The normalized smoothness index and parametric population RDH index of losartan in patients with newly diagnosed hypertension and metabolic syndrome

I. Řiháček, P. Fráňa, D. Schwarz, M. Plachý, M. Souček

Vnitr Lek 2010, 56(9):901-909  

Introduction:Ambulatory blood pressure monitoring provides an opportunity to evaluate 24-hour efficacy of once daily preparations. Aims of the study:To evaluate 24-hour efficacy of losartan in patients with newly diagnosed hypertension and metabolic syndrome using the parametric population RDH index and normalized smoothness index. Patient sample and methodology:Twenty seven patients with newly diagnosed hypertension and with metabolic syndrome, sufficiently responding to blood pressure therapy with losartan, assessed using sphygmomanometer. 18 men, 9 women, mean age of 48 years, body mass index of 32.6 kg.m-2,...

Our experience with endoscopic drainage of pancreatic pseudocysts

B. Kianička, I. Novotný, M. Souček, I. Řiháček, J. Špác

Vnitr Lek 2010, 56(9):910-914  

Introduction:The authors first provide and overview of the main knowledge on pancreatic pseudocysts. They discuss the individual types of pancreatic pseudocysts, their clinical picture, complications and diagnosis. As part of the differential diagnosis, they emphasise the need to distinguish pancreatic pseudocysts from cystic tumours and benign cysts. Special attention is then paid to various modalities of treatment of pancreatic pseudocysts. Methods:The authors present their own results of endoscopic drainage of pancreatic pseudocysts, one of the key options in the treatment of this condition. Results:A total...

Cardiovascular morbidity in patients after treatment for testicular cancer

M. Valentová, B. Mladosievičová

Vnitr Lek 2010, 56(9):915-919  

Increase of incidence and favorable prognosis of testicular cancer are accompanied by growing evidence of late complications following antineoplastic treatment, such as cardiovascular diseases, peripheral neuropathy, renal damage, hearing impairment, secondary malignancies, pulmonary toxicity, gonadal dysfunction and bone mineral density abnormalities. During the last years a sufficient evidence has been accumulated that there is a higher incidence of cardiovascular diseases, particularly in patients treated with high-dose cisplatin chemotherapy or mediastinal irradiation. Acute myocardial infarction and angina pectoris are the most common from cardiovascular...

Rivaroxaban and factor Xa inhibitors in clinical practice

M. Penka

Vnitr Lek 2010, 56(9):920-926  

Prevention and treatment of thrombosis represent some of the most common medical interventions in the clinical area that remains among the most common causes of mortality and morbidity. At present, heparins, pentasaccharides and warfarin are used to prevent thromboembolic events. Nevertheless, these drugs have a range of adverse effects and other disadvantages that force scientists to seek new treatment options that would fulfil the concept of an 'ideal antithrombotic drug'. Characteristics of such an agent include selectivity of its effect, absence of adverse effects, possibility to administer the drug without the need for laboratory control and low...

Hereditary angioedema - neglected diagnosis

P. Králíčková, E. Burešová, T. Freiberger, I. Tachecí

Vnitr Lek 2010, 56(9):927-931  

Hereditary angioedema caused by C1 esterase inhibitor deficiency is a rare autosomal dominant inherited disorder. It is characterized by reccurent episodes of potentially life-threatening swellings without itching localized in the dermis and submucosa. We report a case of 41 years old woman with hereditary angioedema manifested as episodes of localized skin swellings and painful gastrointestinal colics. This report underlines the fact that hereditary angioedema is underdiagnosed in differential diagnoses. If hereditary angioedema is correctly diagnosed, effective treatment highly improving patients' quality of life is available.

Z odborné literatury

Vnitr Lek 2010, 56(9):940  

Zemřel doc. MUDr. Dušan Mrkos, CSc., editor emeritus časopisu Vnitřní lékařství

Petr Svačina

Vnitr Lek 2010, 56(9):937  

Profesor Jiří Ehrmann jubilantem

Vlastimil Procházka

Vnitr Lek 2010, 56(9):938-939  

Dopis adresovaný prof. MUDr. Zdeňku Adamovi, CSc.

