ZAZNĚLO NA 21. interní medicíně pro praxi - Clarion Congress Hotel Olomouc, 12.–13. 3. 2026Supplement

MUDr. Zuzana Zafarová

Vnitr Lek 2026, 72(Suppl.C)  

Praktická doporučení - Expertní konsenzus pro diagnostiku a léčbu pacientů s hyperurikemií a vysokým kardiovaskulárním rizikem: aktualizace 2025Supplement

MUDr. Zuzana Zafarová, prof. MUDr. Michal Vrablík, Ph.D.

Vnitr Lek 2026, 72(Suppl.B)  

XXXII. KONGRES ČESKÉ INTERNISTICKÉ SPOLEČNOSTI ČLS J. E. PURKYNĚ: 19.–21. 11. 2025, BrnoAbstracts

Redakce

Vnitr Lek 2026, 72(Suppl.A)  

Do you want to be healthier? Try cutting back on highly processed foodsGood advice#E-publication

Markéta Sovová, Eliška Sovová

Vnitr Lek 2026, 72(4):E4-E6 | DOI: 10.36290/vnl.2026.054  

In recent decades, there has been a significant increase in the consumption of ultra-processed foods (UPF) worldwide, which in some countries account for almost half of total energy intake. The aim of this review article is to summarize current knowledge on the definition and classification of UPF, the extent of their consumption in Europe and the Czech Republic, possible mechanisms of their effects on human health, and their relationship to health risks. Special attention is paid to the NOVA classification, which is currently the most widely used tool for identifying UPF. Available epidemiological studies and meta-analyses consistently show that higher...

Type 2 diabetes mellitus + glaucoma = type 4 diabetes mellitusReview articles#E-publication

Štefan Sotak

Vnitr Lek 2026, 72(4):E1-E3 | DOI: 10.36290/vnl.2026.053  

The term "type 4 diabetes mellitus (DM)" is not generally recognized. It occurs more in popular science than in professional science literature. However, it is interesting that this term has two meanings, two different definitions. The first definition of this type of diabetes is that it is a type 2 DM that occurs in patients with glaucoma. Although the relationship between any type of glaucoma and any type of DM has been debated in the past, cumulative epidemiological evidence confirms that the risk of developing glaucoma, specifically primary open-angle glaucoma, is increased in the diabetic population. Other types of glaucoma in diabetes have not...

Hlavní téma – současné trendy v gastroenterologiiEditorial

MUDr. Denisa Kyselová, Ph.D.

Vnitr Lek 2026, 72(4):203  

Vasculitides - a fast diagnostic-therapeutic guide for internistsIn brief

Jakub Videman, Martina Skácelová, Pavel Horák

Vnitr Lek 2026, 72(4):268-274 | DOI: 10.36290/vnl.2026.052  

Vasculitides represent a broad group of diseases characterized by inflammatory involvement of the vessel wall. Primary vasculitides are categorized according to the caliber of the affected vessels. Symptoms of primary vasculitides are significantly heterogeneous and vasculitides should be included in a broader differential diagnostic consideration of many clinical scenarios. The diagnosis of vasculitides is usually challenging, based on the synthesis of clinical, laboratory, and radiographic findings, evidence of organ damage, and often requiring biopsy verification. A wide range of immunosuppressive agents is used in therapy. Oftentimes, the possibility...

OsilodrostatPharmacological profile

Michal Kršek, Marta Šimůnková

Vnitr Lek 2026, 72(4):262-266 | DOI: 10.36290/vnl.2026.051  

Cushing's syndrome (CS) is a disease caused by excessive autonomous production of cortisol and its effects on cells, tissues and organs of the human body. The clinical feature of CS is very complex and directly threatens the lives of its carriers. Morbidity and mortality of patients with active CS is up to four times higher than in the reference population, mainly due to cardiovascular causes, but patients are at risk of a number of other complications. In addition, there is evidence that increased morbidity and mortality persist for many years even after successful treatment. Treatment of CS must be early and comprehensive. In all situations with...

