Controlled hypothermia - editorial

R. Gál

Vnitr Lek 2008, 54(6):595-596  

Comparative study of detection and evaluation of the size of oesophageal varices with the use of 12 and 20 MHz frequency radial endosonography vs. esophagogastroduodenoscopy

I. Tozzi, V. Procházka, M. Holinka, J. Zapletalová, I. Vinklerová

Vnitr Lek 2008, 54(6):597-603  

Introduction:Portal hypertension is an important marker in the development of life-threatening complications of hepatic cirrhosis. It is the direct cause of oesophageal varices (OV), liver encephalopathy, and of ascites. One of the most important locations where the junctions between the portal and systemic circulation become dilated is the region of the oesophagus and the stomach. Bleeding from OV can be the cause of death in as many as 1/3 of cirrhosis patients with portal hypertension. Oesophagogastroduodenoscopy (EGD) is a standard procedure to examine gastro-oesophageal varices, but radial endosonography (EUS) allows for precise quantification...

Late recurrences of atrial fibrillation in patients after direct-current cardioversion

M. Gurčiková, J. Kalužay, S. Remišová, O. Jurkovičová, P. Ponťuch

Vnitr Lek 2008, 54(6):604-608  

Aim:To analyze factors after successful direct-current cardioversion in patients with atrial fibrillation and to explore late recurrences of the arrhythmia. Methods:Forty-three patients with atrial fibrillation without associated valvular heart disease, who underwent non-emergent cardioversion within the years 2002-2006, were included. We retrospectively analyzed clinical data from the medical records. Late reccurence of the arrhythmia was defined as arrhythmia in patients discharged with sinus rhythm. Results:Median follow-up of the patients was 33 (17, 48) months. We found 20 late recurrences of atrial fibrillation...

Overcooling during mild hypothermia in cardiac arrest survivors - phenomenon we should keep in mind

R. Škulec, T. Kovárník, J. Bělohlávek, G. Dostálová, J. Kolář, A. Linhart, J. Šeblová

Vnitr Lek 2008, 54(6):609-614  

Background:Mild hypothermia (MH) in cardiac arrest survivors has became a routine part of early postresuscitative support. Overcooling is a frequent phenomenon with the unknown outcome. Aim of the study:To analyze the incidence and outcome of overcooling below body core temperature (BT) of 32 °C. Material and methods:We performed retrospective analysis of all 56 consecutive cardiac arrest survivors treated by MH who reached therapeutic BT in the 2nd Department of Internal Medicine, General Teaching Hospital, Prague. MH was initiated as soon as possible after the return of spontaneous circulation to reach BT...

Hypertension in HIV positive patients

Z. Pozdíšek, O. Ludka, V. Musil, J. Vlašínová, S. Snopková, P. Lokaj, J. Špinar

Vnitr Lek 2008, 54(6):615-617  

Survival of HIV-positive patients on highly active antiretroviral therapy (HAART) has significantly improved. Although traditional heart complications of the infection such as pericarditis or myocarditis has become rather rare owing to the therapy, wide range of metabolic abnormalities have been described. We focused on the evaluation of prevalence of hypertension among HIV positive patients with respect to their high cardiovascular risk. We examined 40 HIV positive patients (28 males and 12 females) followed in AIDS center in Brno. All probands underwent 24-hour ambulatory blood pressure monitoring as a part of their cardiological examination. 40...

Repolarization homogeneity in patients after acute myocardial infarction assessed from long-term 12-lead electrocardiographic recordings

T. Novotný, I. Dohnalová, M. Šišáková, M. Poloczek, K. Hnátková, O. Toman, L. Dostálová, L. Maňoušková, A. Floriánová, P. Kala, J. Špinar, M. Malik

Vnitr Lek 2008, 54(6):618-622  

Background:Abnormal heterogeneity of myocardial electrophysiologic processes increases the risk of malignant arrhythmias. The aim of the study was to assess changes of repolarization homogeneity in patients after acute myocardial infarction (MI) using morphological parameters obtained from long-term 12-lead electrocardiographic recordings. Methods:In the group of 200 patients (45 females, 155 males) a long-term (10 minutes supine) 12-lead electrocardiographic recording (SEER MC, GE Medical) was performed 48-72 hours after acute myocardial infarction. The following parameters were calculated using experimental software: total...

Treatment of haemorrhage with transfusion preparations and blood derivatives

A. Buliková, M. Matýšková, M. Penka

Vnitr Lek 2008, 54(6):623-631  

Appropriate use of blood components and blood products improved both patients care and use of health care resources. In bleeding and/or risk bleeding situations use of these products is often indicated. The authors summarise different guidelines, experiences, indications and problems in hemotherapy concerning bleeding complications.

