Kdo bude hlídat hlídače?

MUDr. Radkin Honzák, CSc.

Interní Med. 2016; 18(5)  

Antithrombotic therapy of thromboembolic disease

doc. MUDr. Ondřej Ludka, Ph.D.

Interní Med. 2016; 18(5): 222-225 | DOI: 10.36290/int.2016.051  

Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). This is a relatively common cardiovascular disease with acute risk of death and possible long-term consequences, which affects approximately 2–5% of the population. Patients with PE are at risk up to 20% mortality rate and long-term consequences of VTE are also negligible. Post-thrombotic syndrome (PTS) occurs in up to 40% of patients and chronic thromboembolic pulmonary hypertension (CTPH) in 2–4%. The goal of treatment is to prevent progression, dislocation of thrombus, achieving maximum recanalization and prevention of relapse for which we used...

Possibilities of IFN-free therapy of hepatitis C

prof. MUDr. Petr Husa, CSc., MUDr. Petr Husa ml.

Interní Med. 2016; 18(5): 226-230 | DOI: 10.36290/int.2016.052  

Chronic hepatitis C therapy using Directly Acting Antivirals (DAA) has high efficacy (till 100 %), minimum contra-indications and extraordinarily favorable safety profile. Primarily, it is necessary to pay attention to drug-drug interactions. However they are well documented and successfully resolvable already in general clinical practice. Current possibilities of interferon-free therapy represent combinations of sofosbuvir with other DAA or with ribavirin and combination of paritaprevir boosted by ritonavir + ombitasvir ± dasabuvir. Fixed combinaton of elbasvir and grazoprevir is already available in some countries of the world.

Therapy of nonalcoholic steatohepatitis (NASH)

MUDr. Tomáš Fejfar, Ph.D., prof. MUDr. Petr Hůlek, CSc., MUDr. Irma Dresslerová

Interní Med. 2016; 18(5): 233-235 | DOI: 10.36290/int.2016.053  

Incidence of nonalcoholic steatohepatitis as a part of non-alcoholic fatty liver disease is still increasing and NASH and its complications are becoming one of the most common indications for liver transplantation. Screening of NASH in high risk subgroups and its diagnosis is still difficult with a need of liver biopsy. Management of NASH is based on lifestyle intervention, diet and weight loss. Cornerstone of pharmacotherapy is the treatment of associated diabetes, arterial hypertension and dyslipidemy and there is an indication for the treatment with vitamin E and pioglitazon in some patients. The prospective randomised trials with some new promising...

Primary cutaneous lymphomas: current view of rare hematologic malignancies

MUDr. Jindřich Polívka

Interní Med. 2016; 18(5): 236-241  

Primary cutaneous lymphomas are rare and heterogenous group of lymphoproliferative disorders involving the skin. The diagnosis of primary cutanous lymphomas require the intergration of clinical and histopathologic data. Treatment depends on the subtype of cutaneous lymphoma and clinical stage of the disease. Treatment requires a multidisciplinary approach. Review article aims to present the current view of the diagnostic and therapeutic approach to primary cutaneous lymphomas, is more focused on mycosis fungoides and Sézary syndrome.

The combination of empagliflozin and insulin analog therapy of patient with diabetes mellitus type 2

MUDr. Jana Psottová

Interní Med. 2016; 18(5): 250-253 | DOI: 10.36290/int.2016.057  

I present the case of polymorbid patient with nineteen years diabetes history which shows advandages of individualized therapy. The combination of insulin analogs therapy and empagliflozin would be the best.

Rhabdomyolysis and renal failure in patient with alcohol abuse and severe sepsis

MUDr. Petr Němec

Interní Med. 2016; 18(5): 254-255 | DOI: 10.36290/int.2016.058  

Rhabdomyolysis is the syndrome caused by striated muscle lesion. The most serious impact is acute renal failure. We describe a case of 44-old man with acute renal failure in rhabdomyolysis, caused by sepsis and alcohol abuse, which was solved by repeated hemodialysis. The condition of patient was stabilized and renal function restored.

Diagnosis and treatment of chronic myelomonocytic leukemia - a view from clinical practice

doc. MUDr. Peter Rohoň, Ph.D., MUDr. Petra Bělohlávková, MUDr. Zuzana Rusiňáková, doc. MUDr. Vít Procházka, Ph.D., MUDr. Eva Kadlčková, MUDr. Luděk Raida, Ph.D., MUDr. Alžběta Zavřelová, prof. RNDr. Marie Jarošová, CSc., doc. MUDr. Pavel Žák, Ph.D., prof. MUDr. Karel Indrák, DrSc.

Interní Med. 2016; 18(5): 256-259  

Chronic myelomonocytic leukemia (CMML) is a hematopoietic stem cells disorder, it carries myelodysplastic and myeloproliferative features. CMML occurs rarely, especially in the elderly, and often transforms into acute myelogenous leukemia. Recently, in a large proportion of patients sophisticated molecular-biology technologies can determine mutations in epigenetic regulatory genes (e. g. TET2, ASXL1, …) that modify chromatin condensation and also gene expression. These facts support the inclusion of hypomethylating agents (HMA) in the standard treatment of CMML and opened the gates for the use of other new molecules. The aim of this paper is...

Lipertance® – first fixed triple combination of atorvastatin, perindopril arginine, and amlodipine

prof. MUDr. Jiří Widimský jr., CSc.

Interní Med. 2016; 18(5): 242-244  

The article briefly introduces a novel fixed triple combination of the hypolipidaemic drug atorvastatin and two antihypertensives: perindopril arginine and amlodipine. Because of the frequent co-occurrence of hypertension and dyslipidaemia, this combination can be of benefit and useful in a large number of patients. The use of this combination can improve compliance with the pharmacological treatment of hypertension and dyslipidaemia.

What is the current potential of acute pain service and when to refer patients?

MUDr. Jan Procházka, Ph.D.

Interní Med. 2016; 18(5): 245-248  

Pain services are special facilities designated for the care of patients with chronic pain, which is not possible to relieve in primary care offices. For chronic pain therapy we can use opioid and non-opioid analgesics and adjuvants with preference to slow-release forms. Methods of interventional pain therapy are specific for pain service. Interdisciplinary cooperation is necessary.

What do the data from real practice of using novel anticoagulants suggest? Focus on apixaban

prof. MUDr. Josef Kautzner, CSc.

Interní Med. 2016; 18(5): 260-262  

The European Society of Cardiology (ESC 2016) annual congress took place in Rome from 27th to 31st of August 2016. It is the world’s largest cardiology congress that hosted 32,897 attendees from all over the world this year. A total of 11,000 abstracts were presented and around 500 expert sessions were held during the congress. The lectures were dedicated to the latest developments in cardiovascular medicine and to the presentation of the new ESC guidelines. One of the central topics in the field of arrhythmology was the management of atrial fibrillation, including antithrombotic prophylaxis. Also presented at the congress were a number of abstracts...