Telemedicine in internal medicine

Zdeněk Monhart

Vnitr Lek 2022, 68(3):139  

Telemedicine in diabetology

Robert Bém

Vnitr Lek 2022, 68(3):144-153 | DOI: 10.36290/vnl.2022.030  

The basis of telemedicine is the use of modern technologies that are used in everyday life, but also in diabetes management. Technology are applied not only in insulin administration and glycemic monitoring, but also in the management of lifestyle interventions such as healthy eating and physical activity. Telemedicine in diabetes can significantly expand our options for the care of patients with diabetes and its complications, leading to convincing improvements in diabetes control and self-management of patients with diabetes. The positive effect of telemedicine depends on the correct setup of data transmission and processing, but also on the education...

Use of telemedicine in patients with heart failure

Marie Lazárová, Antonín Hlavinka, Patrik Šulc, Jozef Dodulík, Jan Václavík

Vnitr Lek 2022, 68(3):154-158 | DOI: 10.36290/vnl.2022.031  

Chronic heart failure (HF), like any chronic disease, is a medical and socioeconomic burden. The number of patients with HF is increasing and our effort is to apply the most effective way of care in practice, preferably together with using telemedicine. Early diagnosis, therapy establishment and reduction of rehospitalizations play the key role in HF management. For patients for whom we add telemedicine (telephone consultation, physiological data transfer, data transfer from implantable devices, teleconsultation) and especially if we are able to provide the background of a well-functioning telemedicine center that is able to respond promptly to the...

Telemedicine in arrhythmology

Veronika Bulková, Jakub Pindor, Filip Plešinger, Ivo Viščora, Martin Fiala

Vnitr Lek 2022, 68(3):160-165 | DOI: 10.36290/vnl.2022.032  

Telemedicine can be defined as a health care service that, specifically in the field of diagnostics, employs remote transfer of a large volume of data from a large number of subjects at the same time. This data is subsequently processed on a central basis and returned to a large number of health care providers by whom the service was ordered on national or international level. In arrhythmology, telemedicine is used particularly in long-term ECG monitoring to diagnose arrhythmias and check out treatment outcome via external recorders, smart watch, and implantable devices. To facilitate analysis of large telemedicine data volume, artificial intelligence...

Digitisation and telehealth - Telemedicine in rehabilitation in the Czech environment

Jakub Pětioký, Kristýna Hoidekrová, Marcela Grünerová Lippertová

Vnitr Lek 2022, 68(3):166-171 | DOI: 10.36290/vnl.2022.033  

Currently, Telemedicine mainly represents the passive transfer of data from the patient to the doctor, while telerehabilitation is an active therapeutic tool. Telerehabilitation and its applications are mainly the domain of physiotherapists, occupational therapists, clinical speech therapists, clinical psychologists, and other non-medical professionals. Case model of telerehabilitation in the Czech Republic is the model of the Virtual Ambulance for distance therapy in the Rehabilitation Centre Kladruby, which covers all basic areas of rehabilitation (physiotherapy, occupational therapy, psychology, speech therapy). It uses platforms developed in the...

Hypertension and dyslipidemia treament in stroke

Barbora Nussbaumerová

Vnitr Lek 2022, 68(3):172-177 | DOI: 10.36290/vnl.2022.034  

Stroke is the second most common cause of mortality worldwide and the third most common cause of disability. Arterial hypertension is the most prevalent risk factor for stroke. A precise management of arterial hypertension prevents the first episode of stroke and the recurrence. Blood pressure must be decreased carefully and not very vigorously in the acute phase of the stroke. Recommended blood pressure goals in chronic tratment are at least 140 / 90 mm Hg and lower if tolerated. ACE inhibitors or angiotensin receptor blockers in combination with calcium channel blockers or indapamide are favorable antihypertensive drugs. Dyslipidemia is also a strong...

Beta‑blockers after myocardial infarction and chronic coronary heart disease

Jiří Vítovec, Jindřich Špinar, Lenka Špinarová

Vnitr Lek 2022, 68(3):178-180 | DOI: 10.36290/vnl.2022.035  

Treatment with beta-blockers has been an essential part of secondary prevention after myocardial infarction or chronic CHD for several decades. Studies that have shown a beneficial prognostically beneficial effect of beta-blockers were conducted in the period prior to the routine use of reperfusion therapy. In patients who have been treated with fibrinolytic therapy, their contribution is less pronounced. The situation is even less clear in patients who are treated with primary percutaneous coronary intervention, as prospective studies and observational data from registries do not yet give a clear view of the indications and clinical contribution of...

