Něco končí, a něco začíná

Mirek Souček

Interní Med. 2019; 21(5): 263  

Advances in biological treatment for severe asthma

MUDr. Beáta Hutyrová, Ph.D.

Interní Med. 2019; 21(5): 266-269  

Bronchial asthma is a heterogeneous disease with a range of phenotypes and endotypes, which require a different therapeutic approach, especially in the case of severe forms of asthma that are refractory to standard therapy. Severe refractory asthma represents a serious problem with high morbidity and mortality of patients, and as a considerable health care burden. Introduction of biological therapy, which targets allergic and non-allergic eosinophilic asthma, represents a significant progress in the treatment of severe asthma. Monoclonal antibodies are already used in common practise against immunoglobulin E and interleukin-5, and more recently, monoclonal...

Probiotics use in geriatric medicine

MUDr. Jana Řádková

Interní Med. 2019; 21(5): 270-274  

The intestinal microbial composition changes with aging in a variable manner. The composition and function of gut microbiota closely correlates with health status of older adults. Microbiota-targeted interventions present a promising option for impacting longevity and healthy aging. Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host (1). The data obtained from younger age groups cannot be automatically extrapolated to the elderly, nor will results acquired from older individuals with a good health status necessarily apply to those with multiple co-morbidities or frailty. Therefore, additional...

Gestational diabetes – pathophysiology, prevention and treatment options

MUDr. Dominika Goldmannová, MUDr. Ondřej Krystyník, MUDr. Ľubica Cibičková Ph.D., MUDr. Jan Schovánek, doc. MUDr. David Karásek Ph.D.

Interní Med. 2019; 21(5): 276-279  

Gestational diabetes mellitus (GDM) belongs to the specific complications of pregnancy and it is characterized by impaired glucose tolerance with beta-cell dysfunction and insulin resistance. During the pregnancy, we can see many physiological changes due to the effort of the maternal body to provide all the demands for growing fetus. One of the changes is insulin resistance that reaches peak in the third trimester. Gestational diabetes develops when beta-cells are not able to produce enough insulin to cover the needs of newly formed insulin resistance. Lately, the role of adipose tissue as an endocrine organ and the effect of gut microbiome, has been...

News in the treatment of hemophilia

MUDr. Antonín Hluší, Ph.D.

Interní Med. 2019; 21(5): 280-283  

The prognosis and quality of life of haemophilia patients has changed dramatically with the use of coagulation factor concentrates.In the last two decades, the quality of care has improved considerably thanks to the availability of costly treatment, theuse of prophylactic therapy, the use of safe intravenous recombinant products and comprehensive care in haemophilia centres.Recent trends include therapy with extended half-life, individualization of pharmacokinetics or a completely innovative approachusing non-factor therapy with the subcutaneously administered bispecific antibody emicizumab replacing factor VIII function.

Current possibilities for treatment of diabetes with incretin mimetics

MUDr. Ľubica Cibičková, Ph.D., doc. MUDr. David Karásek, Ph.D.

Interní Med. 2019; 21(5): 285-288  

In the present article we describe mechanism of action of incretins (mainly GLP-1) and their role in diabetes type 2 therapy. Wediscuss importance of application of incretin effect in diabetes therapy, we describe pathophysiology of incretin effect andprinciples of therapy by incretin mimetics. Afterwards we cover incretin mimetics which are used in Czech Republic for diabetestreatment – exenatide, liraglutide, lixisenatide, dulaglutide and semaglutide.

Central‑acting and alpha-1 adrenoreceptor blocking antihypertensives (fifth‑line antihypertensive agents), part 2

PharmDr. Iva Míšková, Ph.D.

Interní Med. 2019; 21(5): 289-291  

Central-acting and alpha-1 adrenoreceptor blocking antihypertensive agents are used in the practice more frequently thancardiologic guidelines recommend. In our setting, rilmenidine, moxonidine, urapidil, methyldopa, doxazosin, and clonidine canbe included in this group of drugs. This review summarizes why these agents are among fifth-line antihypertensive agents andwhat their benefits as well limitations are. It also deals with specific types of hypertension wherein the use of central-acting andalpha-1 adrenoreceptor blocking antihypertensive agents has clinical justification.

Tofacitinib

Mgr. Šárka Sperottová, MUDr. Petra Matalová, Ph.D.

Interní Med. 2019; 21(5): 292-294  

Tofacitinib (Xeljanz®), is a small molecule that inhibits Janus kinases. They are responsible for signal transduction for activation ofpro-inflammatory – cytokine receptors. Tofacitinib binds ATP and prevents autoactivation of Janus kinases. It is used in the treatmentof chronic inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis or Crohn‘s disease. However, it is also effective againstother inflammatory diseases, such as juvenile idiopathic arthritis. The recommended dosage of tofacitinib is 5 mg twice daily, or 10 mgtwice daily. However, with a higher dose regimen, side effects such as...

Vaskulární věk

MUDr. Pavel Rutar

Interní Med. 2019; 21(5): 304-306  

Vitamin D – When and Why to Investigate?

MUDr. Olga Nývltová

Interní Med. 2019; 21(5): 295-298  

The health consequences of vitamin D deficiency are a global problem. The incidence of osteoporosis as well as other myoskeletaldiseases is increasing. In doing so, the appropriate supplementation with vitamin D can be used to prevent and treat thesediseases. Unfortunately, the laboratory determination of vitamin D is costly and it is not possible to carry out general screening,but to focus at least on people with a higher risk of deficit. The article answers the question of how to identify these people.

Differential diagnosis of slowly progressive cognitive disorders

MUDr. David Šilhán, doc. MUDr. Aleš Bartoš, Ph.D.

Interní Med. 2019; 21(5): 299-303  

The aim of the review article is to acquaint the reader with the most frequent causes of gradually developing cognitive disorders.We want to point out the possibilities of their differential diagnosis in routine clinical practice and using modern diagnostic approaches.We introduce new Czech memory tests and classic cognitive tests. We also mention suitable therapeutic proceduresaffecting the course of individual diseases.