Slovo úvodem

MUDr. Jana Lacinová

Interní Med. 2016; 18(4)  

EMPA-REG OUTCOME and reduction of the risk of heart failure in patients with diabetes

doc.MUDr.David Karásek, Ph.D.

Interní Med. 2016; 18(4): 163-167 | DOI: 10.36290/int.2016.038  

Type 2 diabetes is a serious disease with rising prevalence. Chronic heart failure substantially contributes to high cardiovascular mortality in diabetics. All available pharmacological and non-pharmacological therapeutic methods used in the general population with regard to the special pathogenetic mechanism of heart failure in diabetics and with regard to the results of a series of intervention studies can be applied. Recently, the selection of hypoglycemic treatments that may influence the prognosis of diabetic patients with heart failure is emphasized. EMPA-REG OUTCOME is the first prospective, randomized study that demonstrated a positive...

Current approaches to combination therapy of hypertension

doc. MUDr. Robert Holaj, CSc., MBA

Interní Med. 2016; 18(4): 168-175 | DOI: 10.36290/int.2016.039  

In light of current knowledge, combination therapy of hypertension involving, in particular, the administration of drugs affecting the renin–angiotensin–aldosterone system, calcium channel blockers, and diuretics in fixed combinations represents a gold standard. Due to different mechanisms of action of the individual agents, these combinations of antihypertensive drugs have a significant additive and synergic antihypertensive effect leading to a more pronounced reduction in blood pressure and lower rates of adverse events of the individual components. Prescription of fixed combinations also increases patient compliance. Moreover, selection...

Obesity in relationship with diseases of the pancreas

MUDr.Martina Bojková, prof.MUDr.Petr Dítě, DrSc.

Interní Med. 2016; 18(4): 176-178 | DOI: 10.36290/int.2016.040  

Epidemy of obesity is a serious medical and social problem. Its consequences lead to disability of organ systems, including the pancreas. This work focuses on a brief overview of the relationship of obesity and certain diseases of the pancreas.

New drugs for sarcoidosis

MUDr.Monika Žurková, prof.MUDr.Vítězslav Kolek, DrSc., MUDr.Vladimíra Loštáková, Ph.D., Dr.Eva Kriegová

Interní Med. 2016; 18(4): 180-183 | DOI: 10.36290/int.2016.041  

Sarcoidosis is a systemic inflammatory disease of unknown etiology characterized by the presence of granulomatous inflammation in the affected tissues. It may involve practically any organ, particularly the lungs, eyes and skin. Treatment of sarcoidosis requires a multidisciplinary team approach. If not recognized early or not adequately treated, sarcoidosis may progress to a chronic stage in up to one-third of patients; in extreme cases, it may lead to serious health problems or premature death. In case of typical pulmonary manifestations, the condition is not very difficult to diagnose. Cooperation of many experts is necessary when looking...

Cardiac function in hypertensive patients with metabolic syndrome and microalbuminuria

MUDr.Roman Miklík, Ph.D., MUDr.Marie Pavlušová

Interní Med. 2016; 18(4): 184-190 | DOI: 10.36290/int.2016.042  

Dual antiplatelet therapy (DAT) together with coronary intervention are the cornerstone of the treatment of acute coronary syndrom (ACS). DAT decreases both acute and late ischemic complications but, on contrary, increases the risk of bleeding. The combination of acetylsalicylic acid (ASA) and clopidogrel had been used for a long time. Recently we have been given more potent P2Y12 receptor inhibitors prasugrel and ticagrelor. Current guidelines prefer these drugs in majority of the patients over clopidogrel. There are differencies in farmacology of these drugs and specific contraindications but no head to head randomized clinical trials....

Generics and their therapeutic position, the risk of substitution in pharmacies

MUDr.Karolína Hronová

Interní Med. 2016; 18(4): 191-193 | DOI: 10.36290/int.2016.043  

Therapeutic position of generics is frequently discussed. Physicians of various fields often question whether they are as effective and safe for their patients as the original drug. The aim of the article is to summarize the problematics, from the development to the practical impact on disease management in accordance with current knowledge, with an explanation of some ambiguities.

Chronic obstructive pulmonary disease - benefit of dual bronchodilator therapy

MUDr.Václava Bártů, Ph.D.

Interní Med. 2016; 18(4): 198-202 | DOI: 10.36290/int.2016.045  

Obstructive ventilatory defect that is not fully reversible following the administration of a rapid-acting bronchodilator is a significant feature of chronic obstructive pulmonary disease (COPD). Inhaled long-acting and ultralong-acting ß2 agonists (LABAs, U-LABAs) as well as inhaled long-acting and ultralong-acting muscarinic receptor antagonists (LAMAs, U-LAMAs) are the mainstay medications in treating COPD based on the disease stage and patient’s symptoms (1). This is blanket therapy. However, in the situation when disease symptoms and their frequency fail to be reduced with a monocomponent drug, dual combination is indicated that...

Effect of adding dapagliflozin to insulin in a patient with long-standing type 2 diabetes

MUDr.Barbara Buzová

Interní Med. 2016; 18(4): 203-205 | DOI: 10.36290/int.2016.046  

The present case report demonstrates the success of combination therapy with a premixed insulin analogue administered in a conventional regimen along with the SGLT-2 receptor inhibitor dapagliflozin in a patient with a long-standing history of type 2 diabetes. The treatment has shown to be effective not only in terms of improving diabetes compensation, but also in reducing body weight, decreasing insulin consumption, and normalizing blood pressure.

REG OUTCOME.

MUDr.Jana Psottová

Interní Med. 2016; 18(4): 206-209 | DOI: 10.36290/int.2016.047  

Combined empagliflozin-metformin therapy of the patient with diabetes and ischaemic heart disease Combined empagliflozin-metformin therapy is cardiovasculary safe and allowes to achieve better compensations of diabetes in key parameters of patient with cardiovascular ischaemic disease. Patient’s weight was moderately reduced. The patient tolerates this therapy well, it does not cause any hypoglycemia and patient is absolutely without subjective difficulties.

Modern, safe, combined therapy of diabetes mellitus type 2 patient by dapagliflozin and methformin standard case

MUDr.Jana Psottová

Interní Med. 2016; 18(4): 211-212 | DOI: 10.36290/int.2016.048  

with positive effect The case report of the real, typical patient based on personal experiences and clinical knowledge. The chosen approach confirms positive effect of individual care of patient therapy and advantages of dapagflozin therapy. It causes better compensations after indication chosen antidiabetic therapy, hypoglycemic events are not present and quality of patient's life become better, there is not chance to change patient´s body weight due to wrong behavioral habits of life style and not sufficient personal activity.

Neuropathic component of back pain

prof.MUDr.Josef Bednařík, CSc.

Interní Med. 2016; 18(4): 194-197  

Back pain is probably the most prevalent clinical syndrome at all – lifetime prevalence is thought to be approximately > 70% and currently about 30% of the population have this condition. Presently, chronic lumbar radicular pain is the most common neuropathic pain syndrome at all. Neuropathic component is present in at least 1/5 patients suffering from back pain. The pathophysiology of back pain is complex. Nociceptive – and neuropathic pain–generating mechanisms are thought to be involved, which established the term mixed pain syndrome. Radicular syndromes serve as typical examples of neuropathic pain. Neuropathic component, however,...

Vzpomínka na prof. MUDr. Ivo Krče, DrSc.

MUDr. Hana Šarapatková

Interní Med. 2016; 18(4): 214