Jakou roli představuje péče o výživu ve smyslu malnutrice ve stáří? - editorial

Božena Jurašková

Vnitr Lek 2014, 60(7-8):550-551  

Celiakie u pacientů s diabetes mellitus 1. typu - editorial

Martin Prázný

Vnitr Lek 2014, 60(7-8):552  

Diagnóza psaná klínovým písmem - editorial

Jaromír Hradec

Vnitr Lek 2014, 60(7-8):553-554  

Diabetes mellitus u žen - editorial

Jana Brunová

Vnitr Lek 2014, 60(7-8):555  

Effect of the liquid milk nutritional supplement with enhanced content of whey protein on the nutritional status of the elderly

Jolana Rambousková, Bohumír Procházka, Michael Binder, Michal Anděl

Vnitr Lek 2014, 60(7-8):556-561  

Aim:The aim of this study was to evaluate the effect of long-term administration of liquid nutritional supplement with increased amounts of whey protein and reduced amounts of lactose, produced in accordance with a new recipe "Nutrisen" on the elderly living in institutionalized care. Methods:The study was carried out from May to July, 2013, on 47 retirement home residents, living in Prague, all of which were 65 years or older. Supplemented group (n = 23) consumed (200 ml) milk drinks with three different flavours on a daily basis for eight weeks. The reference group was on a normal diet. There was no significant difference...

Celiac disease in adult patients with type 1 diabetes mellitus

Iva Haladová, Daniela Čechurová, Silvie Lacigová, J. Gruberová, Zdeněk Rušavý, Karel Balihar

Vnitr Lek 2014, 60(7-8):562-566  

Objective:To assess the prevalence of celiac disease in adult patients with type 1 diabetes mellitus (T1DM). Influence the new started treatment of celiac disease on glycemic control and body mass index (BMI) of the patients. Prevail the anti-transglutaminase antibody (atTG) positivity one year after commencement of the therapy. Methods:A retrospective assessment of celiac disease targeted screening in 465 adult T1DM patients at Diabetes Center, 1st Medical Department, University Hospital in Pilsen (80 % of all T1DM patients) from 1. 1. 2007 until 1. 7. 2011. Enterobiopsy was indicated in case of atTG-A (or atTG-G) positivity....

Acute pancreatitis - Validation of Revised Atlanta Classification on 159 patients and prognostic factors

Katarína Floreánová, Petr Dítě, Bohuslav Kianička, Lenka Dovrtělová, Marie Přecechtělová

Vnitr Lek 2014, 60(7-8):567-574  

Introduction:In the last few years the Atlanta classification of acute pancreatitis (AP) have been revised. However prognostic markers of AP are still being searched for. The aim of this study is to validate the 3 severity cathegories proposed by the revised Atlanta classification. We also tried to reevaluate the association between two laboratory markers (leucocyte count and RDW - red cell distribution width) on admission and prognosis of the patients with AP. Methods:159 patients were included into the study. The patients were classified according to revised Atlanta criteria and the subgroups evaluated according to mortality,...

Genetics and pharmacogenetics of osteoporosis

Ivana Žofková, Radoslav Omelka

Vnitr Lek 2014, 60(7-8):575-581  

Osteoporosis is a serious disease characterized by high morbidity and mortality due to atraumatic fractures. In pathogenesis of osteoporosis, except environment, internal factors, such as hormonal dysbalance and genetic background, are also in play. In this review, candidate genes for osteoporosis are classified accorging to metabolic or hormonal pathways, which regulate bone mineral density/and or quality (estrogen, RANKL/RANK/OPG, mevalonate, Wnt circuit, genes for collagen and vitamin D). Authors discuss the perspectives of practical utilization of pharmacogenetics (identification of single candidate genes using PCR) or pharmacogenomics (using genome...

Importance of lymphangiogenesis and ultrastructure of lymphatic capillaries in metastasis of malignant melanoma

Eva Rovenská

Vnitr Lek 2014, 60(7-8):582-585  

Lymphangiogenesis - proliferation of lymphatic capillaries - in melanoma and in its vicinity plays an important role in metastatic process of malign melanoma cells in organism. Melanoma produces epidermal growth factor EGF which induces vascular endothelial growth factor VEGF-C and thereby starts lymphangiogenesis. It is very probable that malignant melanoma cells enter lymphatic capillaries also through specialized inter-endothelial junctions (endothelial microvalves, primary valves) situated in their walls. After entry of malign cells into lymphatic capilla-ries, these cells travel in lymph to the sentinel lymph node. Malign cells metastasize through...

What is new in heart failure with preserved ejection fraction within last five years?

Zdeňka Gregorová, Jaroslav Meluzín, Lenka Špinarová

Vnitr Lek 2014, 60(7-8):586-594  

Heart failure with preserved ejection fraction of left ventricle (heart failure with normal ejection fraction, HFPEF, HFNEF) is frequent disease with serious consequences. Incidence of HFPEF in population is still growing. The exact pathophysiological mechanism of HFPEF remain unclear .Recent evidence suggests a relationship between inflammation associated with obesity or Diabetes mellitus and progression of HFPEF. Consistently, it has been reported that serum concentration of some pro-inflammatory markers such as adiponectin is positively related to HFPEF. By HFPEF is attended diastolic dysfunction. Diastolic dysfunction is linked to many other cardiac...

