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News CASE STUDY: Key Benefits of GLP-1RA in Diabetes Therapy in the Office of a General Practitioner
Modern therapy using glucagon-like peptide-1 receptor agonists (GLP-1RA) offers diabetics highly effective management of their primary condition as well as several other advantages: it reduces the risk of hypoglycemia, aids in weight loss, and has a positive impact on the heart and blood vessels, including increasing the chances of preventing and delaying the progression of micro and macrovascular complications. Early initiation of this treatment not only significantly improves diabetes control but also helps in preventing or delaying the development of atherosclerosis and cardiometabolic syndrome.
News Low Molecular Weight Heparin in an ECMO Patient − Case Study
Extracorporeal membrane oxygenation (ECMO) has an irreplaceable role in intensive care medicine. In the context of preventing complications caused by blood clot formation, unfractionated heparin is most commonly used in patients on extracorporeal circulation. However, its administration can lead to complex coagulopathies, which may result in increased bleeding or, perhaps surprisingly, a higher frequency of blood clot formation. A unique case study recently presented by authors from Motol University Hospital in Prague demonstrates the safety and effectiveness of using low molecular weight heparin (LMWH) enoxaparin in this indication for a patient connected to ECMO for a very long duration (3 months), with several days even on two devices simultaneously.
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 The Position of Lurasidone in Schizophrenia Therapy − Current Conclusions and Consensus of the Expert Panel
Lurasidone is an antipsychotic belonging to the group of serotonin and dopamine antagonists (SDA) indicated for the treatment of schizophrenia in adults and adolescents aged 13 years and older. The efficacy of lurasidone has been confirmed by a number of clinical studies, compared to placebo and using active control with known antipsychotics (e.g., olanzapine or quetiapine). The aim of the recently published study was to define current possibilities of using lurasidone in the treatment of schizophrenia and to identify patient groups that would benefit the most from this therapy.
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 Prenatal Phenotype of Children with Noonan Syndrome
Until recently, the various phenotypes of RASopathies were clinically diagnosed only after birth. However, we are now striving for the earliest possible diagnosis, sometimes even prenatally. Ultrasound examination of the fetus during screening tests, focusing on certain characteristic morphological changes, plays a crucial role in this. In the case of pathological findings on imaging methods, molecular genetic testing and monitoring of pregnancy in specialized centers are indicated.
News Evaluation of the m7-FLIPI score in patients with follicular lymphoma revealed a promising predictive biomarker for determining suitable chemotherapy
The authors of a study presented at the December congress of the American Society of Hematology (ASH) in Orlando introduced a new prognostic tool, m7-FLIPI, for determining the risk level of patients with follicular lymphoma (FL). They tested its utility using samples from the GALLIUM clinical trial and, during the analysis, discovered a promising biomarker that could help in selecting the primary chemotherapy for FL patients.
News Bacterial Biofilm as a Complication of Respiratory Disease Treatment
One of the unique characteristics of certain microorganisms is their ability to form organized communities enveloped in extracellular polymeric matrix and firmly attached to a solid surface or interphase or forming aggregates, collectively referred to as biofilm. Clinically, the major issue is the formation of pathogenic and conditionally pathogenic organisms' biofilm on tissues (such as respiratory tracts) or the surfaces of various medical devices (including catheters and implants), as it represents a dangerous complication leading to the development of chronic, recurrent, and scarcely treatable conditions.
News Venetoclax in the Treatment of CLL: Open Doors for the Longest Possible Maintenance of Remission Without Active Therapy
William G. Wierda from MD Anderson Cancer Center in Houston, USA, and Francesco P. Tambaro from Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon in Naples, Italy, evaluate in their report for the journal Blood from April 2020 the practical aspects and benefits of using venetoclax in the first-line treatment of chronic lymphocytic leukemia (CLL), as well as in cases of relapsing/refractory forms of the disease.
News Early and effective treatment of PBC significantly reduced the need for liver transplantation due to this disease
Current European and Czech guidelines include obeticholic acid (OCA) as the only registered option for 2nd line treatment of primary biliary cholangitis (PBC). In the Czech Republic, it is approved as a center-specific treatment and was granted permanent reimbursement from public health insurance in May 2022. The use of OCA in the treatment of PBC was also addressed in a symposium that was part of the professional program at this year's XLIX. May Hepatology Days in Olomouc.
