Slovo úvodem

prof. MUDr. Michal Kršek, CSc.

Interní Med. 2015; 17(4)  

Thyroid hormones in clinical practice

prof.MUDr.Václav Zamrazil, DrSc.

Interní Med. 2015; 17(4): 165-167  

Thyroid hormones are widely used for substitution of hypothyroidism, in some cases for supresion of TSH level. For treatment thyroxin (tetrajodotyronin) is used in most of patients. When dejodation of thyroxine (productive of trijodothyronine) is supposed to be insuficient, the combination of thyroxine and trijodotyronine (13 : 1) should be considered. Several new methods of treatment with thyroid hormones are currently evaluated for clinical practice.

Differential diagnosis of sellar masses

prof.MUDr.Michal Kršek, CSc.

Interní Med. 2015; 17(4): 169-172  

Sellar tumours are quite frequently found during imaging examination of respective region. Their aetiology is very variable, the most prevailing tumours being pituitary adenomas. Their clinical spectrum differs from clinically non-significant asymptomatic masses to life threatening ones and it could be determined by endocrine dysfunction and/or compressive symptoms. All these aspects and differences have to be carefully assessed and based on detailed examination further management has to be determined. Present review article reviews current view on the issue of sellar tumours with respect on their differential diagnosis.

Pharmacological treatment of postmenopausal and involution osteoporosis

MUDr.Vít Zikán, Ph.D.

Interní Med. 2015; 17(4): 174-184  

Osteoporotic fractures dramatically reduce the quality of life and increase the morbidity and mortality rates following vertebral and proximal femoral fractures. The goal of osteoporosis treatment is to reduce the risk of fractures and enhance the quality of life in fracture patients. Pharmacotherapy for osteoporosis should be considered in patients with a significant risk of osteoporotic fractures. To assess the individual risk of osteoporotic fractures within the following ten years, it is recommended to use the FRAX algorithm that evaluates additional, bonedensity independent risk factors for fracture (age, previous fractures, fractures...

Testosterone therapy and cardiovascular risk

prof.MUDr.Jan Čáp, CSc.

Interní Med. 2015; 17(4): 185-187  

Testosterone level in men declines with age and if symptomatic, testosterone substitution is indicated. Low testosterone level in aging male is associated with increased prevalence of cardiovascular risk factors (obesity, hyperlipidaemia, decreased insulin sensitivity, increased inflammatory markers) and in some studies also with increased total and cardiovascular mortality. In majority of interventional studies testosterone substitution improves these risk factors and in some the decrease of cardiovascular mortality was described. However, recent studies have raised concerns that testosterone therapy may increase cardiovascular risk. This...

Asthma treatment 2015

prof.MUDr.Václav Špičák, CSc.

Interní Med. 2015; 17(4): 188-191  

Asthma is one of the noncommunicable chronicrespitatory inflammatory diseases. Asthma represents important social and economic burden. WHO initiated Global Initiative for Asthma (GINA). The first strategy of diagnostic, treatment and prevention of asthma was published 1995. Czech Initiative for Athma was established 1996. The implementation of the new strategy was succesful. Mortality for asthma significantly decreased, the hospitalityy for asthma is low and quality of life of asthmatics is better. The 2014 version of Global Strategy on Asthma Management, Global Strategy of diagnostic, treatment and prevention of bronchial asthma represents the background...

News and perspectives in insulin treatment

prof.MUDr.Martin Haluzík, DrSc.

Interní Med. 2015; 17(4): 192-195  

Insulin therapy is an inseparable part of the treatment of patients with type 1 diabetes and also of many patients with type 2 diabetes, in particular those with longer disease duration. In many patients with type 2 diabetes, insulin therapy is often initiated later than optimal. One of the reasons is suboptimal pharmacokinetics of the currently available insulins. This is why there is an intensive effort aiming at the development of novel insulins with improved characteristics closer to physiological regulation of insulin secretion. The aim of this paper is to summarize the current knowledge concerning new insulins that have been recently...

Barrett’s esophagus

MUDr.Soňa Režnáková, MUDr.Emilie Niedobová, Ing.Helena Gbelcová, Ph.D., prof.RNDr.Vanda Repiská, PhD.

Interní Med. 2015; 17(4): 196-198  

The current review describes the topic of Barrett’s esophagus. The paper mentions the epidemiology and basic etiopathogenesis of this disease. It also deals with current diagnostic and therapeutic options, including modern endoscopic therapeutic methods. Finally, the procedures used during the endoscopic monitoring of patients are listed.

New oral anticoagulants - hematologist’s perspective

MUDr.Antonín Hluší, Ph.D., Mgr.Luděk Slavík, Ph.D., MUDr.Miroslava Palová, doc.MUDr.Věra Krčová, CSc.

Interní Med. 2015; 17(4): 200-203  

The standard anticoagulation therapy with warfarin or heparin is often replaced by new directly acting drugs known as the new oral anticoagulants (NOAC) in recent years. For routine clinical use direct thrombin inhibitor dabigatran and direct inhibitors of activated factor Xa rivaroxaban and apixaban are currently used. NOAC are administered mostly by the internists, particularly cardiologists, neurologists, orthopedists and angiologists. Hematologist is often involved in the issue, if interpretation of hemostatic parameters in anticoagulant therapy monitoring or therapy related hemorrhagic complications is necessary.

How to deal with a non-compliant hypertensive patient, or The path is not always easy

MUDr.Eva Kociánová, doc.MUDr.Jan Václavík, Ph.D.

Interní Med. 2015; 17(4): 204-205  

The goal of hypertension management is undoubtedly to reduce the risk of its complications. For this purpose, there is a wide variety of effective antihypertensive drugs. With their help, the vast majority of patients reach the recommended target blood pressure levels. However, the willingness of a particular patient to adhere to the prescribed therapeutic regimen in the long term has proved to be a major issue. When non-compliance is identified, it is essential to critically evaluate all the tablets administered in terms of their necessity and efficacy, to use fixed combinations, whenever possible, and, in particular, to make rigorous efforts...

Multiple organ failure induced by repeated yew intoxication

MUDr.Tomáš Suchý

Interní Med. 2015; 17(4): 206-207  

The author describes the course of yew intoxication at a young patient. This relatively rare type of poisoning is associated with high mortality rate. It is caused by significant cardiotoxic effect of taxines. In conclusion the author briefly reviews available therapeutic options.

The unexpected finding of the large vessel vasculitis on 18F-FDG PET/CT imaging in 57-year-old woman with the loss

doc.MUDr.Jiří Doležal, Ph.D., Petr Bradna, Ivana Motyčková, Eva Krčálová

Interní Med. 2015; 17(4): 208-210

of weight and chronic fatigue Aim: To present a case report of the unexpected finding of the large vessel vasculitis on 18F-FDG PET/CT imaging in a 57-year-old woman with the loss of weight and chronic fatigue. Material and Method: The woman underwent 18F-FDG PET/CT imaging, which was obtained 60 minutes after intravenous injection of 18F-FDG (344 MBq). The PET scan acquisition time was 2.5 minutes per bed position. Contrastenhanced CT (venous phase) provided both full CT evaluation (including intravenous and oral contrast) and PET attenuation correction. Results: The examination revealed the unexpected intense 18F-FDG uptake 18F-FDG uptake...