K významnému životnímu jubileu emeritního editora časopisu Vnitřní lékařství doc. MUDr. Dušana Mrkose, CSc.

Vnitr Lek 2009, 55(Suppl 1):3  

XXVIII. dny mladých internistů. Olomouc, 4.-5. 6. 2009

Vnitr Lek 2009, 55(Suppl 1):153-194  

Koloběhy života aneb doc. MUDr. Dušan Mrkos, CSc., devadesátníkem

P. Svačina

Vnitr Lek 2009, 55(Suppl 1):6-8  

Chronic cardiac failure treatment in an internal medicine ambulance

J. Vítovec, L. Špinarová, J. Špinar

Vnitr Lek 2009, 55(Suppl 1):9-12  

Management of chronic heart failure in an internal medicine ambulance at present is based on blockade of the rennin-angiotenzin-aldosterone system (RAAS) with angiotenzin-converting enzyme inhibitors (ACEI) or angiotenzin II receptor₁ (AT₁) blockers - sartans (ARB) or, alternatively, aldosterone receptor blockers (BAR) and, in addition, blockade of the sympathetic nervous system with beta-blockers (BB). When water retention occurs, diuretics are added to this combination. Should this treatment be ineffective, or in case of atrial fibrillation, digoxine is added. Further therapeutic modalities are more suitable for specialized...

Hypertension therapy in obese patients

M. Souček

Vnitr Lek 2009, 55(Suppl 1):13-18  

Inter-relationship between hypertension and obesity is very well known although the actual grounds for this linkage are not clear. There is growing evidence to support the role of increased sympathetic nervous system activity and involvement of the RAAS in aetiology of hypertension in obese patients. Visceral obesity is the type of obesity we should focus on in clinical practice. Treatment of hypertension should start with the treatment of obesity aiming at body weight reduction and changes to the lifestyle. Where indicated, lifestyle changes could, or even should, be supported with an anti-obesity agent. Positive effect of lifestyle management as...

Differences between male and female patients in acute cardiac failure

J. Špinar

Vnitr Lek 2009, 55(Suppl 1):19-22  

Acute heart failure is a major and growing cause of in hospital mortality in developed countries. Differences between male and female hospitalised for acute heart failure were observed in all registries and clinical studies. We compare data from European registries AHEAD (Acute HEArt Database), EHFS II (EuroHeart Failure Survey programme II) or DIAMOND (Dispensibility Improvement And Remodeling in Diastolic Heart Failure study) with US registries ADHERE and OPTIMIZE HF. Women are older than men when admitted with heart failure in all registries, the mean age of women is 73-75 years, and the mean age of men is 68-70 years. Women have higher systolic...

New classification of Ph negative chronic myeloproliferative neoplasias

J. Kujíčková, M. Doubek

Vnitr Lek 2009, 55(Suppl 1):23-28  

New classification of Ph negative chronic myeloproliferative neoplasias starts from the previous classification of the World Health Organization from 2001. New evidence in molecular biology and new views of histopathological evaluation were the stimuli for the current revision of classification. The review introduces current classification criteria of Ph negative myeloproliferative neoplasias.

Acute upper gastrointestinal bleeding

J. Lata, R. Kroupa, I. Novotný, T. Vaňásek

Vnitr Lek 2009, 55(Suppl 1):29-33  

In gastroenterology, upper gastrointestinal bleeding is a severe acute situation. Mortality is about 10% and has not changed importantly over the last decades. The incidence of bleeding and its mortality increase with increasing age, co-morbidities and polytherapy. Peptic ulcers of the stomach and duodenum are the most frequent causes (42-50%). 5-20% are patients with portal hypertension-related bleeding. Upper gastrointestinal bleeding requires a specific therapeutic approach. Endoscopic examination is essential; apart from diagnosis, it also enables management of the source of bleeding in most cases. Endoscopy also enables evaluation of the severity...

Patient with diabetes - internal medicine patient

R. Češka

Vnitr Lek 2009, 55(Suppl 1):34-40  

Patients with type 2 diabetes mellitus (DM2T) are a part of all physicians', including internal medicine physicians', everyday practice. Furthermore, it is possible to presume that the number of patients with diabetes mellitus will increase consequent to the obesity and metabolic syndrome epidemic as well as deteriorating lifestyle within the population. What is the role of an internal medicine physician, primary or secondary care-based, in the care of a DM2T patient? It first needs to be taken into account that a patient with diabetes is a patient with polymorbidity who is at risk of cardiovascular disease as well as nephropathy, infections and other...

Indication for examination of risk factors for venous thrombosis

M. Matýšková, M. Šlechtová, J. Zavřelová, M. Penka

Vnitr Lek 2009, 55(Suppl 1):41-47  

Pathogenesis of thrombosis includes many interacting factors, both inherited and environmental. We are able to detect a lot of thrombotic risk factors. Surveying these should be indicated only in cases where knowledge of the defect can influence patient's treatment. Wide range screening of defects in which there is no definite proven relation to clinical picture is not recommended.

