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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 To Vaccinate or Not to Vaccinate? That’s the Question for MS and COVID-19
What is the response of patients with multiple sclerosis (MS) to vaccination against COVID-19 considering the type of their treatment? Is there an increased risk of relapse after vaccination? And how to proceed with a particular patient? Although COVID-19 has been a relevant issue for a relatively long time, unfortunately, this topic remains current. Unlike in 2020, however, our knowledge has significantly advanced. Currently, relatively extensive data are available even for specific groups of the population – including precisely MS patients.
News INFOGRAPHIC: Which treatment to choose in the 1st line for a patient with type 2 diabetes?
Diabetes mellitus is a complex chronic disease that requires continuous treatment and a strategy to reduce associated risks beyond mere glycemic control. Comorbidities and the risk of complications are key elements in deciding the choice of therapy for type 2 diabetics. This fact is also considered by the American Diabetes Association (ADA) in its annually published standards of care for patients with diabetes, which brought several changes in 2022.
News Regorafenib and Trifluridine/Tipiracil: Hospitalization and Clinical Outcomes in the Treatment of Metastatic Colorectal Cancer
Regorafenib and trifluridine/tipiracil are drugs that prolong overall survival (OS) in pre-treated patients with metastatic colorectal cancer (mCRC). The difference in the toxicity of these agents led to the hypothesis that treatment toxicity of individual drugs might increase the number of hospitalizations, thereby affecting patients' quality of life. The study presented below aimed to analyze the number of hospitalizations during treatment and their possible impact on OS.
News Reduction of Inflammation in Vertebral Bodies and Posterolateral Structures of the Spine in Patients with Ankylosing Spondylitis Treated with Tofacitinib
A post hoc analysis of a phase II study with tofacitinib in patients with active ankylosing spondylitis (AS) evaluated the suppression of spinal inflammation using magnetic resonance imaging (MRI) based on the Canadian-Danish scoring system (CANDEN), which allows for the assessment of changes in posterolateral structures of the spine, characteristic of AS involvement.
News The Role of the General Practitioner in the Care of Incontinent Patients
General practitioners are sometimes likened to frontline soldiers because they are usually the first to whom patients turn with their health issues. Taking care of incontinent patients is a daily routine for them. They should therefore be knowledgeable about basic diagnostics and treatment and be able to actively identify incontinent patients.
News Comparison of Enoxaparin and Unfractionated Heparin in Hospitalized Patients in Terms of Clinical and Cost Effectiveness
Thromboembolic disease represents one of the severe complications in hospitalized patients. Low molecular weight and unfractionated heparin are most commonly used during hospitalization as part of pharmacological thromboprophylaxis. An extensive study conducted in the United States evaluated the clinical and cost-effectiveness and safety of both therapy modalities in hospitalized patients at risk of thromboembolic disease.
News The Importance of Limosilactobacillus reuteri in Administration to Diabetics with Gingivitis
We summarize the results of a clinical study on the effect of probiotics containing Limosilactobacillus reuteri on the improvement of gingivitis in patients with diabetes. It has been proven that the supplementary administration of L. reuteri statistically significantly improves gum health and helps to suppress gingival inflammation.
News Most Common Dermatoses Around the Stoma
The incidence of stomal complications ranges between 20 and 70%. One type of complication is dermatoses affecting the peristomal skin. These issues can occur in the early postoperative period, but also several years later.
News Current View on Obstacles in Proper Use of Antibiotics and the Role of Biomarkers in Infection Diagnosis
In the fight against antibiotic resistance, principles for the proper use of antibiotics (ATB) have been introduced globally. The following overview briefly describes the obstacles in leading rational antibiotic therapy and considers the use and benefits of biomarkers.
News MDT Board: a unique project for doctors caring for patients with lung diseases and other thoracic pathologies
A unique concept of a cooperative thoracic group has been created in the Czech Republic, involving specialists from several leading Prague clinics. The primary purpose of the so-called board is to provide the best diagnostic and treatment plan for a patient with lung disease and other pathologies in the thoracic area, shared by all members of the multidisciplinary team and based on current knowledge. The MDT Board project, which operates on the principle of online indication seminars, is intended for doctors of patients with common and rare lung diseases.
