Strach z výsledků vyšetření aneb Čeho a proč se vlastně bojíme?

Mgr. Roman Pešek

Interní Med. 2012; 14(10): 347  

Differential diagnosis and therapy of chronic obstructive pulmonary disease and asthma

prof.MUDr.Vladimír Vondra, DrSc., MUDr.Iveta Vondrová

Interní Med. 2012; 14(10): 350-356  

Chronic obstructive pulmonary disease (COPD) and asthma have several different but also similar characteristics in diagnosis and therapy. There are different etiologic factors they play the main role (in COPD mostly inhaled harmful irritants, in asthma allergic triggers. The most important parameter of differences between COPD and asthma are lung function results of bronchial obstruction and its reversibility. Both diseases are generally under diagnosed and some mistakes are frequent. Correct diagnoses have important influence on early and optimal therapy according the stage of COPD, and control and severity of asthma. Indacaterol (Onbrez Breezhaler)...

New possibilities of prevention and therapy of cardiovascular embolism

MUDr.Zdeněk Coufal

Interní Med. 2012; 14(10): 357-360  

Heparin, first antikoagulant agent, will celebrate 100-year anniversary from its discovery. Warfarin is clinically used during past 60 years. Patients with atrial fibrillation are under risk of stroke and CVE. New ESC guidelines for the management of atrial fibrillation stratifies risk of stroke and CVE and quantifies bleeding risk in optimal contolled treatment by OAC. Based on results from recent studies RE-LY, ROCKET AF and AVERROES new and safer direct oral antiocagulants dabigatran and rivaroxaban are introduced on the market. New antikoagulant agents are shown to be more potent in prevention of stroke ant CVE simultaneously with lower...

Antiinflammatory properties of statins

MUDr.Peter Riško, doc.MUDr.Pavel Kraml Ph.D., Bc.Jana Potočková, MUDr.Jana Střížová

Interní Med. 2012; 14(10): 362-364  

Statins have been extensively prescribed for its ability to reduce blood cholesterol level and positive impact on cardiovascular diseases. In recent years, increased evidence of its pleiotropic effects – antioxidant, antithrombotic, anti-inflammatory, immunomodulatory effect, possible anti-foam cell effect and improving of endothelial dysfunction. In this review, is outlined possible mechanism of antiinflammatory and immunomodulatory effect of statins.

Must the start of insulin treatment in type 2 diabetes be connected with increasing of their body weight?

prof.MUDr.Jindřiška Perušičová, DrSc., et al.

Interní Med. 2012; 14(10): 391-395  

BACKGROUND AND AIMS: The primary objective of the observational study was to evaluate the change in body weight and BMI during 12 months of insulin detemir treatment and to compare it with the changes in body weight and BMI during the previous 12 months of another basal insulin (NPH, glargin) treatment. Treatment with Short acting insulins were adjusted by physicians according to the standard of care. The secondary objective of the study was to evaluate the changes in glycaemic control measured by HbA1c and fasting glycemia blood glucose after 6 and 12 months of the treatment with insulin detemir and compare it with the retrospective period....

Fabry disease - lysosomal storage disease with multiorgan involvement

MUDr.Lubor Goláň

Interní Med. 2012; 14(10): 378-382  

Fabry disease is an inherited lysosomal storage disorder. The inheritance is gonosomal recessive but females can also be involved. A gene mutation causes a shortage of the enzyme α-galactosidase A leading to storage of globotriaosylceramide in cells of various tissues and their damage. It is a rare disease which manifests in childhood with symptoms secondary to peripheral nerve involvement (paresthesias, pain of extremities, fevers). Hypertrophic cardiomyopathy and renal disease leading to failure of function are characteristic. Involvement of central nervous system, gastrointestinal tract, ear and vestibular apparatus may also be present....

Extrinsic allergic alveolitis

MUDr.Šárka Bartizalová

Interní Med. 2012; 14(10): 383-385  

The paper describes etiology, pathogenesis, clinical picture, diagnostics and therapy of occupational extrinsic allergic alveolitis. The contribution describes the work of a 37year female patient having been employed in a company for production of automotive accessories. She used various glues (cyanoacrylate glue). In January 2010 the workplace was moved into a hall, where chemical remedies (glues, hardeners) containing isocyanates are used. The paper describes the evolution of respirátory symptoms in the patients and the diagnostics of extrinsic allergic alveolitis of the isocyanate lung type, which was assessed as an occupational disease.

The Role of Candesartan in the Therapy and Prevention of Cardiovasular Diseases

MUDr.Marek Janka

Interní Med. 2012; 14(10): 386-388  

In the past years there has been a big progress on the field of prevention and therapy of arterial hypertension a heart failure, which are the most important risk factors of morbidity and mortality in the developed countries. As the understanding of the pathophysiology and clinical presentation of these diseases gets deeper, new approaches in the prevention and therapy have been developed. Very successful group of medication are the angiotensin-receptor blockers (ARB). Especially candesartan has reached great results with maintained excellent safety profile. For this reason candesartan nowadays belongs to the standard therapy of hypertension...

Diagnosis and treatment of acute leukemias

MUDr.Mgr.Cyril Šálek, Ph.D.

Interní Med. 2012; 14(10): 366-372  

Acute leukemias are a group of neoplastic diseases originating in the hematopoietic stem cell. They are characterised by uncontrolled proliferation of leukemic blasts in bone marrow. Based on the adherence of blasts to myeloid or lymphoid lineages, they are divided into acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). A more detailed classification is based on the evaluation of the immunophenotype, cytogenetic abnormalities and molecular genetic profile of blasts. Both characteristics have also prognostic significance. Acute leukemias are treated with chemotherapy. Patients with high risk of relapse are referred to allogeneic...

Chronic lower limb edema and its consequences

prof.MUDr.Alena Pospíšilová, CSc.

Interní Med. 2012; 14(10): 373-377  

Lower limb edema can be a manifestation of many pathophysiological conditions in the development of which a number of factors are involved that affect the pressure balance between the vascular bed and the interstitium. It is a common complaint of patients for which they see a physician. Chronic lower limb edema may be associated with systemic disease or may have a local cause, confined only to the lower limbs. From a dermatologist’s viewpoint, chronic lower limb edema is most commonly represented by hyperosmolar edema: phlebedema, lymphedema, and lipedema. Given the fact that this type of edema is chronic and mostly progressive, it tends...

How to prevent traveller‘s thrombosis?

MUDr.Alena Broulíková, CSc.

Interní Med. 2012; 14(10): 389-390  

The need for preventing venous thrombosis results from the severity of complications of this condition; in the acute phase, there is a risk of pulmonary embolism, later on there are symptoms of post-thrombotic syndrome with the development of advanced stages of chronic venous insufficiency with skin manifestations that may ultimately result in the development of leg ulcer. One of the risk factors of venous thrombosis is the slowing of blood flow in lower limb veins and this is a major risk factor that causes a more frequent occurrence of venous thrombosis in long-distance travellers. The strategy of appropriate prophylactic measures depends...

Originální lék versus generikum

doc. MUDr. Otto Mayer, CSc.

Interní Med. 2012; 14(10): 396-398