Ladislav Slezák

Vnitr Lek 2010, 56(9):934-935  

Dopis adresovaný prof. MUDr. Zdeňku Adamovi, CSc.

Milan Žuffa

Vnitr Lek 2010, 56(9):936  

Prof. MUDr. Andrej Dukát, CSc., FESC - šesťdesiatročný

Peter Gavorník

Vnitr Lek 2010, 56(9):944-945  

Gastroenteropatic neuroendocrine tumors: multidisciplinary approach in therapy

S. Kiňová, Ľ. Kekeňák, E. Kováčová, M. Koreň

Vnitr Lek 2010, 56(9):946-950  

Introduction:Gastroenteropancreatic neuroendocrine tumors (GEP-NET) are classified on the basis of hormonal activity of tumor cells to functional and non-functional tumors. Therapy of well differentiated NETs includes surgical procedures, debulking of tumor mass, biotherapy and peptid receptor radionuclid therapy. Aim of the study:Analysis of therapeutic modalities in group of patients with well differentiated GEP-NETs. Results:In time period from 1. 1. 2005 to 1. 1. 2010 we followed up 50 pts (19 men/31 women) with well differentiated GEP neuroendocrine tumors. Primary localisation was: stomach - 6 times, pancreas...

Arterial hypertension with orthostatic hypotension

B. Krahulec, Z. Bartošová

Vnitr Lek 2010, 56(9):951-954  

Arterial hypertension (AH) with orthostatic hypotension (OH) is quite important clinical problem, present especially in older age and in various forms of autonomic nervous system (ANS) failure. ANS damage may be primary, or secondary, most offen in diabetes mellitus. In older age OH occurrence is about 30% and postprandial hypotension is also possible. Various antihypertensive drugs, also tricyclic antidepressants, α₁-adrenergic receptors antagonists and diuretics may provoke OH. Diagnostic value has simple screening bedside orthostatic test, respectively head up tilt table test and cardiovascular reflex tests. Therapy is non-medicamentous...

Immunotherapy and long-term chemoprophylaxis in prevention of recurrent urinary infections in women

S. Krčméry, J. Hromec, Z. Gábrišová, R. Tahotný

Vnitr Lek 2010, 56(9):955-960  

In clinical practice, management of urinary infections is a frequent task. Long-term prophylactic administration of small-dose chemotherapy had been shown to prevent recurrent urinary infections. Recently, an interest increases in applying immunotherapy in this indication. The authors compare immunomodulators Urovaxom and Luivac as part of a combined immunotherapy and chemoprophylaxis regimens with small doses of fluorochinolones over 12 months in women with recurrent urinary infections. This treatment statistically significantly decreases occurrence of relapses and has been relatively well-tolerated. Unlike previous studies, we managed to isolate...

Adrenal incidentalomas - is the present management rational?

I. Lazúrová

Vnitr Lek 2010, 56(9):961-966  

Adrenal incidentalomas, i.e. clinically inapparent adrenal mass, are considered to be one of the most frequent tumours in human pathology. They more frequently occur in women, older age, patients with metabolic syndrome and in patients with malignant diseases. The first step in the management is exclusion of hormonal activity and differentiation of malignant and benign lesions. At present, there is no consensus with respect to differential diagnosis and treatment of adrenal incidentalomas since the development of hormonal hyperfunction and a risk of malignancy are negligible. The most frequent cause of hyperfunction is subclinical hypercortisolism,...

Serum lipoprotein profile in newly recognized arterial hypertension. The role of atherogenic lipoproteins in the pathogenesis of disease

S. Oravec, A. Dukát, P. Gavorník, M. Čaprdna, M. Kučera

Vnitr Lek 2010, 56(9):967-971  

New examination approaches in biochemical analysis of lipoproteins can identify and quantify atherogenic plasma lipoproteins, including small dense LDL and characterise a lipoprotein spectrum as a non-atherogenic lipoprotein profile phenotype A, respectively as an atherogenic lipoprotein profile phenotype B. Identification of a non-aterogenic hypercholesterolemia (48%), atherogenic hypertriglyceridemia (93%), atherogenic normolipemia (13%) in patients with arterial hypertension and an atherogenic normolipemia in control group of healthy subjects (7%), is an essential contribution of this new laboratory diagnostics.

