Internal Medicine for Practice, 2017, issue 2

Editorial

Mýty a fakta kolem vakcinace

MUDr. Ján Dindoš

Interní Med. 2017; 19(2): 51

Review articles

Diabetology: a field of new possibilities

MUDr. Marcela Szabó

Interní Med. 2017; 19(2): 54-56 | DOI: 10.36290/int.2017.009

In the recent years, diabetology has been among the most dynamically developing branches of medicine. This has been contributed to by the introduction of both novel drugs and technologies into common clinical practice. In particular, it is the treatment of type 2 diabetes that is undergoing a major transformation, wherein the state-of-the-art medications include incretin-based drugs and sodium–glucose co-transporter inhibitors. However, novel drugs have also provided a new perspective on the efficacy and safety of treatment as well as on the therapeutic goals. Currently, the goals of diabetes treatment include not only improved diabetes...

Combination therapy for hypertension with a focus on fixed combinations

prof. MUDr. Miroslav Souček, CSc., MUDr. Hana Nechutová, Ph.D., MUDr. Jan Novák, MUDr. Ivan Řiháček, Ph.D.

Interní Med. 2017; 19(2): 58-65 | DOI: 10.36290/int.2017.011

Patients with hypertension have a significantly higher risk of cardiovascular disease. Efforts are made to reduce the risk by achieving target blood pressure levels, however with only limited success. Combination therapy is considered to be the best strategy in the setting of inadequate arterial hypertension control. The main goal is to achieve addition/synergy of the therapeutic effect of two or more medications with different mechanisms of action while using lower doses of the individual components. In recent years, no new class of drugs has become available in hypertension treatment and, with monotherapy, target levels can be achieved in only...

Advances in insulin therapy

MUDr. Eva Račická

Interní Med. 2017; 19(2): 66-71 | DOI: 10.36290/int.2017.012

Type 2 diabetes mellitus is a chronic and progressive disease, with the goals of treatment being prolonged survival and improved quality of life. The treatment has to be effective and safe since the initial diagnosis. The underlying pathophysiology for type 2 diabetes mellitus is the combination of insulin resistance and relative, and later on absolute, lack of insulin secretion. This requires initiation of treatment with insulin which currently involves a wide portfolio of human insulins and, in particular, insulin analogues that can be safely combined with oral antidiabetic drugs or injection therapy by means of GLP-1 receptor agonists can be...

Extrahepatic complication of nonalcoholic fatty liver disease. Is it a causal association?

prof. MUDr. Jiří Ehrmann, CSc., MUDr. Květoslava Aiglová, Ph.D., MUDr. et Mgr. Drahomíra Vrzalová, MUDr. Renáta Aiglová, MUDr. Michal Konečný, Ph.D., doc. MUDr. Vlastimil Procházka, Ph.D.

Interní Med. 2017; 19(2): 72-77 | DOI: 10.36290/int.2017.048

The aim of this article is to compare the relationship between NAFLD and extrahepatic diseases. This topic needs to be exactly examined in futural studies, which should clarify this relationship. Nevertheless, strongly association between NAFLD as a independent risk factor in causality of cardiovascular disease and T2DM was confirm. On the level of hypothesis is relationship between colorectal cancer, some kidney diseases, some endocrinopathies, osteoporosis end syndrom of sleeping apnoe.

Allergen immunotherapy – an update

doc. MUDr. Vít Petrů, CSc.

Interní Med. 2017; 19(2): 78-81 | DOI: 10.36290/int.2017.013

Allergen immunotherapy (AIT) is the only causal form of long-term treatment for patients with allergic rhinoconjunctivitis, allergic asthma, or stinging insect allergy. The precise mechanisms responsible for the beneficial effects of AIT remain a matter of research and debate of experts. An effect on regulatory T cells seems most probable and is associated with switching of allergen-specific B cells toward IgG4 antibody production. AIT has been demonstrated to reduce symptoms associated withs seasonal and perennial allergic rhinitis and allergic asthma. In contrast to pharmacotherapies, AIT also provides the benefit of inducing allergen tolerance,...

Augmentation therapy for emphysema due to alpha-1 antitrypsin deficiency

MUDr. Jan Chlumský, Ph.D.

Interní Med. 2017; 19(2): 82-84 | DOI: 10.36290/int.2017.014

Alpha-1 antitrypsin (AAT) deficiency is one of the most common hereditary disorder of the adult age. It is mainly associated with the early developement of COPD and hepatic injury. These patients develop emphysema in younger age and have poorer prognosis due to accelerated decline of lung functions. The augmentation therapy with human AAT slows down the rate of lung destruction and improve prognosis of deficient subjects.

Case report

Tick-borne encephalitis – a disease with variable outcome

MUDr. Martina Pýchová, prof. MUDr. Petr Husa, CSc., MUDr. Lenka Fašaneková, MUDr. Radana Pařízková, MUDr. Michaela Freibergerová, MUDr. Martin Slezák

Interní Med. 2017; 19(2): 85-87 | DOI: 10.36290/int.2017.015

A tick is one of the most important vectors of infectious diseases worldwide. Tick-borne encephalitis (TBE) is one of them. The Czech Republic belongs among countries with the highest occurrence of the disease. Clinical presentation and relevance are variable – from asymptomatic or abortive forms to classical neurological manifestation such as meningitis, encephalitis, meningoencephalomyelitis even death. Complications are more often seen in elderly people and consequences of the disease (post-encephalitic syndrome, palsies) can be permanent. Specific treatment still does not exist and vaccination is the only effective protection against TBE.

Idiopathic pulmonary fibrosis – early diagnosis is important

MUDr. Martina Doubková, Ph.D.

Interní Med. 2017; 19(2): 88-91

Idiopathic pulmonary fibrosis (IPF) is a progressive and usually fatal form of idiopathic interstitial pneumonia (IIP). In recent years, the views on etiopathogenesis and treatment of IPF have been changing, so early diagnosis is important for prognosis. We describe two case reports of IPF patients with different stages of the disease.

At a glance

Proteinuria

MUDr. Jan Vachek, PhDr. MUDr. Oskar Zakiyanov, Ph.D., prof. MUDr. Vladimír Tesař, DrSc.

Interní Med. 2017; 19(2): 93-95

Proteinuria is not only a cardinal sign of primary and secondary nephropathies, but also an independent pathogenic factor of progression of these diseases. Along with the serum creatinine level, red blood cell urine test, and renal ultrasound, qualitative and quantitative data on proteinuria belong to the basic nephrological evaluation. In routine practice, the dipstick test is used for the screening of proteinuria; this, however, cannot detect microalbuminuria, Bence-Jones proteinuria (free light chains, for instance, in multiple myeloma), and signs of tubulointerstitial diseases. For a more precise evaluation of albuminuria and/or proteinuria, the...