate. Also to identify an occurence of right-sided heart thrombi in patients with PE and efficiency/safety of thrombolytic therapy in this subpopulation. To evaluate effectiveness/importance of basic oncology screening in patients with PE (meaning efficiency of provided examinations to uncover hidden malignancy). Methods:Our...

Antithrombotic therapy and nonvariceal upper gastrointestinal bleeding

Veronika Belanová, Martin Gřiva

Vnitr Lek 2015, 61(12):1016-1022  

Background:The incidence of acute upper gastrointestinal bleeding is about 85-108/100,000 inhabitants per year, nonvariceal bleeding accounts for 80-90 %. Antiplatelet and anticoagulation treatment are the significant risk factors for upper gastrointestinal bleeding. Objectives:To evaluate the occurrence of upper gastrointestinal bleeding in the general community of patients in a county hospital. And to compare the role played by antiplatelet and anticoagulation drugs and other risk medication. Design and methods:Retrospective analysis of patients over 18 years of age who underwent endoscopy for acute upper...

Ventilatory function in patients with silicosis or coal workers' pneumoconiosis

Petr Brhel, Markéta Petrovová, Dana Lorenzová

Vnitr Lek 2015, 61(12):1023-1027  

Objectives:The aim of the study was to determine ventilatory function in a group of patients with silicosis and coal workers' pneumoconisos (CWP) newly granted as occupational disease. Methods:The authors have undertaken the analysis of all cases of occupational silicosis and CWP which were diagnosed in men in the South Moravia region. Information on ventilatory function, chest symptoms, age, working and smoking history was collected during the medical surveys, including spirometry testing and chest radiography. Diagnosis was based on history of occupational exposure to coal or silica dust, chest x-ray findings, using International...

Lenalidomide treatment in myelodysplastic syndrome with 5q deletion - Czech MDS group experience

Anna Jonášová, Libor Červinek, Petra Bělohlávková, Jaroslav Čermák, Monika Beličková, Petr Rohoň, Olga Černá, Ivana Hochová, Magda Šišková, Karla Kačmářová, Eva Janoušová

Vnitr Lek 2015, 61(12):1028-1033  

Myelodysplastic syndrome (MDS) is a common hematological disease in patients over sixty. Despite intensive research, the therapy of this heterogeneous blood disease is complicated. In recent years, two new therapeutic approaches have been proposed: immunomodulation and demethylation therapy. Immunomodulation therapy with lenalidomide represents a meaningful advance in the treatment of anemic patients, specifically those with 5q- aberrations. As much as 60-70 % of patients respond and achieve transfusion independence. We present the initial lenalidomide experience of the Czech MDS group. We analyze Czech MDS register data of 34 (31 female; 3 male; median...

Investigation of tubular reabsorption of phosphates in patients with chronic kidney disease

Miroslava Horáčková, Otto Schück, Ivo Sotorník, Janka Franková, Milena Štollová, Irena Látová, Hana Malinská, Jana Urbanová

Vnitr Lek 2015, 61(12):1034-1038  

Introduction:Moderate to medium decrease in glomerular filtration (GFR) in individuals with chronic kidney disease (CKD) does not need to be associated with hyperphosphatemia due to an adaptive decrease in tubular reabsorption of phosphates (TR_Pi) in residual nephrons. The clinical assessment of this function is performed based on the measurement of fractional phosphate excretion (FE_Pi), which is a quantity specifying the proportion of the filtered amount of phosphates which is excreted in the urine. This quantity may provide useful information about the involvement of kidneys in phosphate homeostasis of the internal...

Role of soluble receptor ST2 measurment in diagnosis and prognostic stratification in patients with heart failure

Filip Málek, Dagmar Vondráková, Petr Neužil

Vnitr Lek 2015, 61(12):1039-1041  

ST2 is a member of the interleukin 1 (IL1) receptor family and consists of a trans-membrane ligand (STL2) and a soluble form (sST2). sST2 is released from cardiomyocytes and fibroblasts after mechanical strain and has been identified as a novel biomarker of cardiac stress, fibrosis and remodelling. Many studies showed that sST2 brings important prognostic information in patients with heart failure. Elevated sST2 concentrations predicted risk of hospitalization and mortality independently on natriuretic peptides levels and on other clinical variables. Some studies showed diagnostic role of sST2 u patients with heart failure and normal ejection fraction.

