Je potřeba zavádět pojem bažení do klinické praxe? - editorial

Z. Marinov

Vnitr Lek 2012, 58(2):87-88  

An overview of so far published analyses comparating the effectiveness of the treatment with insulin pump and multiple daily injections in type 1 diabetes mellitus

T. Hendrychová, P. Matoulková, J. Vlček, A. Šmahelová

Vnitr Lek 2012, 58(2):89-93  

The paper brings an overview of published systematic reviews and meta-analyses concerning the evaluation of the effectiveness of the treatment with insulin pump (CSII) in comparison with multiple daily injections (MDI) in type 1 diabetes mellitus. According to found works CSII leads to slightly lower levels of glycosylated hemoglobin (HbA_1c) in patients with type 1 diabetes mellitus against MDI. The levels of HbA_1c and the variability of glycaemia during the day on MDI before an initiation of CSII should serve for the prediction of an effect of CSII in particular patient. Type 1 diabetics on CSII have less often hypoglycaemia,...

Radioiodine ¹³¹I therapy of hyperthyroidism on an outpatient basis - safe, effective and economic option

J. Jiskra, J. Kubinyi, Z. Telička

Vnitr Lek 2012, 58(2):94-98  

Introduction:Radioiodine ¹³¹I therapy of hyperthyroidism on an outpatient basis is widely accepted over the world. In Czech Republic, however, radioiodine therapy is still not enough used, and has been realized on an inpatient basis to date. Our work is the first analysis of the experiences with radioiodine therapy of hyperthyroidism on an outpatient basis in Czech Republic. Methods:Capsule with 550 MBq of ¹³¹I was administered orally in 39 hyperthyroid patients (32 women and 8 men, 21 with autoimmune Graves' hyperthyroidism and 18 with toxic thyroid nodules, mean age 66.8 years). In 32 of them we evaluated...

Celiac disease - a missed diagnosis

T. Chvátalová, G. Vepřeková, A. Houska, P. Frič

Vnitr Lek 2012, 58(2):99-103  

Background:In Czech population celiac disease is diagnosed infrequently and on the contrary frequently too late. Aim:The present quality of diagnostics, therapy, follow-up and relation of celiacs to causal therapy has been evaluated. Methods:A structured questionnaire was offered to celiacs followed at different out-patient departments (medicine, gastroenterology, dermatology, hematology, and endocrinology) of one institution (Central Military Hospital Prague) in the years 2000-2010. The following topics were analyzed: the health care provided to probands before the diagnosis of celiac disease (number and speciality...

Virological sustained response to former young intravenous drug abusers with chronic hepatitis C treated by pegylated interferon-α plus ribavirin

K. Gazdíková, F. Gazdík, I. Kajaba, D. Hučková, D. Daniš, Ľ. Okruhlica

Vnitr Lek 2012, 58(2):104-109  

Introduction:The most risk group with high rate of infection of viral hepatitis C represents the former drug abusers (IDUs). Objectives:The objectives of the clinical study were to assess the sustained virological response (SVR) in the group of former IDUs with chronic hepatitis C (CHC) treated with pegylated interferon-α and ribavirin. Patients and methods:Of 293 previously untreated (naive) former IDUs with CHC who have started treatment, we assessed 239 (69 women, 170 men) with an average age of 27 years who completed treatment and received a follow-up examination after 24 weeks. Prior to therapy abstinence...

Food craving symptoms in older school age children and its relation to body-mass index

M. Světlák, K. Pšenicová

Vnitr Lek 2012, 58(2):110-117  

Recent findings show that food craving represents an important co-factor in overweight and obesity etiology and its severity represents a good predictor of relapse during active weight control. Child overweight and obesity also represents significant predictive factor of adulthood obesity and evidence about its incidence in children is therefore important. In order to achieve this evidence the indices of food craving has measured in 150 older school age children (54 boys and 96 girls; mean age 13.6 ± 1.2). The food craving symptoms were measured by validated Czech translation of the General Food-Craving Questionnaire-Trait (G-FCQ-T). Body proportions...

Shrnutí doporučení České pracovní skupiny pro Ph-negativní myeloproliferativní onemocnění (CZEMP) České hematologické společnosti ČLS JEP pro diagnózu a terapii BCR/ABL-negativních myeloproliferací

M. Penka, J. Schwarz, V. Campr, D. Pospíšilová, L. Křen, L. Nováková, C. Bodzásová, Y. Brychtová, O. Černá, P. Dulíček, A. Jonášová, J. Kissová, Z. Kořístek, M. Schützová, I. Vonke, L. Walterová

Vnitr Lek 2012, 58(2):163-168  

Clinical implications of enlargement of left atrium

Ľ. Družbacká, G. Valočik, M. Jakubová, B. Stančák, L. Fojtíková

Vnitr Lek 2012, 58(2):118-122  

Enlargement of left atrium (LA) has been shown to be a barometer of diastolic burden and a predictor of common cardiovascular outcomes such as atrial fibrillation, stroke, congestive heart failure, and cardiovascular death. Different methods exist for the assessment of LA size. The American Society of Echocardiography recommended LA volume and its indexed value assessed by 2-dimensional echocardiography, to measure LA size. Current findings suggest that echocardiographically determined LA size may become an important clinical risk identifier in preclinical cardiovascular disease and should be assessed as a part of routine echocardiographic evaluation.

