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News Pain Management After Day Surgery
Effective pain control is a crucial part of recovery for patients after painful surgical procedures. In clinical practice, combined analgesia using paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) is commonly utilized, which, however, is not suitable for up to a quarter of patients. An alternative could be metamizole. A study published in the European Journal of Anaesthesiology evaluated the non-inferiority of the combination of paracetamol/metamizole versus paracetamol/ibuprofen in pain management for patients after day surgery.
News Key for Patients with PBC are Timely Diagnosis and Assessment of Therapy Effectiveness
Primary biliary cholangitis (PBC) cannot be cured. It progresses slowly and over several decades leads to liver cirrhosis with all its potential consequences, including possible transplantation and the risk of premature death. The foundation of PBC pharmacotherapy is ursodeoxycholic acid (UDCA) and in recent years, obeticholic acid (OCA) has also been available, which European and Czech guidelines recommend as the second-line treatment. One of the symposiums at this year's XLVIII May Hepatology Days also focused on PBC and its therapy, including experiences from Czech practice.
News Inhibition of Mutated KRAS Protein as a New Option for Targeted Treatment of Non-Small Cell Lung Cancer
RAS proteins are molecular switches for several intracellular signaling pathways. Their dysfunction due to mutation leads to the development and progression of malignant diseases such as colon or lung cancers. At the beginning of 2022, the inhibitor of the mutated KRAS protein, sotorasib, was approved. The following article outlines the effect of this first representative of a new drug group and its potential in the treatment of non-small cell lung cancer (NSCLC).
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 Which Dietary Recommendations Actually Work for Irritable Bowel Syndrome?
Food is both a trigger for symptoms and a treatment tool for individuals with irritable bowel syndrome (IBS). A 2021 review summarizes the results of the latest research on the effectiveness of dietary measures for IBS and the evidence of which measures are truly beneficial. A positive impact was found for general healthy eating recommendations, soluble fiber supplementation, a low short-chain carbohydrate diet, and probiotic administration.
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.
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 Rapid Strengthening and Long-term Stabilization – New Strategy for Sequential Treatment of Severe Osteoporosis
Osteoanabolics have long been considered a treatment modality for osteoporosis that is only considered when antiresorptive medication lacks the desired efficacy. However, their role has been shifting in recent years based on new findings from clinical research, as evidenced by the conclusions of the expert working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases (ESCEO), whose brief summary we bring.
News Successful Resection of a Rectosigmoid Tumor After Long-term Induction Biochemotherapy – A Case Report
Neoadjuvant treatment (chemoradiotherapy) for colorectal cancer is regularly used in advanced rectal tumors, with the goal of reducing the tumor size for the surgeon and ensuring the best possible radical outcome for the patient. In metastatic tumors of the remaining parts of the digestive tract, we talk more about induction treatment, which uses a combination of targeted therapy and chemotherapy for the same purpose – reducing the extent of the tumor disease and possibly enabling surgery including radical removal of metastatic foci. The duration of this treatment is usually up to 6 months followed by surgery (surgeries). The following case report describes a successful surgical solution in a patient with an advanced sigmoid tumor even after more than 3 years of combination chemotherapy and targeted therapy.
News Another Positive Effect of Diosmin − Influence on Oxidative Stress
Diosmin is an established drug in the therapy of chronic venous insufficiency. It is known to act through several different mechanisms. A study by Polish authors provides evidence of its ability to reduce oxidative stress.
News Genuair®/Pressair® Inhaler in the Treatment of COPD – Minimum Errors During Inhalation and High Patient Satisfaction
The article by German authors summarizes the results achieved with the Genuair® inhaler (marketed in the USA under the name Pressair®), highlighting its ease of use, simple patient training, low error rates during inhalation compared to other inhalers, and high patient satisfaction and willingness to continue treatment.
News Efficacy of Bisoprolol in Patients After Acute MI with LV Systolic Dysfunction
What impact does one year of bisoprolol use have in real-world practice on heart rate, left ventricular ejection fraction (LVEF), glycated hemoglobin (HbA1c) levels, or lipid profile in patients after acute myocardial infarction (AMI) with left ventricular systolic dysfunction (LVSD)? This was investigated by the authors of a study whose results were published last year.
News Lung Recovery After COVID-19: How Reversible is the Damage?
During the virtual XXV Hradec Pulmonology Days held in April 2021, various aspects concerning COVID-19 were among the major topics. Dr. Bram van den Borst from Radboud University Nijmegen provided a comprehensive summary of current insights regarding lung recovery following an infection.
