Slovo úvodem

prof. MUDr. Petr Pazdiora, CSc.

Interní Med. 2019; 21(2): 71  

Current approach to diagnosing and treating allergic rhinitis

MUDr. Jiří Nevrlka

Interní Med. 2019; 21(2): 76-82 | DOI: 10.36290/int.2019.040  

Viewing rhinitis through the prism of an uncomplicated transient cold or mild vasomotor disorder may lead to a general underestimation of this diagnosis. Even in society-wide terms, it is necessary to underscore the objective significance of this condition, particularly that of chronic and allergic rhinitis. The aim of the article is to present a fundamental review of the issue of allergic rhinitis, ranging from its characteristics to classification and significance to therapeutic intervention. It also explains the role of an allergist in the system of care for patients affected by allergic rhinitis as well as deals in more detail with the options...

Current trends in the use of fixed combinations in treating diabetes

MUDr. Jana Vyoralová

Interní Med. 2019; 21(2): 84-87 | DOI: 10.36290/int.2019.041  

Type 2 diabetes mellitus is a chronic progressive disease which patients can live with for decades. They are given many recommendationsregarding lifestyle changes, diet, and exercise. Moreover, they also have to take medications according to current recommendations, thenumber of which increases with increasing duration of the disease. This concerns not only the treatment with antidiabetic drugs, but alsoconcurrent hypolipidemic medication, antihypertensives, etc. A large number of pills used during the day leads to their omitting, thuslowering the overall effect. Fixed combinations of drugs administered by mouth or by injection...

Transthyretin cardiomyopathy – an important cause of heart failure with novel opportunities of diagnostics and treatment

MUDr. Miloš Kubánek, Ph.D., MUDr. Marie Buncová, CSc., doc. MUDr. Eva Honsová, Ph.D.

Interní Med. 2019; 21(2): 88-91 | DOI: 10.36290/int.2019.013  

Cardiomyopathy due to transthyretin amyloidosis (ATTR-CM) is caused among Czech inhabitants mainly by wild-type (senile) form. ATTR-CM affects most often elderly males aged above 70 years and leads to heart failure with preserved ejection fraction (HFPEF), which may be associated also with atrial fibrillation and conduction disease. Carpal tunnel syndrome and peripheral neuropathy belong to the most important extracardiac symptoms. ATTR-CM occurs most frequently among HFPEF patients with pronounced thickening of left ventricular walls, which contrasts with the absence of voltage criteria of left ventricular hypertrophy in ECG. Other echocardiographic...

Flow mediated dilation – its role and importace in screening of cardiovaskular disease risk.

MUDr. Vladislav Biel, MUDr. Jan Novák, MUDr. Luděk Pluháček, Ph.D., doc. MUDr. Jiří Špác, CSc.

Interní Med. 2019; 21(2): 92-96 | DOI: 10.36290/int.2019.014  

Endotel is a barrier between blood and vascular compartments, which has a number of unique functions. It provides mechanical protection, the transport of a number of molecules across the vessel wall, optimizes the flow of blood through tissues, fundamentally affects immune processes and others. Its dysfunction therefore has a dramatic effect on the patient’s further prognosis. Flow mediated dilation (FMD) is a simple test based on determining the vasodilatation rate of the selected artery (most commonly the arteria brachialis) caused by increased blood flow. Many studies have shown that the relationship between cardiovascular risk and FMD is...

Sepsis caused by Pasteurella

MUDr. Petr Konvička, doc. MUDr. Dan Marek, Ph.D., MUDr. Mgr. Ivana Kohnová, MUDr. Miriam Chlupová, MUDr. Zuzana Baňasová

Interní Med. 2019; 21(2): 97-99 | DOI: 10.36290/int.2019.042  

Pasteurella species is a common bacteria in oral cavity of dogs or other animals, but it can causealso zoonotic infections in humans. Human Pasteurella infections usually manifest as a local skin or soft tissue infection following an animal bite or scratch. Systemic infections are less common and they are usually limited to newbornes and elderly patients, or those who have serious underlying disorders or who are immunocompromized. We report a case of Pasteurella dagmatis related flegmona in patient with recently diagnosed heart failure,a case of sepsis in a healthy middle-aged woman with discrete panaritium inflicted by a pet dog, and sepsis in a senior...

Scoring systems stratifying the risk of bleeding, thromboembolism in patients with atrial fibrillation and haemorhagic shock of the patient with triple therapy

MUDr. František Nehaj, MUDr. Juraj Sokol, PhD., MUDr. Marianna Kubašková, MUDr. Michal Mokáň, PhD. ml., MUDr. Juraj Chudej, PhD., Jozef Martin Péč, prof. MUDr. Marián Mokáň, DrSc., FRCP Edin, prof. MUDr. Peter Galajda, CSc., MUDr. Renáta Michalová, PhD.

