Co to je za nemoc a proč ji neléčíme?

prof. MUDr. Eva Králíková, CSc.,

Interní Med. 2019; 21(1): 3  

Diagnosis and treatment of asthma‑COPD overlap (ACO)

doc. MUDr. Norbert Pauk, Ph.D.

Interní Med. 2019; 21(1): 8-13 | DOI: 10.36290/int.2019.002  

Chronic obstructive pulmonary disease (COPD) and bronchial asthma are both chronic inflammatory diseases primarily of the bronchi, but there are heterogeneous syndromes which may coexist and produce atypical phenotypes of the diseases. Currently, we know of asthma-chronic obstructive disease overlap (ACO). There have been great efforts by pneumologists to develop universal guidelines on how to name, diagnose, and treat this condition. Among obstructive pulmonary diseases, the prevalence of ACO is estimated to be between 7 and 20%. These patients often have more symptoms than those who have just bronchial asthma or COPD, with the risks of ACO being...

Osteoporosis – 2nd part, pharmacotherapy

MUDr. Petra Matalová, Ph.D.

Interní Med. 2019; 21(1): 14-19 | DOI: 10.36290/int.2019.039  

Therapies of osteoporosis can be varied. Delivery of sufficient levels of calcium, synthesis of vitamin D in the skin and physicalactivity are the most successful. When these nutrients are lacking, they need to be artificially added via use of medicaments.The second most common method of therapy incorporates mainly bisphosphonates. Osteoanabolic therapy is also used. Thereis a possibility of targetted therapy as well. The use of therapy has to be long. In these cases of prolonged therapies and oftenasymptomatic diseases, the most important factor is the patient´s compliance and adherence.

Diabetes mellitus after organ transplantation

MUDr. Dominika Goldmannová, MUDr. Ondřej Krystyník, doc. MUDr. David Karásek, Ph.D.,, prof. MUDr. Josef Zadražil, CSc.

Interní Med. 2019; 21(1): 20-23 | DOI: 10.36290/int.2019.003  

Diabetes mellitus is a very common metabolic disease with a rising incidence. I tis both leading cause of chronic renal disease and one of the most seriois complication in solid organ recipients. Post-transplant diabetes mellitus (PTDM) is associated with higher rate of cardiovascular complications and poor graft function affecting patients morbidity and mortality. Risk factors can be divided into non-modifiable (age, gender, race, genetic backround) and modifiable (obesity, proteinuria, perioperative proteinuria, infection, immunossuppressive drugs). Pre- and post-transplant management can be designed by the risk factors and therefore we could reduce...

Overview of drug interactions of direct oral antikoagulants

MUDr. Katarína Bielaková, PhD., prof. Hana Matějovská Kubešová, CSc.

Interní Med. 2019; 21(1): 24-27 | DOI: 10.36290/int.2019.004  

For many years, the vitamin K anatagonists were the only available oral antikoagulants. This situation changed with the introductionof new oral antikoagulants. The antikoagulant effect of this new group is less influenced by interactions with foods,prescribed drugs and other over-the-counter medications than the vitamin K antagonists. However, drug interactions must stillbe considered with the use of direct oral antikoagulants (DOAC). We present potential interactions in this review paper.

Pharmacotherapy of inflammatory boweldisease

MUDr. Hana Dujsíková, Ph.D.

Interní Med. 2019; 21(1): 28-31  

Inflammatory bowel disease means Crohn’s disease and ulcerative colitis. Mostly, it affects ileocecal area, resp. large intestine. Ethiology of the disease is unknown. The start of the disease is formed by a number of factors. This fact does not enable causal treatment; treatment is possible only as symptomatic. Basic drug groups that are used for treatment of inflammatory bowel disease are aminosalicylates, corticoids, immunosuppressive therapy and biological therapy. As a supplementary treatment can be considered antibiotics, probiotics; in specific cases parenteral or enteral nourishment is prescribed. Treatment is individually chosen for...

The posibilities of combination pharmacotherapy of arterial hypertension and dyslipidemia in cardiovascular risk reducing

MUDr. Barbora Nussbaumerová, Ph.D.