Specifics of diabetes mellitus in women

Ludmila Brunerová, Jan Brož

Vnitr Lek 2014, 60(7-8):595-600  

Approximately 4 % of female population suffers from diabetes. A permanent interaction between diabetes, its treatment and sex hormonal changes (childhood, puberty, reproduction, pregnancy, menopause) occurs in those women. This review article summarizes up to date published studies concerning reciprocal relationship between diabetes and sexual development in women.

Osteoporosis and bone alterations in celiac disease in adults

Iva Hoffmanová, Michal Anděl

Vnitr Lek 2014, 60(7-8):601-606  

Both celiac disease and osteoporosis are common diseases which are considered an emerging problem in medicine. Celiac disease is a condition at high risk for secondary osteoporosis. Osteoporosis or osteopenia are typically present in untreated adult symptomatic celiac disease with an overt malabsorption syndrome, but is found in about 50 % in suboptimally treated celiac patients, subclinical patients and asymptomatic adult celiac patients, too. Etiology of pathologic bone alteration in celiac disease is multifactorial; however, two main mechanisms are involved: intestinal malabsorption and chronic inflammation. The evaluation of bone mineral metabolism...

Dostál P a kol. Základy umělé plicní ventilace

Pavel Ševčík

Vnitr Lek 2014, 60(7-8):670  

Education model at the Clinic of Internal Medicine of the Faculty Hospital Motol Prague - Our experience with local education project for young physicians on postgraduate education

Renata Kratochvílová, Milan Kvapil

Vnitr Lek 2014, 60(7-8):607-610  

In 2004 the principal legislative changes were accepted in the field of postgraduate medical education in Czech Republic (law No. 95/2004 Code). Replacement of two-stage system of specialized education by its one-stage option has brought some problems and according to our opinion did not lead to clear improvement of postgraduate education, more likely the other way around. Our effort to improve the quality of process of postgraduate specialization in internal medicine brought us to creation of own local system of postgraduate education using the next 4 basic principles: principle of robust internal base as a platform for the following specialization,...

Zdeněk Mařatka and his share in the founding of the Czech Gastroenterological Society and its journal. Gastroenterological Society in Czech and Slovac republics

Milan Kment

Vnitr Lek 2014, 60(7-8):611-616  

Zdeněk Mařatka (1914-2010) was a leading person in a Czech and Slovak gastroenterology in spite of the infavourable approach of the official communist policy to him.. He was one of the founders of gastroenterology in Czechoslovakia. He had been habilitated in 1948 for thesis Ulcerative colitis. Mařatka stood at the first steps of foundation of Czech Gastroenterology Society very soon after the WW2 and followed with the preparation as a secretary general of the 8^th ASNEMGE Congress in Prague 1968 and as a president the 1st Congress of Endoscopy in the very optimistic atmosphere of ,,Prague Spring". He was nominated or elected by several international...

Crohn's Disease Surgery

Zdeněk Kala, Filip Marek, Vlastimil A. Válek, Daniel Bartušek

Vnitr Lek 2014, 60(7-8):617-623  

Surgery of Crohn's disease is an important part of the general treatment algorithm. The role of surgery is changing with the development of conservative procedures. The recent years have seen the return to early treatment of patients with Crohn's disease. Given the character of the disease and its intestinal symptoms, a specific approach to these patients is necessary, especially regarding the correct choice of surgery. The paper focuses on the luminal damage of the small and large intestine including complications of the disease. We describe the individual indications for a surgical solution, including the choice of anastomosis or multiple / repeated...

Advances in diagnosis and therapy of inflammatory bowel diseases

Michal Konečný, Jiří Ehrmann

Vnitr Lek 2014, 60(7-8):625-629  

The inflammatory bowel diseases have been an interesting topic not only for gastroenterologists, but also for other medical professionals, since the beginning of the last century, when this group of inflammatory autoimmune diseases was revealed. Logically, the doyen of Czech gastroenterology, Professor MUDr. Zdeněk Mařatka, DrSc., who dedicated a substantial part of his life to research into inflammatory bowel disease, particularly ulcerative colitis, was no exception. The current century is characterized by a very rapid development of scientific research and almost immediate introduction of scientific knowledge into clinical practice. In the area...

Biological therapy in women with inflammatory bowel disease during pregnancy

Jana Koželuhová, Karel Balihar, Eva Janská, Lucie Fremundová, Martin Matějovič

Vnitr Lek 2014, 60(7-8):630-634  

The aim of this article is to objective review available research data regarding the safety of biological therapies during pregnancy and breastfeeding in women with inflammatory bowel disease. Biological therapies appear to be safe in pregnancy, as no increased risk of malformations has been demonstrated. Available clinical results suggest that the efficacy of infliximab and adalimumab in achieving clinical response and maintaining remission in pregnant patients might outweigh the theoretical risks of drug exposure to the fetus. If possible, anti-TNF therapy should be stopped by the end of the second trimester due to transplacental transfer and potential...

