Epikardiální tuk jako další kamínek v mozaice upřesnění kardiovaskulárního rizika? - editorial

Eliška Sovová

Vnitr Lek 2016, 62(4):241-242  

Metformin u nemocných s 2. typem diabetes mellitus a laktátová acidóza - editorial

Jiří Charvát

Vnitr Lek 2016, 62(4):243-245  

Populace pacientů s diabetem se změnila, pacienti žijí déle a vykazují vyšší riziko srdečního selhání - editorial

Milan Kvapil

Vnitr Lek 2016, 62(4):246-247  

DRESS syndrom - editorial

Vladimír Vašků

Vnitr Lek 2016, 62(4):248  

Effective bowel preparation before coloscopy - low-volume PEG in the divided dose regimen

Vladimír Kojecký, Milan Dastych, Zdena Zádorová, Michal Varga, Jan Hajer, Milan Kment, Radek Kroupa, Magda Kunovská, Jan Matouš, Miroslav Mišurec, Aleš Hep, Bohuslav Kianička, Jiří Latta

Vnitr Lek 2016, 62(4):249-254  

Introduction:The good and safe bowel cleansing is key to the success of coloscopy. The standard preparation involves 4 l polyethylene glycol (PEG). Now the combination of PEG and ascorbic acid (PEGA) of half the volume is available. Besides the type of product also the time factors which are not clarified, play a role during the bowel preparation. The aim of the study was to compare the efficiency and tolerance of both the agents and evaluate the effect of the time regimen of preparation. Methods:380 individuals were included in the evaluation in 4 cohorts which used 4 l PEG (Fortrans) in a single dose or split into 3 + 1...

The role of epicardial fat and obesity parameters in the prediction of coronary heart disease

Dana Prídavková, Daniela Kantárová, Renáta Lišková, Peter Červeň, František Kovář, Marián Mokáň

Vnitr Lek 2016, 62(4):256-262  

Background:To assess the relationship of parameters of obesity in relationship to coronary angiography findings with correlation of epicardial fat (EF) thickness in uppermentioned context. Methods:There were 80 patients examined (43 males, 37 postmenopausal females) undergoing elective coronary angiography. We examined the regular obesity parameters - BMI, waist circumference (WC), neck circumference (NC), total body fat (TBF), and visceral fat (VF) using bioimpedance. We assessed the echocardiographically measured EF thickness. We added examination of lipidogram, glycaemia, HOMA-IR (insulin resistance index) and AIP (aterogenic...

Diuretic treatment in patients with acute pulmonary edema did not produces severe hyponatremia or hypokalemia

Jozef Kalužay, Veronika Pokorná, Svetlana Bodíková, Natália Vahančíková, Peter Ponťuch

Vnitr Lek 2016, 62(4):263-267  

Introduction:One of the risks of diuretic therapy for pulmonary edema is the development of hyponatremia and hypokalemia with pro-arrhythmic potential. The aim of our study was to analyze the incidence of hyponatremia and hypokalemia after the first day of treatment in a real clinical practice. Methods:We performed a retrospective analysis of data obtained from medical records. We included all patients with pulmonary edema admitted to the coronary care unit, only patients which died within the first day of treatment were excluded. Absolute dose of administered furosemide, total fluid intake and urine output, saline and pottasium...

Analysis of serum free light chains κ/λ ratio and heavy/light chain pairs of immunoglobulin to the stratification of multiple myeloma according to Mayo Stratification of Myeloma and Revised International Staging System

Vlastimil Ščudla, Jana Balcárková, Pavel Lochman, Miroslava Vincová, Tomáš Pika, Jiří Minařík, Jana Zapletalová, Marie Jarošová

Vnitr Lek 2016, 62(4):269-280  

Introduction:Assessment of serum levels of free light chains (FLC-κ and FLC-λ) and recently heavy/light chain pairs of immunoglobulin (HLC-κ and HLC-λ) and their ratio (FLC-r and HLC-r) has significantly enriched traditional algorithm of multiple myeloma (MM) evaluation. The aim of the presented study was to assess the relationship of classical prognostic parameters of MM, standard FLC-κ/λ and HLC-κ/λ ratio (^sFLC-r and ^sHLC-r), modified ratio of "involved/uninvolved" FLC and HLC (^mFLC-r and ^mHLC-r ), the difference between "involved - uninvolved"...

