Main topic – Hematology

prof. MUDr. Miroslav Penka, CSc.

Vnitr Lek 2022, 68(8):483  

Today's view of hereditary thrombophilia

Jan Kvasnička, Zuzana Kovářová‑Kudrnová, Zuzana Zenáhlíková, Radka Brzežková, Sylvie Šťastná, Petra Bobčíková, Tomáš Kvasnička

Vnitr Lek 2022, 68(8):488-492 | DOI: 10.36290/vnl.2022.105  

Venous thromboembolism (VTE) is still a serious medical problem with the non-decreasing incidence of new cases despite prophylaxis in risky situations. It is a multifactorial disease, in which the hereditary component is also significantly involved. The aim of the current research is to search for new polymorphisms that are involved in thrombogenesis in addition to classical thrombophilia (deficiency of natural coagulation inhibitors and FVL and FII prothrombin mutations). The article provides an overview of the results of already performed genome-wide association studies of VTE and their use for the calculation of the so-called polygenic risk score,...

Venous thromboembolism in antiphosholipid syndrome

Alena Buliková, Miroslav Penka

Vnitr Lek 2022, 68(8):493-497 | DOI: 10.36290/vnl.2022.106  

Antiphosholipid syndrome (APS) is defined by the presence of clinical and laboratory criteria, it means by presence of antiphospholipid antibodies. Venous thromboembolism belongs to the most frequent clinical manifestation of this syndrome. Here we summarised basic pathophysiological mechanisms of venous thrombosis and lung embolism development, epidemiology of APS, and also the situations when this syndrome should be considered. The possible difficulties of laboratory diagnosis and their therapy involvement are mentioned.

Selected severe "haematological" syndromes in adult intensive care patients

Jaromír Gumulec, Ivo Demel, Klára Lančová, Eva Drbohlavová, Alicia Piegzová, Zdeněk Kořístek, Milan Navrátil, Vladimír Černý

Vnitr Lek 2022, 68(8):498-507 | DOI: 10.36290/vnl.2022.107  

Haemophagocytic syndrome, diffuse alveolar haemorrhage, catastrophic antiphospholipid syndrome and various types of thrombotic microangiopathies are rare conditions with significant morbidity and mortality. A common feature is late diagnosis, which can affect the success of treatment. The aim of this review article is to summarize the basic diagnostic and therapeutic steps of the present subpopulation of critically ill patients.

Evolution of deep vein thrombosis treatment from leeches to mechanical thrombectomy

Jan Raupach, Jan Mašek, Vendelín Chovanec, Radovan Malý

Vnitr Lek 2022, 68(8):508-512 | DOI: 10.36290/vnl.2022.108  

Deep vein thrombosis (DVT) is one of the most common diseases in developed countries with significant socioeconomic consequences. The severity of DVT lies in the potential for life-threatening pulmonary embolism and the development of chronic venous insufficiency, referred to as post-thrombotic syndrome. Virchow contributed to the understanding of the pathophysiological events that lead to thrombosis by describing three basic risk mechanisms. The first therapeutic attempts in the 17th century included venepuncture and the application of leeches. The first anticoagulant drug was heparin, which entered clinical practice after 1935. Subsequent commercialization...

Traditional and new biomarkers of congestion in heart failure

Táňa Andreasová, Filip Málek

Vnitr Lek 2022, 68(8):514-516 | DOI: 10.36290/vnl.2022.109  

The presence of pulmonary and systemic congestion is the main cause of the poor outcome of the patients with heart failure. Despite of the availability of several tools of the modern medicine, the degree of congestion is usualy difficult to evaulate. The clinical, imaging and laboratory methods are the tools, which can estimated the degree of congestion.

Allergen immunotherapy in treating allergic eosinophilic asthma

Irena Krčmová, Jakub Novosad

Vnitr Lek 2022, 68(8):517-524 | DOI: 10.36290/vnl.2022.110  

Currently, the approach to a patient with asthma is in accordance with personalized medicine wherein the decision on the treatment pathway is based on the type of asthmatic inflammation and other comorbidities that accompany asthma. For an allergic asthma patient, allergen immunotherapy (AIT), which has a disease-modifying effect and the potential to prevent further progression of allergic symptoms, is one of the treatment modalities. It is an effective treatment that, unlike pharmacotherapy, modifies the course of allergic respiratory diseases and induces allergen specific immune tolerance that persists for up to several years after treatment cessation....

Pulmonary storage

Martina Šterclová

Vnitr Lek 2022, 68(8):525-531 | DOI: 10.36290/vnl.2022.111  

Interstitial lung diseases (ILDs) are not just a matter of scarring or inflammation in the lung tissue. The lungs can also serve as a repository for products that can be produced in excessive amounts in the human body as a result of disease. Geneticaly based dysfunctions of lysosomal enzymes, which leads to an unefficient degradation and transport of various macromolecules from lysosomes, are considered to be storage diseases sensu stricto. ILDs were described in patients with Gaucher disease, Niemann-Pick disease and Fabry disease. In a broader context, however, the accumulation of various substances in the lung tissue is also encountered in cases...

Cognitive impairment and the threat of dementia pandemic or the journey of hypertensive patients to self-care deficit

Peter Wohlfahrt

Vnitr Lek 2022, 68(8):532-536 | DOI: 10.36290/vnl.2022.112  

In the Czech Republic, due to the population aging, the prevalence of cognitive dysfunction is increasing. Researchers estimate that by 2050 the number of patients with dementia in the Czech Republic will more than double. Since dementia cannot be cured, it is important to prevent the cognitive dysfunction development by influencing modifiable risk factors. Arterial hypertension (AH) is one of the main risk factors for the development of cognitive dysfunction and dementia. Elevated blood pressure values in youth are associated with a higher risk of cognitive decline in middle age and with the development of dementia in old age. Blood pressure control...

