HLAVNÍ TÉMA – PNEUMOLOGIE

doc. MUDr. Milan Sova, Ph.D.

Vnitr Lek 2021, 67(6):319  

Respiratory insufficiency, chronic hypercapnia and domiciliary non-invasive ventilation from the point of view of a pneumologist

Jaroslav Lněnička

Vnitr Lek 2021, 67(6):323-327 | DOI: 10.36290/vnl.2021.086  

Domiciliary non-invasive ventilation has been an established method of treating chronic hypercapnic respiratory insufficiency for decades. Its effectiveness is based on a number of clinical studies and the prevalence of use worldwide and in the Czech Republic is increasing. The article offers a brief summary of the pathophysiology of hypercapnic respiratory insufficiency and its treatment.

Inhaled glucocorticoids in treatment of covid-19

Milan Sova, Ondřej Zela

Vnitr Lek 2021, 67(6):328-329 | DOI: 10.36290/vnl.2021.087  

Covid-19 pandemic affects heavily different health care systems. The most important factor/aspect is high number of hospitalized patients in countries with low level of infrastructure. Because of this, many therapeutic methods reducing the risk of more severe course of disease are now under development. The key part of this review is the STOIC trial, which is the largest, randomized trial assessing the effect of inhaled glucocorticoid treatment on the risk of hospitalization due to covid-19.

Nintedanib in the treatment of systemic rheumatic disease-associated interstitial lung disease

Ondřej Zela

Vnitr Lek 2021, 67(6):330-333 | DOI: 10.36290/vnl.2021.088  

Systemic rheumatoid diseases form a large group of entities with variable clinical picture and different involvement and degree of organ impairment. Respiratory tract represents major site of damage, with lung interstitium, pleura, pulmonary vasculature and airways possibly affected. In systemic sclerodermia and rheumatoid arthritis, lung disease is the most significant cause of morbidity and mortality. Breathing difficulties may either present as first symptoms of underlying rheumatoid disease or may appear at any time during the course of the disease. Rheumatologists should routinely screen their patients for possible lung impairment. Similarly,...

Anti-cancer therapy-induced metabolic syndrome

Eva Řiháčková, Lubomír Elbl, Michal Řiháček, Mária Holická, Petr Kala

Vnitr Lek 2021, 67(6):334-338 | DOI: 10.36290/vnl.2021.089  

The increasing number of long-term survivors that underwent the anti-cancer therapy faces the late treatment-related adverse effects and the increased risk of developing metabolic syndrome. This article defines the pathophysiology that underlies development of anti-cancer therapy-related metabolic syndrome and outlines the possibility of optimisation of comprehensive care focusing on prevention. Considering the preventability of metabolic syndrome, effective screening and follow-up appropriate for patients at increased risk of related adverse events should be established. Subsequently, early initiation of therapy targeting the hallmarks of metabolic...

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) Part I. Pathophysiology, clinical symptoms and recommend screening for vascular malformations

Zdeněk Adam, Dagmar Brančíková, Gabriela Romanová, Luděk Pour, Marta Krejčí, Jiří König, Tomáš Nebeský, Zuzana Adamová, Martin Štork, Martin Krejčí, Sabina Ševčíková, Michal Eid, Zdeněk Král

Vnitr Lek 2021, 67(6):339-344 | DOI: 10.36290/vnl.2021.090  

Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is an autosomal dominant disorder that causes abnormal blood vessel formation. Patients with HHT may have telangiectasias and later may develop arteriovenous malformations in various organs. Pacients suffer from many complications caused by the malformations and therefore by patients with HHT must by performed screening of this arteriovenous malformations. Optimal treatment of this malformations is best delivered throught a multidisciplinary approach. Farmacological treatment is described in next paper.

High-rank technology in the medicine - the impact of continuous glucose monitoring system alarm settings values on glycemic control in type 1 diabetes patients: a systematic review

Jana Urbanová, Juraj Michalec, Jan Brož

Vnitr Lek 2021, 67(6):346-350 | DOI: 10.36290/vnl.2021.091  

Alarms in continuous glucose monitoring systems (CGM) represent a very important feature enabling to patients with diabetes who use these systems to keep their blood glucose level in the target range and to avoid excursion to hypoglycemia or hyperglycemia. The possibility to warn the patient that the target range has been crossed means one of the main advantages of CGM over the selfmonitoring of blood glucose with personal glucometers, but also (so far) flash glucose monitoring systems. However, there is surprisingly few studies concerning specifically the relationship between the alarms settings and glucose control. Therefore, there are currently...

Post-intensive care syndrome

Otakar Pšenička, Jarmila Křížová

Vnitr Lek 2021, 67(6):E08-E12 | DOI: 10.36290/vnl.2021.098  

Thanks to advances in intensive care, number of patients discharged from intensive care units is increasing. Along with that, there is also growing interest in long-term outcomes monitoring. A large proportion of patients suffers from cognitive, psychiatric and physical disabilities after discharge from intensive care unit. A set of these disabilities is called Post-intensive care syndrome (PICS). Along with patients, also their relatives could be affected, especially by mental disorders (PICS-Family, PICS-F). Long term or permanent consequences can lead to the loss of self-sufficiency, reduced quality of life, frequent rehospitalizations and numerous...

