Hlavní téma – Pneumologie

Milan Sova

Vnitr Lek 2022, 68(4):203  

COVID-19 and post-COVID - Jekyll and Hyde of modern medicine

Eliška Sovová, Samuel Genzor, Milan Sova, Markéta Sovová, Katarína Moravcová, Martin Šimek, Lenka Obare Pyzsková

Vnitr Lek 2022, 68(4):208-211 | DOI: 10.36290/vnl.2022.044  

COVID-19 pandemic has massive impact on the whole world, lead to the death of milions of people and required excessive restrictions with large economical, psychological and other impacts. Post-COVID syndrome is defined according to the Czech pneumological and phtizeological society as a complex of symptoms persisting for more than 12 weeks from the acute stage of COVID-19 and which is not possible to explain by other causes. Exact pathopysiological mechanisms and its frequency are still not known, and the data from the literature are not consisent. We present case reports of 2 patients with very different disease and convalescence course. COVID-19...

Antifibrotic therapy and its indications for interstitial pulmonary fibrosis

Martina Doubková

Vnitr Lek 2022, 68(4):212-215 | DOI: 10.36290/vnl.2022.045  

Idiopathic pulmonary fibrosis and chronic fibrotic interstitial lung disease with progressive phenotype are characterized by fibrotic lung parenchyma. Current antifibrotic treatment does not affect pre-existing lung parenchyma fibrosis, but prevents fibrosis progression and reduces mortality by reducing fibrotization. This work summarizes fibrotic lung processes and their treatment options.

Neo/adjuvant immunotherapy in the treatment of non‑small cell lung cancer

Martin Svatoň, Jiří Blažek, Marcela Burešová, Josef Vodička

Vnitr Lek 2022, 68(4):217-220 | DOI: 10.36290/vnl.2022.046  

Despite improvements in staging, surgical techniques, and the introduction of adjuvant chemotherapy for stage II and III non-small cell lung cancer (NSCLC), a large number of operated patients have recurrences of the disease. Due to the breakthrough results of immunotherapy in advanced stages of NSCLC, studies examining its potential benefits in operated patients were logically started. The first studies looked at the use of adjuvant immunotherapy after chemotherapy, where they had already shown the benefits of atezolizumab in a phase III study. A press release on positive data for pembrolizumab in the same indication has also been published recently....

Prevention and treatment of cancer associated venous thromboembolism - interdisciplinary consensus

Ivar Vacula, Zuzana Rusiňáková, Denisa Čelovská, Peter Jackuliak, Ján Slopovský, Patrik Palacka, Matej Moščovič, Stanislav Špánik, Ján Staško, Alexander Wild, Angelika Bátorová, Juraj Maďarič

Vnitr Lek 2022, 68(4):221-226 | DOI: 10.36290/vnl.2022.047  

The increasing volume of the data and experience with direct oral anticoagulants (DOACS) in the primary and secondary prevention of venous thromboembolism in oncologic patients (CAVTE) has recently lead to changes in several international guidelines. We reflect these changes within the conditions in Slovak republic. In the primary prevention of CAVTE we recognise oncosurgical patients and nonsurgical patients: hospitalised and out patients. Low molecular weight heparins are still dominant in the primary prevention of CAVTE. Regarding the treatment and the secondary prevention of CAVTE, we recommend always to consider the possibility to use DOACs as...

Acute kidney injury due to antimicrobial therapy

Viktor Klementa, Nadežda Petejová, Josef Zadražil, Pavel Horák, Jitka Prošková, Olga Klementová

Vnitr Lek 2022, 68(4):227-233 | DOI: 10.36290/vnl.2022.048  

One of the common causes of acute kidney injury (AKI) is drug nephrotoxicity. A large group of drugs associated with AKI includes a considerable number of antimicrobials. Clinical manifestations range from mild forms of tubular damage to significant deterioration of renal function requiring renal replacement therapy. Several mechanisms have been described, although the most common are acute interstitial nephritis, acute tubular necrosis, crystalic nephropathy or proximal/distal tubulopathy with electrolyte abnormalities. General risk factors for antimicrobial-induced AKI include pre-existing chronic kidney disease and concomitant use of drugs with...

Development of recommendations for the use of venoactive drugs in the treatment of chronic venous disease - where they are effective and where they are not

Dalibor Musil

Vnitr Lek 2022, 68(4):234-239 | DOI: 10.36290/vnl.2022.049  

The article provides an overview of the development of recommendations for indications of venoactive drugs for treating symptoms and signs associated with chronic venous disease (CVD). Venoactive drugs may be beneficial in patients with subjective problems and/or swelling of the lower limbs, after surgery for varicose veins, in chronic venous insufficiency or in microcirculatory disorders. They are not indicated in asymptomatic patients with CVD, in the prevention of varicose veins or to prevent their progression. Drugs with proven efficacy in clinical trials should be preferred.

