Jan Škrha, Klára Benešová, Jiří Jarkovský, Ladislav Dušek
{"title":"Who treats the patients with diabetes in the Czech Republic?","authors":"Jan Škrha, Klára Benešová, Jiří Jarkovský, Ladislav Dušek","doi":"10.36290/vnl.2023.088","DOIUrl":"https://doi.org/10.36290/vnl.2023.088","url":null,"abstract":"Data zĂskanĂĄ z NĂĄrodnĂho registru hrazenĂ˝ch zdravotnĂch sluĹžeb (NRHZS) o vĂ˝voji poskytovanĂŠ pĂŠÄe diabetology, internisty a praktickĂ˝mi lĂŠkaĹi v letech 2010 aĹž 2021 doklĂĄdajĂ narĹŻstajĂcĂ poÄet i procentuĂĄlnĂ zastoupenĂ pacientĹŻ s diabetem lĂŠÄenĂ˝ch zejmĂŠna neinzulinovĂ˝mi antidiabetiky praktickĂ˝mi lĂŠkaĹi (vzestup z 4,7 % na 22,8 % diabetikĹŻ). ZĂĄroveĹ data poskytujĂ informaci o stagnaci poÄtu diabetikĹŻ lĂŠÄenĂ˝ch jen inzulinem. RegistrovanĂ˝ vĂ˝vojovĂ˝ trend v poskytovĂĄnĂ pĂŠÄe lĂŠkaĹi podnÄcuje diskuzi o dalĹĄĂm smÄrovĂĄnĂ vÄetnÄ potĹeby zajistit kvalitnĂ strukturovanĂ˝ a multidisciplinĂĄrnĂ pĹĂstup k pacientĹŻm s diabetem v nĂĄsledujĂcĂch letech.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134905911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Non-traumatic lower limb compartment syndrome","authors":"David Ambrož","doi":"10.36290/vnl.2023.084","DOIUrl":"https://doi.org/10.36290/vnl.2023.084","url":null,"abstract":"NetraumatickĂ˝ kompartment syndrom je zĂĄvaĹžnĂ˝ stav, kterĂ˝ postihuje svalovĂŠ prostory typicky u nemocnĂ˝ch po ischemickĂŠm inzultu pĹi akutnĂ konÄetinovĂŠ ischemii a mĹŻĹže mĂt vĂĄĹžnĂŠ nĂĄsledky pro postiĹženou konÄetinu a celkovĂ˝ zdravotnĂ stav pacienta. Tento syndrom je charakterizovĂĄn zvýťenĂ˝m tlakem v uzavĹenĂŠm intrafasciĂĄlnĂm prostoru, coĹž vede ke kompresi svalĹŻ, cĂŠv a nervĹŻ vedoucĂ k prohloubenĂ ischemie a aĹž nevratnĂŠmu poĹĄkozenĂ tÄchto struktur. VÄasnĂĄ diagnĂłza a lĂŠÄba jsou klĂÄovĂŠ pro minimalizaci rizika komplikacĂ a zachovĂĄnĂ funkce konÄetiny. V tomto ÄlĂĄnku se zamÄĹĂme na definici, patofyziologii a dĹŻleĹžitĂŠ klinickĂŠ aspekty netraumatickĂŠho kompartmentovĂŠho syndromu.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134905914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Do we still need an exercise ECG?","authors":"Juraj Dúbrava","doi":"10.36290/vnl.2023.094","DOIUrl":"https://doi.org/10.36290/vnl.2023.094","url":null,"abstract":"","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134907064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michaela Veselá, Pavel Jansa, Debora Karetová, Viktor Veselý, Aleš Linhart
