Raloxifene in clinical practice. Results of the non-interventional study CORAL (COmpliance with RALoxifene)

J. Rosa, P. Vaňuga, J. Payer, A. Svobodník

Vnitr Lek 2008, 54(3):217-224  

Osteoporosis is a disease causing higher bone fragility and bone ruptures occurring even in minimal traumas. Good patient compliance is the prerequisite for long-term efficacy of osteoporosis treatment. Compliance data from randomised clinical studies may not provide reliable information about compliance in clinical practice which is usually lower. CORAL (COmpliance with RALoxifene therapy) is a local, Slovak, non-interventional, open, prospective, uncontrolled and multicentre study of woman patients on raloxifen therapy in current clinical practice. Raloxifen is a selective estrogen receptor modulator (SERM) indicated for the treatment and prevention...

The influence of rehabilitation on peak oxygen consumption in patients after myocardial infarction treated with beta-blockers

V. Chaloupka, L. Elbl, S. Nehyba, I. Tomášková, Š. Chaloupková

Vnitr Lek 2008, 54(3):225-228  

The purpose of the study was to verify whether rehabilitation programs improve both stress tolerance and peak oxygen consumption (pVO2) plus the consumption of oxygen at the level of anaerobe threshold (AT) in patients after myocardial infarction treated with beta-blockers. Our objective was to find out the differences in changes in the above indicators in elderly patients.The set of consisted of 2 groups of patients aged over 65 (56 ± 6.1) a ≥ 65 let (69 ± 4.7). The first group contained 96 and the second group 31 patients, respectively. Prior and after the rehabilitation program, stress echocardiography (SE) and...

Macrovascular and microvascular complications in type 2 diabetes patients

H. Rosolová, B. Petrlová, J. Šimon, P. Šifalda, I. Šípová, F. Šefrna

Vnitr Lek 2008, 54(3):229-237  

The prevalence of chronic vascular complications is higher in patients with type 2 diabetes mellitus (DM2).The objective of our cross-sectional study was to assess the incidence and types of macrovascular (MVC) and microvascular (mvc) complications and to analyse their relation to the different risk factors and biomarkers in order to improve their prevention. Set of patients and methodology:415 patients (219 men and 196 women) with an average age of 66 ± 9 years enrolled in the study. A total of 95 % of patients with DM2 had a history of hypertension, 27 % had MVC (of which 55 % had ischaemic heart disease), and 54 % had mvc...

Treatment of IgA nephropathy

K. Matoušovic, J. Mestecky, M. Tomana, J. Novak

Vnitr Lek 2008, 54(3):239-244  

IgA nephropathy is the most common cause of chronic renal failure among primary glomerulonephritides. During the last decade, there was a remarkable progress in understanding its pathogenesis. A number of therapeutic trials has been published that shed light on its treatment. ACEI and AT₁R antagonists (sartans) or their combination represent the cornerstone of therapy of IgA nephropathy. However, this treatment is not given to patients having optimal blood pressure, normal glomerular filtration rate, proteinuria less than 0.3 g/24 h, mild abnormalities in renal biopsy, and stationary course of the disease. The medication is administered...

The options for preserving reproductive functions in women undergoing cytostatic therapy

P. Němec, M. Huser, M. Souček

Vnitr Lek 2008, 54(3):245-250  

The therapy of serious organ damages in systemic connective tissue diseases and systemic vasculitis often requires the use of cytostatics. The serious adverse events associated with such therapy include irreversible damage to the foetal gonadal tissue. Unlike in the case of other fast proliferating tissues of the human body, damage to the ovaries is mostly irreversible, due to the predetermined number of ovarian follicles at birth. Destruction of follicles causes primary ovarian insufficiency and the subsequent sterility with climacteric syndrome symptoms. The issue of preserving ovarian function has not yet been fully resolved. The paper provides...

Glycated haemoglobin - is it its exclusive position in diabetology under threat?

S. Lacigová, D. Čechurová, P. Brož, J. Gruberová, Z. Jankovec, M. Žourek, I. Haladová, M. Krčma, J. Víšek, Z. Rušavý

Vnitr Lek 2008, 54(3):251-256  

Hyperglycaemia is the common characteristic for diabetes patients. Prolonged hyperglycaemia due to absolute or relative lack of insulin is the cause of microangiopathy. Glucose reacts with both blood vessel wall proteins and plasmatic proteins and erythrocyte haemoglobin. This characteristic of glucose is used to monitor the level of diabetes compensation. The level of glycated haemoglobin reflects glycaemia for the last 2 to 3 months. It began to be used in diabetology in the 1980's. This outline paper deals with some of the pitfalls with which glycated haemoglobin has been recently associated. The first part is dedicated to factors influencing haemoglobin...

Von Willebrand disease

P. Smejkal, M. Matýšková, M. Penka

Vnitr Lek 2008, 54(3):257-264  

Von Willebrand disease is the most spread hereditary bleeding disorder with prevalence up to the 1 % in the population. Haemorrhagic symptoms are various intensity, mostly not severe. A large part of affected patients do not come to see a doctor. However these patients are potentially endangered by a serious haemorrhage after a trauma, surgery or during another illness. The estimated number of patients with von Willebrand disease is 1,500-3,500 per 1,000,000 of population; the number of persons with symptomatic von Willebrand disease was estimated to be at least 100 per million. This disease deserves attention not only by haematologists but other physicians...