Preparation of patients with haemostatic disorder for invasive medical interventions

M. Penka, A. Buliková, P. Smejkal, J. Kissová, M. Matýšková, J. Gumulec, S. Králová, M. Šlechtová, G. Chlupová

Vnitr Lek 2008, 54(6):632-637  

The current trend in medicine is to sustain the possibility for necessary procedures to be performed in patients who suffer from haemostatic disorders which complicate eventual surgery. Among such disorders are congenital blood coagulation disorders, haemostatic disorders concomitant with other diseases and also therapies which affect haemostasis either on purpose or as part of adverse effects. Among coagulation disorders are congenital haemorrhagic or thrombotic conditions, acquired blood coagulation disorders - combined in the vast majority of cases - and associated with pregnancy, severe internal diseases and surgery related diseases, severe injuries,...

Cancer personality: Current view and implications for future research

M. Blatný, Z. Adam

Vnitr Lek 2008, 54(6):638-645  

The paper provides an outline of the present state of knowledge of the 'C-type' or cancer-prone personality. Links between personality and cancer have been studied approximately since the mid 1960's. Opinions on the role of personality dispositions and other psychosocial factors in the development of cancer have been changing over the last 50 years. There are basically two periods marking the evolution of thought on the subject. While in the early 1990's, results of research were interpreted in favour of the existence of the C-type personality, in spite of a lack of consistency (and often contradictory findings), currently they are interpreted in disfavour...

The risk of cardiovascular diseases induced by radiotherapy

K. Hudecová, D. Urbanová, H. Petrášová

Vnitr Lek 2008, 54(6):646-652  

At present the number of cancer survivors is still increasing. However, their long-term quality of life after anticancer treatment can be decreased. Radiotherapy may represent a risk for the future of some oncologic patients. The late cardiovascular effects of radiotherapy to the area of thorax, cranium and to the abdominal area are the actual multidisciplinary problem. The unique problem is mediastinal radiotherapy which may induce the development of the cardiomyopathy, constrictive pericarditis, coronary artery disease, myocardial infarction, valvular defects, arrhythmias and other complications. Exact knowledge of pathophysiological mechanisms of...

Treatment of multiple angiomatosis involving the skeleton and the abdominal and thoracic cavities with interferon α, thalidomide and zoledronate

Z. Adam, L. Křikavová, M. Krejčí, M. Mechl, L. Pour, M. Moulis, J. Vaníček, Č. Neumann, M. Navrátil, K. Veselý, J. Vorlíček

Vnitr Lek 2008, 54(6):653-664  

Multiple angiomatosis is a very rare disease formed by histologically benign angiomas spreading beyond single organ or tissue. In the case reported herein, hemangiomas affected several vertebrae of a young man and spread through his peritoneal cavity projecting to his stomach and causing recurrent hematemesis. Also affected was the mediastinum. The patient suffered from bone pain and digestive problems. Initial treatment involved 2 drugs with antiangiogenic effect: interferon α (initial dose of 6 million units 3 times a week, later reduced to 3 million units 3 times a week due to adverse effects) and zoledronate (4 mg i.v. every 28 days). Even...

Acute cholestasis following treatment with nimesulide and oral contraception: case report and review

T. Koller, A. Baňárová, F. Ondriaš, J. Kollerová, J. Payer

Vnitr Lek 2008, 54(6):665-669  

Our case report of acute cholestatic liver injury highlights the potential hepatotoxicity of nimesulide treatment in combination with oral contraception. Rarely occuring histological findings of "pure" cholestasis without any inflammatory or necrotic changes with favourable outcome following ursodeoxycholic acid administration are described. It was not possible to distinguish the separate role of any of these two drugs on hepatotoxicity according to the available information. Based on the known similarities in hepatotoxic profile of nimesulide and oral contraceptives, it can be assumed that their interaction could increase the risk of liver damage,...

The 60th anniversary of the discovery of the LE (lupus erythematosus) cell

J. Vachtenheim

Vnitr Lek 2008, 54(6):672-673  

Professor MUDr. František Pór's School of Internal Medicine

M. Mydlík, K. Derzsiová, P. Schweitzer

Vnitr Lek 2008, 54(6):674-675  

The article pays tribute to prof. MUDr. František Pór and his significant role in the development of internal medicine in Košice and in Eastern Slovakia, where he actively pursued his profession from 1945 to 1971. He was the founder of the school of internal medicine in the proper sense of the word having laid down its organisation, therapy and prevention, training and research bases. His pupils, and the pupils of his pupils, have carried on his legacy till this day. This fact was remembered on the occasion of the 15th commemoration held by the Košice Doctors' Association in his honour and memory and on the occasion of the upcoming 60th anniversary...

Imaging of stenosis of ramus interventricularis anterior by computed tomography and selective coronarography

R. Duchoňová, T. Adla, M. Malý, M. Šramko

Vnitr Lek 2008, 54(6):670-671