News How do patients perceive the treatment of ITP with romiplostim?
Romiplostim, along with eltrombopag and avatrombopag, belongs to the group of thrombopoietin receptor agonists (TPO-RA) used in the second line of treatment for immune thrombocytopenia (ITP). Its efficacy and safety are confirmed by numerous studies, but how do patients perceive its use and to what extent does it improve their quality of life? This was the focus of a review article by authors from the American Baylor College of Medicine.
News ICIS Report: Potential of TPO-RA as Early Immunomodulatory Treatment of Immune Thrombocytopenia
The report from the meeting of the Intercontinental Cooperative ITP Study Group (ICIS) in 2022 in Lenzerheide, Switzerland, published late last year in the British Journal of Haematology, discusses the potential of early treatment of immune thrombocytopenia with thrombopoietin receptor agonists (TPO-RA) in achieving a disease remission sustainable without further therapy.
News Mechanisms of Cardioprotective Effects of SGLT2 Inhibitors
Inhibitors of sodium-glucose cotransporter 2 (SGLT2i, gliflozins) are a relatively new group of medications used in the treatment of type 2 diabetes mellitus (T2DM). Their clinical use is supported by the results of extensive clinical studies, which have particularly demonstrated their cardioprotective and renoprotective effects.
News Lorlatinib in a Patient with Meningeal Carcinomatosis – Case Report
The prognosis of patients with meningeal carcinomatosis is unfavorable. The following case report demonstrates how a targeted mechanism of action and optimal drug penetration into the central nervous system (CNS) can not only quickly relieve patients from neurological problems associated with meningeal infiltration, but also prolong their survival.
News Acquired Hemophilia A Newly Diagnosed in an Elderly Patient − A Case Report
At the XXVIIIth Pařízek Days held in Ostrava, a case of acquired hemophilia A, recently addressed at this institution, was presented in the afternoon session on March 17, 2022, by Assoc. Prof. Petr Dulíček, MD, PhD., from the 4th Department of Internal Medicine, Charles University Faculty of Medicine and University Hospital in Hradec Králové.
News Glucagon for Intranasal Application Newly Available Also in the Czech Republic
Intramuscular administration of glucagon was until recently the only option for acute treatment of hypoglycemia with impaired consciousness at home. However, since July this year, the Baqsimi product – glucagon for intranasal application – is newly available in the Czech Republic.
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 Pregabalin Relieves Patients with Central Neuropathic Pain
Treatment of central neuropathic pain, whether caused by spinal cord or cerebral damage, is often lengthy and not always successful. Study results show that pregabalin may be a suitable alternative to traditional preparations, affecting not only pain but also the quality of life of patients.
News Diabetic Cardiovascular Autonomic Neuropathy: How to Detect This Serious Diagnosis and Why Is It Dangerous?
Diabetic autonomic neuropathy can affect various organ systems. Cardiovascular autonomic neuropathy is one of its most severe forms with a significant impact on patient morbidity and mortality. How can it be detected in clinical practice?
News Recommend Erdostein for children when treating with amoxicillin – symptoms of cough improve in almost 50% of cases within 3 days
Acute respiratory infections are usually treated empirically in primary care as the causative agent is not known. Amoxicillin is among the most commonly chosen antibiotics. Erdostein is a suitable addition to this antibiotic treatment for several reasons.
News Bilastine and its role in the treatment of allergic rhinoconjunctivitis and urticaria in children
The prevalence of allergic rhinitis (AR) in the pediatric population is estimated worldwide at 10-20%. The efficacy and safety of bilastine (a second-generation antihistamine) in adult patients and adolescents have already been proven in clinical studies. Below we summarize experiences with its use in children under 12 years of age.
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 Treatment of Cough in Clinical Practice: Which Preparations Are Suitable and When?
In clinical practice, we differentiate the treatment of non-productive and moist productive cough. When choosing appropriate therapy, we consider the characteristics of the available medicinal products, such as sedation, route of administration, potentiation of antibiotic effect, or anti-inflammatory effect. Combining antitussive and expectorant in one dose is irrational in any case. So, how should one proceed in the treatment of cough correctly?