Liečba AL-amyloidózy v roku 2012, prínos nových liekov - editorial

E. Tóthová

Vnitr Lek 2013, 59(1):13-15  

Outcomes of Catheter Ablation of Atrial Fibrillation in Patients over 65 Years of Age

M. Fiala, L. Škňouřil, O. Toman, J. Pindor, D. Wojnarová, V. Bulková, J. Chovančík, M. Dorda, H. Szymeczek, R. Neuwirth, D. Vavřík, Š. Krawiec, O. Jiravský, L. Rybka, R. Lábrová, J. Januška, J. Špinar

Vnitr Lek 2013, 59(1):16-22  

Purpose:This study assessed ablation techniques, recurrent arrhythmias, long-term outcomes, and complications of catheter ablation for atrial fibrillation (AF) in patients ≥ 65 years of age. Methods:Consecutive patients aged < 65 years (n = 653) vs ≥ 65 years (n = 213), who underwent catheter ablation of AF in the course of eight years, were compared. Ablation strategy and procedure endpoints were left at the operator's discretion. Results:The group of patients ≥ 65 years comprised more females (p < 0.001), and more frequently presented with persistent AF (p = 0.010). These patients less frequently...

Risk factors for relapsing and severe Clostridium difficile infection

L. Vojtilová, M. Pýchová, M. Freibergerová, J. Juránková, Z. Bortlíček, P. Husa

Vnitr Lek 2013, 59(1):23-30  

Background:Describe risk factors for relapsing and severe Clostridium difficile infection (CDI) in a set of patients hospitalized at the Clinic of infectious diseases the University Hospital Brno. Material and methods:A retrospective study observing epidemiological, clinical and laboratory data of 281 patients with proven diagnosis of Clostridium difficile infection hospitalized in the period from 1. 1. 2007 to 31. 12. 2010. Results:In the first part of the evaluation were enrolled 233 patients, 87 (37.3 %) patients had a record of relapsing CDI and 146 (62.7 %) patients had nonrelapsing CDI. Factors...

Is there dependence between the level of adipocyte fatty acid-binding protein and calcium score in asymptomatic relatives of patients with cardiovascular diseases?

E. Sovová, J. Vrbková, D. Stejskal, M. Kaletová, M. Kamínek, I. Metelková, M. Sova, I. Benušová, P. Doupalová

Vnitr Lek 2013, 59(1):31-36  

The objective of our study was to determine a correlation between the level of adipocyte fatty acid-binding protein (A-FABP) (as a possible link between metabolic syndrome and atherosclerosis), the calcium score (CS) and laboratory parameters, including insulin resistance indices in asymptomatic first degree relatives of patients with cardiovascular diseases. Set and methodology:Examination was conducted in 82 persons (53 male) with the average age of 52.79 ± 9.6. The examinations consisted of anthropometric and physical tests (determination of body weight, height, body mass index - BMI and casual blood pressure measurement),...

Treatment of AL amyloidosis in 2012; the benefit of new drugs (bortezomib, thalidomide, and lenalidomide). Summary of published clinical trials

Z. Adam, V. Ščudla, M. Krejčí, Z. Čermáková, L. Pour, Z. Král

Vnitr Lek 2013, 59(1):37-58  

Until 2011, the gold standard of treatment for patients with AL amyloidosis was the combination of alkylating cytostatics (melphalan or cyclophosphamide) and dexamethasone. For a selected group of patients under 65 years of age with only moderate damage to their body caused by amyloid and with good cardiac function (EF> 40%), high-dose chemotherapy with autologous hematopoietic cell transplantation seems to be optimal. Patients with AL amyloidosis and low bone marrow plasma cell count generally undergo the harvest of hematopoietic cells from peripheral blood, followed by high-dose chemotherapy immediately after they are diagnosed. In contrast to...