Acetylsalicylic acid in primary prevention of cardiovascular disease

Roman Miklík, Otakar Jiravský

Vnitr Lek 2022, 68(4):240-245 | DOI: 10.36290/vnl.2022.050  

Acetylsalicylic acid is an effective and widely accepted essential drug in the secondary prevention of ischemic events. Its role in primary prevention has been studied for several decades and still remains controversial. Initial studies showed a reduction in both myocardial infarctions and ischemic strokes, without affecting overall or cardiovascular mortality, but the enrolled subjects were not treated with modern drugs and procedures in primary preventive care as they do today. Recently published studies have also not shown a mortality benefit, but in some sub-populations and groups of patients, the clinical benefit of aspirin continues to outweigh...

Had care of arterial hypertension patients been advanced in 2021?

Anna Vachulová, Adriana Šimková, Slavomíra Filipová

Vnitr Lek 2022, 68(4):246-252 | DOI: 10.36290/vnl.2022.051  

Arterial hypertension (AH) is a very common disease with increasing incidence and prevalence. AH becomes worldwide the main preventable cause of the preventable deaths. Therefore, it is very important to obtain early diagnose and convenient treatment. Still high cardiovascular mortality in Slovakia, where we have a position at the tail compared to other European countries, very closely related to the failure to obtain treatment blood pressure (BP) target ranges. AH rarely occurs in isolation, and often clusters with other CV risk factors such as dyslipidemia and obesity. 2018 ESC/ESH Guidelines for the management of arterial hypertension has brought...

The position and importance of pharmacovigilance in the Czech Republic and in the world

Petra Zatovkaňuková, Jiří Slíva

Vnitr Lek 2022, 68(4):E10-E15 | DOI: 10.36290/vnl.2022.054  

Pharmacovigilance is an integral part of medicine. There is always a risk of side effects when using medication; these can be completely trivial, but there are side effects that can be life-threatening or fatal. Pharmacovigilance practices should prevent such side effects, or at least reduce their incidence, especially by developing preventive measures that are based on adverse drug reaction (ADR) data and the evaluations of these. This article deals with the general concept of pharmacovigilance and compares individual pharmacovigilance systems of several countries and regions.

Recurrent urinary tract infections in kidney transplant patients with polycystic kidneys

Marcel Čellár, Martina Konkoľová, Eva Lacková, Terézia Hrubá, Peter Galajda, Ivana Dedinská⁴

Vnitr Lek 2022, 68(4):E04-E09 | DOI: 10.36290/vnl.2022.053  

Introduction: Kidney transplantation is now a routine method used to treat end-stage renal disease. About 10 % of kidney transplant patients are patients with autosomal dominant polycystic kidney disease (ADPKD). After successful kidney transplantation, recurrent urinary tract infections also occur in initially asymptomatic patients. Material and methods: The group included 320 patients after kidney transplantation. We compared patients with ADPKD versus patients without ADPKD in terms of the presence of recurrent urinary tract infections. The results: The incidence of recurrent urinary tract infections (rIMCs) was 18% in patients without ADPKD and...

Acquired von Willebrand syndrome (AvWS)

Petr Drenko, Petra Přenosilová, Alena Lavičková

Vnitr Lek 2022, 68(4):E16-E19 | DOI: 10.36290/vnl.2022.055  

Acquired von Willebrand syndrome (AvWS) is a rare bleeding disorder caused by von Willebrand factor (vWF) dysfunction of various types and severities. Clinical manifestations and differences in the intensity of bleeding are then given by the diversity of vWF disorders. AvWS usually occurs in adult patients with a negative personal or family history of bleeding symptoms and is associated with underlying disease. In recent years, vWF dysfunction has been most commonly attributed to cardiovascular, autoimmune, lymphoproliferative or myeloproliferative comorbidities. The true prevalence of AvWS is unknown, since many cases may be clinically or laboratory...

Urapidil: an unknown / known antihypertensive

Jiří Slíva

Vnitr Lek 2022, 68(4):253-256 | DOI: 10.36290/vnl.2022.052  

Essential arterial hypertension is not a disease that would significantly adversely affect patients in their daily activities. At least mostly. Nonetheless, it has a significant negative impact on cardiovascular morbidity and mortality. The tight correlation with the degree of hypertension, the patient's age and, of course, commorbidities and cardiovascular risk factors is obvious. Therefore, the goal of hypertensive therapy is not only to try to achieve optimal reduction of blood pressure, but in a broader sense to reduce the risk of the just mentioned consequences, i.e. to reduce morbidity and reduce mortality. The antihypertensive drug urapidil...

Pacient s jaterní cirhózou na interním oddělení – intervence případného abúzu alkoholu

Jana Malinovská, Roman Pavlof, Ondřej Hloch, Veronika Vejtasová, Jana Urbanová, Jan Brož

Vnitr Lek 2022, 68(4):E20-E21 | DOI: 10.36290/vnl.2022.057  

Multimorbidity working group

Jan Václavík

Vnitr Lek 2022, 68(4):E22  

Hlavní teze směřování interny v příštích letech

Výbor ČIS

Vnitr Lek 2022, 68(4):257