Slovo úvodem

prof. MUDr. Petr Dítě, DrSc.

Interní Med. 2015; 17(5)  

Therapy of inflammatory bowel disease during pregnancy

MUDr.Jana Koželuhová, MUDr.Karel Balihar, MUDr.Eva Janská, MUDr.Lucie Fremundová, prof.MUDr.Martin Matějovič, Ph.D.

Interní Med. 2015; 17(5): 218-222  

Inflammatory bowel diseases (IBD) can affect mainly young people in their reproductive years. IBD therefore has a major impact on patient’s family planning decisions. Management of IBD in pregnancy requires a challenging balance between optimal disease control and drug safety. Studies have shown a lack of knowledge among both patients and physicians regarding reproductive issues in IBD. The aim of this article is to objective review available research data regarding the safety of IBD medication during pregnancy and postpartum period in women with inflammatory bowel disease.

Non-alcoholic fatty liver in clinical practice

prof.MUDr.Petr Hůlek, CSc., MUDr.Irma Dresslerová

Interní Med. 2015; 17(5): 224-226  

Metabolic syndrome (MS) is one of the most widely spread diseases in so-called developed countries that is closely linked to the occurrence of cardiovascular as well as other diseases. Abdominal obesity with excess visceral fat and the associated insulin resistance is the main feature. Other main features include impaired glucose metabolism, dyslipidaemia, and arterial hypertension. Metabolic syndrome is closely related to hepatic steatosis that, in the majority of cases, is a benign and reversible liver injury. Under certain circumstances, however, simple steatosis can be accompanied by an inflammatory component and the condition may progress...

Not only diseases of the pancreas and their therapy with pancreatic enzymes

prof.MUDr.Petr Dítě, DrSc., MUDr.Martina Bojková, Mgr.Jarmila Šímová, MUDr.Bohuslav Kianička, Ph.D., MUDr.Kateřina Kapounková, MUDr.Vladimír Hrabovský, Ph.D.

Interní Med. 2015; 17(5): 227-229  

Exocrine pancreatic insufficiency is a serious condition clinically manifested by signs of pancreatic malnutrition. The treatment of these conditions is based on administration of drugs containing pancreatic enzymes of which lipase has the crucial role in the process of digestion. Pancreatic enzymes are delivered in the form of capsules that contain microparticles containing pancreatic enzymes – amylase, lipase, and peptidases. The microparticles are protected from possibly being inactivated by gastric hydrochloric acid by a pH-sensitive coating that is disintegrated only at a pH of 5.0–6.0. This ensures the release of enzymes from...

The Damage of Gastrointestinal Tract Mucosa Caused by Non-Steroidal

MUDr.Pavel Svoboda, Ph.D., prof.MUDr.Petr Dítě, DrSc.

Interní Med. 2015; 17(5): 230-232  

Anti-Inflammatory Agents and Other Drugs Nonsteroidal anti-inflammatory agents are drugs that are frequently linked to side effects; in the Czech Republic approximately 500 000– 600 000 persons use them for treatment and at least 300 patients a year die from complications caused by the treatment. NSAID-related gastropathy manifests itself in the appearance of gastric or duodenal mucosa alterations such as erosions and petechia (50%), ulcers (5–30%), aphthae, mucosal erythema, or in complications (1–2%), particularly in upper GIT bleeding and perforation. Clinical effects include dyspeptic syndrome or anaemia. There is, however,...

News in cardiovascular prevention: from guidelines to novel treatment options

doc.MUDr.Michal Vrablík, Ph.D.

Interní Med. 2015; 17(5): 233-238  

Cardiovascular (CV) prevention remains a top priority not only in our country. Despite a significant decrease of CV mortality the Czech Republic remains a country with a high CV mortality rate. There are more reasons, low attainment of treatment targets being the most important. Options for reduction of atherothrombotic complication risk have widened over recent years. Brand new approaches in the treatment of dyslipidemia including PCSK9 inhibition or therapies utilizing anti-sense technologies rapidly have emerged. We have already learned about their lipid-modifying efficacy but also the first evidence regarding their impact on the risk of...

The influence of obesity on „Postural condition“ - The pilot study

MUDr.Stanislav Horák, Mgr.Renata Nalezencová, prof.MUDr.Eliška Sovová, Ph.D., MBA, MUDr.Dalibor Pastucha, Ph.D., MBA, MUDr.Petr Konečný, Ph.D., MBA, Mgr.Naděžda Calabová, DiS

Interní Med. 2015; 17(5): 239  

Obesity and its complications are globally ranked among the three most common causes of death in the population aged 50 to 70 years. It is associated with a number of health risks that significantly affect the quality of life of the individual. Posture indicates the active movement of body segments against the influence of external forces. The aim of the study was to demonstrate the relationship between the response posture and body weight. The work was used posturographic tests LOS (Limits of Stability) and MCT (Motor Control Test) module Smart Equitest System from posturograph of NeuroCom® companie. The kohort consisted of 20 women with...

