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The estimation of serum drug levels enables diagnosis of non-adherence to recommended therapy. The data suggest that non-adherence is a common problem among patients presenting with acute decompensation of chronic heart failure.

Training protocol based on neuromuscular electrical stimulation of leg muscles combined with standard type of exercise bicycle training, demonstrates significant beneficial effects on physical performance and quality of life in patients with moderate grade of chronic heart failure.

This study focused on the differences between patients with biopsy-proven inflammatory cardiomyopathy with and without improved left ventricular systolic function. Although a higher number of inflammatory cells at baseline and more pronounced decline to follow-up biopsy were observed in the group with improved ejection fraction of the left ventricle, supporting the hypothesis that initial more intense inflammatory changes lead to more rapid retreat of myocardial inflammation and is associated with improved left ventricular function, in the multivariate analysis only NTproBNP level at baseline was confirmed as an independent predictor of improved ejection fraction of the left ventricle.

The authors describe long-term follow-up of a large, selected and homogenous cohort of patients from a single centre reflecting the course of heart failure with severe left ventricular systolic dysfunction barely modified by comorbidities. Short-term prognosis of heart failure patients could be estimated based on simple parameters available on out-patient examination. Patients presenting with these parameters should be referred to a tertiary centre to be considered for advanced heart failure therapy.

The authors found significantly higher levels of carboxymethyl-lysine (CML) in pregnant women with gestational diabetes mellitus than healthy controls. This is a first study on CML levels in connection with persisting glucose abnormality postpartum.

The study focused on the incidence of radial artery injuries after first and repeated transradial coronary catheterizations. The results show a low occurrence of injuries and no differences between the first and follow-up procedure. One of the reasons for the results seems to be the use of short radial sheats for arterial access.

The study confirmed the significance of immunoglobulin heavy/light chain ratio corrected index, id est the ratio of serum levels of involved/uninvolved immunoglobulin heavy/light chain levels to standard prognostic factors and stages 1-3 according to Durie-Salmon and International Staging System in IgG and IgA type of multiple myeloma.

Aim: To compare assessment of fibrinogen by thromboelastography with the standard von Clauss method. Methods: Observational prospective study. Results: Thromboelastography provides direct and complex evaluation of the entire coagulation cascade based upon changes in blood viscosity. It affects both platelets and plasma components. New application of this method measures fibrinogen contribution to coagulation as opposed to fibrinogen antigen levels measured by immunoassay. Paired samples from 117 patients before cardiopulmonary bypass were compared. A moderate correlation was found between fibrinogen and functional fibrinogen with a Spearman correlation coefficient of 0.476. Conclusion: The functional fibrinogen test is a valid point-of-care method for fibrinogen assay with a moderate correlation to the standard method.

The prevalence of isolated, exercise-induced HFNEF has not been systematically studied to date. We evaluated current data on the prevalence, clinical significance and specifically, the establishment of the diagnosis of isolated, exercise-induced HFNEF. There are conflicting results and significant problems associated with this diagnosis .This review will hopefully encourage further research in this difficult but clinically important area of heart failure.

Polymyalgia rheumatica (PMR) has no clear, specific laboratory marker or finding and is difficult to diagnose. In contrast to other imaging modalities (ultrasound and magnetic resonance imaging), PET and PET/CT require no targeting to a limited body part and as "one stop shops" can provide whole body examination. It can also visualize the involvement of diverse regions and their combinations.

Skin cancer is the most frequent type of cancer in heart transplant recipients (HTRs). The authors report the results of the first study in the Czech Republic on HTRs. They compared the risks for different types of cancer. The study provides comprehensive analysis of skin cancer and other types of cancer from which they may be able to derive an evidence-based skin cancer surveillance program.

The aim of the review was to assess current uses of heart rate variability (HRV) in cardiac autonomic neuropathy (CAN) diagnosis with emphasis on proven methodological approaches and current views on the physiological interpretation and clinical uses of HRV methods. In clarifying controversial viewpoints on HRV, the paper supports its use in the routine diagnosis of neuropathic diseases.

