Takotsubo cardiomyopathy - what has changed - editorial

Pavel Gregor

Vnitr Lek 2015, 61(7-8):615-617  

Risk factors of thyroid carcinoma - editorial

Zdeněk Fryšák

Vnitr Lek 2015, 61(7-8):618  

Takotsubo cardiomyopathy, clinical experience with the disease and one-year prognosis of patients

Petr Kubena, Šárka Bohatá, Jan Maňoušek, Jindřich Špinar, Jiří Pařenica

Vnitr Lek 2015, 61(7-8):619-625  

Introduction:Takotsubo cardiomyopathy (TCM) is a rare cardiac disease. In the acute phase it may imitate acute myocardial infarction of the anterior wall with ST elevations. This can be complicated by ventricular fibrilation or heart failure. The aim of this study is to show the characteristics of patients with takotsubo cardiomyopathy, the one year outcome and the application of magnetic resonance imaging of the heart in the diagnosis of this disease. Methods:Forty seven patients with takotsubo cardiomyopathy were enrolled in this study. Severe stenosis of coronary arteries was excluded by selective coronarography. In twelve...

Rituximab infusion-related toxicity in patients with chronic lymphocytic leukemia

Martin Šimkovič, Pavel Vodárek, Monika Motyčková, Pavel Žák, Lukáš Smolej

Vnitr Lek 2015, 61(7-8):626-632  

Background and Aims:Rituximab in combination with chemotherapy is an effective treatment of patients (pts) with chronic lymphocytic leukemia (CLL). The most frequent adverse event of rituximab is infusion-related toxicity, e.g. cytokine-release syndrome that occurs usually during the first infusion. However, there is scarce data on feasibility and tolerability of rituximab infusions in CLL outside clinical trials. Therefore, we performed a single-center retrospective analysis of the frequency of rituximab infusion-related adverse events during the first- and the second line CLL treatment administered in the routine practice. We also analyzed...

Erectile dysfunction as the first sign of systemic vascular diseases and of organovascular arterial ischemic diseases. Guidelines and Challenge of the Angiology section of Slovak Medical Chamber (AS SMC, 2015)

Peter Gavorník, Andrej Dukát, Ľudovít Gašpar, Denisa Medová, Xénia Faktorová, Eva Gavorníková

Vnitr Lek 2015, 61(7-8):660-669  

Erectile dysfunction is a highly prevalent and progressive condition affecting the quality of life of man and his sexual partner. Evidence is accumulating in favour of erectile dysfunction as a sign of a genitovascular disease (GVD) in the majority of patients. Erectile dysfunction may be considered as the clinical manifestation of a organovascular disease affecting penis (male genitovascular disease - MGVD) as well as angina pectoris is the typical manifestation of a vascular disease affecting coronary arteries of a heart (cardiovascular disease - CVD). Several studies confirm the assumption that erectile dysfunction symptoms were found to come prior...

Cardiovascular effects of GLP-1 receptor agonist treatment: focus on liraglutide

Martin Haluzík, Pavel Trachta, Miloš Mráz

Vnitr Lek 2015, 61(7-8):635-640  

Cardiovascular risk reduction is the major aim of type 2 diabetes mellitus treatment. The effects of various antidiabetics on the cardiovascular complications are currently under careful scrutiny. Incretin-based therapy that utilizes the effects of glucagon-like peptide 1 (GLP-1) or stimulation of its receptor by GLP-1 receptor agonists represents one of the most promising approaches from the potential cardiovascular risk reduction point of view. Experimental studies have shown that the GLP-1 and GLP-1 agonists treatment improves endothelial function, decrease blood pressure and protects myocardium during experimentally-induced ischemia. Clinical studies...

Transcatheter aortic valve implantation - diagnostic, procedure and outcomes

Marián Kurečko, Gabriel Valočik, Marianna Vachalcová, Mariana Dvorožňáková

Vnitr Lek 2015, 61(7-8):641-648  

Transcatheter aortic valve implantation (TAVI) is an interventional method for the treatment of severe aortic stenosis. TAVI is indicated in patients who have been identified by the heart team as surgically inoperable or operable at very high risk. The advantage is minimal invasive approach with the absence of sternotomy and extracorporeal blood circulation. Interventional procedure does not allow direct visualization of the anatomical relations at the site of the final valve position (aortic anulus). For this reason it is essential to ensure appropriate view by high quality imaging methods. A standard method for the evaluation of the anatomical relations...

Hepatorenal syndrome - pathophysiology, diagnosis and treatment

Vladimír Hrabovský, Alice Mendlová, Terezie Vavříčková

Vnitr Lek 2015, 61(7-8):649-654  

Hepatorenal syndrome (HRS) is a life-treating complication of liver diseases. This functional kidney impairment is classified into acute (type I) and chronic (type II) types and is connected with high mortality. Treatment options are limited, but administration of vasoconstrictors (terlipressin), albumin and portosystemic shunt may improve their prognosis. Liver transplantation is the most effective method for these patients. Authors want to present recent data relating to HRS, including therapeutic recommendations.

