3rd Department of Internal Medicine

The year 2016 marked the 60th anniversary of the 3^rd Department of Internal Medicine Faculty of Medicine and University Hospital Bratislava, founded on November 1^st, 1956.

Prof. T. R. Niederland, MD., PhD. was appointed the first Head of the Department. After his16-months stay in the laboratory of Nobel Prize laureates Carl and Gerty Cori at Washington University in St. Louis, a very close relationship between clinical chemistry and 3rd Department of Internal Medicine was created since its beginnings.  That naturally led to establishment of Pharmacobiochemical Laboratory of 3^rd Department of Internal Medicine. In this exceptional connection many clinical and therapeutic problems could be solved immediately. Hereby the premises for experimental modeling of many diseases in the field of clinical pharmacology, hepatology, nephrology, diabetology and cardiology were created. This resulted in a unique “Niederland school” and a number of unique works, which have become the PhD., habilitation thesis and inaugural dissertations. In 1968, 3rd Department of Internal Medicine moved into the newly built Academician L. Dérer Hospital, Limbová 5. Pharmacobiochemical laboratory with 2 menageries for laboratory animals remained located at Hlboká street.

Prof. J. Gvozdják, MD., PhD. was the second head of department in the years 1984 – 1995. The third head of department was Prof. V. Bada, MD., PhD. On July 1st, 2014, Assoc. Prof. V. Mojto, MD., PhD., MPH, MHA. was appointed Head of the 3rd Department of Internal Medicine, Faculty of Medicine and University Hospital Bratislava.

In 2009, Ľubomír Valko, MD., PhD., a longtime worker of 3rd Department of Internal Medicine became the new chief physician. The level of endoscopic procedures was strengthening. The endoscopic workplace became a part of 3rd Department of Internal Medicine and University Hospital Bratislava. It provides examination capacity for all of the clinics in the Academician L. Dérer University Hospital. The clinical department offers 40 beds, intensive care unit and ambulance section with the ultrasonographic diagnosis department, gastroenterological department, cardiologic, nephrological, hepatological and internal ambulance.

3^rd Department of Internal Medicine provides comprehensive diagnostics and treatment of internal diseases. Within the gastroenterology provides a range of examination of the upper gastrointestinal tract, including curative procedures such as elastic ligation of esophageal varices, polypectomy, taking samples for histological diagnosis. Emergency endoscopy, if necessary, applying hemoclips and Danis stent respectively is provided.

As a part of the planned interventions percutaneous endoscopic gastrostomy and jejunostomy are performed. Examinations of the lower gastrointestinal tract are realized through rectoscopy and colonoscopy. Patients undergoing treatment procedures such as endoscopic polypectomy are monitored for a long-term and summoned for control examinations.

Sonography ambulance equipment allows its employees to perform abdominal sonography, examination of portal vein flow and echocardiographic examination. Dobutamine stress echocardiography, stress ECG, examination of the thyroid gland, duplex examination of the blood vessels of the leg and renal arteries are standardly carried out on a cardiac unit.

The clinic is performing 24-hour blood pressure monitoring as well as 24-hour Holter ECG monitoring.In the field of cardiology, department is focused on solution of the acute coronary events, prevention, dispensation and treatment of patients with cardiovascular diseases.Intensive Care Unit (ICU) provides comprehensive non-invasive cardiology care.

The department is carrying out the treatment of patients with acute coronary syndromes, acute and worsened chronic heart failure, arterial hypertension - urgent and non-urgent states, disorders of the internal environment, respiratory failure and the need for the mechanical ventilation, as well as providing central venous access. ICU is carrying out urgent and planned cardioversion and temporary transvenous cardiostimulation. Transthoracic echocardiographic examinations, stress echocardiography, bicycle ergometry, 24-hour monitoring of ECG and blood pressure and ECG diagnosis of esophageal lead are carried out ambulatory Library facilities are significantly improved for the educational process due to multimedia projector with a laptop and a large-screen TV with a computer allowing viewing high-quality X-ray images, respectively CT and MRI results of examinations of the hospital system.

Within the hepatology is carried out complex diagnostics and treatment of chronic liver diseases. Department is one of the centers for the treatment of chronic viral hepatitis in Slovakia. Dispensarization and treatment of hereditary metabolic liver diseases (Wilson's disease, hereditary hemochromatosis), indication of liver transplantation, monitoring and treatment of the alcohol and non-alcohol hepatic steatosis, steatohepatitis, steatofibrosis and cirrhosis of the liver, also autoimmune diseases of the liver, liver disease during pregnancy, and monitoring of patients after liver transplantation  is carried out. The department is involved in the collection of epidemiological data of the patients lifestyle  from the hepatology ambulances in Slovakia. Hepatology team provides the latest standard of non-interferon treatment of viral hepatitis B, C and metabolic liver diseases.

Nephrology deals with the prevention, diagnosis, dispensarization, prognosis, conciliar activities, and treatment of an acute and chronic renal damage in primary renal disease, or due to various pathological conditions in which the kidneys are damaged secondary. These disorders include hypertension, diabetes mellitus, rheumatologic, and systemic vascular and disease. Dispensarization of patients with acute and chronic renal insufficiency, treatment of intoxications and disorders of the internal environment, and the management of patients with complications during and after the dialysis treatment, as well as preventive examinations and preparation of patients in chronic dialysis program in the pre-dialysis period is performed.

The care of patients with metabolic diseases and chronic diabetic complications, especially diabetic nephropathy is at a high level. The department has a long experience in the treatment of diabetic nephropathy regarding to professional contacts and experience at leading institutions abroad.
 Prevention and treatment of obesity and other civilization diseases is a daily activity.

Publication activities of the 3^rd Department of Internal Medicine

Publication activity is very rich with a very good citation response.
One of the first monographies was “Biochemical syndromology in clinical hepatology” (Niederland, Brixová). Prof. Gvozdják initiated and edited the first praegradual textbook of internal medicine, which was published three times. The first guide to the basis of clinical electrocardiography was written at the 3^rd Department of Internal Medicine by Prof. Bada in 1975 and achieved by 1991 a total of 7900 copies.

At present, reprint has been approved and is preparing to be published in English.
Clinic staff is co-authors of the most comprehensive textbook: Principles of Internal Medicine (eds Duris, Hulin, Bernadič) and postgraduate textbook: Gastroenterology (Jurgoš, Kužela, Hrušovský), monographs: Vascular diseases, Principles of modern angiology (Štvrtinová et al). Doc. MD. V. Mojto, CSc., MHAis a co-author of a textbook: Internal Medicine (Kiňová, Hulin et al), 2013. In 2000, Assoc. Prof. Szántová and Prof. Kupčová published a scientific monograph: Doppler diagnostics and treatment options for portal hypertension. In 2016, Assoc. Prof. Mojto published university textbook: Selected chapters from clinical diabetology.

Teaching activity

3^rd Department of Internal Medicine is the base for undergraduate and postgraduate teaching. The Head of the Department Assoc. Prof. V. Mojto, MD., PhD., MHA is the chairman of the State examination committee of internal medicine and a member of the Academic Senate; three professors and one associate professor are members of the two other committees for state examinations in internal medicine. Teaching is carried out for medical students in the 3rd, 4th, 5th and 6th class according to the current schedule of Faculty of Medicine. Employees of the 3^rd Department of Internal Medicine. Faculty of Medicine and University Hospital Bratislava together with the employees of the Pharmacobiochemical Laboratory prepare teaching of compulsory elective subject Mitochondrial Medicine.