News Current Expert Consensus on Prophylaxis of Individuals with Mild and Moderate Hemophilia A: These Patients Also Deserve Better Care
What is the importance of prophylaxis in 'non-severe' hemophilia A? Italian doctors have attempted to answer this question in their recent expert consensus.
News Self-administration of alpha-1-antitrypsin can significantly improve patients' quality of life
Treatment of alpha-1 antitrypsin deficiency (AATD) requires lifetime administration of weekly intravenous infusions of this substance, mostly in medical facilities. The possibility of AAT application at home is being discussed. This topic was also addressed at a symposium held during the European Respiratory Society (ERS) congress, which took place in November 2019 in Madrid.
News Results of a 10-year follow-up on the safety and efficacy of etanercept treatment in patients with juvenile idiopathic arthritis
Juvenile idiopathic arthritis (JIA) is defined as persistent arthritis of unknown etiology lasting > 6 weeks with the first onset before the age of 16. In the treatment of JIA, non-steroidal anti-inflammatory drugs (NSAIDs), intra-articular corticosteroid injections, and conventional disease-modifying antirheumatic drugs (DMARDs) are typically utilized. In case of inadequate response, targeted biological therapy can also be used. An effective and well-tolerated drug for the treatment of polyarticular JIA is the tumor necrosis factor alpha (TNF-α) inhibitor etanercept. The results of its use in various forms of JIA were examined in the CLIPPER and CLIPPER2 studies.
News Comorbidities of Migraine and Their Impact on Pain Frequency and Intensity
The MAST study, published in March of this year in the prestigious The Journal of Headache and Pain, focused on the occurrence of associated diseases in patients with migraine. What is the prevalence of individual comorbidities and which of them are associated with changes in pain intensity and frequency?
News Beta-blockers in the treatment of chronic heart failure: How did the analysis of the effects of 4 drugs in 26 studies turn out?
As a cornerstone of therapy for chronic heart failure with reduced ejection fraction (HFrEF), it is recommended to start treatment with a very low dose of beta-blockers (BB) and titrate it to the maximum tolerated dose. However, it remains unclear whether one BB is superior to others. For this reason, a comprehensive pooled analysis of the efficacy and safety of bisoprolol, carvedilol, nebivolol, and metoprolol in 26 studies, including 14 randomized controlled and 12 observational, was recently published.
News Importance of Testing for Iron Deficiency in Patients with Chronic Heart Failure and Treatment Options
Intravenous iron application in patients with heart failure and iron deficiency is now part of ESC guidelines aimed at improving symptoms, increasing exercise tolerance and quality of life in these patients, and simultaneously reducing the risk of hospitalization or death from cardiovascular causes.
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 Insufficiently Controlled Epilepsy Reduces Quality and Length of Life
The effects of uncontrolled epilepsy far exceed the moment of a seizure, having a substantial impact on the psychological and physical well-being of patients. These individuals often sustain injuries during seizures, leading to reduced mobility, a higher risk of associated diseases, and premature death.
News Ligamentous Changes as a Harbinger of Cardiac Amyloidosis – Histopathological and Clinical Study
Amyloid deposits can be present in various types of tissue. Their accumulation in connective tissue can lead to pathological changes resulting in the rupture of stressed structures (e.g., the Achilles tendon) or stenosis in areas where blood vessels and nerves pass through (e.g., carpal tunnel syndrome). Swedish doctors focused on patients with lumbar spinal stenosis to analyze how often this diagnosis is associated with amyloid deposits.
News Enoxaparin in the Treatment of Pulmonary Embolism in a Morbidly Obese Patient – Case Report
The number of patients suffering from overweight and obesity has been steadily increasing in recent years. Obesity is one of the independent risk factors for thromboembolic disease. Treating thrombotic complications in obese patients poses a challenge not only because of the adjustments in anticoagulant dosing but also due to the lack of evidence regarding the safety and efficacy of higher doses of anticoagulants in this growing group of the population.
News Doc. Petr Dulíček: Physical activity in hemophiliacs? Today it is a reality - just don't be afraid!
Thanks to modern treatment, the lives of hemophiliacs are becoming more active. Patients today can engage in most sports activities. On the contrary, avoiding physical activity carries the risk of developing other diseases. A doctor should support their patients so they are not afraid of physical activities and highlight their benefits, says the head of the Center for Hemostasis Disorders at the IV. Internal Hematology Clinic of LF UK and FN Hradec Králové, Doc. MUDr. Petr Dulíček, Ph.D., in an interview on hemophilia and sports.