Risk factors of thyroid carcinoma

Dana Nováková, Martin Křenek, Květuše Vošmiková, Petr Vlček

Vnitr Lek 2015, 61(7-8):655-659  

Thyroid cancer is one of the world's fastest growing tumor incidences. The number of new cases has particularly increased in differentiated papillary thyroid carcinoma. In the Czech Republic it is documented that the incidence of thyroid cancer continues to grow, since 1980 has increased four times. The Czech Republic has a higher incidence than most other European countries and at the same time is a country with average and declining mortality from this disease. This review summarizes the known risk factors that may contribute to the formation and rise of thyroid carcinomas.

Jan Brož et al. Léčba inzulinem

Jan Škrha

Vnitr Lek 2015, 61(7-8):670  

Otakar Bleha. Endokrinolog vzpomíná

Jan Petrášek

Vnitr Lek 2015, 61(7-8):671  

XXXIV. dny mladých internistů České republiky a Slovenska v Olomouci

Pavel Horák

Vnitr Lek 2015, 61(7-8):672  

Prof. MUDr. Josef Erben, DrSc., zomrel

Miroslav Mydlík

Vnitr Lek 2015, 61(7-8):673-674  

Nedožitých 88 rokov profesora Miroslava Mikuleckého

Anna Remková, Ladislav Dedík

Vnitr Lek 2015, 61(7-8):675-676  

Profesor Jaroslav Blahoš pětaosmdesátiletý

Luboslav Stárka

Vnitr Lek 2015, 61(7-8):677-678  

Aktuální trendy v léčbě chronických onemocnění - program

Vnitr Lek 2015, 61(7-8):679  

Cannabis - therapy for the future?

Jan Hajer

Vnitr Lek 2015, 61(7-8):680-685  

Despite all the progress achieved in the treatment of chronic gastrointestinal diseases, in some patients the treatment does not reach long-term optimum effectiveness. Therefore a number of patients have turned to complementary and alternative medicine (CAM). Of the different types of CAM patients with GIT diseases tend to prefer in particular homeopathy, acupuncture and not least phytotherapy, where therapeutic use of cannabis may also be included. The pathophysiological basis of therapeutic effect of curative cannabis has not been fully clarified so far. Many scientists in many fields of medicine and pharmacology have been engaged in the study of...

New trends in treatment of non-variceal bleeding in the upper gastrointestinal tract

Radan Keil, Ladislav Douda

Vnitr Lek 2015, 61(7-8):686-690  

Acute upper gastrointestinal tract bleeding is a life-threatening incident in which a right diagnostic and therapeutic approach is necessary. Beside the standards in endoscopic hemostasis (adrenalin injection, hemostatic clips) there are some new technologies in endoscopic hemostasis.

Home nutrition care in the Czech Republic

Michal Šenkyřík

Vnitr Lek 2015, 61(7-8):691-694  

Home artificial nutrition includes application of enteral and parenteral nutrition in home environment, in cases of natural nutrition access failure. Home enteral nutrition uses various modality and ways, when persist the functional bowel. Chronic intestinal failure indicates dependence of home parenteral nutrition and is aplicated with central venous accesses. Home artificial nutrition improves patient's quality of life and is more economical compared with hospital care.

Vitamin D - old substance in new perspectives

Vladimír Kojecký

Vnitr Lek 2015, 61(7-8):695-697  

Receptors for vitamin D are present almost in all body tissues. Vitamin D does not only act as a regulator of calcium and phosphorus metabolism, but also a substance which modulates the immunity system function, regulates cell proliferation. Genetic, epidemiological and experimental data indicate a possible role of vitamin D deficiency in the development of some diseases, mainly of autoimmune diseases and tumours. The benefit of curative intake of vitamin D has so far not been proven. There is no reason why the deficiency of vitamin D should not be covered. The substitution should start with the replenishment of the lacking amount of vitamin D (which...

Possible endoscopic solutions of polypoid and non-polypoid lesions in the colon

Milan Dastych, Radek Kroupa

Vnitr Lek 2015, 61(7-8):698-702  

Colorectal cancer (CRC) is one of the most frequent malignant diseases in the Czech Republic. Almost 70 % of CRC develop based on adenomatous polyps, 30 % arise de novo. The pathogenesis of development of colorectal cancer confirms an adenoma to carcinoma sequence, based on the gradually developing mutations of oncogenes and suppressor genes. By removing the adenomatous mucosal neoplasia the pathway of CRC development is cut off, which is the practical goal of the screening programme. To meet the goals of the preventive programme the gastroenterologists performing endoscopy must be appropriately trained and experienced in the detection of and procedures...

Ordinary disease - appendicitis

Karel Lukáš

Vnitr Lek 2015, 61(7-8):703-710  

Appendicitis is the most common abdominal emergency. While the clinical diagnosis may be easy in patients who present with classic signs and symptoms. Atypical presentations may result in diagnostic embarrassment and delay in treatment. Typical sign is abdominal pain. Furthermore, it can be nausea, vomiting and anorexia. Abdominal examination reveals localised tenderness and muscular rigidity in the right lower abdominal quadrant. Laboratory data usually reveal an elevated leukocytosis with a left shift and elevated C-reactive protein. To establish the diagnosis greatly help native abdominal X-ray, ultrasound or CT. In1889, an appendectomy was accepted...

