Autoimmune pancreatitis - diagnostic consensus - editorial

Antonín Vavrečka

Vnitr Lek 2015, 61(2):93-94  

Acromegaly and pharmacotherapy - editorial

Michal Kršek

Vnitr Lek 2015, 61(2):95-96  

Kalcifikující uremická arteriolopatie - editorial

Sylvie Dusilová Sulková

Vnitr Lek 2015, 61(2):97-100  

Has the pregnancy outcome of women with pregestational diabetes mellitus improved in ten years?

Daniela Čechurová, Michal Krčma, Zdeněk Jankovec, Jiří Dort, Jan Turek, Silvie Lacigová, Zdeněk Rušavý

Vnitr Lek 2015, 61(2):101-105  

Introduction:In spite of progress in medicine, studies from a number of countries indicate steadily increased risk of perinatal morbidity and mortality in the offspring of diabetic mothers. No data regarding the pregnancy outcome in women with diabetes mellitus type 1 and 2 (pregestational DM) have been published in the Czech Republic. The aim of the study was to evaluate the pregnancy course of women with pregestational DM and outcome of their offspring and to assess whether it has improved in ten years. Methods:A retrospective evaluation of pregnancy outcome of pregestational DM women followed up in the University Hospital...

Present and future in the management of venous vascular diseases

Peter Gavorník, Andrej Dukát, Ľudovít Gašpar, Eva Gavorníková

Vnitr Lek 2015, 61(2):151-156  

The prevalence and the incidence of chronic and acute venous vascular disease has been shown to be globally very high, in both industrialized and developing countries. Chronic venous diseases of lower extremities are being an integral part of the third millennium's deadly angiopandemy, at the present time. The rate of the most severe cases with advanced stage of venous failure is approximately twice as high in the population (2.1 %) as has been assumed so far. Among venoactive drugs (VAD), micronized purified flavonoid fraction (MPFF) of diosmin hesperidin remains the agent with the highest degree of recommendation and it also indicated to pharmacotherapeutical...

The importance of transcutaneous oxygen tension monitoring in diabetic patient with complications

Dávid Baláž, Andrea Komorníková, Peter Sabaka, Ľudovít Gašpar, Andrej Dukát

Vnitr Lek 2015, 61(2):106-113  

Monitoring of transcutaneous perfusion pressure of tissue oxygen (tcpO₂) is a simple, non-invasive method performed in diagnostic process of chronic diabetic complications. Primary, tcpO₂ is used as an indicator of microcirculatory function. Properly placed and fixed Clark electrode is able to detect with high accuracy partial oxygen pressure on the skin surface by polarographic system of dissolved oxygen from capillary bed through tissues to upper layers of the skin. The microcirculation function is influenced by macrocirculation, thus, tcpO₂ is a suitable parameter in diagnosis of peripheral arterial obliterative...

Autoimmune pancreatitis - diagnostic consensus

Petr Dítě, Ivo Novotný, Bohuslav Kianička, Martin Rydlo, Hana Nechutová, Arnošt Martínek, Magdalena Uvírová, Martina Bojková, Jana Dvořáčková

Vnitr Lek 2015, 61(2):114-118  

The autoimmune type of pancreatitis represents the specific disease of pancreas, with significant contribution of autoimmune processes in its etiopathogenesis. Currently, there are two proved subtypes of this particular pancreatopathy, which are defined clinically, histomorphologically and serologically. They have many histomorphological signs in common, but differ in the presence of so-called granulocytic epithelial lesions (GEL), which are absent in subtype 1. The subtype 1 is characterized by the presence of gammaglobulines, esp. immunoglobuline G4 and IgG4 positive extrapancreatic lesions. The subtype 2 is typically associated with the inflammatory...

Interstitial lung diseases and granulomatoses associated common variable immunodeficiency.

Martina Doubková, Mojmír Moulis, Jana Skřičková

Vnitr Lek 2015, 61(2):119-124  

Common variable immunodeficiency disorder belongs to the most common primary human immunodeficiencies and it is characterized by primary defective immunoglobulin production. Hypogammaglobulinemia manifests in every age, usually in adult people. There is no gender predisposition. The prevalence is 1 : 25 000-1 : 50 000. The ethiopathogenesis of the majority of CVIDs is unknown. The main clinical respiratory symptoms include recurrent respiratory infects, especially bacterial etiology, sinusitis, bronchitis, pneumonia, leading to bronchiectasis and lung fibrosis. Interstitial lung fibrosis and granulomatosis often manifest at diagnosis of CVID and they...

The examination of the small intestine by magnetic resonance imaging

Jiří Vaníček, Lukáš Hruška, Bohuslav Kianička

Vnitr Lek 2015, 61(2):125-128  

Diagnostic imaging of the abdominal cavity and the gastrointestinal tract is increasingly performed by new-emerged fast MR imaging sequences and it is moving to the centers of magnetic resonance. Our work is devoted to the examination of the small intestine by magnetic resonance, so-called MR enterography. Review discusses general description - from preparation of patient to basic pathological findings, with special focus on currently most investigated small intestine disease - Crohn's disease.

The new drug is much more effective than ACE inhibitors in chronic heart failure

Jiří Widimský sr

Vnitr Lek 2015, 61(2):129-133  

PARADIGM-HF study observed clinical outcomes after treatment by new drug LCZ696 or enalapril in patients with systolic chronic heart failure. It was randomized double-blind trial with LCZ696 (200 mg twice a day) and enalapril (10 mg twice a day). 8442 patients were enrolled with NYHA class II or III and left ventricular ejection fiction of 40% or less. Study drugs were added to other recommended medication. The trial was prematurely terminated after median follow-up of 27 months. The primary endpoint of the study was a combination of cardiovascular mortality and the first hospitalization for heart failure. LCZ696 drug, an inhibitor of angiotensin receptor...