This case report describes an interesting case of overt hyperthyroidism in a thyroidectomised patient. It illustrates the clinical search for functional ectopic thyroid tissue utilizing a multidisciplinary clinical approach.

This study provides a unique view on the clinical impact of different immunosuppressive regimens used in cardiac transplant care on bone marrow suppression. The authors confirm that use of contemporary medication regimens lead to significant lymphocytopenia and leukopenia. In the case of significant myelotoxicity, reducing or stopping of MMF leads to normalization of blood count without increased incidence of rejections.

The aim of this study was to demonstrate the outcomes of the anti-VEGF treatment in patients with the wet form of AMD in real clinical practise in Czech Republic. A comparison of the results with clinical trials was surprising. A sub analysis of the results identified parameters that could predict treatment success.

The authors summarize the facts and their clinical experience with omitting adjuvant radiotherapy in the early stages of breast cancer in elderly patients. Adjuvant radiotherapy is standard treatment after breast conserving surgery but in elderly patients the benefit of radiotherapy is unclear. The experience of the authors is that adjuvant radiotherapy may be safely omitted in older patients with low risk breast cancer.

A case report of a patient with rare duodenal localization of MALT lymphoma. The extremely rare manifestation of this neoplasm is described.

This was a study of the effect of continuous positive airway pressure (CPAP) on the prevalence of masked hypertension in Obstructive Sleep Apnea patients. Masked hypertension is very prevalent in these patients and CPAP could be effective in blood pressure lowering. However this study nopositive effect of CPAP on the prevalence of masked hypertension was found

Liver functions in 1 473 patients with acute heart failure (AHF) from the AHEAD registry were evaluated. Liver function tests (LFTs) were associated with acute heart failure severity: the most abnormal values were found in patients with cardiogenic shock. Hepatocellular LFTs pattern (elevated AST and ALT) predominated in left sided forward heart failure, while cholestatic pattern (elevated GGT and ALP) occurred mainly in bilateral and right sided AHF.

Adaptation to hypoxia requires many genetic and biochemical responses that mutually regulate one another. Hypoxia-induced resistance is consequently very complex. The most studied factor responsible is hypoxia-inducible factor-1 (HIF-1) that significantly contributes to the aggressiveness and chemoresistance of various tumours. Also described are HIF-1 independent mechanisms of drug resistance in hypoxic tumours. Since hypoxia is closely associated with chemo- and radio resistance, different approaches have been developed to circumvent hypoxia-induced resistance.

Background: Thyroid gland disturbances are the most common endocrine disorders in pregnancy. There are some particular recommendations for the investigation of women in risk groups, but no consensus guidelines for general screening exists at present in the Czech Republic. Aim: The aim of our study was to determine whether universally conducted screening of pregnant women would reveal a significant number thyropathies. Material and Methods: We examined 592 pregnant women for thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels and for autoantibodies against thyroperoxidase (antiTPO) in the 6^th - 10^th week of their pregnancy. Results: Levels of TSH, fT4 or antiTPO beyond laboratory reference limits were found by gynaecologists in 214 women (36.1%) and 141 of whom (23.8%) underwent endocrinological examination. In the women without known risk factors (n=91) we found undiagnosed autoimmune thyroiditis in 20 cases (22 %) and in 7 cases (7.7%) some degree of subclinical hypothyroidism was confirmed. Finally, 18 (19.8%) women had hypothyroxinemia in the 1^st trimester (fT4 average 8.76 pmol/L) with normal TSH levels. Altogether, a total of 45 women were succesfully identified (49.5% of the endocrinologically examined group without risk factors, i.e. 7.6% of the whole screened group) who warranted monitoring. Of 73 women (12.3%) who underwent screening and, despite recommendation, did not undergo endocrinological examination, there were 55 cases (9.3% of the screened group) with positive levels of antiTPO and with elevation of TSH above the upper normal limit. Conclusions: Of 592 women in the 6^th - 10^th week of pregnancy who underwent thyropathy screening, we newly diagnosed 3.4% of women with autoimmune thyroiditis, 1.2% with subclinical hypothyroidism and 3% with hypotyroxinemia, for whom n o thyropathy risk factor had been evident. Thyropathies were identified in 7.6% of probands. We believe that our results support the importance of universal screening in pregnancy.