News Ocrelizumab in the Treatment of Multiple Sclerosis – 10-Year Data
Multiple sclerosis (MS) is a lifelong disease with a high risk of permanent disability. Current information on the long-term efficacy and safety of treatment is therefore absolutely essential for the optimal choice of therapeutic agent – in this case, ocrelizumab.
News H₂FPEF Score for Estimating the Probability of Heart Failure with Preserved Ejection Fraction in Persons with Unexplained Dyspnea
The simple, validated H₂FPEF scoring system based on clinical and echocardiographic parameters, developed by experts from the Mayo Clinic, allows the differentiation of heart failure with preserved ejection fraction (HFpEF) from dyspnea of other etiologies and helps decide whether further examinations are necessary. The score can be calculated online and in the Czech language.
News Epilepsy with Generalized Tonic-Clonic Seizures in an Adolescent Patient – A Case Study
This is the story of Anička, a 16-year-old girl who has been treated for epilepsy since she was 14. Her condition is accompanied by generalized tonic-clonic seizures, which may need to be managed acutely with rescue medication, either at home or at school. Instead of the previously used rectally administered diazepam, a new, safer and more comfortable option for rescue medication is now available: buccally administered midazolam. This modality may also help alleviate anxiety and other psychological impacts related to the condition, as illustrated by our case study.
News The Importance of Early Diagnosis and Treatment of AATD in Preventing Pulmonary Emphysema
Alpha-1 antitrypsin deficiency (AATD) is a risk factor for the development of various diseases, including pulmonary emphysema. Currently, it is significantly underdiagnosed, and the availability of effective treatment is a reason for conducting its screening. The Czech Pneumological and Phthisiological Society ČLS JEP (ČPFS) recommends examining AAT levels in all patients with irreversible obstructive ventilatory disorders of any origin, direct relatives of patients with AATD, and individuals with chronic liver disease of unclear origin. The RAPID-OLE study has shown that treatment of alpha-1 antitrypsin deficiency modifies the course of this disease and underscores the importance of early intervention.
News Current Treatment Options for Multiple Myeloma
Multiple myeloma (MM) accounts for about 10% of all hematologic malignancies. Thanks to advancements in diagnostic methods, it is now understood as a collection of several cytologically distinct plasma cell malignancies. Alongside progress in diagnostics, there has also been rapid development in therapy, significantly improving survival rates for this previously very unfavorable diagnosis, especially in the last 15 years.
News What a Decade of Experience with Tapentadol Hydrochloride in Pain Treatment Has Shown
In an interview with Dr. Marek Hakl, Ph.D., from the Brno Pain Treatment Center, we focus on the role of tapentadol hydrochloride in the treatment of chronic pain. We discuss, among other things, its suitability for specific patients and the latest findings that confirm its excellent efficacy and fewer side effects compared to other opioids.
News Newer Beta Blockers Offered for Use in Atherosclerosis Prevention
An article highlighting recent scientific findings on the beneficial effects of beta-blockers (BB) directly on the arterial wall and the potential benefit for the prevention of atherosclerotic cardiovascular disease (ASCVD) by adding BB to already established strategies for treating dyslipidemia and diabetes was published this year in the journal Current Atherosclerosis Reports.
News Metamizole in Pain Therapy in the General Practitioner and Pediatric Office
Metamizole is a pyrazole analgesic-antipyretic with spasmolytic effects, indicated for the treatment of post-traumatic or postoperative pain, visceral colic, cancer pain, and high fever unresponsive to other treatments. The advantage of this drug is its good tolerance without serious adverse effects on the gastrointestinal system, no impact on platelet aggregation, and usability in adults and children of all ages.
News Doc. Jiří Kubeš: The major benefit of proton therapy lies in protecting healthy tissues
Nearly 9,000 patients with oncological diseases have already undergone modern proton radiotherapy at the Proton Center in Prague. Which diagnoses are suitable for this treatment modality, what are its main benefits, and what is its place in the comprehensive therapy of malignant tumors? We discuss these topics with the chief physician of this medical facility, Doc. MUDr. Jiří Kubeš, Ph.D.
News Alopecia Areata – Autoimmune Inflammatory Disease and a New Targeted Treatment Option
Alopecia areata (AA) is one of the non-scarring focal alopecias. It is an autoimmune disease of the hair follicle, the etiopathogenesis of which is not entirely understood. At the hair root, a lymphocytic inflammatory infiltrate develops, resulting in follicle miniaturization and the growth of a thin dystrophic hair. Recently, however, a new strategy for the treatment of AA has emerged, focusing on reducing inflammation of the hair follicle by inhibiting Janus kinases (JAK). This is the first therapeutic modality officially approved for this indication.