Spontaneous bacterial peritonitis

Renáta Šenkeříková, Soňa Fraňková, Jan Šperl, Julius Špičák

Vnitr Lek 2015, 61(2):134-140  

Spontaneous bacterial peritonitis (SBP) represents a frequent and serious complication in patients with ascites in liver cirrhosis. Hospital mortality in patients with SBP reaches 10-20 %, so it is necessary to consider this diagnosis in every clinical decompensation of a cirrhotic patient, diagnose it early and treat it effectively. The clinical manifestation is nonspecific and variable, up to one third of patients might be asymptomatic. The diagnosis of SBP is based on the ascitic neutrophils count greater than 250 per mm³. Bacteriological examination of ascites fluid detects causative agents at less than half of the cases and the result...

What are biosimilars and what do they bring to us?

Jiří Slíva

Vnitr Lek 2015, 61(2):143-145  

Biosimilar medicines are a new category of medicinal products that substantially differ from generic preparations through the necessary submission of conclusive evidence of their therapeutic efficacy and therefore it is not sufficient to merely state their biological equivalence. Apart from the proven efficacy, also their safety is evaluated of course, with an emphasis on immunogenicity regarding biological nature of these substances. As a result, requirements for registration are much stricter. With regard to the current boom of the preparations labelled in a simplified way as biological or specifically targeted drugs, we can certainly expect a growing...

Insulin analogues of patients with diabetes and renal impairment

Alena Adamíková

Vnitr Lek 2015, 61(2):147-150  

The main cause of renal failure is diabetic nephropathy which affects 20-40 % of diabetic patients. Diabetics with altered renal function have restricted therapeutic options due to the risk of accumulation of oral antidiabetic drugs and of their metabolites at a reduced glomerular filtration rate. Good metabolic control is very important during the early phases of nephropathy for reducing the risk of progression and in the stage of renal failure reduces the risk of progression of atherosclerosis and improves life prognosis. Metabolism of insulin is changed during renal failure, clearance of insulin is prolonged, the risk of hypoglycemia increases....

Akromegaly and pharmacotherapy

Helena Šiprová, Miroslav Souček

Vnitr Lek 2015, 61(2):157-160  

Acromegaly is a rare and serious disease. A successful and rational therapy of acromegaly ought to combine surgery, radiotherapy and pharmacotherapy. The submitted article presents a case of acromegaly that was only diagnosed at the stage when total pituitary adenoma removal was impossible. Even so, the long-term stabilisation of the disease was reached by way of repeated surgery through transfenoidal and transcranial approach, by linear accelerator radiation therapy and Leksell Gamma Knife radiotherapy and by pharmacotherapy with somatostatin analogon octreotide and growth hormone receptor antagonist pegvisomant. The octreotide and pegvisomant dosage...

A rare case of multiple myeloma: multiple solitary plasmacytomas of distal extremities

Štěpán Hrabovský, Zdeněk Řehák, Jakub Stulík, Jiří Prášek, Jiří Mayer

Vnitr Lek 2015, 61(2):161-165  

This article describes a case of 68-years-old male with very atypic variation of multiple myeloma occuring as multifocal osteolysis limited to tibiae, cuboid bone, radius and ulna, in the absence of diffuse bone marrow infiltration. The main goal of this article is to point out the importance of permanent awareness during diagnostics and treatment of this insidious disease.

Calcific uremic arteriolopathy - treatment with sodium thiosulfate

Markéta Vyskočilová, Jan Svojanovský, Jana Blaštíková, Gabriela Dvořáková, Miroslav Souček

Vnitr Lek 2015, 61(2):166-172  

Calcific uremic arteriolopathy or calciphylaxis is a rare disorder characterized by systemic medial calcification of arterioles that leads to ischemia and subcutaneous necrosis. It most commonly occurs in patients with end-stage renal disease who are on haemodialysis or who have received a renal transplant. Calciphylaxis is dangerous by its fast progression into tissue necrosis, difficult healing process and a great risk of secondary infection which is the most common cause of death in this condition. The reported mortality rates are as high as 60-80 % in a couple of months once it is diagnosed. The key to successful treatment of calciphylaxis is fast...

Václav Hána. Endokrinologie pro praxi

Karel Starý

Vnitr Lek 2015, 61(2):181  

Hana Papežová a kol. Naléhavé stavy v psychiatrii

Magdalena Valová

Vnitr Lek 2015, 61(2):181  

Peter Gavorník. Angiológia 2 pre všeobecných lekárov - Arteriológia

Zoltán Mikeš

Vnitr Lek 2015, 61(2):182  

XXXIV. dny mladých internistů

Vnitr Lek 2015, 61(2):173  

Empagliflozin - the new representative of SGLT2 transporter inhibitors for the treatment of patients with diabetes 2 type

Martin Prázný, Jiří Slíva

Vnitr Lek 2015, 61(2):175-178  

Empagliflozin is a new medicine used to reduce hyperglycemia in patients with type 2 diabetes. It belongs to the most advanced class of antidiabetic drugs, known as gliflozins, which prevent reabsorption of glucose through inhibiting SGLT2 sodium-glucose cotransporter. Thereby they cause therapeutic glycosuria, thanks to which a loss of approximately 70 g of glucose per day occurs. This not only effects the decrease in glycemia, but also the loss of body mass, since this excreted glucose cannot be used as an energetic substrate. The studies within phase 3 have proven the therapeutic efficacy of empagliflozin in monotherapy, in combination with the...