Hlavní téma – revmatologie

prof. MUDr. Pavel Horák, CSc.

Vnitr Lek 2024, 70(6):339  

Autoantibodies in the diagnosis of autoimmune rheumatic diseases - practical use

Martin Žurek

Vnitr Lek 2024, 70(6):344-351 | DOI: 10.36290/vnl.2024.070  

Autoimmune rheumatic diseases represent a diverse group of conditions that may manifest with the production of autoantibodies, immune dysfunction, and systemic symptoms. Diagnosis can be challenging due to many nonspecific manifestations. A key test used in practice is the detection of organ-nonspecific autoantibodies. Autoantibodies present in individuals with systemic rheumatic diseases can serve not only as markers for classification, diagnosis, and prognosis but also in assessing disease activity and guiding treatment decisions. Autoantibodies often also play a direct role in the pathogenesis of individual diseases.

Early diagnosis of rheumatoid arthritis: The key to successful therapy

Adam Lukáč

Vnitr Lek 2024, 70(6):352-356 | DOI: 10.36290/vnl.2024.071  

Early diagnosis of rheumatoid arthritis (RA) is a key factor for successful treatment and improving patient prognosis. This article provides an overview of the diagnostic approach for RA. It also discusses the challenges associated with early diagnosis. Furthermore, it focuses on the benefits of early treatment initiation, including reducing disease progression and improving patients' quality of life. In conclusion, recommendations for clinical practice are provided, emphasizing the importance of timely recognition and intervention in patients with RA. This article highlights the necessity of a proactive approach by physicians to early RA diagnosis...

Rheumatoid arthritis as an internal disease

Martina Skácelová, Pavel Horák

Vnitr Lek 2024, 70(6):358-365 | DOI: 10.36290/vnl.2024.072  

Rheumatoid arthritis (RA) is an autoimunne disease that, in addition to persistent synovial inflammation with bone destruction and cartilage loss, can manifest a variety of extra-articular symptoms and associated comorbidities that can significantly affect the quality of life of patients or limit the treatment options for RA. Extraarticular manifestations include skin, eye, mucous membrane, lung or pleural involvement, and less commonly heart a kidney involvement. The higher mortality and morbidity in RA patients is due to the high prevalence of comorbidities. These include cardiovascular diseases, infections, solid tumors and lymfomas, lung and gastrointestinal...

Cardiovascular risks of systemic corticosteroid therapy

Jiří Vymětal, Pavel Horák

Vnitr Lek 2024, 70(6):366-369 | DOI: 10.36290/vnl.2024.073  

Glucocorticoids are a group of drugs used to treat a wide range of immune-mediated diseases and conditions in many fields, including acute conditions. On the one hand, they are very effective drugs, but on the other hand, they also have many side effects, especially when used for long periods of time and at higher doses. In this communication, we present a review of the knowledge and evidence on the cardiovascular risks of glucocorticoid treatment and their clinical forms, which are still perceived more in the context of classical risk factors for cardiovascular disease, such as hypertension, dyslipidemia, etc.

Inflammation and the cardiovascular continuum

Peter Wohlfahrt

Vnitr Lek 2024, 70(6):370-375 | DOI: 10.36290/vnl.2024.074  

The aim of this review article is to highlight the crucial impact of inflammation on the development and complications of arterial hypertension and cardiovascular diseases. The use of specific anti-inflammatory therapies, such as canakinumab or colchicine, indeed reduces cardiovascular risk but also increases the risk of infectious complications. Addressing traditional risk factors, such as arterial hypertension, dyslipidemia, obesity, and smoking, offers a safe pathway to reduce cardiovascular risk and systemic inflammation. In the realm of antihypertensive therapy, ACE inhibitors excel in their ability to reduce systemic inflammation. Since both...

