Vnitřní lékařství, 2019 (vol. 65), issue 11

Guidelines

Sekundární prevence ischemické choroby srdeční a chorob periferních tepen kombinací antiagregační a antikoagulační léčby. Odborné stanovisko České kardiologické společnosti, České internistické společnosti ČLS J.E. Purkyně a České angiologické společnosti ČLS J.E. Purkyně k výsledkům studie COMPASS

Petr Widimský, Debora Karetová, Richard Češka, Miloš Táborský, Hana Rosolová, Jean-Claude Lubanda, Aleš Linhart

Vnitr Lek 2019, 65(11):704-710 | DOI: 10.36290/vnl.2019.122

Reviews

Functional gastrointestinal disorders and pain

Karel Lukáš

Vnitr Lek 2019, 65(11):674-677 | DOI: 10.36290/vnl.2019.117

Functional gastrointestinal disorders, the most common diagnoses in gastroenterology. Are recognized by abnormalities than often occur in combination including motility disturbance, visceral hypersensitivity, altered mucosal and immune function, altered gut microbiota, and altered central nervous processing. In gastrointestinal pain functional origin, must be excluded an organic cause for the pain. In the Rome criteria IV. is pain included in: Functional chest pain, Reflux hypersensitivity, Epigastric pain syndrome, Irritable bowel syndrome, Centrally mediated abdominal pain syndrome, Narcotic bowel syndrome - Opioid induced, Biliary pain and Functional...

May warfarin prevent cancer?

Anna Remková, Milan Remko

Vnitr Lek 2019, 65(11):679-684 | DOI: 10.36290/vnl.2019.118

Animal and epidemiologic studies suggest that the use of warfarin might reduce cancer incidence. The antitumor potential of warfarin is demonstrated in different experimental cancer models. Specifically, studies in murine cancer models have shown that warfarin blocks AXL receptor tyrosine kinase by inhibiting a vitamin K-dependent protein called GAS6, thereby may halt the spread of cancer cells. An off-target effect of the anticoagulant warfarin is inhibition of GAS6-AXL signaling, which enhances antitumor immunity and blocks tumorigenesis independently of anticoagulation. Hence, the observed association between warfarin use and lower cancer incidence...

Immunodeficiency in the differential diagnosis of interstitial lung diseases

Martina Doubková, Jana Špeldová, Zita Chovancová

Vnitr Lek 2019, 65(11):685-693 | DOI: 10.36290/vnl.2019.119

Interstitial lung processes (IPP), or diffuse parenchymal lung diseases, are a broad group of diseases characterized by varying degrees of pulmonary fibrosis and inflammation affecting predominantly, but not exclusively, pulmonary interstitium. IPP mostly occur in adulthood with maximum manifestation between 40 and 70 years of age. Although IPP mostly present as a primary diagnosis, they also belong to the portfolio of pulmonary disorders in patients with primary immunodeficiencies. The authors present case reports of patients with interstitial lung involvement and primary immunodeficiencies [particularly those manifesting also in adulthood, such as...

Why rapid achievement of goal blood pressure is important in the treatment of arterial hypertension

Peter Wohlfahrt, Renata Cífková

Vnitr Lek 2019, 65(11):694-697 | DOI: 10.36290/vnl.2019.120

Currently, there is a change in the algorithm of hypertension treatment, introducing its simplification. While in the past a careful stepwise titration of antihypertensive drugs was used, the current European Society of Hypertension Guidelines prefer a more aggressive and rapid approach to combination treatment as the initial step with the aim to achieve the goal blood pressure within three months. This review summarizes changes in recommendations and evidence supporting a more aggressive treatment of hypertension.

Interferon-alpha in the treatment of myeloproliferative diseases

Jarmila Kissová

Vnitr Lek 2019, 65(11):699-703 | DOI: 10.36290/vnl.2019.121

Despite significant progress, the treatment options for myeloproliferative neoplasms (MPN) are still limited. Interferon α (IFNα) has been recognized as a substance for the treatment of MPN for more than 30 years, but its widespread use has been limited by higher frequency of short-term adverse reactions compared to conventional treatment and until recently, by its off-label indication in BCR/ABL negative MPNs. With the development of pegylated forms of IFNα with a more favorable toxicity and pharmacokinetic profile have renewed interest in the use of IFNα in the treatment of MPN. Recent studies confirm that IFNα is important...

Case reports

Spinal epidural abscess - a rare complication of Crohn's disease: case report

Karolina Poredská, Vladimír Zbořil, Lucie Prokopová, Lenka Kučerová, Milan Dastych, Svatopluk Richter, Petra Praksová, Jiří Dolina, Lumír Kunovský

Vnitr Lek 2019, 65(11):712-714 | DOI: 10.36290/vnl.2019.123

Spinal epidural abscess (SEA) is a rare disease that occurs mainly in immunocompromised patients after spinal surgery or spinal trauma and can lead to a severe neurological deficit or even death if diagnosed too late. However, cases of SEA have also been reported in patients with fistulising Crohn's disease (CD). We present a case of a young patient with CD and a history of relapsing perianal disease followed by a complication of SEA in the thoracic spine. In close cooperation with the orthopedists and the neurologists, the gastroenterologists have successfully treated the SEA in this patient, allowing her to return back to biological treatment for CD.

Pancytopenia, panhypopituitarism and liver cirrhosis: analysis of a difficult clinical case

Pavel Polák, Jan Kamelander, Jana Michalcová, Jiřina Zavřelová, Libor Červinek, Tomáš Rohan, Zuzana Pazdičová, Václav Odstrčilík, Miroslav Penka

Vnitr Lek 2019, 65(11):715-720 | DOI: 10.36290/vnl.2019.124

Panhypopituitarism following craniopharyngioma resection has systemic impact with potential influence on physiological hematopoiesis. There is a growing body of evidence of liver fibrosis/cirrhosis risk development due to altered metabolism and lipid accumulation. The authors present a case report of a woman with a history of craniopharyngioma resection followed by aggravating pancytopenia with suspected indolent lymphoproliferative disorder and possible acquired bone marrow aplasia syndrome due to paroxysmal nocturnal hemoglobinuria. A complex hemostasis disorder with deficiency of multiple coagulation factors (FXII, FXI, FX, FIX, FVII, FX, FV, FXIII,...

News

Vitamin D deficiency and its health effects

Pavel Horák

Vnitr Lek 2019, 65(11):724-727 | DOI: 10.36290/vnl.2019.128

Vitamin D₃ cholecalciferol is produced from its cholesterol precursors in the skin under the influence of ultraviolet calc. Its subsequent hydroxylation in the liver and kidneys leads to the formation of its most active metabolite calcitriol, which plays one of the key roles in the management of calcium phosphate metabolism. However, it also has the ability to regulate the function of a number of cells and tissues that express the vitamin D receptor. The most widespread method to evaluate the status of vitamin D in the body is to measure serum levels of its metabolite 25 hydroxyvitamin D - 25 (OH) D. Optimal values range between 75-125 nmoll...

The myths and facts about arterial hypertension: do we really know everything about arterial hypertension?

Anna Vachulová

Vnitr Lek 2019, 65(11):728-733 | DOI: 10.36290/vnl.2019.129

Arterial hypertension is one of the most commonly underestimated diseases. At the same time various myths are frequently associated with this illness. Likewise, the overload of available clinical data causes misconceptions, which then lead to the misinterpretation of real and also doubtful issues. Unfortunately, these misconceptions result in insufficient blood pressure control. Let's sort through some common myths in our article, so you can make health decisions in the management of hypertension based on the facts.