{"title":"Case‑report: Paget‑Schrötter syndrome as a cause of chronic thromboembolic pulmonary hypertension","authors":"Michaela Veselá, Pavel Jansa, Debora Karetová, Viktor Veselý, Aleš Linhart","doi":"10.36290/vnl.2023.085","DOIUrl":"https://doi.org/10.36290/vnl.2023.085","url":null,"abstract":"PagetĹŻvÂ‑SchrĂśtterĹŻv syndrom je oznaÄenĂ pro idiopatickou trombĂłzu hornĂ konÄetiny. Toto vzĂĄcnĂŠ onemocnÄnĂ nejÄastÄji postihuje mladĂŠ muĹže, typicky po prĂĄci Äi sportu s hornĂmi konÄetinami nad hlavou. Anatomicky rozliĹĄujeme nÄkolik prostorĹŻ, kde mĹŻĹže dojĂt k Ăştlaku nervovÄ cĂŠvnĂho svazku v oblasti regio cervicalis lateralis.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134905783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martin Sučík, Róbert Rosoľanka, Peter Bánovčin, Peter Lipták, Diana Važanová, Lenka Nosáková
{"title":"Intrathoracic bacterial infection caused by Delftia acidovorans","authors":"Martin Sučík, Róbert Rosoľanka, Peter Bánovčin, Peter Lipták, Diana Važanová, Lenka Nosáková","doi":"10.36290/vnl.2023.076","DOIUrl":"https://doi.org/10.36290/vnl.2023.076","url":null,"abstract":"Delftia acidovorans je gramnegatĂvna aerĂłbna tyÄinkovitĂĄ baktĂŠria. Ochorenia u ÄžudĂ vyvolĂĄva len raritne. SpĂ´sobuje predovĹĄetkĂ˝m nozokomiĂĄlne nĂĄkazy, opisovanĂŠ ÄastejĹĄie u imunokompromitovanĂ˝ch pacientov v rĂĄmci vĹĄetkĂ˝ch vekovĂ˝ch skupĂn. V odbornej literatĂşre bolo v poslednĂ˝ch rokoch publikovanĂ˝ch niekoÄžko prĂpadov, v rĂĄmci ktorĂ˝ch sa uplatnila pri vzniku infekciĂ postihujĂşcich rĂ´zne orgĂĄnovĂŠ systĂŠmy. S ohÄžadom na ÄastĂş rezistenciu voÄi aminoglykozidom a polymyxĂnom, ktorĂŠ mnohokrĂĄt slúŞia ako zĂĄchrannĂŠ lieÄivĂĄ pri komplikovanĂ˝ch infekciĂĄch gramnegatĂvnymi baktĂŠriami, nastĂĄva nevyhnutne potreba jej rĂ˝chlej identifikĂĄcie s nĂĄsledne sprĂĄvne zvolenou lieÄbou. V kazuistike opisujeme prĂpad pacientky s rozsiahlym fluidothoraxom hrudnĂka v dĂ´sledku infekcie baktĂŠriou Delftia acidovorans a sumarizujeme aktuĂĄlne dostupnĂŠ informĂĄcie o infekciĂĄch spĂ´sobenĂ˝ch tĂ˝mto zriedkavĂ˝m patogĂŠnom.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136295026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dominika Sojáková, Jitka Husáková, Vladimíra Fejfarová, Veronika Wosková, Andrea Němcová, Radka Jarošíková, Michal Dubský
{"title":"Stem cells therapy in patients with chronic limb-threating ischemia","authors":"Dominika Sojáková, Jitka Husáková, Vladimíra Fejfarová, Veronika Wosková, Andrea Němcová, Radka Jarošíková, Michal Dubský","doi":"10.36290/vnl.2023.080","DOIUrl":"https://doi.org/10.36290/vnl.2023.080","url":null,"abstract":"AutolognĂ bunÄÄnĂĄ terapie je uĹž Ĺadu let vyuĹžĂvĂĄna u pacientĹŻ s chronickou konÄetinu ohroĹžujĂcĂ ischemiĂ. Byly publikovĂĄny ÄetnĂŠ studie a metaanalĂ˝zy, kterĂŠ posuzovaly benefity terapie a pĹedstavily i jejĂ novĂŠ moĹžnosti. KromÄ standardnÄ vyuĹžĂvanĂ˝ch zdrojĹŻ kmenovĂ˝ch bunÄk (kostnĂ dĹenÄ a perifernĂ krve) se otevĂrajĂ novĂŠ moĹžnosti vyuĹžitĂ jinĂ˝ch alternativ - rĹŻznĂ˝ch typĹŻ tkĂĄnĂ. StĂĄle vĹĄak pĹetrvĂĄvĂĄ otĂĄzka porovnĂĄnĂ ĂşÄinkĹŻ jednotlivĂ˝ch typĹŻ bunÄk a jejich aplikace. Velmi zajĂmavĂŠ jsou i moĹžnosti kombinovanĂŠ terapie hyperbarickou oxygenoterapiĂ spoleÄnÄ s bunÄÄnou terapiĂ. Dle zkuĹĄenosti naĹĄeho pracoviĹĄtÄ je autolognĂ bunÄÄnĂĄ terapie efektivnĂ metoda s nĂzkĂ˝m poÄtem neŞådoucĂch udĂĄlostĂ.