Combined heme and nonheme iron: a detailed perspective on their synergy, biology, and significance based on new in vitro evidenceGood advice

Jiří Slíva

Vnitr Lek 2026, 72(4):256-260 | DOI: 10.36290/vnl.2026.050  

Combining heme and nonheme iron represents a promising strategy capable of overcoming the limitations of conventional nonheme iron supplements. New in vitro evidence demonstrates that such formulations not only enhance iron absorption but also preserve and stabilise intestinal barrier integrity, supporting improved safety and tolerability. They concomitantly activate both major iron transport pathways, DMT1 and HCP1, while promoting intracellular metabolic handling through ferritin and ferroportin. These synergistic mechanisms explain the significantly higher bioavailability observed with combined formulations compared with traditional soluble iron...

Primary aldosteronism: A review of the 2025 American-European Endocrine Society Clinical Practice GuidelinesReview articles

Zdeněk Ramík, Libor Jelínek, Monika Beliančinová, Martin Ráchela, Jiří Vrtal, Josef Dodulík, Tomáš Kvapil, Jan Václavík

Vnitr Lek 2026, 72(4):247-254 | DOI: 10.36290/vnl.2026.049  

Primary aldosteronism represents a common and clinically important cause of secondary hypertension, the diagnosis and management of which have undergone substantial advances in recent years. The updated 2025 Endocrine Society clinical practice guidelines provide a structured framework for screening, laboratory diagnostics, disease confirmation, subtyping, and the selection of targeted therapy. Particular emphasis is placed on the expansion of screening indications, standardization of aldosterone-to-renin ratio interpretation with regard to the analytical method used, clinical stratification of patients according to the probability of lateralized aldosterone...

Mineral and bone disorder in chronic kidney disease (CKD-MBD): a practical perspective for the internistReview articles

Kateřina Oulehle, Jan Vachek, Oskar Zakiyanov, Martin Jedlička, Richard Pikner, Vladimír Tesař

Vnitr Lek 2026, 72(4):240-246 | DOI: 10.36290/vnl.2026.048  

disorders of mineral and bone metabolism in chronic kidney disease (CKD-MBD) represent a complex systemic syndrome involving dysregulation of calcium, phosphorus, parathyroid hormone (PTH), vitamin D, and fibroblast growth factor 23 (FGF23) metabolism, disturbances of bone remodeling and mineralization, and extraskeletal-particularly vascular and valvular-calcifications. Understanding of this issue has undergone a fundamental transformation: from an isolated perception of secondary hyperparathyroidism, through the concept of renal osteodystrophy, to the current integrated view that also includes osteoporosis, cardiovascular risk, and the overall clinical...

MASLD and its lean phenotypeMain topic

Kateřina Janstová, Denisa Kyselová, Pavel Trunečka

Vnitr Lek 2026, 72(4):232-239 | DOI: 10.36290/vnl.2026.047  

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease, with a global prevalence of 30-40%. Although it is typically associated with obesity and metabolic syndrome, a significant and often overlooked group of patients consists of individuals with normal body weight, referred to as the lean phenotype of MASLD. These individuals account for approximately 5-20% of MASLD patients, and their disease is often diagnosed only at advanced stages. The pathogenesis is complex and involves combination of genetic predisposition, visceral adiposity, insulin resistance, and sarcopenia. Despite having a normal body...

Acute pancreatitis: a practical update through the eyes of young gastroenterologistsMain topic

Martin Kyselý, Štěpán Šembera

Vnitr Lek 2026, 72(4):224-230 | DOI: 10.36290/vnl.2026.046  

Background: Acute pancreatitis (AP) is one of the most frequent gastrointestinal diseases with a steadily increasing incidence. Despite declining mortality, clinical practice remains burdened by outdated management strategies not aligned with current evidence. Aim: To provide a practical and up-to-date overview of the diagnosis, classification and management of acute pancreatitis for internal medicine physicians, highlighting recent paradigm shifts in clinical practice. Methods: This narrative review is based on current international guidelines (2025) and recommendations of professional societies. It summarizes contemporary evidence on etiology, diagnostic...

