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News ESC 2022: What Current Insights Say About the Role of Dabigatran in Stroke Prevention with Atrial Fibrillation and Comorbidities
The risk of atrial fibrillation (AF) increases with age as risk factors accumulate and comorbidities arise. What do current data from randomized clinical trials and registries show about stroke prevention (SP) in the context of concurrent AF and some other chronic diseases? This was the focus of one of the symposia at this year's European Society of Cardiology (ESC) Congress.
News To what extent can the actual level of ALP, ALT, or bilirubin differ from the measured value?
A physician who bases clinical decisions on laboratory-determined values of biological parameters or their changes should always consider the possible measurement deviation, which for alkaline phosphatase (ALP), alanine aminotransferase (ALT), or bilirubin can reach several percent in both positive and negative directions.
News Interactive Case Study: Use of Cannabis Extract for Local Treatment of Neuropathic Pain
We have been using cannabis for pain treatment for several years. We also have good experiences with it in difficult-to-control symptoms of neuropathic pain, as illustrated in the following case study. Until recently, our patients only used cannabis orally or via vaporization. With the availability of cannabis extracts, a new option has emerged – local therapy.
News Summary of Recommendations for the Treatment of Immune Thrombocytopenia in Pregnancy
Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by a temporary or permanent reduction in the number of platelets, leading to an increased risk of bleeding. It also occurs in 1-5 out of 10,000 pregnant women. We summarize recommendations for the treatment of these patients.
News ACC 2023 Expert Consensus: How to Optimize Diagnosis and Treatment of Heart Failure with Preserved EF LK
Heart failure (HF) remains a significant cause of morbidity and mortality, with the incidence and prevalence of HF with preserved left ventricular ejection fraction (HFpEF) rising. The following document focuses on individuals with HFpEF and supports the principles of evidence-based diagnosis and treatment of HF from 2022. It emphasizes the need for individualized care and multidisciplinary cooperation.
News PID in children manifest differently, 10 warning signs help in diagnosis
We asked MUDr. Eva Hlaváčková from the Department of Clinical Immunology and Allergology, Faculty of Medicine, Masaryk University, and St. Anne's University Hospital in Brno about the essential details regarding the 10 warning signs of primary immunodeficiencies (PID) and in which cases the vaccination schedule needs to be adapted for sick children.
News Can Erdostein Help in Treating Infections Related to Biofilm Formation?
One of the reasons for the very difficult treatment of diseases caused by resistant bacterial strains is the significant ability of these infection-causing agents to form biofilms. What exactly is a biofilm? Which bacteria are likely to form it, and how can erdostein help in the fight against it?
News Impact of erdostein on bacterial biofilm − and what it means for clinical practice?
One of the substances that could potentially influence the success of treatments for infections associated with biofilm formation in the future is erdostein. This medication is used in the treatment of both acute and chronic diseases of the respiratory system (including chronic obstructive pulmonary disease) usually accompanied by increased mucus production. Its effect is mediated by several mechanisms that can also affect bacterial biofilm.
News Fatigue as a Significant Symptom of Immune Thrombocytopenia from the Patients' Perspective
The I-WISh survey assessed the impact of immune thrombocytopenia (ITP) and its treatment on patients' lives. Patients identified fatigue as the most frequent, severe, and persistent symptom associated with ITP, unlike doctors who did not attribute such significance to this symptom. Recently published survey results also showed that patients need support from multiple sources, including doctors, family, friends, and patient groups.
News How to Communicate and Receive an Oncological Diagnosis
Communicating the truth to a patient about their health condition does not have a very long tradition in the Czech Republic. The Czech healthcare system started emphasizing this aspect, i.e., honest and open communication between doctor and patient, several years after the Velvet Revolution.
News Position of Parenteral Therapy in Patients with Severe COVID-19 Disease
Patients with severe COVID-19 disease are at risk of developing acute respiratory insufficiency requiring non-invasive or invasive pulmonary ventilation. Intensive care therapy is associated with a high risk of severe malnutrition. According to current recommendations by the European Society for Clinical Nutrition and Metabolism, parenteral therapy plays an important role in the nutrition of patients.
News Prof. Hana Rosolová: According to recent studies, caution is needed with beta-blockers only in severe cases of asthma and COPD
Beta-blockers (BB) are among the most widely used drug groups in cardiology. While their position is clear in some indications, it is debated in others. Additionally, individual BBs differ in various aspects, which plays an important role in selecting the right treatment for a particular patient. We discussed some current topics related to beta-blockers with the head physician of the Center for Preventive Cardiology of the 2nd Department of Internal Medicine LF UK and FN Plzeň Prof. MUDr. Hana Rosolová, DrSc., FESC.