Prothrombin gene 20210A mutation in Slovak population

Juraj Chudej, Ivana Plameňová

Vnitr Lek 2016, 62(4):281-286  

Introduction:Factor V Leiden (FVL) and prothrombin G20210A mutation (PTM) are the two most common genetic polymorphisms known to predispose to a first episode of venous thromboembolism (VTE). PTM is present in 2 % Caucasian population. The main aim of this study was to identify the PTM in the patients with positive history of thrombotic events vs. control subjects. Materials and Methods:The assessment of PTM was performed by the PCR analysis of the chromosomal DNA, which was isolated from the peripheral blood leukocytes. Results:Of the 2 274 patients included, 157 (6.9 %) were carriers of the PTM. The mutation...

PCSK9 inhibitors - new possibilities in the treatment of hypercholesterolemia: For which patients will be indicated? Czech atherosclerosis society statement

Vladimír Soška, Michal Vrablík, Vladimír Bláha, Renata Cífková, Richard Češka, Tomáš Freiberger, Pavel Kraml, Jan Piťha, Hana Rosolová, Tomáš Štulc, Helena Vaverková, Zuzana Urbanová

Vnitr Lek 2016, 62(4):329-333  

First line drug for the treatment of hypercholesterolemia are statins, which reduce LDL-cholesterol up to 50 %; such reduction is sufficient for most patients to achieve the target values. The exceptions are patients with familial hypercholesterolemia and patients with statin intolerance. To achieve target LDL-cholesterol in these two groups of patients will be possible with new drugs - PCSK9 inhibitors, which decrease LDL-cholesterol by an additional 50-60 %. The first two PCSK9 inhibitors (alirocumab and evolocumab) already had been approved for clinical use by European regulatory authorities. The primary indication for combination statin with PCSK9...

Treatment of 14 cases of Castleman's disease: the experience of one centre and an overview of literature

Zdeněk Adam, Petr Szturz, Marta Krejčí, Renata Koukalová, Eva Michalková, Zdeněk Řehák, Eva Pourová, Luděk Pour, Pavlína Volfová, Viera Sandecká, Zdeňka Čermáková, Leoš Křen, Filip Sokol, Ivo Hanke, Igor Penka, Hana Petrášová, Sabina Ševčíková, Zdeněk Král, Jiří Mayer

Vnitr Lek 2016, 62(4):287-298  

Castleman's disease is the term for reactive lymphocytary and plasmocytary proliferation which occurs in the unicentric (localized) form, usually without systemic symptoms, or in the generalized/multicentric form, typically with systemic symptoms (www.vzacne-diagnozy.cz). Over the past 25 years we diagnosed, treated and followed 14 histologically proven cases of Castleman's diseases. Seven patients had the localised form of the disease. In 5 of 7 cases the pathological lesion was located intrathoracically or intraabdominally and in only 2 cases it was on the surface of the body. No clinical symptoms were present in any of the patients with the unicentric...

Chronic kidney diseases, metformin and lactic acidosis

Zoltán Borbély

Vnitr Lek 2016, 62(4):299-303  

Chronic kidney disease and diabetes mellitus represent a worldwide public health problem. The incidence of these diseases is gradually growing into epidemic proportions. In many cases they occur simultaneously, what leads to increased morbidity and mortality among the affected patients. The majority of the patients treated for diabetes mellitus are unaware of the presence of renal insufficiency. Vascular hypertrophy and diabetic kidney disease in patients with type 2 diabetes are the most common causes of kidney failure in countries with advanced healthcare systems. Metformin is a basic drug used for the treatment of type 2 diabetes mellitus. It is...

Beta-blockers and chronic obstructive pulmonary disease

Milan Sova, Monika Kamasová, Jan Václavík, Eliška Sovová, Lenka Hajdová, Vítězslav Kolek

Vnitr Lek 2016, 62(4):305-307  

This general article discusses the problems of beta-blockers use in patients with chronic obstructive pulmonary disease (COPD). Its aim is to refute exaggerated concerns of physicians over possible undesirable effects of beta-blockers on the patient respiratory functions and present new data on the effects of beta-blockers on the extent of COPD exacerbations, bronchial reactivity and mortality of patients.