Current advances in the care for patients with haemophilia

M. Penka, J. Blatný, M. Matýšková, P. Smejkal, E. Tesařová

Vnitr Lek 2009, 55(Suppl 1):48-51  

Haemophilia is a disease known from antiquity and always stirring significant expert and lay discussion. This is an infrequent disease that, nevertheless, is characterized by certain regularities that have rather unusual but often paradigmatic nature. Non-medical issues, at present in particular, are predominantly financial. It is, therefore, necessary to address the issue of haemophilia in detail and to attempt to provide comprehensive solutions based on seamless organization and clear definitions of the character and extent of care as well as on rational utilization of all available resources provided by the current medicine and age. The paper reviews...

Paediatric tumours metastasizing to bone marrow and their haematological characterisation

S. Valníček, J. Zapletal, J. Blatný, B. Jordanová, M. Kokeszová, D. Kodýtková

Vnitr Lek 2009, 55(Suppl 1):52-58  

The paper provides an overview of paediatric tumours most frequently metastasizing to bone marrow, reviews briefly possible clinical and laboratory signs of metastases and lists and evaluates morphological methods of their diagnosis with particular focus on haematological investigations of bone marrow aspirations. The paper briefly touches upon the morphology of the most important tumours in this group and, in attachments, presents their microphotographs with explanatory notes. Possible difficulties faced by the clinicians when evaluating the tumours are highlighted. The authors cite published literature and share experiences from their own practice.

Iron overload - recent advances in pathogenesis and treatment

J. Čermák

Vnitr Lek 2009, 55(Suppl 1):59-63  

Iron overload may result as a consequence of increased iron income or deffective iron utilization. The most common reason in our region is hereditary hemochromatosis or red blood cell transfusions dependent anemias with a high rate of ineffective erythropoiesis (eg. myelodysplastic syndrome). A key moment for the development of the toxicity caused by iron overload is increased iron release into circulation. An exceeded transferrin saturation leads to increased amount of non-transferrin bound iron in circulation and one of its components, so called labile plasmatic iron may initiate lipid peroxidation resulting in cellular destruction. Basic laboratory...

Treatment of chronic myeloid leukemia in era of imatinib

K. Indrák, E. Faber, M. Jarošová

Vnitr Lek 2009, 55(Suppl 1):65-73  

Authors introduce their review with description of historic achievements that enabled to reach the actual stage of knowledge on ethiopathogenesis of chronic myeloid leukemia (CML), to synthetize first tyrosine kinase inhibitor - imatinib (Glivec, IM) and to develop the revolutionary targeted treatment of CML. Targeted therapy has both completely changed prognosis of patients with CML and stimulated further discoveries in ethiopathogenesis of other malignancies that was followed also by introduction of specific targeted treatment. Authors explain basic terms of cytogenetic and molecular evaluation of treatment results, determination of optimal therapeutic...

Gastrointestinal lymphomas

P. Klener

Vnitr Lek 2009, 55(Suppl 1):74-76  

Gatrointestinal tract is the most commonly affected site of extranodal non-Hodgkin's lymphomas (NHL) accounting for approximately 40% of all extranodal primary NHL. Almost a half of them are indolent lymphomas, mainly MALT lymphoma. From agressive forms is the most frequent difuse large cell B-lymphoma (DLCBL). In this review, principles of diagnostic and treatment of gastrointestinal lymphomas are presented.

Present possibilities of diagnosis and treatment of systemic AL-amyloidosis

V. Ščudla, T. Pika

Vnitr Lek 2009, 55(Suppl 1):77-87  

The aim of presented communication is summary of actual knowledge in pathogenesis, diagnosis and treatment of primary systemic AL-amyloidosis. Great attention is devoted to contribution of assessment of serum levels of free light chains including κ/λ ratio, measurement of cardiac biomarkers NT-proBNP and troponin, and also ¹³²I-SAP immunoscintigraphy for treatment response monitoring. The necessity of standardized evaluation of treatment results according to International Society for Amyloidosis recommended criteria are discussed. And also current possibilities of conventional chemotherapy, contribution of high-dose chemotherapy...

Problems of haemostatic disorders in metabolic syndrome

P. Galajda, M. Mokáň

Vnitr Lek 2009, 55(Suppl 1):88-93  

Metabolic syndrome (MS) is defined as cluster of independent risk factors of coronary heart disease (CHD) and type 2 diabetes mellitus (DM2) including glucose metabolism disorders associated with insulin resistance, central obesity, dyslipidaemia with increasing of triglyceride levels and decreasing of high density lipoprotein levels and arterial hypertension. There are differences in prediction of CHD and DM2 risk among recommendations for diagnostic criteria of MS according to WHO (1999), NCEP-ATPIII (2001), ACE/AACE (2003), AHA/NHBLI (2004) and IDF (2005). New risk factors include markers of low grade inflammatory reaction, endothelial dysfunction...

