The effectiveness of anagrelide treatment in patients with Ph-negative myeloproliferative diseases: influence on the incidence of thrombosis in the data from the Registry of patients with essential thrombocythemia and thrombocythemia associated with other myeloproliferative diseases treated with Thromboreductin® to the end of 2012

M. Penka, J. Schwarz, P. Ovesná, L. Červinek, P. Dulíček, D. Pospíšilová, J. Kissová, T. Pavlík, kolektiv České pracovní skupiny pro myeloproliferativní choroby (CZEMP)

Vnitr Lek 2013, 59(6):516-531  

In the Czech Republic, anagrelide (Thromboreductin®) [29] is used according to the recommendations of the Czech Working Group on Myeloproliferative Disorders (CZEMP) for treatment of thrombocythemia associated with Ph-negative myeloproliferative disorders (MPDs). The patient data are collected in the Registry of patients with essential thrombocythemia (ET) and thrombocythemia associated with other MPDs treated with Thromboreductin®. At the end of 2012, the Registry contained data on 1,161 patients. Out of these, 1,159 patients with the diagnosis of a Ph-negative MPD were evaluated. In 844 patients, precise WHO based diagnosis was known at start...

Chronic obstructive pulmonary disease in the light of new guidelines - brief summary of phenotypically oriented guidelines for non-pulmonary physicans

V. Koblížek, J. Chlumský, V. Zindr, K. Neumannová, J. Zatloukal, V. Sedlák, J. Kociánová, J. Zatloukal, B. Novotná

Vnitr Lek 2013, 59(6):505-514  

Introduction:COPD is a global health and social problem. Morbidity and mortality increases in the Czech Republic. There are currently several global statements and strategies. Methods:The Czech Pneumological and Phthisiological Society (CPFS) at the end of 2011 mandated the Section of bronchial obstruction in drafting national guidelines concerning the stable COPD. Subsequently, this document was discussed during the National Consensus Conference (COPD forum) in November 2012 and presented at series of local workshops and national conferences. National guidelines has been subject to a review and eventually posted on the website...

Recept na individualizaci antikoagulační léčby

Martin Kleissner, Jan Kulhavý

Vnitr Lek 2013, 59(6):534-536  

Významné životní jubileum prof. MUDr. Karla Horkého, DrSc.

Michael Aschermann

Vnitr Lek 2013, 59(6):424-425  

Národní Program Komplexní Interní Péče (NPKIP). Interna jako páteřní obor zdravotního systému ČR

R. Češka, K. Horký, L. Kotík, M. Souček, J. Václavík, J. Widimský jr.

Vnitr Lek 2013, 59(6):426-432  

The origins of the Czech Society of Cardiology and of Czech cardiology

J. Widimský

Vnitr Lek 2013, 59(6):433-439  

The paper presents the origins of the Czech Society of Cardiology on the one hand, and the origins of Czech cardiology on the other. The Czech Society of Cardiology is the third oldest in the world (after the American and German Societies). It was founded in 1929 by Prof. Libenský. As early as in 1933, the Society organised the first international congress of cardiologists in Prague, which was attended by 200 doctors, out of which 50 were from abroad. The most participants came from France and Poland. Other participants came from England, Argentina, Belgium, the Netherlands, Italy, Romania, Spain and Switzerland. The worldwide importance of this congress...

Up-to-day trends in insulin therapy

A. Adamíková, J. Rybka

Vnitr Lek 2013, 59(6):440-443  

Patients with type 2 diabetes mellitus have a double risk of development of cardiovascular diseases than patients without diabetes. Two thirds of patients with type 2 diabetes mellitus can die from heart attack or a cerebrovascular accident if it is not possible to influence these risks by procedures such as decreasing the blood pressure, cholesterol level, glycemia and to stop smoking. The recommendations of ADA/EASD for therapy of type 2 diabetes mellitus emphasizes that the therapy should be conducted in such a manner as to decrease the risk of cardiovascular complications and undesirable effects, primarily hypoglycemic events. A whole line of clinical...

Impact of aortic stiffness on central hemodynamics and cardiovascular system

J. Bulas, M. Potočárová, M. Filková, A. Šimková, J. Murín

Vnitr Lek 2013, 59(6):444-449  

Arterial stiffness increases as a result of degenerative processes accelerated by aging and many risk factors, namely arterial hypertension. Basic clinical examination reveals increased pulse pressure as its hemodynamic manifestation. The most serious consequence of increased vascular stiffness, which cannot be revealed by clinical examination, is a change of central hemodynamics leading to increased load of left ventricle, left ventricular hypertrophy, diastolic dysfunction and to overall increase of cardiovascular risk. This review aimed to point at some patophysiological mechanisms taking part in the development of vascular stiffness, vascular remodeling...