Early recanalisation of the occluded cerebral artery in acute ischemic stroke patients.plays a major role in improvement Treatment with intravenous thrombolysis is associated with high probability of poor outcome with low recanalization rates. Intraarterial thrombolysis may be more effective but treatment can be delayed by catheterization. The combination of IV and IA thrombolysis allows faster start of thrombolysis using the IV route and higher recanalization rate using the intraarterial approach. This article reports the safety and efficacy of combined IV + IA thrombolysis compared to IV thrombolysis alone in acute ischemic stroke patients with occluded middle cerebral artery.

Laser induced arteriolar constriction used in early phase of branch retinal vein occlusion (BRVO) brings significantly better visual results if compared with standard grid photocoagulation. This study proved that initial visual acuity (VA) is a strong and independent prognostic factor; initial VA ≤ 0.1 and age over 70 years are strong predictors for poor final VA. Prognostically unfavorable BRVO is defined as an occlusion with an initial VA ≤ 0.25 and these BRVOs should be treated as soon as possible.

The article deals with peripartum cardiomyopathy, a relatively rare disease, which is very likely in our region underdiagnosed. Increased awareness of the disease should contribute to its detection. The authors describe their own experience with the diverse clinical course of the disease. When properly diagnosed and treated it has a very good prognosis, and vice versa unrecognized or improperly treated can have fatal consequences.

Accelerated atherosclerosis in systemic lupus erythematosus (SLE) is a serious cause of morbidity and mortality. This paper provides a comprehensive overview of the possible etiology of atherosclerosis in patients with SLE. Traditional risks factors (lifestyle, lipid spectrum, hypertension, diabetes), immunology profile, markers of endothelial dysfunction, intima media thickness, medication, disease activity and damage are covered. Subgroups with and without lupus nephritis are compared with a healthy population.

In patients with proven unilateral overproduction of aldosterone, adrenalectomy can cure the hyperaldosteronism with a high probability and a positive effect on hypertension. The main aim of this retrospective study was to determine the effects of unilateral adrenalectomy on blood pressure and laboratory parameters in a cohort of 51 patients. Unilateral adrenalectomy had a positive effect in 82% of the patients and led to either blood pressure normalization or reduction of the antihypertensive medication. This study demonstrated a better effect of surgery on blood pressure in younger patiens.

This is the first study to describe the high prevalence of isolated exercise-only induced heart failure with normal ejection fraction (HFNEF) reaching 58% in a cohort of 81 post-heart transplant patients with normal left ventricular ejection fraction. This finding explains their low exercise tolerance due to exertional dyspnea and/or fatigue. Of the noninvasive parameters obtained at rest, multivariate regression analysis identified left ventricular mass index adjusted for allograft age to be an independent predictor of exercise-induced HFNEF.

Hematopoietic stem cells in combination with portal vein embolization provides new insight into the solution of primary unresectable colorectal liver metastases. The authors present a case report describing successful use of a novel method.

The MEDINA (MEtabolic parameters, DIabetes mellitus and NephropAthy) study compares angiotensin converting enzyme inhibitors (ACE-I) with angiotensin receptor blockers(ARB) in monotherapy and combined therapy with diuretic and/or a calcium-channel blocker (CCB) in 439 hypertensive patients with metabolic syndrome and/or diabetes mellitus. The blood pressure decrease difference between ACE-I and ARB was insignificant. Adding either hydrochlorothiazide or amlodipin was equally effective. There were no significant differences in metabolic parameters. The MEDINA trial has confirmed the equivalence of ACE-I and ARB in hypertension treatment and a combination with diuretics or CCB has an additive effect. Adding statins can further reduce the cardiovascular risk.

This paper evaluates fundamental aspects of electrical skin conductance as an objective parameter of measurements of pain perception in newborns, focusing on all gestational categories of newborns. It also describes the practical use of this method in daily routine practice in neonatal units. Measurement of parameters of electrical skin conductance is quick and non-invasive, does not affect significantly the staff or children and provides results immediately.