Jak se v medicíně připravujeme na svět 4.0?

prof. MUDr. Vladimír Mihál CSc.

Interní Med. 2018; 20(2): 55  

Diabetes and cardiovascular risk

doc. MUDr. David Karásek, Ph.D.

Interní Med. 2018; 20(2): 58-61 | DOI: 10.36290/int.2018.011  

Diabetes mellitus is a major risk factor for atherosclerosis and generally, patients with diabetes have a considerably higher cardiovascularrisk than individuals without diabetes. But especially in the last time, this risk seems to be rather heterogeneous. It ishigh, very high or even extreme for most diabetics. However, it can match the risk in general population for smaller part of diabeticpatients. This review deals with main factors for cardiovascular risk in diabetics and possibilities of its improvement.

New guidelines for treatment of rheumatoid arthritis

prof. MUDr. Ladislav Šenolt, Ph.D.

Interní Med. 2018; 20(2): 62-67 | DOI: 10.36290/int.2018.012  

In 2017, the Czech Rheumatology Society issued the revised Guidelines for the Treatment of Rheumatoid Arthritis (RA). Theirmainstay is timely diagnosis of the disease and immediate initiation of effective treatment. Treatment strategy is guided by assessmentof disease activity using composite indexes at regular time intervals and by medication adjustment in the case of failureto achieve the treatment goal. Usually by the third month of treatment initiation, it is recommended to achieve at least a 50%reduction in the activity and, by the sixth month, the treatment goal, i.e. remission (alternatively low clinical activity). It is advisedto initiate monotherapy...

Do we have reserves in treatment after myocardial infarction?

prof. MUDr. Jindřich Špinar, CSc., FESC, prof. MUDr. Lenka Špinarová, Ph.D., FESC, prof. MUDr. Jiří Vítovec, CSc., FESC

Interní Med. 2018; 20(2): 68-72  

Early reperfusion is the basic treatment of acute coronary syndrome. Regime recommen-dation and pharmacotherapy must followin order to prevent remodelation of left ventricle, restenosis, rethrombosis and arrhythmias. Four basic drug groups are usedrenin angiotensin aldosteron blockers, betablockers, antiagregation and lipid lowering drugs. The use of these drugs in the Czechregistry FARIM was: ACE-inhibitors (ACE-i) or sartans 90 % of patients, betablockers (BB) 86 % and statins 92 %.

Modern aspects of allergic rhinitis

MUDr. Irena Krčmová, Ph.D., MUDr. Jakub Novosad

Interní Med. 2018; 20(2): 74-80 | DOI: 10.36290/int.2018.014  

Allergic diseases are seen as systemic diseases with organ symptoms. Allergic rhinitis is defined as a group of nasal symptoms,arising from an underlying IgE-mediated inflammation following exposure of the nasal mucosa to allergens. The basic feature ofallergic rhinitis is a persistent eosinophilic inflammation accompanied by typical clinical manifestations. Allergic rhinitis developson the basis of numerous environmental factors in a genetically predisposed individual. The symptoms of rhinitis may be spontaneouslyreversible or resolve following treatment. The management of allergic rhinitis involves patient education, eliminationof allergens, pharmacotherapy,...

Hypolipidemic treatment and target values of lipids

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

Interní Med. 2018; 20(2): 82-84 | DOI: 10.36290/int.2018.015  

Hypolipidemics are one of the most frequently prescribed drugs in the world. Last year, the updated guidelines were released:European Guidelines on cardiovascular disease prevention in clinical practice by European Society of Cardiology (ESC) and ESC/EAS (European Atherosclerosis Society) Guidelines for the Management of Dyslipidaemias. Both of them contain changes mainlyin estimation of individual cardiovascular risk and target levels of LDL-cholesterol. Targeting these goals is usually very difficultand often impossible in patients with familial hypercholesterolemia. PCSK9 inhibitors are a new and very potent hypolipidemicsthat should make target...

Direct anticoagulants and their new indications

MUDr. Kateřina Gončarová, doc. MUDr. Ondřej Ludka, Ph.D.

Interní Med. 2018; 20(2): 85-88 | DOI: 10.36290/int.2018.052  

Direct anticoagulants have become increasingly popular in recent years. Their benefits include, among other things, ease ofapplication, high safety and the absence of the need for regular monitoring. The well-known and validated indications are theprevention of thromboembolic events in patients with non-valvular atrial fibrillation, post-orthopedic surgery, treatment andprevention of venous thrombosis and pulmonary embolism. In actual article we mention relatively new knowledges about theuse of direct anticoagulations in patients before cardioversion, catheter ablation or after percutaneous coronary intervention.