Does "LDL hypothesis" also apply to patients with diabetes?

Milan Kvapil

Vnitr Lek 2015, 61(7-8):711-716  

The basic symptom of diabetes mellitus is hyperglycemia. However the increased cardiovascular risk in patients with both type 1 and type 2 diabetes mellitus has a multifactorial etiology. Concurrent negative effects of hyperglycemia, hypertension and hyperlipidemia on the vascular system reinforce one another. Consistent prevention of cardiovascular risk parameters in patients with type 2 diabetes mellitus (DM2T) has brought significant decline in mortality and morbidity due to cardiovascular diseases. Still there is "residual risk" remaining. The full use of the potential of statins and their combination with ezetimibe may lower the CV risk even more...

Lowering of blood pressure - by treatment of other risk factors

Miroslav Souček

Vnitr Lek 2015, 61(7-8):717-720  

Reaching the target value of blood pressure is still a big problem. A mere 30 % of treated hypertensives reach blood pressure values < 140/90 mm Hg. Hypertensive patients often exhibit further risk factors - diabetes mellitus, dyslipoproteinemia, excess weight and obesity, all of which are included in the definition of metabolic syndrome. The cardiovascular risks associated with the individual risk factors are not summed, they are multiplied. Unfortunately, the individual risk factors have been treated separately until now. However, there is an effort aimed at treating individual risk factors in the way that may positively affect others. The study...

How to treat dyslipidemia in patients with metabolic syndrome

Vladimír Soška

Vnitr Lek 2015, 61(7-8):721-724  

Typical feature of dyslipidemia in patients with metabolic syndrome is increase triglycerides, decrease HDL-cholesterol and prezence of small atherogenic LDL particle; nevertheless majority of patients do not reach target level of LDL-cholesterol for their risk category as well. An essential part of treatment should be non-pharmacological approach - lifestyle changes (weight loss, change in eating habits, increased physical activity). In patients in primary prevention without diabetes decision about pharmacotherapy depend on their risk of fatal cardiovascular events in the perspective of 10 years (table SCORE). In diabetic patients and in patients...

AB0 incompatible kidney transplantation - first experiences

Ondřej Viklický, Alena Paříková, Janka Slatinská, Vladimír Hanzal, Libuše Pagáčová, Eva Honsová, Eva Kieslichová, Libor Janoušek, Jiří Froněk

Vnitr Lek 2015, 61(7-8):725-730  

Living donor AB0 incompatible kidney transplantation represents a new tool how to improve the access to transplantation. Majority of European protocols are based on desensitization with rituximab, triple drug immunosuppression, intravenous immunoglobulins and specific immunoadsoption (IA) which eliminates isohaemaglutinins. AB0i kidney transplant program was initiated in our centre in 2011 and 21 patients have received grafts from incompatible donors until recently. Highest accepted isohaemaglutinins titers before rituximab were 1 : 64 and corresponding pretransplant immunoadsorption procedures varied from 2 to 9. In 5 patients 1-2 IA procedures were...

Pancreas transplantation: State of the art and future prospects

František Saudek, Peter Girman, Květoslav Lipár, Petr Bouček, Radka Kožnarová, Matěj Kočík

Vnitr Lek 2015, 61(7-8):731-737  

During the past 30 years pancreas transplantation evolved into a routine procedure especially suitable for type 1 diabetic recipients undergoing simultaneously kidney transplantation significantly improving quality of life and life expectancy as compared with kidney only recipients. It provides insulin independence with near-normal glucose control without special dietary restriction, freedom from hypoglycemia and chance for halting or regression of microangiopathic diabetes complications. As a separate procedure, pancreas transplantation is carried out mainly in selected subjects suffering from severe hypoglycemic episodes and impaired hypoglycemia...

Tumours and liver transplants

Vladimír Mejzlík, Libuše Husová, Milan Kuman, Soňa Štěpánková, Jiří Ondrášek, Petr Němec

Vnitr Lek 2015, 61(7-8):738-740  

Liver transplantation as a curative treatment method can be used for selected primary liver tumours, in particular for hepatocellular carcinoma and rather rare semi-malignant tumours such as epithelioid hemangioendothelioma, further for infiltration of liver by metastatic neuroendocrine tumours (provided that metastases are only located in the liver and the primary tumour was removed) and for benign tumours (hemangiomas and adenomas) with oppression symptoms and size progression. Cholangiocarcinoma is not indicated for liver transplantation at the CKTCH Brno. In recent years liver transplants for hepatocellular carcinoma have increased and hepatocellular...

Solid organ transplantation in the Czech Republic

Milan Kuman

Vnitr Lek 2015, 61(7-8):741-746  

Solid organ transplantation (heart, lung, liver, kidney, pancreas, small intestin and their combinations) are standard therapy of terminal organ failure. Czech Republic belongs to the states with developed transplantation program. The results correspond with current knowledge and results of leading centers in the world, as demostrated in this article. Organ donor shortage is major factor limiting development of organ transplantations as elsewhere in the Europe or in the world.