Lipids and the size of lipoprotein particles in newly diagnosed and untreated patients with type 2 diabetes mellitus

A. Dukát, Ľ. Fábryová, S. Oravec, P. Sabaka, L. Mistríková, D. Baláž, P. Gavorník, Ľ. Gašpar

Vnitr Lek 2013, 59(6):450-452  

Type 2 diabetes mellitus leads to the typical known form of dyslipidaemia among the patients. This dyslipiademia type represents prognostically important type of atherogenic dyslipiadaemia, that significatly increases the risk of atherothrombosis. Estimation of the size of lipoprotein particles with Lipoprint method among newly diagnosed, untreated patients with these patients have not been evaluated yet. Dyslipidaemia among patients with type 2 diabetes mellitus has its course and changes after the treatment. At the beginning i tis characterized by the significant increase of VLDL, large and middle size IDL lipoprotein particles, as well as by lowering...

Metabolic syndrome and prediabetic states

P. Galajda, Michal Mokáň, Marián Mokáň

Vnitr Lek 2013, 59(6):453-458  

Metabolic syndrome is defined as cluster of independent risk factors of coronary heart disease and type 2 diabetes mellitus including prediabetic glucose metabolism disorders associated with insulin resistance as impaired fasting glucose, impaired glucose tolerance and/or borderline increasing of glycosylated haemoglobin; central obesity, atherogenic dyslipidaemia with increasing of triglyceride levels and decreasing of high density lipoprotein levels and hypertension. In diagnosis of prediabetic states there are used fasting glycaemia, 2 hours glycaemia during oral glucose tolerant test and HbA_1c level, which importance in diagnostic is...

Resistant hypertension in the elderly

Ľ. Gašpar, I. Balažovjech

Vnitr Lek 2013, 59(6):459-462  

The issue of resistant hypertension is complex and from the clinical aspect very current, especially in the elderly. For the diagnosis of resistant hypertension in routine practice, ambulatory blood pressure monitoring is a proven method to distinguish it from the white coat hypertension. Fixed combinations of antihypertensive drugs helps to improve compliance not only in geriatric patients, but are also indicated in hypertensive patients with diabetes mellitus, metabolic syndrome, in patients with target organ damage, renal disease, coronary heart disease and post stroke conditions. Especially in the population of older hypertensive patients, listed...

Epigenetic cancer drugs and their role in anticancer therapy

P. Klener

Vnitr Lek 2013, 59(6):463-465  

Epigenetic modification have been causally linked to cancer development and progression, and are potentially reversible by treatments with epigenetic cancer drugs. The aim of this review is to give an overview of the basic current knowledge on molecular mechanisms of epigenetic cancer drugs and their possible clinical use. Many of them are in inclinical trials. However only two demethylating agents ie. inhibitors of DNA methyltransferase (5-azacytidin and decitabin) are approved in the treatment of myelodysplastic syndrome and a few inhibitors of histonacetylase (vorinostat, romidepsin and panobinostat) are approved in the treatment of hematological...

The environmental estrogen bisphenol A and its effects on the human organism

Z. Lazúrová, I. Lazúrová

Vnitr Lek 2013, 59(6):466-471  

Bisphenol A (BPA), i.e. an environmental estrogen, is one of the most common synthetic chemicals which enter the human body from plastic bottles, food packaging and dental materials. As many studies show, a long-term exposure to BPA is connected with a risk of developing various diseases and endocrine disorders. Exposure to BPA, particularly during development, increases the risk of breast carcinoma, obesity, diabetes mellitus type 2 as well as reproductive disorders. It also increases the risk of testes carcinoma and prostate carcinoma. Some isolated studies support also the relation between BPA and the risk of cardiovascular and autoimmune diseases....

Impact of pregnancy on pituitary disorders

J. Marek

Vnitr Lek 2013, 59(6):472-477  

In pregnancy, the volume of pituitary increases by multiplication of lactotopic and gonadotropic cells and developing placenta is the source of numerous hormones and enzymes that significantly affect and alter the function of the endocrine system. This naturally has an impact on the course of pituitary disorders and their treatment. The most common disorders of pituitary gland, which we can meet in pregnancy, are adenomas, particularly prolactinomas, and functionless adenomas. During pregnancy we avoid the treatment of microprolactinomas, but in macroprolactinomas where there is the risk of their enlargement by stimulation of placental estrogens, we...