Differential diagnosis of chronic lower limb edema

David Ambrož

Vnitr Lek 2022, 68(3):181-184 | DOI: 10.36290/vnl.2022.036  

Lower extremity edema is a common complaint of patients across all medical specialties. This is a wide group of conditions, ranging from relatively minor conditions such as false swelling in lipedema to life-threatening conditions such as heart failure and nephrotic syndrome. The most common cause of chronic edema is chronic venous disease. High-quality differential diagnosis aims to determine the etiology of edema and initiate targeted treatment

Acute infections in kidney transplant recipients

Zdeněk Lys, Klára Dombrovská, Jarmila Dědochová, Petra Kovářová, Ivo Valkovský, Jan Václavík

Vnitr Lek 2022, 68(3):E12-E17 | DOI: 10.36290/vnl.2022.041  

Immunosuppressed kidney transplant recipients have a high risk of infectious complications. A variety of infections of viral, bacterial, or mycotic etiology, including opportunistic infections, occur in this group of patients, but bacterial infections are primarily responsible for the high infection-related mortality. Of the bacterial infections, urinary tract infections and pneumonia are the most common, often requiring hospitalization and temporary reduction of immunosuppressive therapy after consultation of the transplant center. In addition to symptoms due to the location of the infection, fever is often present. The differential diagnosis of fever...

Detection, examination and therapy of sexual dysfunctions in patients with diabetes

Jitka Husáková, Klára Sochorová, Vladimíra Fejfarová, Michal Dubský

Vnitr Lek 2022, 68(3):E18-E21 | DOI: 10.36290/vnl.2022.042  

Diabetes mellitus is a disease associated with multiple complications due to ineffective diabetes management in the early period after diagnosis and especially in the long term. However, the risk of developing sexual dysfunctions, which affect both men and women, is rarely mentioned in association with diabetes (1). Sexual complications not only disrupt with the social and sexual life of patients, but are often the first symptom of other health problems. For these reasons, in people with diabetes, early detection and proper treatment of sexual dysfunctions should be of concern physicians caring for diabetic patients.

The mortality risk of patients hospitalized for ischemic stroke between 2003 and 2019

Lenka Kielbergerová, Otto Mayer jr., Jan Bruthans

Vnitr Lek 2022, 68(3):E04-E11 | DOI: 10.36290/vnl.2022.040  

Background: Stroke represents an essential part of the burden of cardiovascular diseases. Despite specific mortality from cerebrovascular diseases decreasing in the Czech Republic since the '80s, the trends in case fatality and individual risk of patients who suffered from stroke remain questionable. In patients hospitalized for ischemic stroke, we evaluated the mortality trends in the last two decades. Methods: 9076 patients (mean age 71.8, 51.9% males) hospitalized for ischemic stroke between 2003 and 2019 were followed. The vital status we ascertained up to 31.12.2020, other circumstances from the hospital information system Results: In total, 5583...

Myocardial free wall rupture as a complication of STEMI

Lukáš Urban, Milan Dragula, Tomáš Bolek, Miloš Kňazeje, Matej Samoš

Vnitr Lek 2022, 68(3):187-190 | DOI: 10.36290/vnl.2022.037  

Myocardial free wall rupture is a rare, but serious complication of acute myocardial infarction with high mortality. We present a case of a 64-year-old patient with this devastating complication of an anterior ST segment elevation myocardial infarction (STEMI) with a prolonged time delay. Cardiac surgery was not performed due to prohibitive surgical risk and predicted poor prognosis. We describe our successful therapeutic intervention consisting of immediate pericardial drainage, vasoactive and inotropic support, intraaortic balloon pump placement and continuous veno-venous hemodialysis. This combined therapy led to patient stabilization and after...

Dyslipidemia and PCSK9 inhibitors - practical focused update of indication and reimbursement criteria

Vladimír Soška

Vnitr Lek 2022, 68(3):191-194 | DOI: 10.36290/vnl.2022.038  

PCSK9 inhibitors are modern and effective hypolipidemic drugs for lowering LDL-cholesterol, which belong to the "biological therapy". Their prescription is limited to specialized centers and to the fulfillment of other conditions set by SÚKL. This article lists the current valid criteria under which they can be indicated for reimbursement from public health insurance, and comments conditions and limitations in terms of the possibility of their fulfillment in clinical practice.

Adrenal incidentaloma

Tomáš Zelinka

Vnitr Lek 2022, 68(3):E22-E25 | DOI: 10.36290/vnl.2022.043  

Incidentally found adrenal tumors are found with increased frequency due to widespread use diagnostic methods such as sonography, computed tomography, or magnetic resonance. The main goal is to evaluate its potential metastatic potential on one side, and possible hormonal overactivity on other side.

What connects SGLT2 inhibitors, diabetes mellitus, heart failure and empagliflozin?

Richard Češka

Vnitr Lek 2022, 68(3):195-196 | DOI: 10.36290/vnl.2022.039  

Ultrasound working group

MUDr. Zdeněk Monhart, Ph.D.

Vnitr Lek 2022, 68(3):E26