Interní Med. 2019; 21(1): 32-38  

Hypertension and dyslipidaemia are the most important risk factors of atherosclerotic vascular diseases. Most of hypertensivepatients need combination treatment to reach target blood pressure values. The first line combination contains ACE inhibitors/AT1 blockres and calcium channel blockers or diuretics. About 70 % of hypertensive patients suffer from dyslipidaemia. Statintherapy must be taken in account, according to the total cardiovascular risk. Fixed combinations improve compliance and efficacyof the treatment. Antihypertensive drugs, hypolipidemics and also the combination of both are available in fixed combinations.

Treating hypercholesterolaemia with evolocumab

doc. MUDr. Richard Češka, CSc., MUDr. Michaela Šnejdrlová, prof. MUDr. Michal Vrablík, Ph.D.,, MUDr. Tereza Altschmiedová, doc. MUDr. Tomáš Štulc, Ph.D.

Interní Med. 2019; 21(1): 40-46  

Cardiovascular diseases (CVDs) still remain a crucial problem for all western countries as well as for those countries that follow their pattern of economic development. Even though the treatment of CVDs has gone through enormous success in recent years, risk factor control is of no less (or even more) importance. Among risk factors, LDL-C plays an essential role as a primary goal of treatment. Nonpharmacological measures with an emphasis on lifestyle modification are the mainstay of treatment. In a high proportion of patients, however, pharmacological treatment must be used. Statin therapy is a cornerstone in treatment, with ezetimib being added in...

Rhabdomyolysis in patients with high‑voltage

MUDr. Jakub Holoubek, doc. MUDr. Břetislav Lipový, Ph.D., MBA, MUDr. Filip Raška, MUDr. Hana Řihová, MUDr. Ivan Suchánek, prof. MUDr. Pavel Brychta, CSc.

Interní Med. 2019; 21(1): 51-54 | DOI: 10.36290/int.2019.009  

Rhabdomyolysis is a serious complication during the acute phase of burn truama. If not promptly diagnosed and treated, it cancause irreversible damage especially to renal function. An ambivalent attitude towards the therapy of rhabdomyolysis in patientswith high-voltage electrotrauma causes that there is no unambiguous consensus on many issues. The purpose of this article is topoint out the potential risk of developing rhabdomyolysis in a highly specific group of patients and also to summarize the currentmanagement of the therapy of the affected patients. Diagnostic-therapeutic procedure is also illustrated in the case studies.

Dulaglutide‑pharmacological profile

MUDr. Alena Adamíková, Ph.D.

Interní Med. 2019; 21(1): 62-66 | DOI: 10.36290/int.2019.011  

Dulaglutide, an antidiabetic agent applied by injection, ranks among the longer-acting GLP-1 receptor agonists for glucagon-like peptides 1 (GLP-1). During higher concentrations of glucose after application of dulaglutide there occurs release of insulin; dulaglutide further suppresses glucagon secretion which leads to reduction of hepatic glucose production. As all GLP-1 receptor agonists it slows down emptying of the stomach. Fasting glycaemia and postprandial glycaemia, HbA1c and weight are affected. The prolonged biological half-life of 4.7 day enables application by injection 1× a week any time during the day independently of meal time. Stable...

Vitamin D3, its aspect and possible use for urology

doc. MUDr. Juraj Fillo, PhD., MPH, MUDr. Michaela Levčíková

Interní Med. 2019; 21(1): 47-50  

There is increasing evidence from experimental and epidemiological studies suggesting that vitamin D deficiency may be the cause of increased morbidity, cancer and associated mortality. The vitamin D deficit is very widespread and most of the population in Europe, especially in the northern part, suffers from a deficiency. Promising knowledge about vitamin D3 in prevention and treatment has been known for over 30 years. Significant results with D3 supplementation were achieved for colorectal cancer and breast cancer. The thesis deals with the effects of vitamin D3 on prostate cancer. The results are controversial. Recommended doses in various studies...

Patient with lower limb swelling – frequent problem in GP surgery

MUDr. Miroslav Chochola, CSc.

Interní Med. 2019; 21(1): 55-60  

Lower limb edema is a frequently encountered problem in clinical practice, it can be a manifestation of many pathophysiological conditions in the development of which a number of factors are involved. They affect the pressure balance between the vascular bed and the interstitium. Chronic lower limb edema may be associated with systemic disease or may have a local cause, confined only to the lower limbs. In the clinical practice are important differentiate chronic venous inufficiency, deep vein trombosis and lymfatic edema from other possible causes. This review article focuses on quick orientation in the etiology, differential diagnosis and treatment...