Differential diagnosis and treatment of hyponatremia

M. Mydlík, K. Derzsiová, K. Frank

Vnitr Lek 2013, 59(6):478-481  

Hyponatremia is one of the most common metabolic disorders in clinical medicine. The value of Na⁺ in serum equalling 135 mmol/l and lower is regarded as hyponatremia. Its clinical manifestations are the following: headaches, nausea, vomiting, seizures, numbness, coma and death. Hyponatremia caused by non-osmotic hypersecretion of vasopressin can be divided into: a) hypovolemic, b) normovolemic and c) hypervolemic. Hyponatremia which is not caused by the hypersecretion of vasopressin is the so-called pseudohyponatremia, water intoxication, cerebral salt loss syndrome. Hypovolemic hyponatremia is caused by the loss of Na⁺ and fluid...

Adherence and persistence with a focus on the treatment of hypertensive patients

M. Souček

Vnitr Lek 2013, 59(6):482-485  

Insufficient adherence of patients to treatment is a serious problem and it is monitored most frequently in hypertensive patients. The possibilities of increasing adherence to long-term treatment include mainly the motivation and education of patients, simple dosage regimes, telephone consultations and involving the patient in the treatment process (self-monitoring), but it also means providing information about the consequences of failure to adhere to the treatment process. Other possibilities can include new dosage forms which increase the biological availability of medicines, reduce the variability of absorption, and thus allow for achieving their...

Diuretics in monotherapy and in combination with other diuretics and non-diuretics in the treatment of hypertension

J. Špinar, L. Špinarová, J. Vítovec

Vnitr Lek 2013, 59(6):486-494  

Diuretics belong to the basic group of medicines for the treatment of hypertension and heart failure. In the case of hypertension treatment, their main indication is higher age and isolated systolic hypertension. In the case of heart failure they are used for the treatment of swellings and shortness of breath. The most frequently prescribed group of diuretics is thiazides and similar products. In patients with renal insufficiency, loop diuretics are administered. In the case of hypertension, diuretics are mainly used in the combination treatment. The most frequently used diuretic in combination is again hydrochlorothiazide, which is combined with renin-angiotensin...

Hypertension in patients with polycystic kidney disease - incidence, pathogenesis, prognosis, therapy

V. Tesař, J. Reiterová

Vnitr Lek 2013, 59(6):496-500  

Hypertension is common in patients with autosomal dominant polycystic kidney disease (ADPKD) very early usually already in adolescence and its occurrence precedes the decrease of glomerular filtration rate. Expansion of renal cysts causing local renal ischemia and activation of the renin-angiotensin system is believed to play a decisive role in its pathogenesis. Hypertension in ADPKD leads to early development of left ventricle hypertrophy and definitely contributes to the progression of chronic renal insufficiency. In ADPKD optimal control of blood pressure dramatically decreases the risk of left ventricle hypertrophy and contributes to its regression,...

Primary hyperaldosteronism: common cause of secondary hypertension with higher cardiovascular risk

J. Widimský jr.

Vnitr Lek 2013, 59(6):501-504  

Primary hyperaldosteronism (PH) is common cause of secondary hypertension with autonomous aldosterone overproduction by adrenal cortex with high plasma aldosterone, suppressed renin and high blood pressure. Patients with PH have compared to essential hypertension (EH) more frequent sublinical organ damage and higher cardiovascular risk (CV). Higher carotid IMT, arterial stiffness and microalbuminuria was found in PH. Early specific therapy of PH may lead to the regression of target organ damage and decrease of CV risk. Early diagnostic and therapeutic measures are very important due to high prevalence of PH.

Systémové amyloidózy a jejich léčba (Z odborné literatury)

prof. MUDr. Zdeněk Adam, CSc.

Vnitr Lek 2013, 59(6)

XXXII. dny mladých internistů České republiky a Slovenska v Olomouci (Zprávy z odborných akcí)

prof. MUDr. Pavel Horák, CSc.

Vnitr Lek 2013, 59(6)

Astma bronchiale. Průvodce ošetřujícího lékaře (Z odborné literatury)

MUDr. Jiří Vlček

Vnitr Lek 2013, 59(6)

Hypoglykemie. Od patofyziologie ke klinické praxi (Z odborné literatury)

prof. MUDr. Marián Mokáň, DrSc.

Vnitr Lek 2013, 59(6)