Overview of current modalities of colorectal cancer screening

Ivana Mikoviny Kajzrlíková, Petr Vítek

Vnitr Lek 2016, 62(4):308-311  

There are one-step and two-steps programs for colorectal cancer screening. The aim of all screening examinations is to detect early stage of the disease in asymptomatic patient. The aim of this article is actual review of current screening modalities such as fecal occult blood test, flexible sigmoideoscopy, colonoscopy, CT colonography, capsule endoscopy, blood-based tests and stool DNA tests. Colonoscopy still remains the gold standard for detection of colorectal neoplasias. In majority of countries worldwide programs for colorectal cancer screening are based on immunochemical fecal occult blood test followed by colonoscopy when positive.

The effect of antihypertensive treatment on patients with diabetes depends on the values of blood pressure: a systematic survey and meta-analyses

Jiří Widimský sr

Vnitr Lek 2016, 62(4):312-315  

What was already known about these problems before the publication of the Northern Swedish study? Hypertension is the most important risk factor for mortality and cardiovascular disease on a global scale. Patients with diabetes mellitus demonstrate an increased risk for cardiovascular disease and they often also have hypertension at the same time. Antihypertensive treatment reduces the risk of cardiovascular diseases in patients with diabetes, however an optimum value of blood pressure is a matter of debate. What is the special contribution of the Swedish study? Antihypertensive treatment in patients with diabetes and a systolic pressure...

What are the effects of fixed-dose combination of candesartan and amlodipine

Jiří Vítovec, Jindřich Špinar

Vnitr Lek 2016, 62(4):317-321  

We are presenting a current view on a fixed-dose combination of amlodipine and candesartan in the treatment of hypertension. Major studies on the individual preparations as well as studies examining their combination are included. This fixed-dose combination expands our possibilities with regard to attaining the blood pressure target values, in particular in patients with risk factors or patients with comorbidities. Finally, the benefit mainly consists in the greater compliance of the patient with a minimum adverse effects.

Are some antidiabetic drugs also drugs useful for heart failure treatment?

Ján Murín

Vnitr Lek 2016, 62(4):322-328  

The prevalence of diabetes mellitus type 2 is rapidly growing. It is the cardiovascular mortality and morbidity why these patients suffer. Also heart failure becomes very frequent in diabetics, as it is a strong risk factor for development of heart failure and for its progression. Recently published data of EMPA-REG OUTCOME trial with empagliflozin hint to the possibility of heart failure treatment with this drug. The author presents data about the influence of antidiabetic drugs on cardiovascular risk factors, specifically on heart failure. This can be a way how to prevent heart failure in diabetic patients. Later he presents data about the influence...

DRESS syndrome

Monika Adamcová, Igor Šturdík, Tomáš Koller, Juraj Payer

Vnitr Lek 2016, 62(4):334-337  

DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is severe drug-induced allergic-type reaction which occurs few days to weeks after taking a drug in a predisposed patient. Organ damage, eosinophilia and skin rash are typical at presentation. Corticotherapy is often necessary in severe cases. In this report we describe a case of 56-year old female with fever, elevated liver tests and skin rash. DRESS syndrome was diagnosed and allopurinol was indentified as a causative drug. Due to possible fatal outcome, DRESS syndrome should be considered in a differential diagnosis of all patients presenting with similar signs and symptoms.

Eva Sedláčková, Viera Bajčiová a kol. Neuroendokrinní nádory

Bohuslav Melichar

Vnitr Lek 2016, 62(4):340  

Oznam/Oznámení

Vnitr Lek 2016, 62(4):280  

MUDr. Karel Roztočil, CSc., předseda České angiologické společnosti České lékařské společnosti JEP slaví 75. narozeniny

Jiří Spáčil, Alena Broulíková

Vnitr Lek 2016, 62(4):338  

41. Angiologické dny

Jiří Spáčil

Vnitr Lek 2016, 62(4):339