Novinky v liečbe srdcového zlyhávania - editorial

Ján Murín

Vnitr Lek 2017, 63(4):234-235 | DOI: 10.36290/vnl.2017.049  

Diabetic foot syndrome: importance of calf muscles MR spectroscopy in the assessment of limb ischemia and effect of revascularization

Andrea Němcová, Michal Dubský, Alexandra Jirkovská, Petr Šedivý, Miloslav Drobný, Milan Hájek, Monika Dezortová, Robert Bém, Vladimíra Fejfarová, Anna Pyšná

Vnitr Lek 2017, 63(4):236-241 | DOI: 10.36290/vnl.2017.050  

Aim:The standard method for assessment of effect of revascularization in patients with diabetic foot (DF) and critical limb ischemia (CLI) is transcutaneous oxygen pressure (TcPO₂). Phosphorus magnetic resonance spectroscopy (³¹P MRS) enables to evaluate oxidative muscle metabolism that could be impaired in patients with diabetes and its complications. The aim of our study was to compare MRS of calf muscle between patients with DF and CLI and healthy controls and to evaluate the contribution of MRS in the assessment of the effect of revascularization. Methods:Thirty-four diabetic patients with DF and...

Controversies around QALYs

Vladimír Rogalewicz, Miroslav Barták

Vnitr Lek 2017, 63(4):242-248 | DOI: 10.36290/vnl.2017.051  

The paper summarizes the criticisms of the QALY concept utilization in health-economic evaluations that has been growing stronger in the last years. Despite of its limitations, the QALY concept has been routinely used in many countries incl. the Czech Republic. However, some states disapproved QALYs as an optimizing criterion at the level of their political decisions. The critical reflection concerns both the theoretical and the experimental issues. Based on a literary review, fundamental arguments against the concept are summarized, and a synthesis of material objections is presented. The critical arguments focus on the foundations of the QALY concept...

The role of cardiovascular magnetic resonance imaging in the diagnosis of hypertrophic cardiomyopathy. Part II

Martin Pleva, Júlia Borová, Ilona Plevová, Jaroslav Januška, Margita Belicová

Vnitr Lek 2017, 63(4):249-253 | DOI: 10.36290/vnl.2017.052  

Hypertrophic cardiomyopathy is currently understood as a group of diseases with left ventricular hypertrophy, which are not based on adaptive mechanisms. The first part of the review details the possibility of cardiac magnetic resonance in the diagnosis of sarcomeric forms of hypertrophic cardiomyopathy, the second part will focus on the possibilities of distinguishing the sarcomeric forms from their phenocopies.

Novelties in the treatment of heart failure

Filip Souček, Jan Novák

Vnitr Lek 2017, 63(4):255-264 | DOI: 10.36290/vnl.2017.053  

Heart failure (HF) is a complex clinical syndrome which is manifested by characteristic symptoms and objective signs of cardiac insufficiency. The incidence of HF, particularly its chronic form, is estimated 0.4-2 % in the central and western Europe, with an increase in higher age groups, affecting 10-20 % of the population aged over 80. With respect to its growing incidence and prevalence, novel modalities of pharmacological and non-pharmacological treatment are being developed in order to improve quality of life and survival of the affected patients. This review based on up-to-date guidelines focuses in the first part on brief description of the...

AT₁ blockers - comparability with ACE inhibitors

Václav Monhart

Vnitr Lek 2017, 63(4):267-271 | DOI: 10.36290/vnl.2017.054  

The reduction in overall mortality, cardiovascular mortality and the occurrence of myocardial infarction in patients treated with AT₁ blockers is comparable with the use of ACE inhibitors. In addition, there is a lower proportion of AT₁ blockers withdrawal of treatment due to adverse reactions.

How to create cooperative patient for antihypertensive and hypolipidemic therapy

Jan Piťha

Vnitr Lek 2017, 63(4):272-276 | DOI: 10.36290/vnl.2017.055  

Patient drug adherence is a major problem especially in the prevention of cardiovascular disease of atherosclerotic origin. On one hand, antihypertensive drugs and hypolipidemic drugs/statins are among the most successful, ones the other hand, they are among the drugs which are most frequently skipped by the patients. Improvement could be realized by education of patients, more frequent follow-ups, as well as by the use of new technologies involving specific dispensers and other, even more sophisticated methods. Nevertheless, among the most successful strategies is the simplification of medication, particularly the use of drugs with a longer half-life...

Relapsing autoimmune pancreatitis type 1: case report

Alena Ondrejková, Bohuslav Kianička, Hana Nechutová, Lukáš Hruška, Ivo Novotný, Miroslav Souček

Vnitr Lek 2017, 63(4):277-283 | DOI: 10.36290/vnl.2017.056  

Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis, classified into 2 subtypes - AIP type 1 and AIP type 2. We present a case of a 31-years-old female admitted to our institution with upper abdominal pain and obstructive jaundice. Endoscopic retrograde cholangiopancreatoscopy (ERCP) revealed stenosis of intrapancreatic distal bile duct. Diffuse parenchymal enlargement and typical features of AIP were shown by computed tomography (CT) and endoscopic ultrasonography (EUS). The patient's serum IgG4 was elevated at 3.8 g/l (range 0.08-1.4 g/l). She was diagnosed with AIP type 1 and treated with prednisone (initial dose of 30 mg per day,...

Indeterminate cell histiocytosis - disappearance of skin infiltration following electron beam therapy and an application of 2-chlorodeoxyadenosine: case report

Zdeněk Adam, Marta Ježová, Pavel Šlampa, Leoš Křen, Vladimír Vašků, Renata Koukalová, Zdeněk Řehák, Luděk Pour, Marta Krejčí, Zdeněk Král, Jiří Mayer

Vnitr Lek 2017, 63(4):284-288 | DOI: 10.36290/vnl.2017.057  

Indeterminate cell histiocytosis is a rare disease belonging to the group of malignant histiocytic diseases. The disease predominantly affects the skin. The disease appeared in the described patient at the age of 80 years. Morphs began to develop on the skin and rapidly spread over the whole body including the face. Only the hands and feet were left uncovered. The patient's skin samples were taken from 2 sites for histological examination. The resulting conclusion was indeterminate cell histiocytosis. The treatment we chose was analogous to the procedures for Langerhans cell histiocytosis. We chose PUVA phototherapy as the first-line treatment. This...

Antikoagulační terapie dabigatranem vs rivaroxabanem u seniorů ve věku nad 65 let: porovnání dat "head to head"

Martin Polák

Vnitr Lek 2017, 63(4):289-291 | DOI: 10.36290/vnl.2017.058  

Gender and Coronary Artery Disease - a challenge for the 21^st century

Ján Murín, Renata Cífková

Vnitr Lek 2017, 63(4):292-294