Interní Med. 2019; 21(2): 100-104 | DOI: 10.36290/int.2019.043  

The number of patients with atrial fibrilation (AF) has increased during last years. Number of men and women with AF in the year 2010was 33,5 million in the world, with the highest incidence in developed countries (1, 2). It is estimated, that till the year 2030 around14–17 million patients with AF will be in European union and around 12 000–215 000 new diagnosed patients per year (3). Prevalenceof AF is approximately 3 % in adult population, mostly occur in the elder population and in patients with arterial hypertension, cardiacinsufficiency, coronary heart disease, valvulopathy, obesity, diabetes mellitus and chronical...

If a fixed combination, then a fixed combination!

MUDr. Jaroslav Brotánek

Interní Med. 2019; 21(2): 105-109  

The article presents a clinical case report on the experience with the use of a novel fixed combination of the β-blocker bisoprololand the ACE inhibitor perindopril. A wide range of indications for administering this drug is highlighted. Also, given the presence of aβ-blocker in this combination, we focus on some “myths” that may be associated with the treatment with this particular drug group.

Fixed combination of ACE inhibitor and betablocker for heart failure and IHD

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

Interní Med. 2019; 21(2): 110-111 | DOI: 10.36290/int.2019.016  

Fixed combinations increase the adherence/compliance of patients to treatment and so increase the disease control. The combinationwith betablockers is recommended in patients with ischemic heart disease.Cosyrel is the first fixed combination of betablockers (bisoprolol fumarate) and ACE inhibitor (perindopril arginin) available on Czechmarket. The drug is indicated in patients with ischemic heart disease, hypertension and/or heart failure (doses 5 mg bis/5 mg per,10 mg bis/5 mg per).

Ezetimibe in the treatment of hypercholesterolaemia

doc. MUDr. David Karásek, Ph.D.

Interní Med. 2019; 21(2): 112-116 | DOI: 10.36290/int.2019.017  

Currently, the primary aim of lipid‑ lowering treatment is focused on reduction of LDL‑ cholesterol, because there is a compelling evidence for association between its decrease and the decline of cardiovascular events. Ezetimibe in combination with statins effectively reduces the levels of atherogenic lipids and, in particular for high‑ risk individuals, this therapy is associated with significant reduction of cardiovascular risk. This therapy is very well tolerated and current availability of a fixed combination of ezetimibe and statins improves patient’s compliance with treatment and increases the likelihood of achieving lipids...

Dual inhibition of at1 receptor for angiotensin ii and neprilysin or sacibtril‑valsartan

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

Interní Med. 2019; 21(2): 118-124 | DOI: 10.36290/int.2019.044  

Dual antagonist of AT1 receptors for angiotensin II (ARB) and neprilysin, generic name sacubitril valsartan (formaly LCZ 696 or angiotensin receptor blocker and neprilysin inhibitor – ARNI) was clinicaly tested in the treatmet of hypertension and heart failure. The mechanism of action is in the blockade of AT1 receptros by valsartan in combination with decreased degradation of natriuretic peptides with increased vasodilatation. The first clinical trial PARAMOUNT with LCZ696 in the treatment of Heart failure patients with preserved ejection fraction has whown significant decrea-se of NT-proBNP concentrations. Clinical trial PARADIGM-HF in patients...

Hemoroidální onemocnění a možnosti jeho léčby

MUDr. Pavel Rutar

Interní Med. 2019; 21(2): 128-130  

How to manage mild hypertension?

doc. MUDr. Jitka Mlíková Seidlerová, Ph.D.

Interní Med. 2019; 21(2): 125-127  

Grade 1 hypertension is defined as a blood pressure of 140–159/90–99 mmHg. The pharmacological antihypertensive treatment is indicated in patients with manifest cardiovascular complications or in patients with a high cardiovascular risk. Recently published data shows that also patients with low cardiovascular risk might benefit from antihypertensive treatment. The treatment can be started either with monotherapy or with dual combination in low doses preferably using fixed dose combination which are associated with higher adherence to treatment. In most clinical situations we should use combination of angiotensin-converting enzyme inhibitor...

Zpráva z kongresu ACC 2019 v New Orleans
Přehled vybraných studií a detailní pohled na výsledky studie AUGUSTUS – antitrombotická léčba po akutním koronárním syndromu nebo po PCI u pacientů s fibrilací síní

doc. MUDr. Jan Bělohlávek, Ph.D.

Interní Med. 2019; 21(2): 131-134