Úvodní slovo předsedy České internistické společnosti J. E. Purkyně profesora MUDr. Richarda Češky, CSc., FACP, FEFIM. Interna a ateroskleróza: Více rozdílů nebo pojítek?

Richard Češka

Vnitr Lek 2014, 60(11):917  

Empagliflozin: další z tichých revolucionářů - editorial

Milan Kvapil

Vnitr Lek 2014, 60(11):924-925  

New SGLT2 inhibitor empagliflozin: modern and safe treatment of diabetes

Zdeněk Rušavý

Vnitr Lek 2014, 60(11):926-930  

Empagliflozin is agent of new antidiabetic drugs that cause glycosuria blocking the glucose reuptake in the proximal tubule. The loss of 50-100 g of glucose / 24 hours in the urine results in a reduction of fasting glucose, especially post-prandial glucose, the energy expenditure of 200-400 kcal / day and blood pressure lowering. Treatment efficacy does not decrease over time, as it is not dependent on its own insulin production. The work evaluates the safety of modern treatment with empagliflozin which will soon appear in the portfolio of antidiabetic agents in the Czech Republic. The conducted studies with a special focus on empagliflozin treatment...

Prevention of cardiovascular diseases in clinical practice: is it possible to achieve improvement?

Tomáš Štulc, Michaela Šnejdrlová, Richard Češka

Vnitr Lek 2014, 60(11):931-936  

Prevention through evaluation and treatment of cardiovascular risk factors is an efficient approach to reduce the risk of cardiovascular events, however, the problem remains that the available treatment options are underused. Implementation of cardiovascular disease prevention guidelines into clinical practice is therefore important for decreasing the burden of cardiovascular disease in general population. However, there are many barriers to this process, including questionable relevance of scientific results for clinical practice, personal preferences and expertise of the doctors, patient attitudes, lack of time, and economical factors. All these...

Residual cardiovascular risk markers

Hana Rosolová, Barbora Nussbaumerová

Vnitr Lek 2014, 60(11):937-941  

The European definition of biomarker is presented; it is a measurable factor, which reflects a physiological or pathological process in human body. There are also mentioned transferred meanings of the term marker used in different fields of medicine. The importance, categorization and calculation of global cardiovascular (CV) risk are explained in patients in primary prevention of CV disease (SCORE risk chart). Residual CV risk persists in patients in primary or secondary prevention of CV diseases treated according to current guidelines, even if their risk factors (blood pressure, LDL-cholesterol, glucose level) have achieved the recommended values....

New aspects of hormone replacement therapy

Tomáš Fait

Vnitr Lek 2014, 60(11):942-947  

All existing recommendations sign hormone replacement therapy (HRT) as first therapy for acute climacteric syndrome. The low dose vaginal therapy is the first choice for prevention and therapy of urogenital atrophy and its complications. Early start of HRT has neutral or slightly beneficial influence on ischaemic heart disease. It is sure that HRT is effective in prevention and therapy of postmenopausal osteoporosis. Long term therapy must be individualized on base of benefits to risks ratio with differences by type of HRT.

News in lipid lowering treatment

Michal Vrablík, Richard Češka

Vnitr Lek 2014, 60(11):949-957  

Options for modification of lipoprotein metabolism and, thus, for reduction of atherothrombotic complication have widened over recent years. Apart from the development of novel approaches new pharmacological formulations of common lipid lowering drugs have been prepared - e.g. statin-containing nanoparticles, fibrate nanoparticles with a much higher bioavailability etc. Even the oldest lipid lowering agents - resins - have not been forgotten due to its once again discovered positive impact of these agents on glucose homeostasis while optimally complementing the action of statins. Clinical trials of therapies targeting HDL particle metabolism are being...

Non-pharmacological treatment - results from Poděbrady

Lukáš Zlatohlávek, Michal Vrablík, Zuzana Urbanová, Hana Pejšová, Jaroslav Hubáček, Richard Češka

Vnitr Lek 2014, 60(11):958-962  

Objectives:The study was aimed to determine risk factors of atherosclerosis after one month lifestyle intervention in overweight/obese children and also FTO and MC4R gene variants associated with obesity. Design and Methods:350 non-diabetic Czech children (age 13.7 ± 2.1 years, 163 ± 10.6 cm hight) was examined. Before and after 4 weeks of lifestyle intervention (comprising a reduction of energy intake), biochemical and anthropometrical measurements were performed. Results:The mean weight loss achieved was 6.2 ± 2.1 kg (P < 0.001). Significant associations between BMI decrease and FTO...

Familial hypercholesterolemia - past and present. My experiences and findings in our group of patients with familial hypercholesterolemia

Richard Češka, Michal Vrablík, Tereza Altschmiedová, Martina Prusíková, Zuzana Urbanová, Josef Šobra

Vnitr Lek 2014, 60(11):963-969  

Currently, the familial hypercholesterolemia (FH) rises the interest. The reason is that this genetic disorder is targeted by newly emerged and highly effective hypolipidemic agents, PCSK-9 inhibitors, lomitapid and mipomersen. Present paper discusses 2 patient study groups, before 50 years and nowadays. Although direct statistical analysis is impossible some changes in clinical features of FH might be found over the course of the time. In fact, the basic FH characteristic has not changed dramatically. Severe isolated hypercholesterolemia with total cholesterol 9-10 mmol/l, LDL-cholesterol 7-8 mmol/l and normal values of triglycerides dominates in...