24-hours mortality in seniors hospitalised with medical conditions

Martin Dúbrava, Soňa Kiňová, Jarmila Jánošiová

Vnitr Lek 2021, 67(6):E03-E07 | DOI: 10.36290/vnl.2021.097  

Aim: Mortality is the hardest outcome characterising the severity of diseases and the result of the health care. It is connected mainly with elderly patients (pts.). Information on 24-hours hospital mortality (M24) in seniors admitted to nonsurgical departments is scarce. Patients and methods: In a retrospective observational study, we investigated M24 in pts. of 65 years of age and older, who were discharged from an university geriatric department in years 2016-2018. The identification of diseases which primarily led to M24 and their classification was independently performed by authors from geriatric and internal medicine departments. Results: We...

Complete remission of necrobiotic xanthogranuloma after disappearance of monoclonal immunoglobulin induced by bortezomib, lenalidomid and dexamethasone

Zdeněk Adam, Luděk Pour, Zdeněk Řehák, Klára Dvořáková, Renata Koukalová, Josef Feit, Petr Kameník, Marta Krejčí, Martin Štork, Martin Krejčí, Viera Sandecká, Ivanna Boichuk, Zdeněk Král

Vnitr Lek 2021, 67(6):352-356 | DOI: 10.36290/vnl.2021.092  

Necrobiotic xanthogranuloma (NXG) is a rare chronic condition, belonging to the group non-Langerhans cell histiocytoses, which is relevant due to the possibility of extracutaneous involvement and association with systemic diseases, particularly monoclonal gammopathy, MGUS and multiple myeloma. The case reported here NXG was diagnosed after 1 years of evolution in patient with asymptomatic multiple myeloma. After treatment with bortezomib, lenalidomid and dexamethasone, there was evident abrupt decrease of monoclonal immunoglobulin to not measurable level (complete remission of multiple myeloma) and in the same time was evident disappearance of cutaneous...

Localised forms of pulmonary amyloidosis

Eva Mnacakanová, Lenka Henzlová, Pavla Flodrová, Tomáš Pika

Vnitr Lek 2021, 67(6):357-364 | DOI: 10.36290/vnl.2021.093  

Amyloidosis is a rare disorder caused by amyloid deposits in various organs and tissues resulting in vital organ dysfunction, eventually death. There are two forms of amyloidosis - systemic, characterized by multiple organs affected, and localized (focal). Localized forms of amyloidosis usually affect urinary bladder, skin and lungs. Pulmonary amyloidosis may be localized or systemic such as diffuse alveolo-septal pulmonary amyloidosis which usually accompanies systemic AL amyloidosis. Other two forms of pulmonary amyloidosis are tracheobronchial and nodular. All three forms are usually detected by accident when patients undergo chest examination for...

Schock and other complications after being bitten by a poisonous snake

Lenka Foltýnová Caisová, Vladimíra Caisová

Vnitr Lek 2021, 67(6):E13-E16 | DOI: 10.36290/vnl.2021.099  

The case report presents the case od 66-year-old woman with schock, severe general and grave local symptoms after a snake bite into the left limb. The species of attacking snake was not clearly specific, it should not have been clearly seen, but it was propably a common viper, a snake of viper family, which commonly occurs in our latitude. Due to the unclear origin of the bite, no specific antiserum and symptomatic treatment were given.

Screening for gestational diabetes mellitus

Kateřina Anderlová

Vnitr Lek 2021, 67(6):366-367 | DOI: 10.36290/vnl.2021.094  

A brief summarization of guidelines for screening for gestational diabetes mellitus in pregancy.

Why we still don't achieve blood pressure targets

Vladimír Tuka, Aleš Linhart

Vnitr Lek 2021, 67(6):368-371 | DOI: 10.36290/vnl.2021.095  

Arterial hypertension is one of the main modifiable risk factors for atherosclerotic cardiovascular disease. The prevalence of hypertension remains high, and its compensation is still unsatisfactory. In most patients, we should try to achieve office blood pressure values below 140/90 mm Hg, and in those who tolerate treatment well, values around 130/80 mm Hg, as soon as possible, ideally within three months of diagnosis. While lifestyle interventions are essential and should not be overlooked, most hypertensive patients cannot avoid pharmacotherapy, primarily using a combination of two or more antihypertensives. Achieving blood pressure targets, which...

Za doc. MUDr. Janem Malým, CSc.

prof. MUDr. František Saudek, DrSc.

Vnitr Lek 2021, 67(6):E17-E18  

Aktuální témata kardiovaskulární prevence

MUDr. Zuzana Zafarová

Vnitr Lek 2021, 67(6):372-377 | DOI: 10.36290/vnl.2021.096  

I přes pokroky medicíny v oblasti kardiovaskulárního (KV) zdraví tráví Češi mnoho let svého života s KV onemocněním. Českým ženám patřilo v roce 2016 z hlediska tohoto parametru druhé nejhorší místo v Evropě, českým mužům 6. nejhorší místo (Obr. 1) (1). Při střední délce života 81,9 roku tráví české ženy 20 let svého života s KV onemocněním, u mužů při střední délce života 76,1 roku představuje čas strávený s onemocněním 15 let. Spolu se stárnutím populace znamená tento fakt obrovské ekonomické náklady, zátěž pro zdravotní systém a snížení kvality života pacientů. Pojďme se na ilustračním příkladu pacienta zamyslet nad tím, proč je stav české populace...