New approaches in the diagnosis of hypertrophic cardiomyopathy

Miloš Kubánek

Vnitr Lek 2024, 70(6):376-383 | DOI: 10.36290/vnl.2024.075  

Hypertrophic cardiomyopathy (HCM) represents a heterogeneous group of diseases. The most common form of HCM is the phenotype of typical sarcomeric form with a hypercontractile left ventricle, impaired diastolic function and variable occurrence of obstruction in the left ventricle. Less frequently is this morphology related to infiltrative or storage diseases of myocardium like cardiac amyloidosis or inborn metabolic diseases (Anderson-Fabry´s disease, glycogenoses, etc). They represent phenocopies of HCM. We aim to describe the diagnostic criteria of HCM and guidelines for detection of obstruction in the left ventricle. In addition, we describe the...

Fixed combination of amlodipine and bisoprolol

Jaroslav Brotánek

Vnitr Lek 2024, 70(6):384-388 | DOI: 10.36290/vnl.2024.076  

Hypertension is one of the most important cardiovascular risk factors and is closely associated with increased cardiovascular morbidity and mortality. This article discusses the use of fixed combination therapy with amlodipine and bisoprolol in clinical practice. This combination leads to successful achievement of target blood pressure values and also improves patient adherence to treatment. The article also considers suitable indications for which it is preferable to use this drug.

Indications, specifics and reimbursement of glucose sensors in type 2 diabetes patients

Kateřina Štechová

Vnitr Lek 2024, 70(6):390-397 | DOI: 10.36290/vnl.2024.077  

The use of glucose sensors first changed self-monitoring and also the treatment of patients with type 1 diabetes mellitus, as it enabled safer and more flexible reaching of physiological blood glucose values. Despite certain inconsistencies in subsequent studies, it is clear that this form of glycaemic self-monitoring has the potential to improve diabetes control in patients with type 2 diabetes as well (DM2; possibly also with other forms of diabetes). In addition, DM2 patients generally appreciate this type of glycaemic self-monitoring. The effect of using personal continuous monitoring of glucose concentration (either in real time or in the form...

Semaglutide in different indications

Ľubica Cibičková

Vnitr Lek 2024, 70(6):399-402 | DOI: 10.36290/vnl.2024.078  

Semaglutide belongs to the group of GLP-1 receptor agonists, which have a significant effect on the adjustment of blood sugar and body weight. The development of semaglutide administration led to subcutaneous administration once a week and orally once a day. This article provides information on current indications for semaglutide treatment, as well as contraindications and side effects. Finally, the use of semaglutide as an antiobesity drug is mentioned.

Microvascular complications of diabetes - their prevention and treatment

Martina Lášticová

Vnitr Lek 2024, 70(6):E3-E9 | DOI: 10.36290/vnl.2024.079  

Microvascular complications of diabetes are a cause of significant morbidity and cardiovascular mortality of patients with diabetes. Their development and progression is associated with chronic hyperglycemia, and other risk factors are hypertension, dyslipidemia, smoking and genetic factors. Preventative startegies should focus on optimal individualized glycemic control, and also treatment of other modifiable factors. Early detection of complications using screening procedures and early and appropriate treatment lower the risk of advanced complications and of their subsequent physical, social and economic impact.

Primary and secondary prevention of stroke and arterial hypertension

Jiří Widimský

Vnitr Lek 2024, 70(6):E10-E12 | DOI: 10.36290/vnl.2024.080  

Strokes are among the most common cardiovascular complications, with arterial hypertension being considered the most significant risk factor. It is estimated that more than 50% of strokes are caused by hypertension, and high blood pressure alone increases the risk of stroke by 3-4 times! Furthermore, hypertension is an independent risk factor for the development of atrial fibrillation. The following brief summary addresses approaches to antihypertensive treatment in the primary and secondary prevention of strokes. Adequate control of hypertension through pharmacological treatment leads (among other benefits) to a significant reduction in the risk of...

Z čeho jsme se učili internu?

Jan Petrášek

Vnitr Lek 2024, 70(6):E18-E26  

Dopis redakci

prof. MUDr. Milan Kvapil, CSc., MBA

Vnitr Lek 2024, 70(6):E27-E28  

Národní program snížení příjmu soli v ČR v letech 2023-2030 - "30 % do roku 2030"

Jan Václavík, Richard Češka, Michal Vrablík, Jan Piťha, Petr Ošťádal

Vnitr Lek 2024, 70(6):E13-E17