LDL-apheresis in the treatment familial hypercholesterolemia

Vladimír Bláha, Milan Bláha, Miriam Lánská, Eduard Havel, Pavel Vyroubal, Zdeněk Zadák, Pavel Žák, Luboš Sobotka

Vnitr Lek 2014, 60(11):970-976  

LDL-apheresis is an extracorporeal elimination technique, which specifically removes LDL-cholesterol from the circulation. There are six methods for the selective LDL-cholesterol removal these days. The main indications for LDL-apheresis are the diagnosis of homozygous familial hypercholesterolemia, heterozygous familial hypercholesterolemia which is refractory the standard care and intolerance of routine care, and also patients with lipoprotein(a) increase resistant to the farmacotherapy. There is still debate which LDL-cholesterolemia is indication for LDL-apheresis therapy, and the recommendation differs among various countries. Despite large randomized...

Extended options of anticoagulant treatment in thromboembolism

Debora Karetová, Jan Bultas

Vnitr Lek 2014, 60(11):977-984  

Thromboembolic disease (TD) is a relatively common disease with acute risk of death and potential long-term consequences in term of postthrombotic syndrome or chronic pulmonary hypertension. Anticoagulant therapy is the basic therapeutic procedure; thrombolytic therapy and the introduction cava filter are appropriately indicated for individual cases. In past few years, new direct oral anticoagulant drugs (NOAC) have occurred - Xa factor or thrombin inhibitors which have demonstrated the same efficacy and even higher safety in comparison to conventional treatment. In mid 2014, 3 drugs of this group are registered in Czech Republic - rivaroxaban (Xarelto®),...

What do have arterial and venous disease in common?

Jan Piťha, Ondřej Auzký, Karel Roztočil

Vnitr Lek 2014, 60(11):985-989  

Venous and arterial disease probably share a number of common risk factors. From the pathophysiological point of view a similar triggering mechanism was proposed for atherosclerosis and venous disease: subclinical inflammation. Life-threatening thrombotic events may also go through similar pathways in both entities and the culprit is probably dysfunctional endothelial cell in the vessel wall. In available clinical and population based studies, however, unequivocal data are presented regarding association between arterial and venous diseases and their risk factors. In our studies, we found a higher prevalence of lower ankle brachial index in women with...

Cardiovascular risk profile in 40-year old men and 50-year old women in the Czech Republic: results of a cross-sectional survey

Michal Vrablík, Zdeněk Chmelík, Věra Lánská

Vnitr Lek 2014, 60(11):991-997  

Background:Cardiovascular (CV) disease belongs to the most important mortality causes worldwide. Early identification of risk factors and increased CV risk may help decrease of morbidity and mortality. An optimal age for CV risk factors screening ages of 40 in males and of 50 in females have been identified. CV risk profile of persons in these age categories has been examined by general practitioners and recorded for the purposes of this cross-sectional survey. Methods:1812 persons, males at average age of 40 years and females at average age of 50 years, were included into the survey. In each of the examined family and personal...

Vrbíková J, Fanta M, Koryntová D. Syndrom polycystických ovarií. Průvodce ošetřujícího lékaře

Jaroslav Živný

Vnitr Lek 2014, 60(11):1011  

K preventivní medicíně musí lékař dozrát. Rozhovor s prof. MUDr. Hanou Rosolovou, DrSc.

Kristýna Čillíková

Vnitr Lek 2014, 60(11):920-923  

Adherence of type 2 diabetes patients on insulin analogues application: missed dose, time imprecision and dose reduction. The results of GAPP2™ (Global Attitudes of Physicians and Patient) survey in the Czech Republic

Martin Prázný

Vnitr Lek 2014, 60(11):999-1006  

Objective:Irregular insulin dose is one of the main problems associated with insulin therapy in patients with type 2 diabetes; its extent is not known precisely. The aim of survey conducted in the Czech Republic in the international project GAPP2™ - Global Attitudes of Patients and Physicians was to determine the incidence and the impact of irregular use of basal insulin analogues in patients with type 2 diabetes, to point out the reasons for these irregularities and to focus on how physicians discuss irregular application of insulin with patients. Methods:The project GAPP2™ is an international cross-sectional...

Účinnost a bezpečnost inzulinu lispro u obézních pacientů s diabetes mellitus 2. typu: retrospektivní metaanalýza sedmi randomizovaných kontrolovaných studií

Eva Horová

Vnitr Lek 2014, 60(11):1007-1009  

Za profesorem Zdeňkem Plachetou

Petr Dobšák, Lenka Špinarová, Pavel Homolka, Tomáš Kára, Jarmila Siegelová, Jiří Vítovec

Vnitr Lek 2014, 60(11):1012  

Pražské evropské dny interní medicíny 2014

Tereza Altschmiedová, Tatjana Aleksičová, Lucie Votavová

Vnitr Lek 2014, 60(11):1010