Statin myopathy - rarity or reality?

D. Pella

Vnitr Lek 2010, 56(9):972-976  

Statins are the most effective drugs for reducing LDL-cholesterol and have strong evidence based medicine documented by significant reduction of cardiovascular events in wide variety of patients. Despite this fact, they are still underused in common clinical practice. Many physicians have expressed concern about potential adverse effects, particularly severe muscle toxicity, which is an impediment to appropriate statin use. The clinical symptoms of statin myopathy include myalgia or muscle weakness, tiredness, cramps and/or creatinkinase activity increases (CK). Because hypercholesterolaemia is usually asymptomatic, any unwanted effect of drug used...

Glycaemia control in critically ill patients is justified and effective

J. Rybka

Vnitr Lek 2010, 56(9):977-987  

Hyperglycemia and insulin resistance develop in the majority of severe acute illness and/or injury. One of the main causes of hyperglycemia in critically ill patients is the release of counterregulatory stress hormones and proinflammatory cytokines, in addition to increased production of glucose along with its decreased utilization. Hyperglycemia plays an important role not only in influencing the cascade of inflammatory cytokines, but it also increases oxidative stress. In the past, stress hyperglycemia was thought to be an evolutionary protective, natural adaptive response of the body to current threat, which allows increased entry of glucose into...

Heart and kidneys - a fatal relationship

P. Solík, E. Gonçalvesová

Vnitr Lek 2010, 56(9):988-994  

Cardiac and renal dysfunction of different degree is common combination in patients in clinical practice. This combination of cardiovascular and renal injury has been defined as a cardiorenal syndrome. The aim of this paper is to offer a comprendious information about actual insights into pathophysiology, terminology, classification and management of cardiorenal syndrome from cardiologist's point of view.

Hypertension in patients with diabetes mellitus

M. Souček

Vnitr Lek 2010, 56(9):995-999  

Hypertension in patients with type 2 diabetes mellitus (DM) is one of the most frequent, most serious but treatable risk factors. The results of randomised studies clearly show the benefits of improved blood pressure control in type 2 DM patients but achievement of target blood pressure values in clinical practice remains a major problem. Type 2 DM, and primarily increased systolic blood pressure, significantly worsen patient prognosis with respect to microvascular as well as macrovascular complications. Recommendations by the European Society of Hypertension and the European Society of Cardiology emphasise the need for good diagnostics and effective...

Metabolic syndrome and aortic stiffness

A. Šimková, J. Bulas, J. Murín, K. Kozlíková, I. Janiga

Vnitr Lek 2010, 56(9):1000-1004  

Introduction:The metabolic syndrome (MS) is a cluster of risk factors that move the patient into higher level of risk category of cardiovascular disease and the probability of type 2 diabetes mellitus manifestation. Definition of MS is s based on the presence of selected risk factors as: abdominal obesity (lager waist circumpherence), atherogenic dyslipidemia (low value of HDL-cholesterol and increased level of triglycerides), increased fasting blood glucose (or type 2 DM diagnosis), higher blood pressure or antihypertensive therapy. In 2009 there were created harmonizing criteria for MS definition; the condition for assignment of MS is...

Is our management of patients with claudicatio intermittens correct?

V. Štvrtinová

Vnitr Lek 2010, 56(9):1005-1009  

Claudicatio intermittens is the major symptom of peripheral arterial disease of extremities. At the same time it is an important manifestation of systemic atherosclerosis. In spite of the fact that the diagnosis of claudicatio intermittens requires only simple, non-invasive, and inexpensive diagnostic methods, the disease is still underdiagnosed and often goes untreated. Proper treatment of patients with claudicatio intermittens prevents the progression of the disease and development of critical limb ischemia as well as reduces other complications of systemic atherosclerosis, including cardiovascular death.

XV. medzinárodný kongres pre výživu a metabolizmus pri chorobách obličiek, 25.-28. mája 2010, Lausanne (Švajčiarsko)

M. Mydlík, K. Derzsiová

Vnitr Lek 2010, 56(9):932-933