Drug induced osteoporosis

I. Žofková

Vnitr Lek 2013, 59(1):59-63  

Loss of bone mass resulting from the treatment of chronic diseases is not unusual. However, osteoporosis in such patients is typically diagnosed too late, usually after a fracture appears. Particular attention should be given to glucocorticoids, which are commonly used in internal medicine. These hormones delay bone formation (via inhibition of osteoblast differentiation and osteoblast function) and activate bone resorption (through RANKL). Moreover, glucocorticoids inhibit calcium absorption from the intestines, which results in hypocalcemia. Following hyperparathyroidism further accelerates bone resorption. Severe damage to bone microstructure and...

Specificities of the diagnostics and therapy of exocrine pancreatic insufficiency

P. Dítě, I. Novotný, P. Kocna, M. Bojková, T. Kupka, H. Nechutová, B. Kianička

Vnitr Lek 2013, 59(1):65-70  

Exocrine pancreatic insufficiency develops steadily; however, the initial reduction in secretion is practically not diagnosable. More advanced stages, which usually replicate morphological changes, can be determined with tests which asses the exocrine pancreatic capacity. Substantial damage of the pancreas and replacement of viable parenchyma with connective tissue is accompanied by the occurrence of steatorrhoea. This corresponds to a reduction in exocrine pancreatic secretion below 10% of physiological secretion. Exocrine pancreatic secretion tests are still not sufficiently sensitive for diagnosing early stages of pancreas defects and thus are not...

AII antagonists in the treatment of hypertension and prevention of CVA

J. Špinar, J. Vítovec

Vnitr Lek 2013, 59(1):71-78  

AII antagonists (sartans) are considered to be a group of pharmaceuticals with comparable indications and comparable effects as ACE inhibitors, while almost lacking the side effect of a dry cough. Large clinical trials showed that AII antagonists had a comparable (statistically insignificantly smaller) effect on so called "hard targets", i.e. mortality and morbidity, in patients with ischemic heart diseases and/or heart failure. The study of their effect in the treatment of hypertension was first limited to diabetics and patients with microalbuminuria and showed that they had a significant renoprotective effect in said cases. Large clinical trials...

Targeted therapeuticts and their role in the treatment of internal diseases

P. Klener

Vnitr Lek 2013, 59(1):5-12  

Targeted therapy is a conceptual notion that should be used for such a treatment approach that has been developed based upon the known pathophysiology and/or biomarkers of a particular disease, mainly malignancies. Monoclonal antibodies and tyrosine-kinase inhibitors were among the first molecularly targeted agents. Monoclonal antibodies approach is based on targeting a biomarker expressed either on the surface of cancer cells or targeting different cytokines. Tyrosin-kinase inhibitors are directed at the druggable molecule involved in the cancer pathophysiology inhibiting aberrant tyrosin-kinase activity. Classification of targeted drugs and their...

Screening nádorů prsu v České republice (Z odborné literatury)

prim. MUDr. Katarína Petráková, Ph.D.

Vnitr Lek 2013, 59(1)

Kardiometabolický syndrom. Průvodce ošetřujícího lékaře (Z odborné literatury)

as. MUDr. Hana Svačinová, Ph.D.

Vnitr Lek 2013, 59(1)

Moderní terapie obezity. Průvodce pro každodenní praxi (Z odborné literatury)

as. MUDr. Hana Svačinová, Ph.D.

Vnitr Lek 2013, 59(1)

EKG v akutní kardiologii (Z odborné literatury)

Jindřich Špinar

Vnitr Lek 2013, 59(1)

Revizní operace totálních náhrad kyčelního kloubu (Z odborné literatury)

Jiří Vokurka

Vnitr Lek 2013, 59(1)

Vaskulární diagnostika a intervenční výkony (Z odborné literatury)

MUDr. Jakub Hustý Ph.D.

Vnitr Lek 2013, 59(1)

Farmakoterapie dyslipidemie. Průvodce ošetřujícího lékaře (Z odborné literatury)

doc. MUDr. Vladimír Soška, CSc.

Vnitr Lek 2013, 59(1)