Zkušenosti s léčbou pana Michala Viewegha

MUDr. Kamil Sedláček

Interní Med. 2018; 20(5): 223-224  

Pharmacotherapy of the symptoms of chronic venous insufficiency

doc. MUDr. Jana Hirmerová, Ph.D.

Interní Med. 2018; 20(5): 227-232 | DOI: 10.36290/int.2018.040  

The main pathogenetic mechanisms of chronic venous insufficiency are increased venous pressure and impaired venous outflow.Objective signs of the disorder include varices, oedema, skin changes and, in the most advanced stage, leg ulcer. Subjectivesymptoms are represented by various complaints about discomfort in the legs, typically worsening after long standing orsitting, in hot weather or in the evening. The treatment should be complex and consists of regime measures and physiotherapy,compression therapy, surgical and endovascular methods, and pharmacotherapy. In this indication, medicinal productsfrom a heterogeneous group of venoactive drugs are...

Cardiologic evaluation in Fabry disease

MUDr. Lubor Goláň

Interní Med. 2018; 20(5): 233-236  

Fabry disease is an inherited metabolic storage disease. The majority of patients present with heart involvement that is typicallymanifested as myocardial hypertrophy. Successful treatment requires a correct diagnosis and thorough evaluation which, inaddition to patient history and physical examination, also involves ECG, echocardiography, and magnetic resonance imaging.Enzyme replacement therapy is a specific type of treatment.

An 2018 update of personalised Czech COPD guidelines; a country specificconsensus of The Czech Pneumological and Phthiseological Society

doc. MUDr. Vladimír Koblížek, Ph.D., MUDr. Jaromír Zatloukal, Ph.D., MUDr. Jan Chlumský, Ph.D., PhDr. Karel Hejduk

Interní Med. 2018; 20(5): 238-244  

COPD expert group of The Czech Pneumological and Phthisiological Society (CPPS) prepared a draft of updates of guidelines formanagement of stable COPD. The Scientific Committee of CPPS reviewed the intended updates upon which a preliminary version ofthe document was created. This document was approved by the National Consensus CPPS Conference in November 2017. An abbreviatedguidebook was created for general practitioners (January 2018). The elementary principle of the novel approach to COPD isthe systematic description of all treatable traits/phenotypical labels in every COPD case. The CPPS defines six clinically relevant phenotypicaltraits: frequent...

Osteoporosis – 1st part, etiopathogenesis, risk factors and diagnostics

MUDr. Petra Matalová, Ph.D.

Interní Med. 2018; 20(5): 247-252 | DOI: 10.36290/int.2018.043  

Osteoporosis is considered to be a disease prevails highly not only in the most developed industrial countries. As a chronic diseaseof the skeleton it is characterised by the decrease of bone density with deterioration of bone microstructure. Lowered bonestrength is a result of quantitative and qualitative changes in the bone mass and this contributes to higher risk of fractures. Creationof the highest level of bone mass is the most important preventative factor. This can be achieved by consistent and appropriatephysical activity and sufficient nutrition high in calcium, vitamin D and proteins. The diagnosis of osteoporosis is achieved eitherby laboratory...

Novel treatment options for anaemia in patients with chronic kidney disease

prof. MUDr. Romana Ryšavá, CSc.

Interní Med. 2018; 20(5): 253-258  

Anaemia is a very common complication of chronic kidney disease (CKD) and renal failure. Since the introduction of ESAs (erythropoiesis-stimulating agents) in the clinical practice, the view of anaemia treatment has changed considerably and, currently, thetreatment safety is preferred to complete correction of anaemia. In addition to ESAs, a wide range of novel agents developed inorder to favourably affect erythropoiesis have recently been tested. They include, in particular, HIF-stabilizers (roxadustat, molidustat,vadadustat, and daprodustat), sotatercept, or GATA2 inhibitors. The requirements for treatment safety were the reasonfor the conduction...