Inflammatory bowel diseases - current situation in the Czech Republic and future perspectivesMain topic

Václav Štěpánek, Martin Bortlík

Vnitr Lek 2026, 72(4):215-223 | DOI: 10.36290/vnl.2026.045  

Crohn's disease and ulcerative colitis belong to chronic inflammatory conditions (IBD) with increasing prevalence. In the Czech Republic, the current prevalence reaches 1%. Both conditions require long-term medical therapy that consists of conventional and advanced drugs (biologics and small molecules). Advanced therapy is more effective and safer compared to conventional drugs and should be preferred in patients with moderate to severe disease. In the Czech Republic, IBD patients with advanced drugs are enrolled into the registry called CREdIT. The proportion of such patients is, however, low compared to most developerd countries in the Europe. On...

Oncological screening in gastroenterology and hepatology

Jan Křivinka, Přemysl Falt, Barbora Pipek, Ondřej Urban

Vnitr Lek 2026, 72(4):8 | DOI: 10.36290/vnl.2026.044  

Gastrointestinal cancers are among the leading causes of death in the Czech Republic. Screening programs focused on the detection of precancerous lesions and early-stage disease play a crucial role in secondary prevention, as they have been proven to reduce mortality and improve overall survival rates. In this review article, we summarize current epidemiological data, etiopathogenesis and screening diagnostic methods for patients with Barrett's esophagus, colorectal cancer (including patients with inflammatory bowel disease), hepatocellular carcinoma in patients with liver cirrhosis and individuals at risk of developing pancreatic cancer.

Při jaké klidové srdeční frekvenci se zvyšuje riziko kardiovaskulárních příhod u pacientů s diabetem 2. typu? Komentář ke studii Sobieraj et al.: Heart rate and cardiovascular risk in diabetesCommentaries#E-publication

Sabina Kvasnicová, Jan Brož

Vnitr Lek 2026, 72(3):E8-E9 | DOI: 10.36290/vnl.2026.043  

Immunosuppression with tacrolimus in kidney transplant recipients aged 65+Review articles#E-publication

Silvie Rajnochová Bloudíčková, Roman Šafránek, Zdeněk Lys, Karel Krejčí, Milan Kuman, Vladimír Hanzal, Ondřej Viklický

Vnitr Lek 2026, 72(3):E5-E7 | DOI: 10.36290/vnl.2026.042  

Although the number of kidney transplant recipients aged 65+ is increasing, clear recommendations regarding immunosuppressive regimens have not yet been clearly defined. Immunosenescence increases the risk of post-transplant complications and adverse drug effects, contributing to a decline in quality of life, non-adherence, increased morbidity and mortality. The optimal strategy to minimize these complications is to take age and sensitization into account when accepting and allocating donors in order to limit the use of depletion induction therapy and utilize maintenance immunosuppression with lower toxicity.

Diabetic ketoacidosis and hypophosphatemiaReview articles#E-publication

Ondřej Lukáč, Ondřej Hloch, Nikola Stieranková, Juraj Michalec, Martin Wasserbauer, Jan Brož

Vnitr Lek 2026, 72(3):E1-E4 | DOI: 10.36290/vnl.2026.041  

Hypophosphatemia is a common but generally underestimated electrolyte abnormality associated with diabetic ketoacidosis (DKA) that can cause serious clinical complications. Monitoring and, if necessary, supplementation of phosphate levels should be an integral part of the care of patients with diabetic ketoacidosis, although routine supplementation is not currently recommended.

Hlavní téma – Novinky v léčbě alergie, astmatu a poruch imunityEditorial

doc. MUDr. Tomáš Milota, Ph.D.

