Elastografie jater: moderní trend v diagnostice chronických jaterních onemocnění - editorial

Karel Dvořák

Vnitr Lek 2018, 64(10):899-900  

Tuk, pankreas a metabolický syndrom - editorial

Jan Trna

Vnitr Lek 2018, 64(10):901-902 | DOI: 10.36290/vnl.2018.124  

Is functional dyspepsia really that frequent?

Vít Navrátil, Pavol Dvoran, Vladimír Ďurana, Jiří Ehrmann, Vlastimil Procházka

Vnitr Lek 2018, 64(10):903-910 | DOI: 10.36290/vnl.2018.125  

The literature shows, that the prevalence of functional dyspepsia is between 11 and 29.2 % in general population. The first goal of this study was to present a narrative review of the current findings of functional dyspepsia. The second goal was to find out the prevalence of functional dyspepsia in the II. Internal Clinic of Gastroenterology and Geriatry in Teaching Hospital of Olomouc (Czech Republic). According to the clinical experience, the prevalence of patients with functional dyspepsia seems to be not as high as literature shows. Normal gastroscopy findings are mandatory for the diagnosis of functional dyspepsia. That is why we examined 302...

Does the time from symptoms onset to treatment impact further development of vein thrombosis in the leg?

Jiří Spáčil, Jaroslava Svobodová

Vnitr Lek 2018, 64(10):911-915 | DOI: 10.36290/vnl.2018.126  

Introduction:It is unknown how many days pass from the symptom onset to anticoagulation therapy of vein thrombosis (VT) in the leg in our country and whether this time has an impact on further development of the disease. Methods:Among patients treated at our department in recent years for deep vein thrombosis in the leg, we selected 50 patients with the required data available. In each case the diagnosis was confirmed by duplex sonography. The mean age was 51 years and the group included 31 males and 19 females. Proximal VT was found in 72 % of the patients. Idiopathic VT was found in 38 % of the patients. The patients were...

Transient elastography - role in the assessment of the liver disease development

Nikola Uzlová, Nikola Mejzlíková, Soňa Fraňková, Pavla Libicherová, David Nosek, Ivan Rychlík

Vnitr Lek 2018, 64(10):916-922 | DOI: 10.36290/vnl.2018.127  

Transient elastography, an examination based on the liver stiffness measurement, is a method validated for the non-invasive liver fibrosis staging. This method was recently successfully introduced into routine clinical practice. In accordance with the global-wide screening of viral hepatitis (chronic viral hepatitis type B and type C) and with the increasing effectiveness of antiviral therapy, as well as with the increasing prevalence of non-alcoholic fatty liver disease (NAFLD), the part of population requiring the care of hepatologists is certain to increase. Now more than ever we need a non-invasive, fast, safe, inexpensive and reliable method for...

Some causes of poor adherence to long-term statin therapy and their solution

Vladimír Soška, Ondřej Kyselák

Vnitr Lek 2018, 64(10):923-927 | DOI: 10.36290/vnl.2018.128  

Statins are among the most important drugs in preventive cardiology because they greatly improve the prognosis of risk patients in both primary and secondary prevention of atherosclerotic cardiovascular disease. Adherence to long-term statin therapy is poor and decreases with the duration of statin use. A number of fake news about adverse effects of statins disseminated on the internet, such as damage of the brain, liver or kidney, contribute to worsening adherence. Statins therapy is sometimes unnecessary discontinued before planned surgery. The worse adherence to statin therapy may be also due to the fact that the patient does not know the connection...

Angiotensin-converting enzyme inhibitor-induced angioedema: epidemiology, pathogenesis and management

Marta Sobotková

Vnitr Lek 2018, 64(10):928-933 | DOI: 10.36290/vnl.2018.129  

Angiotensin-converting enzyme-induced angioedema occurs in 0.1-0.7 % of recipients. Swelling often affects head and neck and makes it an extremely dangerous adverse effect. Bradykinin is considered to be the main mediator of edema in these cases. There is currently no specific treatment for angioedema of this etiology. Drugs used for treatment of attacks in hereditary angioedema with C1 inhibitor deficiency are tried also in this indication, but there are currently no clinical studies available supporting their effectiveness. Patients using angiotensin-converting enzyme inhibitors with angioedemas of unknown etiology must discontinue using this drug....

Obstructive sleep apnea and dyslipidemia

Pavel Šiarnik, Katarína Klobučníková, Imrich Mucska, Katarína Černá, Branislav Kollár, Peter Turčáni

Vnitr Lek 2018, 64(10):934-938 | DOI: 10.36290/vnl.2018.130  

Obstructive sleep apnea is a sleep disorder characterized by repetitive partial or complete upper airway obstruction that lead to hemodynamic changes, arousals from sleep and intermittent hypoxia. Obstructive sleep apnea activates multiple pathways that lead to vascular disease. The vascular risk imposed by obstructive sleep apnea may be mediated through the metabolic consequences of sleep-disordered breathing. There is increasing evidence that obstructive sleep apnea is independently associated with dyslipidemia, a well known vascular risk factor. However, the role of obstructive sleep apnea in causality of dyslipidemia remains to be established....