Laboratory diagnostics of pleural effusion

P. Jakubec, K. Palatka, T. Jakubcová, V. Kolek

Vnitr Lek 2008, 54(3):265-272  

Pleural effusion is a frequent reason for a pulmonologist's investigation. Many pulmonary and extrapulmonary causes of pleural effusion exist. Heart failure, pneumonia and malignancies are the most frequent among them. Laboratory examination of pleural liquid is a corner stone of diagnostics. We use various biochemical, microbiological, cytologic and other methods. The first step is a differentiation between transudate and exudate. If the laboratory examinations are unsuccessful, we can use invasive procedures - pleural biopsy and thoracoscopy. Despite all modern diagnostic methods the causes of about 15 % pleural effusions remain unclear.

SIADH as only paraneoplastic cause of the small cell lung cancer: case report

P. Lokaj, L. Křivan

Vnitr Lek 2008, 54(3):273-275  

62 years old patient was admitted to the hospital with weakness of lower extremities. Using laboratory examination, we found very severe hyponatrenaemia, hypochloraemia and hypotonia of blood plasma, because of SIADH. We searched for the cause of that syndrome and finally we found that the cause of that syndrome was small cell lung cancer with an expansion into the mediastinum and metastases into the skelet.

Purtscher-like retinopathy - a rare complication of acute pancreatitis

B. Krahulec, J. Štefaničková, S. Hlinšťáková, E. Hirnerová, V. Kosmálová, J. Hasa, K. Peško, P. Strmeň, A. Dukát

Vnitr Lek 2008, 54(3):276-281  

The article reports the case of a 27-year old woman hospitalised in the internal medicine ward for acute pancreatitis after eating fat food and drinking alcohol. In addition to acute pancreatitis, the patient complained of vision problems. The ophthalmologist detected bilateral occurrence of large whitish nidi located primarily around the optic disc, intraretinal hemorrhage and a massive retinal oedema in the central field and diagnosed Purtscher-like retinopathy. After a month of treatment of acute pancreatitis, the clinical picture improved, the patient's vision sharpness improved and the laboratory parametres returned to normal. The finding on the...

Idiopathic retroperitoneal fibrosis - Ormond's disease

M. Průcha, P. Beňo, M. Bartůněk, J. Votrubová, L. Sedláčková, R. Kříž

Vnitr Lek 2008, 54(3):282-286  

Ormond disease - idiopathic retroperitoneal fibrosis - is a rare condition characterized in situ by the development of fibrous plaques in the retroperitoneal space and anatomicaly dependent structures. The associated encasement of both ureters and progress to hydronefrosis of the kidney are typical clinical manifestations. Less typical manifestations are possible (for example chronic periaortitis), where clinical diagnosis is more difficult. The laboratory findings are not specific for this disease and a biopsy is not always possible for anatomical reasons. In these cases, the use of positron emission tomography/computed tomography - has been found...

Broulík P. Osteoporóza a její léčba

Luboslav Stárka

Vnitr Lek 2008, 54(3):310  

Svačina Š et al. Klinická dietologie

Hana Svačinová

Vnitr Lek 2008, 54(3):310-311  

Stárka L et al. Pokroky v endokrinologii

Karola Balšíková

Vnitr Lek 2008, 54(3):311-312  

Mastík J. Migréna. Průvodce ošetřujícího lékaře

Jolana Marková

Vnitr Lek 2008, 54(3):312  

Fait T, Šnajderová M et al. Estrogenní deficit

Otmar Stránský

Vnitr Lek 2008, 54(3):313  

Šlampa P, Petera J et al. Radiační onkologie

Jana Prausová

Vnitr Lek 2008, 54(3):313-314  

Reminiscences on the occasion of the Whipple's disease centenary: a summary paper

Z. Kojecký, L. Benýšek, I. Krč, J. Ehrmann, R. Koďousek, J. Malínský

Vnitr Lek 2008, 54(3):287-304  

The disease referred to eponymically as Whipple's disease (WD) in medical literature was thoroughly described by the American physician and pathologist George Hoyot Whipple (1878-1976) in 1907 and given a temporary denomination of "intestinal lipodystrophy". According to literature, WD is rare, but its precise incidence has not yet been established. Familial incidence of the disease is acknowledged, and its immunogenetic pathogenesis is assumed. The incidence of WD is prevailingly observed in middle-aged men (mean age 55), exceptionally at child age - the ratio being 3 to 6 for men and women, respectively. 1. Clinical diagnosis is based on symptoms...

Za profesorem MUDr. Zdeňkem Kojeckým, DrSc. (nar. 28. 10. 1913 v Kelči na Moravě, zemřel 21. 2. 2008)

J. Ehrmann

Vnitr Lek 2008, 54(3):308-309  

Druhý celostátní seminář Českého institutu metabolického syndromu První středo- a východoevropské sympozium o metabolickém syndromu 28. a 29. února 2008, Brno

Petr Sucharda

Vnitr Lek 2008, 54(3):305  

XXXIV. kongres Európskej spoločnosti pre umelé orgány (ESAO), 5.-8. septembra 2007, Kremža (Rakúsko)

M. Mydlík, K. Derzsiová

Vnitr Lek 2008, 54(3):306-307