Online závislosti: Příspěvek ke zmírnění paniky

Mgr. Kateřina Škařupová, Ph.D.

Interní Med. 2017; 19(4): 175  

Why are patients with peripheral artery disease dying unnecessarily for ischemic heart disease?

doc. MUDr. Jan Piťha, CSc.

Interní Med. 2017; 19(4): 179-185 | DOI: 10.36290/int.2017.032  

Peripheral artery disease (PAD) is caused mostly by atherosclerotic process similarly as to ischemic heart disease (IHD). Since theatherosclerotic process is diffuse, not surprisingly, other arterial blood vessels are frequently affected. The fate of patients with PADis to be changed by intervention atherosclerosis everywhere in all locations but mainly in coronary arteries. When PAD is diagnosed,it is necessary to immediately get under control four basic risk factors – smoking, diabetes mellitus, dyslipidemia and hypertension– as much as possible and as soon as possible to prevent often fatal manifestation of IHD. The main goal of PAD...

Fixed-dose combinations – therapy of type 2 diabetes mellitus

MUDr. Eva Račická

Interní Med. 2017; 19(4): 186-190 | DOI: 10.36290/int.2017.033  

Diabetes mellitus type 2 is a progressive condition and treatment with single glucose – lowering agent cannot be expected to beeffective in the course of years after diagnosis. Diabetes mellitus is an example of progressive and chronic disease, its pathogenesisis complex with multiple pathophysiological abnormalities. That is the reason for combination therapy. It has been provedpatients adherence to recommended therapy decreases especially with the number of tablets prescribed, frequency of use,duration of treatment and side effects of therapy. Adherence to treatment with two or more drugs is very important for efficacyof combination therapy....

Treatment of elderly and comorbid patients with chronic lymphocytic leukemia

MUDr. Martin Šimkovič, Ph.D., MUDr. Monika Motyčková, Ph.D., MUDr. Pavel Vodárek,, doc. MUDr. Lukáš Smolej, Ph.D.

Interní Med. 2017; 19(4): 192-197  

Chronic lymphocytic leukemia (CLL) occurs primarily in the elderly. The high prevalence of serious comorbidities, which mayhave a major impact on the treatment course, is frequent in these patients. Recently, the focus of clinical research in CLL hasbeen shifted on the elderly and comorbid patients. Results of the randomized trials provided us a fundamental improvement oftreatment responses and prolonged overall survival. Chemoimmunotherapy combining chlorambucil with an anti-CD20 antibody(obinutuzumab, ofatumumab a rituximab) is current standard approach for 1st line treatment of elderly/comorbid patients. Bendamustinplus rituximab or dose attenuated...

Ethanol sclerotherapy of thyroid cysts – an effective alternative to surgery

MUDr. Milan Halenka, Ph.D., doc. MUDr. Zdeněk Fryšák, CSc., doc. MUDr. David Karásek, Ph.D.

Interní Med. 2017; 19(4): 198-202 | DOI: 10.36290/int.2017.054  

Ultrasound-guided Percutaneous Ethanol Injection Therapy (US-PEIT) is used to treat recurrent symptomatic thyroid cysts, in caseof failed simple evacuation. It is an alternative to surgical treatment in highly risk patients and it can also be used in patients whoare reluctant to undergo surgical procedure. The therapeutic success of the published studies ranges from 68 to 100%. Accordingto the 2010 Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules was US-PEIT approved inboth the Unites States and Europe as a credible alternative surgical procedures.

Hospital-acquired pneumonia – optimal settings of the initial empirical antibiotic therapy

MUDr. Radovan Uvízl, Ph.D., MUDr. Tomáš Herkeľ, prof. MUDr. Milan Kolář, Ph.D.

Interní Med. 2017; 19(4): 225-229 | DOI: 10.36290/int.2017.035  

Hospital-acquired pneumonia (HAP) is one of the most severe complications occurring in patients during their hospital stayand an important factor affecting the economy of health care; it is often associated with bacterial resistance. The presence ofindividual etiological pathogens causing HAP and their resistance to antimicrobial agents play a key role in the selection of adequateantibiotic therapy. However, not knowing these pathogens usually complicates causative antibiotic therapy at the onsetof pneumonia. It takes hours to days to identify them and, in the meantime, empirical antibiotic therapy must be initiated. Theusual pathogens causing HAP...

A long-term use of ivabradine in a middle-aged woman with chronic heart failure

MUDr. Jiří Leso

Interní Med. 2017; 19(4): 214-216 | DOI: 10.36290/int.2017.055  

Longterm application ivabradine in middle-aged woman with chronic heart failure. Case report of a female patient who was monitoredfor a period of 18 eyars from the „innoncent“ beginnings until the clear morphological manifestation of a left ventricular non-compactcardiomyopathy with systolic dysfcuntion, which as preceded by a working diagnosis of idiopathic dilated cardiomyopathy. Theunfavourable development of chronic heart failure was reversed by decreasing the heart rate using ivabradine for 9 years.

Paget Schroetter syndrome – clinical case of effort thrombosis

MUDr. Petr Grenar, MUDr. Dan Rakušan, MUDr. Tomáš Adámek, Ph.D., doc. MUDr. Pavel Kohout, Ph.D.

Interní Med. 2017; 19(4): 217-219  

Paget Schroetter syndrome (idiopatic thrombosis of upper extremity, exertional thrombosis) is generally rare clinical conditionwith progressively worsening symptoms, which affects mainly young patients. In cases with delayed diagnostic processand inappropriate treatment, it tends to have long term impact on patients health status. This article is mainly concerned withrecomended diagnostic and treatment approaches to Paget Schroertter syndrome. There is a case report included in order toprove a manifestation of the syndrome in clinical practice.

Apixaban has been available for the treatment of venous thromboembolic disease for more than two years

prof. MUDr. Debora Karetová, CSc., prof. MUDr. Jan Bultas, CSc.

Interní Med. 2017; 19(4): 210-213  

Apixaban – a direct, oral, selective activated factor Xa inhibitor – has been approved since the year 2014 for the treatment ofacute venous thrombosis and the so-called low-risk pulmonary embolism (in addition to the registration for the prevention ofsystemic embolization in non-valvular atrial fibrillation and the prevention of venous thromboembolism in orthopaedics). It isan effective and very safe option for oral monotherapy since the establishment of the diagnosis of thromboembolic disease inboth outpatient and inpatient settings.

Herpetic infections of the central nervous system

MUDr. Lenka Fašaneková, MUDr. Matúš Mihalčin, MUDr. Martina Pýchová, prof. MUDr. Petr Husa, CSc.

Interní Med. 2017; 19(4): 204-208 | DOI: 10.36290/int.2017.036  

Herpesviruses are the most complex viruses infecting humans. They usually establish latent infections and persist in the organismfor lifelong. Herpesviruses can cause neuroinfections of various severity. Hemorrhagic encephalitis is the most serious neurologicalcomplication and despite available treatments, the disease still has high morbidity and mortality. Cerebrospinal fluid analysis, usingcytology and polymerase chain reaction (PCR) for direct proof of the virus, is considered the gold standard for the diagnostics. Inthis article we summarized the current diagnostic and therapeutic approaches used for management of herpetic neuroinfections.

Co nového o apixabanu přinesl kongres ESC 2017?

prof. MUDr. Petr Neužil, CSc., FESC

Interní Med. 2017; 19(4): 220-222