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MUDr. Hana Šarapatková, Ph.D.,

Interní Med. 2019; 21(4): 195  

The new horizons in therapy of rare diseases in cardiology

doc. MUDr. Štěpán Havránek, Ph.D.

Interní Med. 2019; 21(4): 200-204 | DOI: 10.36290/int.2019.048  

The therapy of rare diseases in cardiology is based on symptomatic treatment, treatment of complications of rare diseases andin some cases on specific treatment. We mention two diagnosis where modern therapy could slow down progression of disease:Fabry disease where enzyme replacement therapy and chaperon treatment were introduced with good results. Amyloidosisassociated with transthyretin where new evidence for specific treatment of cardiac manifestation has been recently published.

Treatment of chronic hepatitis C in 2019

MUDr. Soňa Fraňková, Ph.D.

Interní Med. 2019; 21(4): 206-211 | DOI: 10.36290/int.2019.049  

HCV infection is a major cause of chronic liver disease in western countries, with approximately 71 million infected individuals worldwide. Most people are unaware of their infection. The infection may have an asymptomatic course, with the hepatic injury ranging from minimal liver fibrosis to hepatic cirrhosis, liver failure and hepatocellular carcinoma. The primary goal of HCV therapy is to cure the infection, i.e. to achieve sustained virological response, defined as undetectable HCV RNA 12 or 24 weeks after therapy completion. HCV eradication prevents the risk of hepatic as well as extrahepatic complications of HCV infection. The new, all-oral,...

Treatment of gout and hyperuricemia

doc. MUDr. Petr Bradna, CSc.

Interní Med. 2019; 21(4): 212-216 | DOI: 10.36290/int.2019.032  

Gout is the most common inflammatory arthritis in adult populations. Its prevalence is growing, especially in developed countries. Gouty arthritis is a extremely painful disease severely affecting the quality of life and with its relationship to cardiovascular risks gout is also life-threatening disease. In recent times has changed the paradigm of the treatment of acute gouty arthritis and also long- term hypouricemic therapy. An important place in the complex treatment plays non-pharmacological treatment, which include not just a diet, but also other aspects of lifestyle (exercise, overweight). Complex therapy of gout must contain also control of...

News in immunomodulatory treatment with bacterial lysates in allergy and asthma

doc. MUDr. Jaromír Bystroň, CSc.

Interní Med. 2019; 21(4): 217-222 | DOI: 10.36290/int.2019.033  

The author presents the latest findings on the use of bacterial lysates in allergic diseases and bronchial asthma. It presents thelatest developments in both experimental and clinical studies on the mechanism of action, indications and risks of administrationof these products. There are also pharmacoeconomic studies that confirm the utility of bacterial lysates in patients with allergies.At the same time, it also contemplates the main mechanisms by which bacterial lysates can influence the course and intensityof allergic inflammation.

Specifics of diabetes in old age

MUDr. Markéta Kubíčková

Interní Med. 2019; 21(4): 223-227 | DOI: 10.36290/int.2019.034  

Diabetes mellitus (DM) is a major global problem, especially as its incidence continues to increase. This is due both to the increasing life expectancy and also to the prevailing lifestyle, which is characterized by low physical activity and high-energy diets. Currently, there are over 900,000 patients with diabetes in the Czech Republic, and more than one third of these patients are in the geriatric category (1). The incidence of diabetic complications is also increasing. These are, on one hand, microvascular changes specific to diabetes mellitus (retino, neuro, nephropathy), on the other hand, diabetics are more at risk of cardiovascular diseases...

Subacute (de Quervain) thyroiditis, the forgotten disease – part II: clinical study

MUDr. Milan Halenka, Ph.D., MUDr. Jan Schovánek, Ph.D., doc. MUDr. Zdeněk Fryšák, CSc., doc. MUDr. David, Karásek, Ph.D., Bc. Charlotte Mlčochová

Interní Med. 2019; 21(4): 233-237 | DOI: 10.36290/int.2019.036  

Subacute (de Quervain) thyroiditis has a characteristic laboratory and clinical finding, but it is sometimes difficult to establish the correct diagnosis. This may be due to low prevalence among other thyroid diseases. This study involved 55 patients (43 women, 12 men) with severe form of disease who completed the treatment with prednisolone as well as 6-month follow-up in 2004–2018. Seasonal cluster (53 % patients) developed during August to November. Late recurrence at interval 13–18 years after the initial episode was 4% of all cases. Early recurrence rate within 2 months after discontinuation of the drugs was 18%. Initial involvement...

Ertugliflozin – SGLT2 inhibitor

MUDr. Eva Račická

Interní Med. 2019; 21(4): 239-247 | DOI: 10.36290/int.2019.037  

Sodium-glucose transporter 2 inhibitors (SGLT2i) are the most recent therapeutic strategy in the treatment of type2 diabetes mellitus. Ertugliflozin is the new highly selective and reversible SGLT2inhibitor. This cotransporter is responsible for renal reabsorpction of glucose. Due to this mechanism ertugliflozin increases glucose excretion by the kidney, resulting in reduced glycaemia and improved diabetes control with very low risk of hypoglycaemia. This mechanis of action is completely independent of the action of insulin. Ertugliflozin has been aproved by EMA for treatment od diabetes mellitus type 2 in March 2018. Ertugliflozin is aproved for monotherapy...

Inflammation as a part of the pathophysiology of depression and the possibility of its influence by polyunsaturated fatty acids

PharmDr. Bc. Hana Kotolová, Ph.D., PharmDr. Tomáš Hammer

Interní Med. 2019; 21(4): 228-232  

Depression and other affective disorders are among the most prevalent mental disorders. The pathophysiology of this diseaseis complex, and pro-inflammatory processes appear to play an important role in it. The article aims to summarize the existingknowledge of the research of the interconnection of affective disorders and inflammation and their possible influence by recentlyhighly discussed polyunsaturated fatty acids.

Saxenda – how to go about it?

MUDr. Dita Pichlerová

Interní Med. 2019; 21(4): 256-258  

For several months, a new injectable drug to treat obesity has been available in the Czech Republic. Saxenda (liraglutide 3 mg) is intended to treat obese patients with a BMI of more than 30 kg/m², or those with a BMI ≥ 27 kg/m² with at least one comorbidity associated with overweight. The drug can be prescribed to an adult patient if older than 18 years of age. In older patients, there is no need for dosage adjustment. Experience with treatment of patients aged ≥ 75 years is limited and use is not recommended in these patients. So far, there has only been short experience with this drug, but even that suggests that it will be...

Elevated liver tests in the field practice

MUDr. Anna Hovorková, MUDr. Karel Dvořák, Ph.D.

Interní Med. 2019; 21(4): 248-254  

The aim of the article is to summarize essential information concerning the interpretation of elevated liver tests in the clinicalpractice, highlight some of the pitfalls, and use examples to demonstrate common types of hepatic lesions. The introductionsection deals with basic theoretical information regarding liver tests as well as certain specific signs and medical history data thataid in interpreting liver tests and performing differential diagnosis. The final section presents examples of particular patients,their liver tests, and the diagnostic conclusions.