Crohn's disease - etiopathogenetic factors

Tomáš Kupka, Jarmila Šímová, Lubomír Martínek, Pavel Svoboda, Pavel Klvaňa, Martina Bojková, Magdalena Uvírová, Lenka Dovrtělová, Petr Dítě

Vnitr Lek 2014, 60(7-8):635-639  

Crohn's disease is often purely inflammatory, but most patients develop complicated disease with strictures or fistulae. Specific etiopathogenesis of this severe disease is not definitely clear despite research efforts and learning of many pathogenetic mechanisms. Many studies have suggested that NOD2 mutations are associated with increased risk of complicated disease. Presence of NOD2 mutation itself is just one of factors contributing to development of this disease. Genetically predisposed individuals in combination with influence of environmental factors result in a disturbed innate (i.e., disturbed intestinal barrier, Paneth cell...

Etiology and pathogenesis of inflammatory bowel diseases

Milan Lukáš

Vnitr Lek 2014, 60(7-8):640-644  

Zdenek Mařatka has been the first physician, who had brought a new information for the Czech medical community with topic of inflammatory bowel diseases, which had been systematic studied for him. He had prepared an original theory - two component hypothesis about origin of ulcerative colitis, which had been developed and innovated by him for long time. From the international point of view, Mařatka has had an extraordinary impact and significant contribution for recognition of ulcerative colitis and Crohn's disease. Despite the fact that the true origin of ulcerative colitis and Crohn's disease (UC) still remain elusive, basic as well as clinical research...

History of surgical treatment of non-specific inflammatory bowel diseases

Zuzana Šerclová

Vnitr Lek 2014, 60(7-8):645-648  

Treatment of non-specific inflammatory bowel diseases was from the start accompanied by forced operations. In the 19^th and early 20^th century operations were burdened with high mortality, but most were more successful than the limited possibilities of conservative treatment. Gradually developed principles for the treatment of Crohn's disease, a length of bowel sparing surgery are still valid today. Surgical treatment of ulcerative colitis passed the time of colonic irrigation, bypass surgery, limited resection to today's gold standard - proctocolectomy with ileo-pouch-anal anastomosis.

Epidemiology of dyspepsia

Stanislav Rejchrt, Ilona Koupil, Marcela Kopáčová, Miluška Škodová Fendrichová, Bohumil Seifert, Viktor Voříšek, Jana Špirková, Tomáš Douda, Ilja Tachecí, Jan Bureš

Vnitr Lek 2014, 60(7-8):649-656  

Epidemiology of uninvestigated dyspepsia was studied in the Czech Republic for the first time in 2001. The aim of our current multi-centre prospective study was to evaluate dyspepsia using the same methods in a representative sample of general unselected population from the same geographical areas 10 years later. A total of 22 centres entered the study. A total of 1,836 subjects (aged 5-98 years) were enrolled. The overall prevalence of dyspepsia was 12 %; namely 3.5 % in subjects aged 5-24 years, 18 % among 25-64-year-old persons and 15 % in subjects ≥ 65 years. Despite the substantial decrease of Helicobacter pylori infection in the Czech...

Management of patients with dyspepsia

Eduard Veseliny, Mária Zakuciová, Martin Janíčko, Peter Jarčuška

Vnitr Lek 2014, 60(7-8):657-663  

Dyspepsia is a common clinical problem with an extensive differential diagnosis and a heterogeneous pathophysiology. Dyspepsia affects up to 40 % of the general population and significantly reduces quality of life. According to the Rome III criteria, dyspepsia is defined as one or more of the following symptoms: epigastric pain and/or burning (classified as epigastric pain syndrome), postprandial fullness and/or early satiation (classified as postprandial distress syndrome). Initial evaluation should focus on the identification and treatment of potential causes of symptoms such as gastroesophageal reflux disease, peptic ulcer disease, and medication...

Endoscopic classification of colon and rectal neoplasias

Miroslav Zavoral, Gabriela Vojtěchová, Štěpán Suchánek

Vnitr Lek 2014, 60(7-8):664-668  

Along with the dynamic evolution of the new field of digestive endoscopy, the need of unified and unambiguous terms for endoscopic findings arose in the second half of the 20th century. In collaboration with the OMED members, professor Zdeněk Mařatka drew up the first internationally acknowledged terminology for digestive endoscopy which was used in the full range for a period of almost 20 years. The technical progress later brought with it endoscopes which made it possible to view flat lesions, frequently overlooked until then. The classification of the surface lesions was further specified by the Paris Classification which drew from the experience...

Správa z XXXIII. dní mladých internistov

Ľubomír Tomáš

Vnitr Lek 2014, 60(7-8):669