News Long-term Benefit of Sotorasib for Survival of Patients with Pre-treated Advanced/Metastatic NSCLC with G12C Mutation of KRAS Oncogene
Sotorasib is indicated as monotherapy for advanced non-small-cell lung cancer (NSCLC) with the KRASG12C gene mutation, if there has been progression after ≥ 1 prior line of systemic therapy. The 2-year analysis of data from the CodeBreaK 100 study published in April 2023 demonstrated the long-term benefit of sotorasib for this patient population in terms of progression-free survival (PFS) and overall survival (OS), regardless of programmed death-ligand 1 (PD-L1) receptor expression, including patients with a poor prognosis. In the Czech Republic, sotorasib has been reimbursed by public health insurance for this indication since September 2023.
News Bimekizumab in the Treatment of Psoriatic Arthritis
Arthritis can appear in up to a third of patients with psoriasis, mostly after the onset of skin symptoms. Early recognition of this transition by dermatologists and general practitioners is crucial, as early intervention can prevent irreversible joint damage. In the context of effective biological therapy, there is even talk of the potential prevention of arthritis development in individuals with psoriasis.
News Position of aPCC in the Treatment of Hemophilia A Complicated by the Development of Inhibitors
Activated prothrombin complex concentrates (aPCC) are essential drugs that not only allow the control of bleeding in patients with congenital hemophilia A and inhibitors but also help to prevent such bleeding. A recent review article by experts from several European institutions provides an up-to-date view of the development, challenges, and future directions in the use of aPCC in the treatment of hemophilia.
News Ocrelizumab in the treatment of multiple sclerosis in real-world practice – a systematic review of published studies
In controlled study programs, ocrelizumab has demonstrated beneficial effects on improving clinical parameters in patients with multiple sclerosis, such as the annual relapse rate or confirmed disability progression. However, to get a complete picture of its clinical benefit, real-world evidence in a broad patient population is also needed. A systematic review of real-world clinical practice studies with ocrelizumab, published in March 2023, demonstrates its benefits in patients with relapsing-remitting multiple sclerosis (RRMS) and primary progressive multiple sclerosis (PPMS) in terms of relapse frequency, disease activity on MRI, disability, absence of disease activity (NEDA), and quality of life.
News Streptococcus pneumoniae Serotype 3 Continues to Be the Most Frequent Cause of Invasive Pneumococcal Diseases in the Czech Republic
After 2 years influenced by the COVID-19 pandemic, the number of cases of invasive pneumococcal diseases (IPD) has returned to pre-2020 levels. Serotype 3 remains the most frequent cause of IPD for the twelfth consecutive year.
News Substitution Treatment of von Willebrand Disease with vWF and FVIII Concentrates
Recently published recommendations from Poland regarding the diagnosis and treatment of von Willebrand disease (vWD) provide a comprehensive summary of the current approach to substitution therapy using concentrates containing von Willebrand factor (vWF) and coagulation factor VIII (FVIII), administered primarily during bleeding or surgical procedures.
News Prof. Petra Lišková: Prevention of Dry Eye Syndrome is Difficult but Not Impossible
Dry eye syndrome is one of the most common ophthalmological problems, and its incidence is rising. Ophthalmologist Prof. MUDr. Petra Lišková, Ph.D., from the Clinic of Pediatrics and Hereditary Metabolic Disorders of the First Faculty of Medicine, Charles University, and University Hospital in Prague, explains how these difficulties arise and why patients should visit an eye doctor rather than relying solely on self-treatment.
News Li-Fraumeni Syndrome – Indication for Testing and Recommended Surveillance
A germline mutation of the TP53 gene, which causes Li-Fraumeni syndrome, results in a congenital predisposition to the occurrence of malignant tumors, such as pediatric malignancies, breast cancer, bone sarcomas, and others. We bring a summary of indications for testing the pathogenic variant of the TP53 gene according to the recommendations of the National Comprehensive Cancer Network (NCCN) and the surveillance program for carriers of this variant according to the consensus of the current recommendations of the European, American, Japanese, and Australian scientific societies compared to the recommendations of the Czech Oncology Society ČLS JEP.
News Expression of PD-L1 as a Predictive Biomarker for Therapy Selection in mRCC
A newly published systematic review and meta-analysis of studies involving patients with metastatic renal cell carcinoma (mRCC) evaluates the predictive significance of PD-L1 expression in the treatment with immune checkpoint inhibitors.
News Increase in Hematocrit During Empagliflozin Treatment in a Diabetic Patient with Severe Anemia − A Case Study
In a case study involving a 78-year-old diabetic patient, where only the administration of empagliflozin led to the correction of severe anemia of unknown origin, Polish authors demonstrate the previously described pleiotropic effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i, i.e., gliflozins) on increasing hematocrit levels.
News CYP Enzyme? Cytochrome P450 2D6 and Drug Metabolism
The CYP2D6 isoenzyme of cytochrome P450 participates in the metabolism of approximately 20% of commonly used drugs. Genetic variants of this enzyme are very common, leading to significant inter-individual variability in drug metabolism rates. Let’s take a closer look at one of the reasons why the same drug may work very well in one patient, not at all in another, and may cause serious side effects in a third.
News The Immune System in the Pathophysiology of ITP
From the perspective of the pathophysiology of immune thrombocytopenia (ITP), it appears that the etiology of this disease is very complex and involves both antibody and cellular immunity.