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136295217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"FENO potential in asthma","authors":"Petr Čáp","doi":"10.36290/vnl.2023.073","DOIUrl":"https://doi.org/10.36290/vnl.2023.073","url":null,"abstract":"Autor rekapituluje mechanismy vzniku FENO v epiteliĂĄlnĂch buĹkĂĄch sliznice dolnĂch dĂ˝chacĂch cest a zamÄĹuje se na vyuĹžitĂ tohoto biomarkeru astmatu v klinickĂŠ praxi i s ohledem na novÄ nastupujĂcĂ biologickou lĂŠÄbu tÄĹžkĂŠ formy onemocnÄnĂ. FrakÄnĂ vydechovanĂ˝ oxid dusnatĂ˝ (FeNO) je endogennĂ plynnĂĄ molekula, reflektujĂcĂ neinfekÄnĂ zĂĄnÄt dĂ˝chacĂch cest. RozebĂrĂĄ recentnĂ svÄtovĂŠ prĂĄce o vĂ˝znamu FENO u omalizumabu, dĂĄle u lĂŠÄby cĂlenĂŠ na blokaci interleukinu IL-5, tedy mepolizumabu, reslizumabu nebo receptoru proti IL-5 benralizumabu, kterĂŠ jsou schvĂĄlenĂŠ jako pĹĂdavnĂĄ lĂŠÄba u tÄĹžkĂŠho refrakternĂho eozinofilnĂho astmatu dospÄlĂ˝ch. FENO jako marker astmatu ovlivnitelnĂ˝ biologickou lĂŠÄbou, a tedy vyuĹžitelnĂ˝ k hodnocenĂ ĂşÄinnosti lĂŠÄby, se vĹĄak zdĂĄ vhodnĂ˝ zejmĂŠna u dupilumabu (antiÂ‑IL-4 a 13) a nejnovÄji u tezepelumabu (antiÂ‑TSLP). BiologickĂĄ lĂŠÄba zamÄĹenĂĄ na IL-5 sice sniĹžuje eozinofilnĂ zĂĄnÄt, ale mĂĄ omezenĂ˝ vliv na aktivaci epiteliĂĄlnĂch bunÄk, kde se FENO tvoĹĂ. TestovĂĄnĂ FENO je nĂĄkladovÄ efektivnĂ a v kombinaci s klinickĂ˝m hodnocenĂm zlepĹĄuje lĂŠÄbu astmatu.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136295034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Subclinical hypothyroidism","authors":"Jan Drugda, Jan Čáp, Filip Gabalec","doi":"10.36290/vnl.2023.077","DOIUrl":"https://doi.org/10.36290/vnl.2023.077","url":null,"abstract":"SubklinickĂĄ hypotyreĂłza je pomÄrnÄ ÄastĂ˝m jevem, zejmĂŠna u starĹĄĂch pacientĹŻ. Je definovĂĄna zvýťenĂ˝m TSH spolu s normĂĄlnĂmi hladinami volnĂ˝ch hormonĹŻ ĹĄtĂtnĂŠ ĹžlĂĄzy. Oproti klinicky vyjĂĄdĹenĂŠ hypotyreĂłze jsou jejĂ rizika podstatnÄ menĹĄĂ, a proto je klĂÄovĂŠ vybrat pacienty, u kterĂ˝ch potencionĂĄlnĂ benefit lĂŠÄby pĹevåŞà jejĂ neŞådoucĂ ĂşÄinky. K tomu je tĹeba vzĂt v potaz vÄk pacienta, komorbidity, pĹĂznaky a mĂru elevace TSH. LĂŠÄba spoÄĂvĂĄ v substituci levothyroxinem s ĹĄetrnou titracĂ dĂĄvky vedoucĂ k normalizaci TSH. NelĂŠÄenĂ pacienti by mÄli bĂ˝t sledovĂĄni v zĂĄvislosti na rizikovĂ˝ch faktorech, zejmĂŠna pak na riziku progrese do klinicky vyjĂĄdĹenĂŠ hypotyreĂłzy. PĹĂstup ke kaĹždĂŠmu pacientovi by mÄl bĂ˝t vĹždy individuĂĄlnĂ a flexibilnĂ.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136295213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ladislav Šenolt, Mária Filková, Kristýna Bubová, Jakub Závada, Michal Tomčík, Jiří Vencovský, Šimon Tichý, Karel Pavelka