Long-term compression therapy in patients with chronic venous diseases – fantasy and realityIntroduction

MUDr. Leo Puszkailer, MUDr. Jan Bialek, doc. MUDr. Dalibor Musil, Ph.D., Mgr. Kateřina Langová, Ph.D.

Interní Med. 2018; 20(2): 93-95 | DOI: 10.36290/int.2018.018  

Compressive therapy is one of the basic and key modalities in chronic venous disorder therapy. On the contrary, it is known thatadherence to compressive therapy is not, due to variable reasons, high. The aim of this work was to find out if the type of lowerlimb compression can influence the adherence to this treatment.Methodic: 62 patients who finished compressive therapy (with the use either of elastic bandage or elastic stockings) were observed.We searched for the relationship between compression wear, BMI and gender. It was searched for the preferential typeof compression and the level of patient adherence to given therapy. The relation of BMI was...

Metformin: an old substance – new indications

MUDr. Eva Račická

Interní Med. 2018; 20(2): 99-103  

Year 2017 is the year of 60th anniversary of first clinical use of metformin for diabetes. During the era of its use metformin hasproved ability to counter insulin resistence and decrease hyperglycaemia without weight gain and increased risk of hypoglycaemia,its long-term cardiovascular benefit was identified by the UK Prospective Diabetes Study in 1998 and resulted in placementof metformin as initial therapy to manage hyperglycaemia in type 2. diabetes. In 2016 FDA and EMA changed the labelling of allmetformin-containing medication for use with mild and moderate impairment in kidney function with definition of apropriatedoses and contraindications....

Proteinuria

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

Interní Med. 2018; 20(2): 96-98  

Proteinuria is not only a cardinal sign of primary and secondary nephropathies, but also an independent pathogenic factor ofprogression of these diseases. Along with the serum creatinine level, red blood cell urine test, and renal ultrasound, qualitative andquantitative data on proteinuria belong to the basic nephrological evaluation. In routine practice, the dipstick test is used for thescreening 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 urine...

During the compensation of hypertension are more important value of systolic or diastolic blood pressure?

doc. MUDr. Helena Němcová, CSc.

Interní Med. 2018; 20(2): 108-110  

Hypertension is one of the most common diseases in developed countries. Together with other risk factors, it is one of the mostserious risk factors for cardiovascular (CV) diseases. The closest relationship has been demonstrated between the hypertension andthe stroke and the heart failure. Hypertension treatment is one of the most successful medical achievements of the past centuryby use new effective antihypertensive drugs, but still remains a problem to achieve optimal blood pressure (BP) values.A commonrecommendation is to reduce BP below 140/90 mmHg, lower values are preferable. In specific cases, we lower the BP to thetolerated values. In younger...

The importance of physical activity in patients with obesity and type 2 diabetes

MUDr. Ľubica Cibičková, Ph.D.

Interní Med. 2018; 20(2): e1-e5 | DOI: 10.36290/int.2018.016  

We summarize the importance of physical activity (PA) in patients with obesity and diabetes. We describe the influence of PA on basal energy expenditure, metabolism, selected adipocytokines and namely positive effect of FA in patients with diabetes mellitus. We emphasise the influence of PA on prevention of diabetes, obesity and both total and cardiovascular mortality. Finally, we pay attention to recommended intensity and frequency of PA including specific advice which PA to choose.

MTS – Triage patients with internal issues – principles and effectiveness

MUDr. Petr Hubáček, MBA, LL. M., Mgr. Radka Filipčíková, Ph.D., MBA, LL. M., MUDr. Mgr. Drahomíra Vrzalová, MBA, LL. M., Mgr. Monika Labonková, RNDr. Marcela Bezdičková, Ph.D., MBA, Mgr. Marinella Danosová, PhDr. Lenka Machálková

Interní Med. 2018; 20(2): e6-e8 | DOI: 10.36290/int.2018.017  

Principles of classification in pre-hospital emergency care (Emergency Medical Service, EMS) and emergency hospital care – Emer - gency Department (ED) should be in mutual interplay, consistency and continuity. - quickly prioritizing the provision of healthcare according to the severity of the injury, rapid therapy and rapid transfer to definitive treatment, thereby shortening the treatment period. Classification methodology for hospital emergency care under normal conditions is primarily intended for emergency departmetnt, both for the reception of a large number of people in the event of a disaster with mass disability as well as under normal...