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News Comparison of Duloxetine, Gabapentin, and Pregabalin in the Treatment of Diabetic Neuropathic Pain
Painful diabetic neuropathy represents an unpleasant complication of diabetes, in which several groups of drugs are used in therapy. Among their representatives are duloxetine, gabapentin, and pregabalin. The meta-analysis, whose conclusions we summarize below, focused on comparing their effectiveness and tolerability.
News Recurring allergy symptoms after waking up? It could be due to dust mites
Allergens that are part of the feces and exoskeleton of dust mites, invisible members of human households, can cause milder symptoms like mucosal swelling, itching of the nose or throat, but also a stronger immune reaction, asthma, or severe allergic rhinitis. It is stated that 1−2% of the global population suffers from dust mite allergy, which corresponds to 65−130 million people. Why does it arise and what can be done in its prevention and treatment?
News Psychotic patient with high cardiometabolic risk – interactive case report
The following case report describes the treatment of a patient diagnosed with paranoid schizophrenia following a relapse of the disease. During therapy, complications arose in the form of weight gain, deterioration of metabolic parameters, sedation, and sexual dysfunction. Additionally, the patient is not capable of adhering to the principles of a healthy lifestyle. Is it possible to find an optimal treatment approach even in such a case?
News Reducing Cardiovascular Risk in Diabetics Through Hypertension Treatment
The presence of hypertension in patients with diabetes worsens overall cardiovascular (CV) prognosis and increases the prevalence of chronic renal failure. Adequate treatment of hypertension can significantly influence the development and severity of these complications. What target blood pressure (BP) values should we aim for in diabetics, which antihypertensive therapy to choose, and why not forget about 24-hour BP monitoring?
News Favorable effect of linagliptin on renal endothelial functions in patients with type 2 diabetes mellitus
Diabetic nephropathy is the cause of up to 50% of cases of end-stage chronic kidney disease. The main pathological mechanism involved in the development of the early stage of diabetic nephropathy is endothelial dysfunction. The aim of the German study was to evaluate the effects of linagliptin on endothelial function in the renal vasculature.
News Combination of SGLT2 inhibitors with metformin in terms of mechanism of action
In the treatment of type 2 diabetes (T2D), metformin is recommended as the first-line drug alongside lifestyle modification. However, with disease progression, monotherapy is often insufficient. SGLT2 inhibitors (SGLT2i) are recommended in combination with metformin in light of recent findings, as their mechanism of action is independent of insulin effect. They have shown a reduction in cardiovascular (CV) risk in diabetics with CV disease.
News Diabetic Retinopathy: A Blind Diabetic as Proof of Serious Neglect of Prevention
Diabetic retinopathy is the most common cause of blindness in working-age patients in developed countries. Early detection of diabetic retinopathy offers a chance to preserve vision. Therefore, careful screening and timely initiation of treatment are crucial.
News New Alternative in the Treatment of Diffuse Large B-cell Lymphoma
For patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) who are not suitable candidates for autologous stem cell transplantation, a wide range of treatment regimens is available. Recently, the addition of polatuzumab vedotin to rituximab and bendamustine therapy has shown promising efficacy in both registration studies and real-world clinical practice.
News How Do Patients Themselves Perceive Today's Treatment Options for ITP and What Are Their Biggest Fears?
What is the perception and view of the treatment options for immune thrombocytopenia (ITP) from the patients' perspective, what do they fear, what approaches do they prefer, and why? Lozano et al. included a discussion on this topic in their review article for Expert Review of Hematology, which can be helpful in clinical practice for better understanding patients' needs and adjusting treatment algorithms.
News State of the Intestinal Microbiome and COVID-19 Infection − Possible Correlations
Some patients infected with the SARS-CoV-2 virus exhibit gastrointestinal symptoms, including diarrhea, during the course of COVID-19. Current knowledge suggests that COVID-19 symptoms are related, among other things, to the intestinal microbiome. Could the use of probiotics therefore act as a prevention of this disease or its more severe course?
News Characteristics of Patients with Alpha-1 Antitrypsin Deficiency – Two-Year Data from the EARCO Registry
The international registry of individuals with alpha-1 antitrypsin deficiency (AATD) named EARCO has collected data on 1,044 patients from 15 countries, including the Czech Republic, over its first 2 years of existence. In December 2022, the characteristics of patients enrolled from February 2020 to May 2022 were published. They provide information on the prevalence of AATD genotypes, their clinical phenotypes, factors associated with worsening lung function, and the impact of augmentation therapy.
News How to Determine the Optimal Target Value of Intraocular Pressure in Glaucoma Treatment?
Glaucoma remains the second most common cause of blindness in Europe. Therapy needs to be individualized with regard to the severity of the condition, expected lifespan, and the rate of disease progression. Which factors should we consider when determining the optimal target value of intraocular pressure (IOP) for a particular patient?
News Parenteral Nutrition in Oncological Patients in Current ESPEN Recommendations
The current guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) address nutritional care in oncological patients − current knowledge is summarized in a total of 43 recommendations, from which we select some key points, focusing primarily on parenteral nutrition in these patients.
News Long-term Benefit of Luspatercept Therapy – Fresh Data from the MEDALIST Study
The goal of therapy for low-risk myelodysplastic syndrome (MDS) is to compensate for anemia, improve or maintain quality of life, and prolong the time to progression to higher-risk MDS (HR-MDS) or acute myeloid leukemia (AML). To manage anemia, we can resort to transfusion therapy or administer epoetins, lenalidomide, or luspatercept, the first representative of a class of drugs that support erythrocyte maturation. Last year's data from the follow-up of patients enrolled in the MEDALIST study pertain specifically to the latter.
