Slovo úvodem

MUDr. Radkin Honzák, CSc.

Interní Med. 2016; 18(1)  

New options in the treatment of hypercholesterolaemia

prof. MUDr. Vladimír Soška, CSc., MUDr. Ondřej Kyselák

Interní Med. 2016; 18(1): 6-8 | DOI: 10.36290/int.2016.002  

Statins are the key drugs for LDL-cholesterol lowering: they have a lot of evidences that they decrease not only cholesterol, but also cardiovascular events and mortality. Second-line choice for lowering LDL-cholesterol is ezetimibe, which is intended to combination with statins. This year were published results of IMPROVE-IT study which showed that addition of ezetimibe to statin has also clinical benefit – decrease of cardiovascular events. New lipid-lowering drugs are PCSK9-inhibitors, first two of which were already approved for clinical use.

Detection of early stages of atherosclerosis

doc. MUDr. Jan Piťha, CSc.

Interní Med. 2016; 18(1): 9-13 | DOI: 10.36290/int.2016.003  

One of the main efforts of preventive cardiology is to detect persons at high cardiovascular risk yet before clinical manifestation of atherosclerosis, which could be fatal. In general, three approaches are discussed: 1) Algorithms calculating the risk of cardiovascular events based on traditional cadiovascular risk factors, 2) Measurements of the concentration of circulating biomarkers, including genetic parameters and 3) Morphological and functional methods assessing vascular wall or obstructive lesions; this group often labelled as detection of preclinical atherosclerosis. The contribution of these approaches could be viewed from several aspects....

What news brought last year on oral antidiabetic drugs?

MUDr. Jiří Slíva, Ph.D., prof. MUDr. Štěpán Svačina, DrSc.

Interní Med. 2016; 18(1): 14-18 | DOI: 10.36290/int.2016.004  

The progress in the treatment of diabetes mellitus during last decade has been unprecedented, especially in the field of new oral antidiabetics. A high evidence of their effectiveness is needed for their successful clinical use as well as the evidence of their safety. In accordance to regulations of EMA and FDA, their cardiovascular safety has to be newly proven. Hence, the article summarizes most recent information from this topic, which was extensively discussed during last calendar year.

Ustekinumab in treating psoriatic arthritis

MUDr. Hana Ciferská, Ph.D., MUDr. Jiří Štolfa

Interní Med. 2016; 18(1): 19-24  

Ustekinumab is a fully human IgG1κ monoclonal antibody that inhibits interleukin 12 and 23 functions by binding to their p40 subunit. Ustekinumab is used in treating moderate and severe form of dermal psoriasis; however, a number of clinical studies have shown its effect on extradermal manifestations, particularly on the musculoskeletal system. PSUMMIT-1 and -2 clinical studies in patients with psoriatic arthritis have demonstrated good properties of ustekinumab for inducing a rapid therapeutic response with a good safety profile, and allowed registration for this indication as well.

Therapy of hepatitis B virus (HBV) infection before planned pregnancy, during pregnancy and breastfeeding

prof. MUDr. Petr Husa, CSc.

Interní Med. 2016; 18(1): 24-26 | DOI: 10.36290/int.2016.006  

The HBV infection of women in productive period of their lives is not frequent problem in the Czech Republic on account of low incidence and prevalence of HBV infection. This number of young infected women can rapidly increase with growth of immigration from countries with higher prevalence of HBV infection, especially from Vietnam, China, Ukraine and Russia. The most important issue is prevention of vertical transmission of HBV from mothers with high HBV viraemia to their children during delivery. Combination of active and passive immunization is sometimes not enough effective in these situations. Tenofovir, lamivudine, or telbivudine administration...

Occupational lung diseases in the Czech Republic in 2009-2013

prof. MUDr. Petr Brhel, CSc.

