Editorial

David Karásek

Vnitr Lek 2022, 68(2):79  

Prediabetes

Hana Rosolová

Vnitr Lek 2022, 68(2):82-84 | DOI: 10.36290/vnl.2022.016  

Prediabetes is defined as impaired fasting glucose or impaired glucose tolerance. It often appears as a part of metabolic syndrome and then represents high cardiometabolic risk. The cornestones of prediabetes management and Type 2 diabetes and cardiovascular disease prevention are weight reduction and regular physical activity. Suitable drugs for prediabetic patients are mentioned.

ADA Standards of Medical Care in Diabetes 2022 - what's new?

Jan Škrha jr.

Vnitr Lek 2022, 68(2):85-88 | DOI: 10.36290/vnl.2022.017  

A selection of the most important changes in recent ADA guidelines on diabetes screening, diagnosis, pharmacotherapy, or technologies in 2022. Key words: guidelines, pharmacotherapy, diabetes, technology.

Oral semaglutide - Rybelsus®, the first GLP-1 receptor agonist for oral use in clinical practice

David Karásek

Vnitr Lek 2022, 68(2):89-95 | DOI: 10.36290/vnl.2022.018  

Glucagon like peptide-1 receptor agonists (GLP-1 RA) are potent antidiabetic drugs associated with significant weight loss and minimal risk of hypoglycemia. Semaglutide is a GLP-1 RA with a proven cardiovascular benefit. It is currently also available in oral form, which is especially suitable for the treatment of the initial phase of type 2 diabetes. However, it is also effective at later initiation of therapy, in different diabetic populations. The PIONEER 6 trial demonstrated cardiovascular safety of oral semaglutide, its administration was accompanied by a significant reduction in cardiovascular and overall mortality.

The position of SGLT2 inhibitors in current medical practice - update 2022

Martin Prázný

Vnitr Lek 2022, 68(2):96-103 | DOI: 10.36290/vnl.2022.019  

Cardiovascular diseases are still the most common cause of mortality in patients with type 2 diabetes. Studies on the cardiovascular safety of new antidiabetic treatments, that have significantly expanded the treatment options for type 2 diabetes over the last 20 years, have provided evidence not only for the cardiovascular safety of SGLT-2 inhibitors (SGLT-2i, gliflozins), but also unexpectedly showed a significant effect on the reduction of cardiovascular risk, incidence and progress of heart failure and nephroprotectivity. For the first time, a reduction in cardiovascular and overall mortality was demonstrated for empagliflozin in 2015 in patients...

What do the new ESC Guidelines for the treatment of heart failure bring to internists?

Jindřich Špinar, Lenka Špinarová, Jiří Vítovec

Vnitr Lek 2022, 68(2):104-110 | DOI: 10.36290/vnl.2022.020  

Chronic heart failure is in european countries in 0,4-2,0% population with an increase with age. The improved care of acute cases enables to decrease the number of patients with chronic heart failure.The disease has a bad prognosis, the diagnosis therapy are demanding. European guidelines for diagnosis and treatment heart failure stress, that patients should have all 4 drugs with class 1 reccomendation (ACE‑I/ARNI, betablockers, MRA and SGLT2) in reccomended doses. These drugs will be given step by step with dose titration.

Anticoagulation in cancer patients; new recommendations based on randomized clinical trials

Dalibor Musil

Vnitr Lek 2022, 68(2):111-115 | DOI: 10.36290/vnl.2022.021  

Venous thromboembolic disease (VTD) is currently the second leading cause of death in cancer patients with a prevalence of approximately 20% compared with that of 5% in the entire adult population. Cancer patients are a heterogeneous group with significant differences in the risk of VTD which is, in particular, determined by the type of tumour, its extent, location, and the presence of metastases. Some tumours represent a mean 3- to 5-fold increase in risk, while in others the risk of developing VTD is even several times higher. In comparison with non-cancer patients, those with a tumour are not only at an increased risk of an initial thromboembolic...

Colorectal cancer in patients with diabetes - epidemiology, pathophysiology and applications for clinical practice

Alexandra Romanová, Jana Malinovská, Michala Lustigová, Jana Urbanová, Ludmila Brunerová, Veronika Vejtasová, Ankita Verma, Tung A. Duong, Jan Šťovíček, Jan Brož

Vnitr Lek 2022, 68(2):116-122 | DOI: 10.36290/vnl.2022.022  

Diabetes mellitus (type 2 diabetes in particular) and colorectal carcinoma are relatively frequent diseases in our population. At the same time, these units share some common risk factors, for example obesity, lack of physical activity and hyperinsulinemia. Available data show patients with diabetes have increased risk of colorectal adenoma and carcinoma, increased risk of colorectal carcinoma at a lower age, as well as increased risk of relapse and increased mortality with colorectal cancer. The aim of this article is to point out the relationship between diabetes and colorectal carcinoma, with emphasis on the information important for clinical practice,...