News What FVIII Levels Are Ideal for Preventing Bleeding in Hemophilia A?
Recent studies indicate that target trough levels of factor 1–3% during prophylactic treatment are insufficient to fully prevent clinical and subclinical bleeding. With a sustained FVIII level > 15%, as shown in studies with mild hemophiliacs, spontaneous bleeding is very rare. This raises the question of whether achieving zero bleeding incidence with FVIII replacement therapy is possible and whether it can be a realistic goal. This topic was also explored in a presentation by Dr. Ester Zápotocká from the Clinic of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University and Motol University Hospital in Prague.
News Therapy of Chronic Leg Ulcers According to Evidence-Based Medicine
Chronic ulcers on the lower extremities are defined as trophic defects that show no signs of healing after 3 months of appropriate treatment or are not healed even after 12 months of treatment. Their incidence and prevalence are continuously increasing, and they currently represent not only a serious medical problem but also a socioeconomic issue. An overview article published by German physicians focuses on summarizing the therapy of leg ulcers according to the principles of evidence-based medicine.
News Current (and Future) Possibilities for Diagnosing Alpha-1-Antitrypsin Deficiency
Alpha-1-antitrypsin deficiency (AAT) is associated, among other things, with the development of chronic obstructive pulmonary disease (COPD) with emphysema. Most patients, however, remain undiagnosed and therefore do not receive adequate treatment. Below we summarize the current possibilities for diagnosing this genetic disorder.
News Incidence of Osteoporosis in Patients with Atrial Fibrillation Treated with Different Oral Anticoagulants
Previous research has suggested an increased risk of osteoporosis and osteoporotic fractures in patients with atrial fibrillation treated with warfarin. A recent analysis also identified a higher incidence of osteoporosis in patients treated with warfarin or direct oral anticoagulants (DOACs). However, less is known about the risk of this disease when using DOACs compared to warfarin. Therefore, Australian doctors compared its incidence in patients treated with different oral anticoagulants for atrial fibrillation (AF) in a population cohort study using data from a nationwide primary care database.
News Benefit of a single intra-articular injection of hyaluronic acid in the treatment of osteoarthritis
Viscosupplementation serves as a minimally invasive procedure to restore the rheological properties of synovial fluid and alleviate pain in patients with symptomatic osteoarthritis (OA). We now have a new 3rd generation hyaluronic acid (HA) product for intra-articular injections – Hyruan One, which uses HA cross-linking technology. The following text summarizes its benefits in the pharmacological management of OA.
News Dual Inhibition of IL-17A/IL-17F Across the Spectrum of Axial Spondyloarthritis
Many patients with axial spondyloarthritis (axSpA) still have a need to seek additional therapeutic options and new mechanisms of action for medicinal substances. Phase III studies BE MOBILE 1 and 2 therefore evaluated the effect of administering bimekizumab—a monoclonal antibody selectively inhibiting interleukins (IL) 17A and 17F—across the full spectrum of patients with axSpA.
News Prof. Petr Marusič: Is the Success of Therapy Changing with the Arrival of New Antiepileptics?
At the XXV. postgraduate course in epileptology, 'Jiří Dolanský Days', prof. MUDr. Petr Marusič, Ph.D., from the Neurological Clinic of the 2nd Faculty of Medicine, Charles University, and Motol University Hospital, lectured on the topic of changes in the efficacy of epilepsy treatment with the arrival of new anti-seizure medications.
News Lurasidone in a Patient with Paranoid Schizophrenia and Asperger's Syndrome – A Case Study
Lurasidone is an effective and very gentle antipsychotic which is establishing a prominent position in modern psychopharmacotherapy. Its unique receptor profile makes it a suitable choice for hyperprolactinemia induced by risperidone. A significant benefit of lurasidone is its favorable cardiometabolic profile. Switching from another antipsychotic to lurasidone can be performed on an outpatient basis. Most importantly, it is essential to highlight its effect on both positive and negative symptoms of schizophrenia, as demonstrated by the presented case study.
News Thrombocytopenia Following mRNA Vaccination Against SARS-CoV-2
In connection with the administration of mRNA-based vaccines against the SARS-CoV-2 coronavirus, cases of secondary immune thrombocytopenia (ITP) have been described. A commentary published by a large team of authors in the American Journal of Hematology described a series of cases of low platelet counts identified within 2 weeks of vaccination. The data was obtained from the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Department of Health and Human Services (HHS), and the Vaccine Adverse Event Reporting System (VAERS), as well as through direct communication with patients and their physicians.
News The Link Between Various Sleep Disorders and the Onset of Depression: What Findings Did the Population Study in Denmark Bring?
A Danish population study published in June 2019 examined the link between different types of sleep disorders and the risk of developing depression. Which disorders confirmed this link after evaluating data from tens of thousands of patients?
News Immunomodulation and Romiplostim − What Does the Recently Published iROM Study Say?
Primary immune thrombocytopenia (ITP) is caused by an immunity disorder, involving not only the production of antibodies but also changes in cytokine levels, predominance of Th1 lymphocytes over Th2, increase in Th17 cells, and conversely a decrease in T-regulatory lymphocytes (Tregs). One treatment option is the use of thrombopoietin receptor agonists (TPO-RA), which primarily increase platelet production. Recently, attention has also been focused on their potential immunomodulatory effects and protolerogenic effect associated with Tregs activation, which was the subject of the Swiss iROM study.