Prothrombotic state in NAFLD and its consequences

A. Hvizdáková, M. Vyskočil, Ľ. Kekeňák, E. Kováčová, H. Kratochvíľová, M. Boča

Vnitr Lek 2009, 55(Suppl 1):94-96  

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in population. NAFLD is one part of metabolic syndrome (MS). The liver plays the role in haemostasis by the synthesis of coagulant, anticoagulant factors and haemostasis regulation. It seems recently, that there are prothrombic changes in haemostasis in patients with MS and NAFLD. They are caused by endothelial dysfunction, hypofibrinolysis and hypercoagulant state. Prothrombotic state in patients with NAFLD can by means of the insulin resistance increase cardiovascular risk as well as the risk of thromboembolism. The formation of microthrombi in hepatic vessels can participate...

Management of the diabetic patient with coronary artery disease

P. Mikeš, J. Murín

Vnitr Lek 2009, 55(Suppl 1):97-102  

The prevalence of 2 type diabetes in the world as a consequence of modern urban lifestyle is convincingly growing. Diabetes together with other risk factors for cardiovascular disease creates a part of metabolic syndrome. Diabetic cardiomyopathy is defined as heart failure in diabetic patient without any other known reason and an impairment of myocardial metabolism with preference of less efficient free fatty acids beta oxidation in generating ATP is typical for it. The main goal in the management of diabetic patient with CAD is to prevent macro- and microvascular complications and improve the prognosis of the patient. To achieve this we need a multifactorial...

Changes to the renal function results following marathon run, a 100-kilometre run and a 24-hour long-term run

M. Mydlík, K. Derzsiová, B. Bohuš

Vnitr Lek 2009, 55(Suppl 1):103-107  

Methods:Renal function assessment was conducted in 29 marathon runners, 21 runners of a 100-kilometre run and in 7 runners after 24-hour run at a stadium. Results:Runners' body weight decreased in marathon runners by 1.3 ± 0.5 kg, in 100-kilometre runners by 2.4 ± 0.7 kg and in 24-hour runners by 4.4 ± 1.1 kg. Blood pressure declined after the first two runs and increased after the 24-hour run. Total proteinuria and albuminuria increased significantly after all three types of run, the least after the 24-hour long-term run. Non-glomerular erythrocyturia was present in the majority of runners after the marathon...

Zájem pana doc. MUDr. Dušana Mrkose, CSc., o vzácné choroby předběhl o mnoho let program EU zaměřený na vzácné nemoci

Z. Adam

Vnitr Lek 2009, 55(Suppl 1):108  

Histiocytic disorders

Z. Adam, M. Krejčí, L. Pour

Vnitr Lek 2009, 55(Suppl 1):109-124  

Histiocytic disorders occur sporadically and may thus be considered as rare diseases. The most frequent serious histiocytic disorder of adulthood is the Langerhans cell histiocytosis. Juvenile xanthogranuloma is associated with foamy histiocytes and affects patients in early childhood. Erdheim-Chester disease, on the other hand, is a disease of adulthood. Foamy macrophages usually infiltrate lower extremities as well as retroperitoneum and mediastinum and are the cause of fibrosis. Both Erdheim-Chester disease and Langerhans cell histiocytosis sometimes infiltrate hypothalamus and pituitary stalk and diabetes insipidus is thus the first sign of the...

Differential diagnosis of eosinophilia

Z. Adam, M. Tomíška, M. Krejčí, L. Pour

Vnitr Lek 2009, 55(Suppl 1):125-144  

Elevated eosinophil count might be a sign of many different pathologies. Most frequently, this is a result of allergic conditions. Elevated eosinophil count associated with a parasitic infection is considered as physiological. Eosinophilia may be linked to certain organ and connective tissue disorders. The primary increase in eosinophil count may be caused by pathologic (benign or malignant) cloning of T-lymphocytes that, through their cytokines, stimulate proliferation and differentiation of eosinophilic lineage. Nonetheless, the primary malfunction could also be directly in the myeloid cell line. Some of the myeloid cell mutations associated with...

Foreign relations of the Czechoslovak Hematology Society in 1951-1989

L. Chrobák

Vnitr Lek 2009, 55(Suppl 1):145-148  

International scientific networking had been considerably restricted after 1948. The reasons were political as well as financial. Restrictions included attendance at international congresses abroad as well as organization of international professional events in CSSR. Czechoslovak Hematology Society strived for breaking up this isolation by initiating and organizing bilateral conferences with societies of hematology in Poland, the then GDR and Hungary. Furthermore, Prague hosted 3 important international professional events before 1989: Symposium on the role of blood platelets in haemostasis and thrombosis in 1971 (Secretary General P. Pudlák), II....

Vývoj oboru klinické hematologie dospělých v Brně do 90. let minulého století (vzpomínky klinického hematologa)

J. Jedličková

Vnitr Lek 2009, 55(Suppl 1):149-152