{"title":"What's new in rheumatology","authors":"Ladislav Šenolt, Mária Filková, Kristýna Bubová, Jakub Závada, Michal Tomčík, Jiří Vencovský, Šimon Tichý, Karel Pavelka","doi":"10.36290/vnl.2023.078","DOIUrl":"https://doi.org/10.36290/vnl.2023.078","url":null,"abstract":"Revmatologie zaĹžĂvĂĄ v poslednĂch letech vĂ˝znamnĂ˝ pokrok, kterĂ˝ je dĹŻsledkem zdĹŻrazĹovĂĄnĂ ÄasnĂŠ diagnostiky a uplatĹovĂĄnĂ principĹŻ lĂŠÄby k cĂli, stejnÄ jako novĂ˝ch imunopatogenetickĂ˝ch poznatkĹŻ a dostupnosti ĹĄirokĂŠho spektra biologickĂ˝ch a cĂlenĂ˝ch syntetickĂ˝ch lĂŠÄivĂ˝ch pĹĂpravkĹŻ. V tomto sdÄlenĂ pĹinĂĄĹĄĂme novĂŠ poznatky z oblasti diagnostiky a lĂŠÄby vybranĂ˝ch revmatickĂ˝ch onemocnÄnĂ, a to konkrĂŠtnÄ revmatoidnĂ artritidy, spondyloartritid, systĂŠmovĂŠho lupus erythematodes, systĂŠmovĂŠ sklerodermie, idiopatickĂ˝ch zĂĄnÄtlivĂ˝ch myopatiĂ, systĂŠmovĂ˝ch vaskulitid, revmatickĂŠ polymyalgie a obrovskobunÄÄnĂŠ arteriiitidy a takĂŠ osteoartrĂłzy. Toto sdÄlenĂ si klade za cĂl pĹinĂŠst souhrn nejnovÄjĹĄĂch poznatkĹŻ a trendĹŻ v diagnostice a lĂŠÄbÄ tÄchto revmatickĂ˝ch onemocnÄnĂ, kterĂŠ majĂ zĂĄsadnĂ vliv na kvalitu Ĺživota pacientĹŻ.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136294733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alarmins - novel targets for biological therapy","authors":"Irena Krčmová, Jakub Novosad","doi":"10.36290/vnl.2023.070","DOIUrl":"https://doi.org/10.36290/vnl.2023.070","url":null,"abstract":"BiologickĂĄ lĂŠÄba je nadÄjĂ pro tÄĹžkĂŠ astmatiky a jsou oÄekĂĄvĂĄna dalĹĄĂ biologika ve fĂĄzĂch klinickĂ˝ch zkouĹĄek cĂlenĂĄ na typy respiraÄnĂho zĂĄnÄtu. VĂ˝bÄr biologik u pacientĹŻ s tÄĹžkĂ˝m astmatem vychĂĄzĂ z diagnostickĂŠho posouzenĂ, zda se jednĂĄ o T2-high (tj. eozinofilnĂ, alergickĂ˝ Äi nealergickĂ˝) anebo T2-low (t. j. noneozinofilnĂ) zĂĄnÄtlivĂ˝ endotyp/fenotyp astmatu. V klinickĂŠ praxi mĂĄme dostupnĂŠ tĹi molekuly s antieozinofilnĂm pĹĂstupem do drĂĄhy cytokinu 5 (mepolizumab, benralizumab, reslizumab), molekulu zamÄĹenou na receptor pro IL4/13 (dupilumab), molekulu s vazbou na imunoglobulin E (omalizumab). PoslednĂ molekulou, kterĂĄ vstoupila do klinickĂŠ praxe, je tezepelumab blokujĂcĂ cytokin ze skupiny epiteliĂĄlnĂch alarminĹŻ - thymickĂ˝ stromĂĄlnĂ lymfopoetin. Inhibice alarminĹŻ (\"upstream\" cytokinĹŻ) je novĂ˝m konceptem cytokinovĂŠ blokace. StudovĂĄny jsou dalĹĄĂ molekuly urÄenĂŠ k inhibici alarminovĂ˝ch drah, z nichĹž jako slibnĂ˝ se jevĂ antiÂ‑IL33 itepekimab. Blokace epiteliĂĄlnĂch alarminĹŻ mĹŻĹže bĂ˝t i perspektivou pro astmatiky s T2-low typem zĂĄnÄtu, kde ĂşÄinnĂŠ biologikum zatĂm chybĂ.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136295029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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