Vnitr̆ní lékar̆ství
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Vnitr̆ní lékar̆ství · Sep 2014
[Basal insulin glargine using a basal-bolus regimen in a common clinical practice: observational, non-interventional, multicenter, national project LINDA (Lantus in daily practice - safety and efficacy in basal bolus regimen)].
To evaluate the safety and efficacy of basal insulin glargine using a basal-bolus regimen in a common clinical practice setting in the Czech Republic. ⋯ In the common clinical practice setting, the initiation of treatment with insulin glargine using the basal-bolus regime in patients with previous insulin therapy resulted in a reduction in the incidence of hypoglycemic events, including severe hypoglycemia and severe nocturnal hypoglycemia, and improved metabolic control in patients with diabetes (reduced glycated hemoglobin, fasting glucose values and 6-point blood glucose profile). Greater satisfaction with the current treatment was reported by both patients and physicians.Key words: basal-bolus regimen - diabetes mellitus - insulin glargine - observational project.
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Vnitr̆ní lékar̆ství · Jul 2014
[Acute pancreatitis - validation of revised Atlanta classification on 159 patients and prognostic factors].
In the last few years the Atlanta classification of acute pancreatitis (AP) have been revised. However prognostic markers of AP are still being searched for. The aim of this study is to validate the 3 severity categories proposed by the revised Atlanta classification. We also tried to reevaluate the association between two laboratory markers (leucocyte count and RDW - red cell distribution width) on admission and prognosis of the patients with AP. ⋯ New categories of severity as defined by Revised Atlanta classification are describing well the mortality, length of hospital stay and need for interventions in the patients with AP. Leucocyte count and RDW on admission are needed to be confirmed as potential prognostic markers of severity and mortality in AP.
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Vnitr̆ní lékar̆ství · Apr 2014
[Optical coherence tomography, delayed stent implantation and primary percutaneous coronary intervention in patients with myocardial infarction and ST segment elevation].
Primary percutaneous coronary intervention (PCI) is an effective treatment for myocardial infarction with ST-segment elevation. However, the stent may slow (slow-flow) or even interrupt the flow (no-reflow) in the infarct-related artery with an increase in short-term and long-term mortality. Due to these limitations there is an effort to search for alternative methods or certain modifications of existing PCI. ⋯ Control angiography and OCT done 9 months after event have revealed insignificant stenosis in all patients. It is plausible that universal medical procedure with stenting is not suitable for all patients with STEMI and especially patients with large thrombus may benefit from the alternative procedure performed by manually trombo-aspiration technique with intensive anticoagulant/antiaggregant therapy. Nevertheless, only randomized trials with sufficiently follow-up may confirm this hypothesis.
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Vnitr̆ní lékar̆ství · Feb 2014
[Dynamics of interleukin 6 levels in the patients with cardiogenic and septic shock and in a control group of patients with uncomplicated AMI].
Cardiogenic shock (CS) is the leading cause of mortality in patients with acute myocardial infarction (AMI). Inflammatory response seems to be common response in patients with AMI, especially those with CS. We have therefore conducted a study to determine diagnostic and prognostic utility of interleukin 6 (IL6) levels in the cohort of patients with cardiogenic and septic shock (SS) and in a control group of patients with uncomplicated AMI. ⋯ Patients with cardiogenic shock demonstrated more pronounced cytokine response as evidenced by increased levels of IL6 compared to patients with uncomplicated STEMI. Levels of IL6 peaked in SS patients at admission, in CS patients 12-24 hours after admission. In daily clinical practice routine measurement of IL6 levels for prediction of prognosis both in cardiogenic and septic shock are of little value mainly due to significant interindividual variability of IL6 values.