Interní Med. 2016; 18(1): 28-32 | DOI: 10.36290/int.2016.007  

Occupational respiratory diseases are caused by exposure to harmful substances in the work-place. This paper presents the profile of occupational lung disorders in the Czech Republic in the years 2009–2013. A total of 1159 new cases were recorded., of which 37.2% were coalworkers’pneumoconioses, 20.0 % was occupational asthma, the rest was divided between asbestos-related disorders (12.5%), silicosis (11.8%) and variety of other respiratory diseases (18.5 %). The author analyses structure, causes, occurrence, and trends of occupational diseases.

Celiac disease in elderly - diagnostics, comorbidity, therapy

MUDr. Jiří Latta, MUDr. Jana Povová, Ph.D.

Interní Med. 2016; 18(1): 33-34 | DOI: 10.36290/int.2016.008  

Celiac disease is poorly diagnosed in elderly. Studies have suggested that the prevalence of celiac disease in ederly is higher. The base of diagnosis celiac disease is an analysis of antibodies against tissue transglutaminase and antibodies against endomysium. A pathological value of the test indicates the performance of gastroscopy with a biopsy of the aboral duodenum mucosa and the histological examination using the Marsh classification. This review summarizes prevalence of celiac disease in elderly, comorbidity, delay in diagnosis, benefit of gluten- free diet.

Management of hypertension with fixed-dose triple-combination treatment improves compliance and disease control

MUDr. Jiří Pudich

Interní Med. 2016; 18(1): 36-37 | DOI: 10.36290/int.2016.009  

Arterial hypertension, along with smoking, diabetes, dyslipidaemia, and obesity, is among the most significant risk factors of cardiovascular diseases. In the Czech Republic, the prevalence of hypertension in the adult population (25–64 years old) hovers around 35%, with an increase in older age groups. Achievement of target blood pressure levels in hypertensive patients is unsatisfactory and is around 30% in the Czech Republic. The use of fixed-dose triple-combination of perindopril/indapamide/ amlodipine aids in modifying the most significant factors of poor hypertension control, i.e. inadequate patient compliance and underuse of combination...

Fulminant myocarditis

MUDr. Marcela Vránová

Interní Med. 2016; 18(1): 38-42 | DOI: 10.36290/int.2016.010  

Myocarditis is a disease characterized by inflammatory infiltrate with myocardial necrosis or degeneration of adjacent myocytes. It has a number of infectious and non-infectious causes. The most common cause of inflammatory diseases of the myocardium is a viral infection. May have non-fulminant or fulminant course – from asymptomatic or moderate disease course, to the most serious forms of manifesting severe heart failure or sudden death. Dilated cardiomyopathy that occur in connection with myocarditis is called inflammatory cardiomyopathy (ZKMP). In our case report, we discuss a rare form of fulminant myocarditis with fatal course.

Relapsing Salmonella-sepsis in an immunocompromised host

MUDr. Pavel Polák, Ph.D., prof. MUDr. Petr Husa, CSc., MUDr. Miloš Keřkovský, Ph.D.

Interní Med. 2016; 18(1): 43-45 | DOI: 10.36290/int.2016.011

The authors present a clinical case of a secondary relapsing Salmonella-sepsis in a patient with systemic lupus erythematodes. A multilevel spondylodiscitis with paravertebral abscesses as a cause of the disease was diagnosed. The choice of antibiotics was complicated by allergy to co-trimoxazole and manifestations of postantibiotic colitis during the ciprofloxacin treatment. Meropenem and doxycyclin were used in the treatment without any other complications.

What is the C-reactive protein and how to correctly evaluate its elevated serum levels?

MUDr. Pavel Polák, Ph.D., prof. MUDr. Hana Matějovská-Kubešová, CSc.

Interní Med. 2016; 18(1): 49-51  

The work is dedicated to the pathophysiology of inflammatory processes leading to the C-reactive protein (CRP) synthesis and to its immune functions. The understanding of possible infectious and non-infectious causes leading to CRP-synthesis as well as understanding of the dynamics of its synthesis and degradation and of the role of elevated CRP levels in the indication of antibiotic treatment are emphasized.

Případ netypických bolestí v oblasti krku

MUDr. Hana Šarapatková, Ph.D., MUDr. Yvona Hrčková, MUDr. Romana Šarapatková

Interní Med. 2016; 18(1): 46-48