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News Rebound effect after denosumab discontinuation in a patient with lung cancer
The case study of a patient with metastatic lung cancer describes the emergence of vertebral fractures following the discontinuation of denosumab. This antiresorptive treatment was halted prophylactically to reduce the risk of osteonecrosis in connection with a planned dental procedure. Fifteen months after receiving the last dose of denosumab, the patient experienced atraumatic compression fractures of the spine requiring kyphoplasty to alleviate symptoms. Other causes of the fractures were ruled out.
News Preserving Quality of Life for Patients During Palliative Treatment of Triple-Negative Breast Cancer
An analysis of the quality of life of patients treated with a combination of atezolizumab with nab-paclitaxel for metastatic triple-negative breast cancer was published in the Annals of Oncology journal.
News Telmisartan, amlodipine, and chlorthalidone in a low-dose fixed triple combination – better control of target blood pressure values?
The secondary analysis of the TRIUMPH study, recently published in JAMA Cardiology, is likely the first published assessment of time spent in the target blood pressure (BP) range during antihypertensive treatment. This parameter was assessed in patients with moderate hypertension using a low-dose triple combination of antihypertensives (telmisartan 20 mg, amlodipine 2.5 mg, and chlorthalidone 12.5 mg) compared to usual care.
News Doc. Milan Sova: AAT substitution is available to all indicated patients. It is therefore crucial to now educate about the necessity of regular treatment
Alpha-1-antitrypsin deficiency (AATD) is one of the most common genetic disorders in adults. It is usually associated with the early development of chronic obstructive pulmonary disease (COPD) or liver damage. We discuss how modern substitution therapy can change patients' prognosis and when to consider this diagnosis with the head of the Clinic of Pulmonary Diseases and Tuberculosis at Masaryk University Faculty of Medicine and Brno University Hospital, Doc. MUDr. Milan Sova, Ph.D.
News Treatment of a patient with colorectal cancer after kidney transplantation – case report
Patients after organ transplantation currently live to an older age thanks to advances in surgery and pharmacotherapy. However, the longer a person takes immunosuppressants, the more they are at risk of developing malignant disease. The case report of Hungarian doctors from the university hospital in Pécs illustrates what the treatment of metastatic colorectal cancer (mCRC) after kidney transplantation can look like.
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 Treatment Options for Advanced Parkinson's Disease Using Medical Devices (DAT)
A new treatment option for advanced Parkinson's disease (PD) using medical devices (DAT − device-aided therapy) is the intestinal infusion gel containing levodopa, entacapone, and carbidopa (LECIG). An article published in 2022 in the journal Therapeutic Advances in Neurological Disorders provides an overview of current DAT modalities in PD patients and presents LECIG as the latest extension of options in this area.
News Comparison of Pharmacological Properties of Micronized Diosmin and Hesperidin in the Treatment of Chronic Venous Insufficiency and Hemorrhoids
Diosmin and hesperidin belong to the group of bioflavonoids, which currently find wide application in the treatment of chronic venous insufficiency and hemorrhoidal disease. Both flavonoids have been described to have a similar, but still not fully understood mechanism of action. Nevertheless, diosmin significantly differs from hesperidin, especially in pharmacokinetic parameters, which makes it the main carrier of the effect of venotonics.
News Experiences with the Treatment of Coagulopathy in Obstetrics – ROTEM-Guided Algorithm
An observational study from a hospital in Liverpool, UK, was published in the journal Anaesthesia, where they implemented a bleeding management algorithm for obstetric procedures based on rotational thromboelastometry (ROTEM) testing. After 4 years of using this algorithm, it was found that selective administration of fibrinogen concentrates based on ROTEM results led to better clinical outcomes in the treatment of coagulopathy.
News Efficacy of Baricitinib in Long-term Therapy of Rheumatoid Arthritis
Baricitinib selectively and reversibly inhibits Janus kinases JAK1 and JAK2 and is used in the treatment of adults with active rheumatoid arthritis (RA). Its safety during long-term administration has already been demonstrated by previous analyses, with treatment durations of up to 7 years. Equally important is the long-term efficacy of this drug, which was the focus of work presented in June of this year at the annual European rheumatology congress EULAR 2020.
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 Von Willebrand Disease as a Cause of Abnormal Uterine Bleeding
Abnormal uterine bleeding constitutes a large portion of complaints among women of reproductive age. This type of bleeding is typical for von Willebrand disease (vWD), but also for other types of coagulation disorders. So, is vWD more frequent in women with abnormal uterine bleeding than in the general population?
News fSCIG in Elderly Patients with PID or SID in Real Clinical Practice
The work of a team of German and Dutch authors presents data on the real clinical use of 10% subcutaneous immunoglobulin facilitated by hyaluronidase (fSCIG) in elderly patients with primary (PID) or secondary (SID) immunodeficiency.
News Quick Relief from Severe AD Symptoms – Dupilumab for Children Aged 6 Years and Older
Children aged 6-12 with severe atopic dermatitis (AD) have very limited treatment options. The studies presented below demonstrate how effective and safe dupilumab, a monoclonal antibody targeting interleukins 4 and 13, is in their case. Since October, this medication is newly covered even for children from 6 years of age.
News SCOPE 2021 – State of Osteoporosis and Its Treatment in European Countries
The SCOPE 2021 project (The Scorecard for Osteoporosis in Europe) by the International Osteoporosis Foundation (IOF) gathered and tabulated data from 29 European countries on the burden of osteoporosis, the quality and availability of services related to the diagnosis and treatment of this disease, and the use of these services in individual states. Within the significantly heterogeneous results, the Czech Republic did not fare very well.
News Prim. Václava Adámková: People mistakenly believe that there are enough antibiotics and that they will always handle infections
According to the World Health Organization (WHO), by 2050, infections untreatable with antibiotics could become the leading cause of death, surpassing cardiovascular and oncological diseases. Rising antimicrobial resistance was one of the main topics at the VIII Congress of Clinical Microbiology, Infectious Diseases, and Epidemiology (KMINE 2022), held in September in Prague. The topic was also the focus of the expert block ‘ATB stewardship,’ where epidemiologist Petr Smejkal, infectologist Aleš Chrdle, and microbiologist Václava Adámková discussed possible solutions to this global problem. We asked Adámková to summarize insights into the presented issues for us.
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 Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
A recent survey among German-speaking physicians evaluated the use of non-opioid analgesics in perioperative care in children under 14 years. It focused on the use of metamizole and the monitoring of possible agranulocytosis associated with this drug.
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 Neutropenia with Thrombocytopenia after Alemtuzumab? − Case Report
Early neutropenia with thrombocytopenia is not a common side effect of alemtuzumab. However, the patient in the following case report by Italian colleagues was affected. What was the outcome?
News Lorlatinib showed significant benefit in 1st line treatment of advanced ALK-positive non-small cell lung carcinoma
In the international CROWN study, lorlatinib compared to crizotinib led to a 72% reduction in the risk of disease progression or death and significant improvement in intracranial response to treatment in previously untreated patients with advanced ALK-positive non-small cell lung carcinoma (NSCLC). The results were published in November 2020 in the prestigious New England Journal of Medicine.
News Balance and Rehabilitation – Firm on the Ground Even with Multiple Sclerosis
A large portion of patients with multiple sclerosis (MS) suffer from balance disorders. What are the options for non-pharmacological therapy for these issues according to the latest studies?