Drug Induced Pulmonary Arterial Hypertension

PharmDr. Romana Přikrylová, doc. MUDr. Pavel Jansa, Ph.D.

Interní Med. 2018; 20(5): 259-264 | DOI: 10.36290/int.2018.044  

Pulmonary arterial hypertension (PAH) is a rare disease characterized by progressive obliteration of pulmonary arterioles, increaseof pressure in the pulmonary artery and pulmonary vascular resistance. These factors lead to overload of the right ventricle andits failure. PAH is among others associated with the use of some drugs. For the first time, this relationship has been observedwith the use of anorexigens ( aminorex, fenfluramine and benfluorex). These drugs were after withdrawn from the market for aconfirmed risk of PAH developing. Amphetamines, phentermine and mazindol have also been shown as the other drugs posinga risk of PAH induction and...

One-year experience with a novel antiobesity agent

MUDr. Dita Pichlerová

Interní Med. 2018; 20(5): 265-268 | DOI: 10.36290/int.2018.045  

The novel dual-combination antiobesity agent bupropion/naltrexone was introduced in the Czech Republic in October 2016.Immediately after its introduction to the market, we began to use the drug at the OB clinic. The article summarizes our one-yearexperience with the administration of this novel dual-combination antiobesity agent with central dual action. It was a single-centre,noninterventional, observational study. The efficacy on weight loss and waist circumference reduction as well as toleranceand adverse effects are described.

Whipple disease – do we think of it?

MUDr. Petr Kozák

Interní Med. 2018; 20(5): 269-273 | DOI: 10.36290/int.2018.046  

Whipple disease (WD) is a rare diagnosis caused by the bacterium Tropheryma whipplei. Typically causes chronic diarrhea, weightloss, abdominal pain and joint pain. The aim of this article is a description of the less common cause of chronic diarrhea andarthralgia in a 65 year old patient. Based on typical medical history, WD was suspected to be the cause of the symptoms and thegastroscopy (GFS) with the biopsy confirmed the diagnosis. The patient was treated with intravenous ceftriaxone with subsequentprolonged oral therapy with the combination of trimethoprim/sulfamethoxazole (TMP-STX). This case demonstrates the fact thatWD is a disease with multiple...

Baricitinib in treating rheumatoid arthritis

MUDr. Hana Ciferská, Ph.D.

Interní Med. 2018; 20(5): 274-277 | DOI: 10.36290/int.2018.061  

In the last decade, there has been a major advancement in the treatment of rheumatoid arthritis (RA) through novel therapeuticagents introduced gradually in the clinical practice. Inhibition of Janus kinase (JAK) directly affects the crucial processes involvedin the pathogenesis of RA. Baricitinib is a JAK1/2 selective inhibitor which has been shown to have good efficacy, tolerance, and,so far, even safety in phase II and III trials. The RA BEGIN and RA BUILD phase III trials were focused on a population of patientswith failure of the previous therapy with diseases-modifying drugs, whereas the RA BEACON trial was aimed at patients with failureof the...

Terapie hyperlipidemie

MUDr. Pavel Rutar

Interní Med. 2018; 20(5): 284-286  

Anemia – diferential diagnosis

MUDr. Jan Válka, doc. MUDr. Jaroslav Čermák, CSc.

Interní Med. 2018; 20(5): 278-283 | DOI: 10.36290/int.2018.047  

Anemia, defined as hemoglobin level under lower normal limit, is a symptom of different pathologic conditions and the accuratedifferential diagnosis is necessary to determine the cause of anemia. The article uses the morphological classification of anemiato distinguish macrocytic, normocytic and microcytic types of anemias and divides anemias with increased amount of peripheralblood reticulocytes as a special group. It describes commonly known clinical units as iron deficiency anemia or anemia ofchronic disease, as so as rare clinical units, which are always need to think about in a differential diagnosis of an anemic patient.There is an increasing...