CD38 targeted treatment for multiple myeloma

Tomáš Jelínek, Jana Mihályová, Roman Hájek

Vnitr Lek 2018, 64(10):939-948 | DOI: 10.36290/vnl.2018.131  

CD38 antigen is highly and uniformly expressed on plasma cells and thus represents an ideal target for the treatment of multiple myeloma (MM) with anti-CD38 monoclonal antibodies (mAbs). Daratumumab is the most advanced anti-CD38 mAb in the clinical development with approval in several indications, nevertheless isatuximab that targets completely different epitope of CD38 molecule is also very promising drug. Anti-CD38 possess pleiotropic mechanism of action that have been described also in other mAbs, but quite specific, novel and very important seems to be the immunomodulatory effect provided by depletion of several CD38⁺ immunosuppressive...

Fatty pancreas disease: clinical impact

Martin Blaho, Petr Dítě, Lumír Kunovský, Arnošt Martínek

Vnitr Lek 2018, 64(10):949-952 | DOI: 10.36290/vnl.2018.132  

Pancreatic steatosis is the name for a state characterized by an increased accumulation of fat in the pancreas. It is most frequently due to obesity and the metabolic syndrome, other etiological factors may include some congenital syndromes, toxic substances or viral diseases. Diagnostics is based on non-invasive imaging methods. The most accessible is abdominal ultrasound, also endoscopic ultrasound, computed tomography or magnetic resonance imaging can be used. In clinical practice, pancreatic steatosis is in particular significant because of its close association with type 2 diabetes mellitus, non-alcoholic fatty liver disease and cardiovascular...

Treatment of polycythemia vera

Petr Dulíček

Vnitr Lek 2018, 64(10):955-960 | DOI: 10.36290/vnl.2018.133  

Polycythemia vera is a chronic myeloproliferative neoplasm characterized by hematopoietic stem cell-derived clonal myeloproliferation resulting in erythrocytosis, leukocytosis and thrombocytosis. Survival is reduced compared with general population. Main reasons of death include thrombohemorrhagic complications, fibrotic progression and leukaemic transformation. Presence of Janus kinase (JAK2) gene mutations is a diagnostic marker and standard diagnostic criterion. World Health Organization 2016 diagnostic criteria focusing on hemoglobin levels, hematocrit, red cell mass and bone marrow morphology are mandatory. Therapeutic approach depends on stratification...

Weber-Christian disease: a case report

Kristína Brázdilová, Daniel Čierny, Katarína Hrubišková, Lukáš Plank, Zdenko Killinger, Juraj Payer

Vnitr Lek 2018, 64(10):961-965 | DOI: 10.36290/vnl.2018.134  

Weber-Christian disease is a rare disease from the group of chronic fibrosing conditions characterized by inflammation of the adipose tissue - panniculitis and fibrosing with frequent systemic manifestations. Etiopathogenesis of the disease is not fully known, participation of autoimmune mechanisms is anticipated. Here, we report a case of a patient with this rare disease, diagnosed after a long and demanding diagnostic process, including repeated laparotomies. However, after immunosuppressive therapy, clinical and laboratory symptomatology improved rapidly as well as the patient's quality of life.

Multiple neuroendocrine tumor of the small bowel: a case report and a review of literature

Lumír Kunovský, Milan Dastych, Oldrich Robek, Roman Svaton, Jakub Vlazny, Jakub Hustý, Michal Eid, Karolina Poredska, Petr Kysela, Zdeněk Kala

Vnitr Lek 2018, 64(10):966-969 | DOI: 10.36290/vnl.2018.135  

Primary malignant tumors of small bowel constitute only about 1-2% of all gastrointestinal neoplasms. Although neuroendocrine tumors (NETs) are relatively rare, they still represent the second most common malignancy of the small bowel (after adenocarcinoma). Clinical manifestations include abdominal pain, bowel obstruction, diarrhea, weight loss and bleeding. The differential diagnosis of obscure gastrointestinal bleeding can sometimes be challenging for endoscopy as well as for radiology methods. We present the case of an 80-year-old man suffering from severe hypochromic anemia. Routine endoscopic methods did not show any appropriate pathology. Finally,...

Z odborné literatury

Vnitr Lek 2018, 64(10):973-974  

Rozlúčka s profesorom Milanom Pavlovičom *21. 11. 1931 - †3. 7. 2018

Štefan Hrušovský

Vnitr Lek 2018, 64(10):970  

Za profesorom MUDr. Miroslavom Mydlíkom, DrSc. *21. 7. 1932 - †6. 9. 2018

Viera Spustová

Vnitr Lek 2018, 64(10):971-972  

Příspěvek ke článku Matýšková M et al. Antitrombotika dnes. Vnitř Lék 2018; 64(5): 565-574

Jiří Spáčil

Vnitr Lek 2018, 64(10):975