This should not happen to respiratory specialist - unfortunate end of IPF story in Czech Republic

MUDr.Martina Šterclová, Ph.D., prof.MUDr.Martina Vašáková, Ph.D.

Interní Med. 2015; 17(5): 243-246  

Idiopatic pulmonary fibrosis (IPF) is a serious treatable disease of variable course and lethal prognosis. Presented case report reviews case of the patient, who was treated for many years by inhaled corticosteroids despite known fibrotic interstitial lung involvement detected by computed tomography. This case happened in the era of antifibrotic treatment, which could have been used for Czech IPF patients since 2011. The patient underwent in 2014 acute exacerbation of the disease and he died of this exacerbation. Further discussion involves possible impact of both medical and patients oriented approach to IPF course, especially with regards...

Single pill combination of linagliptin and metformin - case report

MUDr.Jarmila Jirkovská

Interní Med. 2015; 17(5): 247-251  

The case report presents the treatment of patient in working age with type 2 diabetes mellitus with modern antidiabetic therapy of single pill combination of linagliptin and metformin. This therapy resulted in massive decrease of glycated hemoglobin without hypoglycemic events. Single pill combination of linagliptin and metformin was chosen because of better compliance of patients on single pill combination and added benefit of linagliptin molecule in this single pill combination.

Empagliflozin in clinical practice: Better news, at last

MUDr.Barbora Doležalová

Interní Med. 2015; 17(5): 252-255  

The case study presents the experience with empagliflozin therapy as add-on to insulin and metformin in a poorly controlled type 2 diabetes patient. 7 months of treatment led to HbA1c decrease of 15 mmol/mol, together with a weight loss of 3 kg. The treatment was well tolerated, and despite the combination with insulin, hypoglycaemia did not occur. Next therapeutic efforts must be made to sustain the improvement, or eventually, to further improve HbA1c level in order to prevent long-term complications of diabetes.

Systemic embolisation - unusual complication of hypertensive crisis

MUDr.Ľubomír Bunček, MUDr.Miloš Černý, MUDr.Vladimír Rozsíval, CSc.

Interní Med. 2015; 17(5): 256-258  

Arterial hypertension is a very common disease with the risk of end-organ damage and subsequent manifestation of cardiovascular or renal disease. We describe a case of man in whom the discontinuation of antihypertensive medications led to pulmonary edema and systemic embolisation. The aim of this article is to warn physicians about risks of untreated or inadequately treated hypertension when triggering moment of deterioration may be non-adherence of patient to treatment.

The place of naproxen among other non-steroidal anti-inflammatory drugs used to treat pain and inflammation

prof.MUDr.Pavel Horák, CSc.

Interní Med. 2015; 17(5): 259-263  

in the most common rheumatic diseases Naproxen is a classic non-selective non-steroidal anti-inflammatory drug (NSAID), a derivative of propionic acid, used to treat a number of painful conditions. It has a firm place in the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis as well as psoriatic arthritis, gout, and other diseases. Its long elimination half-life allows twice-daily administration. It has a rapid onset of action. As with other non-selective NSAIDs, the administration of naproxen is associated with an increased risk of gastric toxicity. However, its low cardiovascular toxicity is unique in comparison with...

Effectiveness of phytotherapy in treatment of diabetes mellitus TYPe 2

MUDr.David Koupý, PharmDr.Jana Rudá-Kučerová, Ph.D.

Interní Med. 2015; 17(5): 240-242  

Diabetes mellitus type 2 is treated in accordance with current guidelines by diet and administration of oral antidiabetic agents or insulin. Additionally, there is a high number of available phytopreparations marketed not only as food supplements but also as drugs. Herbal drugs used in these preparations posses well described pharmacological effects proven in both preclinical and clinical studies. Thus, it is possible to use them in accordance with evidence based medicine standards for adjuvant treatment of diabetic patients. The aim of this work is to provide a survey of herbal drugs and their pharmacological effects registered as drugs and...

Pharmacotherapy after acute coronary syndrome: What is the right choice?

MUDr.Jan Přeček, doc.MUDr.Martin Hutyra, Ph.D.

Interní Med. 2015; 17(5): 264-266  

The article provides a brief summary of the basic pharmacotherapy recommended in patients following acute coronary syndrome. Emphasis is mainly placed on antiplatelet therapy using the novel antiplatelet agents ticagrelor and prasugrel as well as on highdose treatment with statins. Also discussed is the treatment with beta blockers and with drugs targeting the renin-angiotensinaldosterone system.