Gut microbiome in heart failure and aortic stenosis

Pavol Fülöp, Marianna Dvorožňáková, Marianna Vachalcová, Zuzana Fülöpová, Katarína Šoltys, Gabriel Valočik

Vnitr Lek 2022, 68(2):E04-E10 | DOI: 10.36290/vnl.2022.026  

The gut microbiome is linked to the development of individual diseases. Patients with congestive heart failure (HF) develop intestinal wall edema due to venous congestion, which impairs absorption function and allows bacterial overgrowth. Consequently, the pathogenous bacterial strains produce many harmful substances, including trimethylamine N-oxide (TMAO) and endotoxin (LPS - lipopolysaccharide), which lead to deterioration of HF. These discoveries led to hypothesis about the heart-bowel axis. High levels of TMAO present in patients with HF predispose to higher long-term mortality, even after correlation with traditional risk factors and cardiorenal...

Langerhans cell histiocytosis (LCH). Overview of symptoms of LCH, which may lead the patients to any of these medical specialists.

Zdeněk Adam, Luděk Pour, Miroslav Tomíška, Karel Starý, Teodor Horváth, Martina Doubková, Tomáš Nebeský, Zdeněk Řehák, Renata Koukalová, Marta Krejčí, Martin Krejčí, Ivanna Boichuk, Martin Štork, Sabina Ševčíková, Zuzana Adamová, Zdeněk Král

Vnitr Lek 2022, 68(2):E11-E21 | DOI: 10.36290/vnl.2022.027  

Langerhans cell histiocytosis (LCH) is a rare condition with incidence in adults 1-2/1 million, wherein Langerhans cells proliferate abnormally, adversely impacting organs including most frequently bones, skin, lungs, pituitary gland, lymph nodes, gums and other organs. The LCH course varies widely among patients from a self-limiting condition, to one that progresses. But LCH only very rarely culminates in death. To aim of this text is to review all possible symptoms and manifestations of this disease.

Medication adherence terminology - the first consensual translation using the Delphi method

Kateřina Malá‑Ládová, Eliška Voříšková, Barbora Košťálová, Josef Malý

Vnitr Lek 2022, 68(2):E22-E28 | DOI: 10.36290/vnl.2022.028  

Background: The terminology of adherence (or compliance) describing the patient's medication taking behavior is often used inconsistently and fragmented in the literature. Therefore, the English original of so-called ABC Taxonomy was developed to classify and unify the terminology. The aim of this paper was to establish the first consensual translation of Czech terminology dealing with the issue of medication taking behavior using Delphi method. Methods: In the period from February to May 2021, a three-round anonymous online Delphi questionnaire survey was conducted. The questionnaire contained items for translations of seven terms and their definitions...

Rare cause of spontaneous spleen bleeding: a case report and literature review

Lenka Nosáková, Martin Schnierer, Jakub Hoferica, Miroslav Pindura, Juraj Marcinek, Juraj Miklušica, Katarína Stašková, Ľudovit Laca, Peter Bánovčin

Vnitr Lek 2022, 68(2):E29-E31 | DOI: 10.36290/vnl.2022.029  

Rupture of the spleen is a serious medical condition manifesting as a sudden abdominal event, potentially life-threatening. Spontaneous spleen rupture is a rare condition. Atraumatic rupture of the spleen is a very unlikely condition. Risk factors include splenomegaly, hemato-oncological diseases, and infections, such as malaria or infectious mononucleosis. Extremely rare is splenic rupture described in autoimmune disease or vasculitis. There has been no reported case of spontaneous splenic rupture as a first manifestation of Churg- Strauss syndrome so far.

Any expectations from the more powerful dulaglutide?

Jan Škrha jr.

Vnitr Lek 2022, 68(2):124-126 | DOI: 10.36290/vnl.2022.023  

Dulaglutide is a frequently used GLP-1 analogue and one of the most potent antidiabetic drugs. Practical aspects of treatment with dulaglutide are presented in this article, together with new data from AWARD-11 study with higher concentrations of dulaglutide, especially the effects on diabetes control, body weight and side effects.

Pituitary incidentaloma

Michal Kršek

Vnitr Lek 2022, 68(2):127-130 | DOI: 10.36290/vnl.2022.024  

Pituitary incidentaloma are being accidentally found during imaging procedures in approximately 10% of normal population. Facing pituitary incidentalomas endocrinologists have to decide about further management based on the assessment of hormonal activity, aetiology, size, and possible compressive symptoms. Treatment of choice for prolactinomas is medical therapy. Surgical treatment is a treatment of choice for other hormonally active tumours and in case of complications as defects of visual field, pituitary apoplexy with compressive symptoms, ophthalmoplegia respectively. Tumour not indicated for surgical treatment are followed-up by imaging techniques...

Pharmacological possibilities of vitamin C in oncology

Marek Lapka

Vnitr Lek 2022, 68(2):131-134 | DOI: 10.36290/vnl.2022.025  

Ascorbic acid is a well-described molecule which acts as a cofactor in many reactions and mediates a variety of biological functions. Despite its simple structure, vitamin C has a wide range of interesting effects that bring enormous potential to the clinical practice. The article summarizes available data on efficacy and safety in oncology.

Professor Jarmila Siegelová, MD, DrSc. – 80 years

Petr Dobšák

Vnitr Lek 2022, 68(2)