Vnitr Lek 2026, 72(3):139  

Musculoskeletal pain - osteoporosis, or non-specific back pain?Good advice

Vlasta Tošnerová

Vnitr Lek 2026, 72(3):193-196 | DOI: 10.36290/vnl.2026.040  

Introduction: The question often arises as to how spinal pain is related to osteoporosis, or whether it is mainly non-specific back pain, vertebrogenic algic syndrome. Distinguishing the origin of pain is related to basic clinical specializatiin and the extension field of Rehabilitation and Physical Medicine. Interdisciplinary, it is appropriate, in addition to laboratory and imaging methods, which are related to basic fields, to supplement the examination with active range of motion, passive range of motion and range of motion to the segment in addition to a structured history. Palpation of muscles, fascia, skin, subcutaneous tissue and periosteal...

Pancreatic panniculitis - a cutaneous manifestation of pancreatic diseaseCase reports

David Solil, Petr Dítě, Radek Kroupa, Michal Šenkyřík, Martin Harazim, Petr Litzman, Klára Bochníčková, Jan Šlapák, Milan Dastych, Jiří Dolina

Vnitr Lek 2026, 72(3):189-192 | DOI: 10.36290/vnl.2026.039  

Pancreatic panniculitis is a rare cutaneous manifestation of pancreatic disease, characterized by painful erythematous nodules predominantly affecting the lower extremities, resulting from the release of pancreatic enzymes into subcutaneous tissue and subsequent fat necrosis. It is most commonly associated with acute pancreatitis but may also occur in the setting of pancreatic malignancy. In some cases, it represents the first clinical manifestation of previously asymptomatic pancreatic disease. This article provides an overview of pancreatic panniculitis, inspired by a case report from our institution.

The relationship between atrial fibrillation and dementiaReview articles

Petra Kratochvílová

Vnitr Lek 2026, 72(3):183-186 | DOI: 10.36290/vnl.2026.038  

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide and currently affecting approximately 2-4 % of the population. Its prevalence continues to rise, and by around 2050, the number of patients with AF is expected to approach 100 million (1). Dementia currently affects 5-7 % of individuals over the age of 60, and its prevalence is projected to triple by 2050 (2). This disease leads to loss of independence, increased need for long-term care, and higher overall mortality. In recent years, accumulating evidence has suggested an association between AF and an increased risk of cognitive decline and dementia. The aim of this...

Primary aldosteronism: diagnosis and treatment in clinical practiceReview articles

Ondřej Petrák

Vnitr Lek 2026, 72(3):176-182 | DOI: 10.36290/vnl.2026.037  

Primary aldosteronism is the most common cause of secondary endocrine hypertension, with a prevalence of 5-14% among hypertensive patients. It is caused by autonomous aldosterone overproduction from the adrenal cortex, leading to sodium retention and the development of hypertension, often accompanied by significant hypokalemia. Compared with essential hypertension, primary aldosteronism is associated with an increased cardiovascular and renal risk, independent of blood pressure levels. This article provides a concise overview of the pathophysiology, clinical manifestations, and complications of primary aldosteronism and focuses on a practical diagnostic...

Hypolipidemic therapy in pregnancyMain topic

Pavla Jadrníčková, Jan Václavík, Filip Dubský

Vnitr Lek 2026, 72(3):171-175 | DOI: 10.36290/vnl.2026.036  

Pregnancy is accompanied by significant metabolic adaptations, including a physiological increase in lipid levels, particularly low-density lipoprotein cholesterol (LDL-C), a causal risk factor for cardiovascular disease. Elevated LDL-C exposure during gestation, especially in women with familial hypercholesterolemia (FH), contributes to lifelong cardiovascular risk. Although atherosclerotic coronary artery disease is rare in women of reproductive age, pregnancy in the fourth and fifth decades of life is becoming increasingly common and is associated with a higher prevalence of acute myocardial infarction during pregnancy. This review summarizes current...

Advances in immuno-oncologyMain topic

Zuzana Ozaniak Střížová

Vnitr Lek 2026, 72(3):165-170 | DOI: 10.36290/vnl.2026.035  

Immunotherapy has emerged over the past decade as a central modality in the treatment of many malignancies, representing a fundamental shift from conventional therapeutic approaches toward strategies that harness the patient's immune system. It is no longer considered merely an adjunctive option used after the failure of other therapeutic modalities; rather, in selected indications, it constitutes a first-line treatment. A thorough understanding of the tumor microenvironment and tumor immunogenicity is a key factor influencing treatment efficacy. The following sections provide a detailed overview of the main types of immunotherapy, including nonspecific...