Geriatric multimorbidity - one of the key problem of contemporary medicine

Pavel Weber, Dana Prudius, Hana Meluzínová

Vnitr Lek 2015, 61(12):1042-1048  

In the elderly population there are common permanent decrease of functional capacity, gradual emergence of various diseases leading to the wider multimorbidity and increased problems in the social sphere, which can develop frailty and social dependency. The paper analyzes the complex issue of geriatric multimorbidity and emphasizes its pitfalls, the need of an interdisciplinary approach and thinking of doctors, including the risks of modern pharmacotherapy. The aim of geriatric medicine is to optimize residual functions despite the decline in total functional capacity with increasing multimorbidity. The authors want to direct the attention of the professional...

Carotid stenosis - diagnosis and treatment

Tomáš Novotný, Robert Staffa

Vnitr Lek 2015, 61(12):1049-1066  

Diagnosis and treatment of carotid stenosis is under incessant development. Especially in last years, we have noticed significant changes in opinions based on the results of meta-analyses of old evidence and the new evidence as well. Important factor involved is the fast development of new endovascular therapies. In reaction to these changes, several medical societies published their guidelines for the management of carotid stenosis. Even though, all of them are based practically on the same published medical evidence, they are not always similar in recommendations. The aim of our work was to summarize actual recommendations regarding management of...

PATHWAY-2 Study: spironolactone vs placebo, bisoprolol and doxazosin to determine optimal treatment of resistant hypertension. Spironolactone high effective in lowering blood pressure in drug resistant hypertension

Jiří Widimský

Vnitr Lek 2015, 61(12):1067-1071  

The PATHWAY-2 study, funded by the British Heart Foundation, randomised 335 patients with resistant hypertension (already treated according to guidelines) to sequentially receive 12 weeks of spironolactone (25-50 mg), bisoprolol (5-10 mg), doxazosin (4-8 mg modified release) and placebo. The study design allowed drug comparisons in each patient, with 230 patients completing all cycles. Results showed that spironolactone reduced home systolic BP by 8.70 mm Hg more than placebo (< 0.001), 4.26 mmHg more than bisoprolol/doxazosin (< 0.001), 4.03 mm Hg more than doxazosin (< 0.001), and by 4.48 mm Hg more than bisoprolol. By the end of the trial,...

Monoclonal immunoglobulin (M-Ig) and skin diseases from the group of mucinoses - scleredema adultorum Buschke and scleromyxedema. Description of four cases and an overview of therapies

Zdeněk Adam, Petr Szturz, Marta Krejčí, Vladimír Vašků, Luděk Pour, Eva Michalková, Sabina Ševčíková, Zdeňka Čermáková, Karel Veselý, Jiří Vaníček, Eva Pourová, Zdeněk Král, Jiří Mayer

Vnitr Lek 2015, 61(12):1072-1087  

Introduction:The mucinoses of the type of scleredema and scleromyxedema are diseases marked by excessive production of mucin deposits in the skin and subcutaneous tissue, which causes skin hardening. The skin and subcutaneous deposits hamper the movement of limbs, the thorax as well as mouth. The same mechanism also damages other organs (the heart, lungs, oesophagus). It is probably caused by the stimulation of mucin production in fibroblasts by immunoglobulins, frequently monoclonal immunoglobulin. Therefore these diseases are typically associated with monoclonal gammopathy. Case reports:We describe a cohort of 4 patients,...

Uncorrected Tetralogy of Fallot - a case report of a 69-year-old patient

Naďa Hučková, Katarína Sekurisová, Laura Slezáková, Katarína Kusendová, Andrej Zachar, Mária Szántová

Vnitr Lek 2015, 61(12):1088-1092  

Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart defect. The actual treatment relies on cardio-surgery - complete correction within the infant age. Without surgery only 10 % of subjects survived 3^rd decade and only 3-5 % of subjects were able to survive until their 40^th. This particular paper is dedicated to case of a 69-years old male subject with positive history of uncorrected ToF due to his refusal of surgery, ischemic cardiac disease NYHA III-IV and chronic kidney failure. This subject was hospitalized within the department of internal medicine due to several days of chest pain connected with lower extremities...

Vladislav Hytych. VATS lobektomie...krok za krokem

Ivan Čapov

Vnitr Lek 2015, 61(12):1098  

Medicine at a polar station in Antarctica

Kristián Brat, Ondřej Zvěřina

Vnitr Lek 2015, 61(12):1093-1097  

The paper describes specific aspects of work of a scientific expedition doctor and the stay and life at a polar research station in Antarctica. Apart from the outline of everyday problems, the first named author also learns about the history of medical practitioners working in Antarctica, writes about the results of the biomedical research activities conducted in the period of 2011-2014 and briefly describes the daily routine at a scientific polar station in Antarctica.