Ethanol ablation of recurrent symptomatic thyroid cystic nodules in the Czech Republic

Hana Munteanu, Milan Halenka

Vnitr Lek 2022, 68(8):E04-E07 | DOI: 10.36290/vnl.2022.114  

Ethanol ablation of recurrent symptomatic thyroid cystic nodules is a minimally invasive procedure that can be used as an alternative to surgery. The method is suitable for polymorbid patients with increased surgical risk. Or it can be offered to patients who do not want to undergo surgery.

Liddle syndrome

Štěpán Mareš, Jan Filipovský

Vnitr Lek 2022, 68(8):E08-E11 | DOI: 10.36290/vnl.2022.115  

Liddle syndrome is an inherited form of arterial hypertension with autosomal dominant pattern of inheritance. It is caused by activating mutation of genes coding of the epithelial sodium channel in distal nephron. Mutation leads to excessive reabsorbtion of sodium ions and volume expansion resulting in arterial hypertension. Antoher typical laboratory findings are hypokalaemia, low levels of serum aldosteron and metabolic alkalosis. Phenotypic variability makes it difficult to identify patients with Liddle syndrome, often resulting in misdiagnosis and severe complications at early age. Genetic studies should be done to confirm the diagnosis. Therapy...

How to convince a patient refusing colonoscopy - a qualitative study

Jan Brož, Timea Debnárová, Svatava Krejčová, Alexandra Romanová, Jana Urbanová, Lucie Samková, Barbora Pelechová, Barbora Prýmková, Ondřej Hloch, Pavlína Krollová, Ludmila Brunerová, Veronika Vejtasová, Anna Frühaufová, Juraj Michalec, Iva Hoffmanová, Dita Pichlerová, Jan Šťovíček, Radan Keil

Vnitr Lek 2022, 68(8):E12-E17 | DOI: 10.36290/vnl.2022.116  

The available literature suggests that the most significant barriers to undergoing colonoscopy in general include "fear of pain and discomfort", "fear of bowel preparation", as well as directly unrelated influences such as "lack of support from family and friends", "busy family and work schedules", "other health problems" and the current "fear of getting COVID-19 in hospital". A marital union may play a positive role, previous cancer a negative one. Another important factor is that patients are not used to talking about their barriers spontaneously; a guided conversation is a useful tool. Respondents in this qualitative study addressed these barriers...

Rare cause of obstructive icterus in a young patient

Marie Kundratová

Vnitr Lek 2022, 68(8):E18-E22 | DOI: 10.36290/vnl.2022.117  

In this case report is discussed the diagnosis of papillary carcinoma in the case of a patient in whose age the occurrence of the disease is very rare. The patient underwent a series of non-invasive and invasive examinations, the results of which eventually led to a surgical solution of the suspected lesion (Wipple's procedure). Histological examination of the resection confirmed mixed type ampular adenocarcinoma. In the context of this finding, the results of the examination, their information value, interpretation and mutual interaction are discussed. In the postoperative period, the patient suffered from gastrointestinal bleeding, subileum and poor...

Differential diagnosis of hyponatremia and hypernatremia

Otakar Pšenička, Jarmila Křížová

Vnitr Lek 2022, 68(8):E23-E28 | DOI: 10.36290/vnl.2022.118  

Dysnatremias are among the most common mineral imbalances encountered in clinical practice. Both hyponatremia and hypernatremia are associated with increased morbiditidy and mortality and represent negative prognostic factors regardless of their cause. Serum osmolality, extracellular fluid volume and sodium urine concentration are important parameters for evaluation the cause and differential diagnosis. The rate of onset of ionic disorder and severity of clinical symptoms are essential. While acute disorders with symptoms are treated immediately, in chronic disorders, thorough diagnostic evaluation and a careful approach to their correction are necessary....

Antithrombotic therapy and digestive endoscopy

Jiří Cyrany, Radovan Malý, Stanislav Rejchrt, Ilja Tachecí

Vnitr Lek 2022, 68(8):538-542 | DOI: 10.36290/vnl.2022.113  

Antithrombotic therapy comprises anticoagulation and antiplatelet treatment. The number of patients treated with various forms of antithrombotic therapy is growing. Procedures of digestive endoscopy are very frequently indicated by general practitioners and doctors of various specialisations. Interdisciplinary cooperation and mutual understanding are required in order for digestive endoscopy to be effective and safe. Hence, we present an overview based on recent European, British (1), and North American guidelines (2) for endoscopic procedures, with respect to guidelines for perioperative care in general (3). Antithrombotic therapy management in patients...

Životní jubileum prof. MUDr. Miroslava Součka, CSc.

Jiří Vítovec, Jindřich Špinar

Vnitr Lek 2022, 68(8):E29-E30  

70 let prof. MUDr. Štěpána Svačiny, DrSc., MBA

Jan Škrha

Vnitr Lek 2022, 68(8):E31-E32  

Zemřel profesor MUDr. Zbyněk Píša, CSc.

Michael Aschermann

Vnitr Lek 2022, 68(8):E33  

Jak dobře jsme léčili hypertenzi v posledních 25 letech?

Arian Taniwall, Jan Brož, Barbora Prýmková, Lucie Samková, Veronika Vejtasová, Michala Lustigová, Ludmila Brunerová, Jana Urbanová

Vnitr Lek 2022, 68(8):545-548