Secondary antibody deficiency - novel diagnostic and therapeutic approachesMain topic

Tomáš Milota

Vnitr Lek 2026, 72(3):158-164 | DOI: 10.36290/vnl.2026.034  

Secondary antibody immunodeficiencies (SAD) are a heterogeneous group of diseases of acquired immune disorders that arise under broad spectrum of internal and external factors. Unlike primary antibody immunodeficiencies, they are often accompanied by multiple components of the immune system being affected, either within the disease itself or as a result of its treatment. The picture is often accompanied by neutropenia, lymphopenia, hypocomplementemia, etc. According to etiology, SAD can be divided into loss hypogammaglobulinemia and SAD associated with impaired antibody production. We assess the total levels of immunoglobulins and specific antibodies...

Recent advances in primary immunodeficienciesMain topic

Ondřej Vladyka, Katarína Simonová, Martin Orlický, Adam Klocperk

Vnitr Lek 2026, 72(3):151-157 | DOI: 10.36290/vnl.2026.033  

The article summarises key recent developments in the field of primary immunodeficiencies, now preferentially referred to as inborn errors of immunity (IEI). It is based on the current International Union of Immunological Societies (IUIS) classification, which reflects the rapidly increasing number of described entities, and highlights the shift from an "infection-centred" perspective to a broad spectrum of manifestations including autoimmunity, allergy, autoinflammation, and malignancies. Using selected examples of newly described conditions, it illustrates phenotypic diversity and diagnostic challenges, including incomplete penetrance, mosaicism,...

Advances in asthma treatmentMain topic

Tomáš Slisz

Vnitr Lek 2026, 72(3):148-150 | DOI: 10.36290/vnl.2026.032  

This review summarizes the latest GINA 2025 recommendations, focusing on updated diagnostic criteria, particularly in pediatric patients, the role of biomarkers such as FeNO and blood eosinophils, and modern therapeutic strategies. Special emphasis is placed on the anti-inflammatory reliever concept, which promotes the use of low-dose ICS-formoterol as needed across all severity steps. The article also reviews recent developments in biologic therapy, including expanded indications for dupilumab, the use of tezepelumab across asthma phenotypes, and the emerging role of long-acting agents such as depemokimab. Environmental factors influencing disease...

Recent advances in biologic therapy of allergic diseasesMain topic

Mojmír Račanský

Vnitr Lek 2026, 72(3):144-147 | DOI: 10.36290/vnl.2026.031  

Allergic diseases are showing a continuously rising prevalence worldwide. It is estimated that 20-40 % of the global population suffer from some form of allergic condition. According to data from the World Allergy Organization affiliated with the World Health Organization, roughly one in five people are affected. The severity of allergic diseases varies. However, all forms impact the daily lives of those affected - from seasonal allergic rhinitis, through various manifestations of atopic dermatitis and food allergies, to severe bronchial asthma. Severe forms of allergic diseases considerably diminish patients' quality of life. Their management is challenging...

Valve-in-valve transcatheter implantation of a valve replacement in the mitral position using the LAMPOON techniqueCase reporty#E-publication

Beáta Šoltésová, Zuzana Hlubocká, Tomáš Bouček, Tomáš Kovárník, David Zemánek

Vnitr Lek 2026, 72(2):E7-E11 | DOI: 10.36290/vnl.2026.028  

Over the last ten years, there has been a significant progression in the possibilities of trascatheter intervention on the mitral valve, both on the native valve and on bioprostheses. Although surgical treatment of mitral defects currently prevails, transcatheter mitral valve replacement is mainly used in patients with a high surgical risk or in patients with valve replacement with a bioprosthesis in whom reoperation is no longer possible. Transcatheter implantation of a bioprosthesis into the mitral position has its specifics and complications. One of the possible complications is the formation of a significant obstruction in the outflow tract of...