Haemostatic mechanisms in the process of atherotrombosis

T. Kvasnička

Vnitr Lek 2012, 58(2):123-128  

Hemostasis play an essentials role in protecting of vascular integrity and maintaining normal blood flow, and anatomically and functionally is entwined with the vasculature. The classic concept of atherosclerosis assigns a pivotal role to inflammation in the onset and progression of this disease. Accumulating data suggest an intimate cross-talk between hemostasis and inflammation, underscoring the role of both systems in many complex diseases, including atherothrombosis. An experimental data indicate that platelets and the coagulation system are important determinants of both atherogenesis and atherothrombosis. The hemostatic system is well known for...

Significance of urokinase and its inhibitors in the invasiveness and metastasing of malignant tumors

J. Halámková, I. Kiss, J. Tomášek, Z. Pavlovský, Š. Tuček, M. Penka

Vnitr Lek 2012, 58(2):129-134  

Fibrinolysis is process, which leads to the degradation of fibrin to fibrin monomers. Fibrinolysis helps to regulate hemostasis and prevents the creation of inappropriately large thrombus, which could reduce blood flow to the bloodstream. The main enzyme involved in fibrinolysis is plasmin. Tissue plasminogen activator (tPA) and urokinase (uPA) are agents converting plasminogen into active plasmin, together with urokinase receptor (uPAR) and urokinase inhibitors (PAI 1, PAI 2, PAI 3 and protease nexin) form plasminogen activator system (PAS) which is among others also part of the metastatic cascade and significantly contributes to invasive growth and...

Soft tissues, hormones and the skeleton

I. Žofková

Vnitr Lek 2012, 58(2):135-139  

Mechanical load activates bone modeling and increases bone strength. Thus physical activity is extremely important for overall bone health. Muscle volume and muscle contraction are closely related to bone mineral density in men and women, although these relationships are more significat in men. The muscle-bone unit has been defined as a functional system, in which both components are under control of the somatotropin-IGF-I system, androgens and D hormone. These endocrine systems play, via the muscle-bone unit, an important role in development of the skeleton and its stability in adulthood. That is why deficiency of any of these hormonal systems, or...

Medicines and thyroid gland

M. Tajtáková

Vnitr Lek 2012, 58(2):140-144  

From their primary pharmacological effect, many drugs may also affect the thyroid gland function or the results of thyroid function tests. In addition to the drugs with a known effect on thyroid gland, including thionamides, thyroid hormones, recombinant TSH, iodine, iodide, amiodarone, lithium and heparin, novel compounds, including tyrosin-kinase inhibitors, immunomodulators and cytokines also have adverse effects on the thyroid gland. Novel drugs are then associated with new types of adverse thyroid effects.

Chronic disseminated intravascular coagulation (DIC) markers in a patient with multiple angiomatosis during treatment with antiangiogenics: interferon α, thalidomide and lenalidomide

Z. Adam, L. Pour, M. Matýšková, M. Krejčí, M. Tomíška, P. Szturz, Z. Řehák, R. Koukalová, L. Křikavová, T. Nebeský, Č. Neuman, M. Navrátil, R. Hájek, Z. Král, J. Mayer

Vnitr Lek 2012, 58(2):145-153  

Background:Multiple angiomatosis is a rare disease with angiomatous formations in multiple organs and tissues and associated with a risk of fatal bleeding. Case description:In this patient, the bones, pleural and peritoneal cavities and digestive tract were involved. The patient had long-term been administered zoledronate that provided relief from bone pain as early as after the second dose. The effect of antiangiogenics was evaluated on CT and MRI. Since angiomatous proliferation is associated with chronic disseminated intravascular coagulation (DIC) and anaemisation, blood count and fibrinogen as well as D-dimer and soluble...

Good's syndrome (thymoma associated hypogammalobulinaemia) - 2 case reports

P. Králíčková, R. Slezák, M. Vošmik, P. Malá, H. Hornychová, J. Brožík, B. Melichar

Vnitr Lek 2012, 58(2):154-161  

Although tumours of the thymus are rare, they are common among neoplasms of the anterior superior mediastinum. They usually exhibit indolent behavior, but do have the capacity to invade surrouding structures. Their metastatic potential is low. Paraneoplastic complications including autoimmune disorders (frequently myastenia, cytopenia) or combined immunodeficiency are of clinical significance. Here we report two case reports of thymoma patients associated with secondary immunodeficiency known as Good's syndrom. The first case exhibited as symptomatic combinated immunodeficiency with oral lichen planus. Thymoma findings was accidental. Severity of immunodeficiency...