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News Deficit dihydropyrimidine dehydrogenase and its association with 5-fluorouracil toxicity
Deficit dihydropyrimidine dehydrogenase (DPD) is a risk factor for severe toxicity of 5-fluorouracil (5-FU). Below, we summarize current knowledge regarding the identification of patients with pathogenic variants of the DPYD gene and study results concerning the safety of therapy with respect to dose individualization based on genotyping.
News Metamizole in Pain Management for Patients with Subarachnoid Hemorrhage
A study by Czech authors from the University Hospital St. Anna in Brno, recently published in the British Journal of Neurosurgery, evaluated analgesic treatment in patients with subarachnoid hemorrhage. The use of metamizole as the primary analgesic was associated with a significantly lower risk of adverse clinical outcomes at 2 weeks and 6 months compared to other non-opioid and opioid analgesics.
News Multimodal Treatment of Prostate Cancer in a Patient with Exceptionally Long Overall Survival − Case Report
A recently published case study by Romanian authors presents a rare instance of long-term survival (15 years) in a patient with locoregional prostate cancer that later metastasized. The case illustrates the possibilities offered by currently available modern treatment modalities.
News State of the Intestinal Microbiome and COVID-19 Infection − Possible Correlations
Some patients infected with the SARS-CoV-2 virus exhibit gastrointestinal symptoms, including diarrhea, during the course of COVID-19. Current knowledge suggests that COVID-19 symptoms are related, among other things, to the intestinal microbiome. Could the use of probiotics therefore act as a prevention of this disease or its more severe course?
News Efficacy and Safety of Ultrahypofractionated Proton Therapy in the Treatment of Prostate Cancer in Real-World Czech Practice
A team from the Prague Proton Therapy Center, led by Associate Professor Jiří Kubeš, published a study with nearly 300 patients in the prestigious International Journal of Radiation Oncology, Biology, Physics. It demonstrates the significant efficacy and low toxicity of the ultrahypofractionated proton therapy regimen in patients with prostate cancer. We summarize the main results.
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 OCA in Second-Line Treatment of PBC: Analysis Results and Real-World Data
Ursodeoxycholic acid (UDCA) is the cornerstone treatment for PBC according to the guidelines of the European Association for the Study of the Liver (EASL). However, many patients (25–50%) do not achieve an adequate response to it, and some patients develop intolerance leading to the necessity of discontinuation (in the phase III POISE study, this concerned 7% of participants). Then, obeticholic acid (OCA) is indicated, which is recommended as the only registered second-line treatment option for PBC by current professional guidelines both European (EASL 2017) and Czech (2018). The latest data on OCA from clinical studies as well as real-world practice was also presented at this year's XLVIII May Hepatology Days.
News Longer survival without liver transplant in patients with PBC treated with OCA?
Obeticholic acid (OCA) is a second-line treatment for patients with primary biliary cholangitis (PBC) who have an inadequate response to ursodeoxycholic acid (UDCA) or intolerance to it. The study presented below, the results of which were recently published, examined the effectiveness of OCA in reducing cholestatic enzymes as well as the length of survival without liver transplant in patients with PBC.
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 Probiotics as a Helper in the Fight Against Pregnancy Gingivitis
Gingivitis is a common problem during pregnancy. In addition to quality oral hygiene, regular consumption of probiotic preparations containing certain strains of Limosilactobacillus reuteri can also help reduce or completely eliminate it.
News Viral or Bacterial Etiology? Old Question, New Methods...
The gold standard in the differential diagnosis of viral and bacterial respiratory infections is primarily C-reactive protein (CRP), followed by procalcitonin and interleukins. What are the pitfalls of their use, and what new methods of distinguishing the etiology of infectious diseases are currently being developed?
News Current View on the Issue of Protein Intake in Critically Ill Patients
A summary of current knowledge and guidelines concerning the nutritional needs of critically ill patients presented last year in the journal Clinical Nutrition deals with protein intake, specifically its optimal amount, risks of incorrect approaches to protein administration, and methods for assessing the nutritional status of patients in intensive care units.
News Can the use of sartans reduce mortality and severity of COVID-19 in hypertensives?
Existing scientific and clinical evidence suggests the involvement of the renin-angiotensin-aldosterone system (RAAS) in the pathophysiology of COVID-19. Some of the initial experimental therapy proposals included various interventions in the RAAS.
News The Importance of Proper Protein and Calorie Intake in Critically Ill Patients – Insights from Recent Comparisons
The issue of nutrition, especially proteins, is a crucial aspect affecting the overall health and prognosis of critically ill patients. Two recent studies published in the journals Critical Care and Journal of Parenteral and Enteral Nutrition focused on nutrient intake.
News Effect of Beta-Blockers on Glucose Metabolism and Their Use in Diabetics with Hypoglycemic Episodes
Beta-blockers, through their mechanism of action, can lead to the deepening or direct initiation of both hypoglycemia and hyperglycemia. The study presented below, published last year, evaluated the impact of beta-blocker treatment, their selectivity, and the predisposition of patients to hypoglycemia on the risk of mortality.
News Thanks to Buccolam, the reality of suppressing convulsive seizures in children and adolescents approaches parents' ideal management
What crosses the mind of a parent when they notice their epileptic child or adolescent is having a convulsive seizure? They want it to be over quickly and safely. What constitutes the integral part that makes this wish a reality? And how does the newest treatment modality, buccally administered midazolam (Buccolam), address these needs?
News Biocompatibility of 3D Printed Materials – Their Comparison, Legislation, and Practice
Printing three-dimensional (3D) objects brings new possibilities for producing personalized implants, prosthetics, and other medical devices in healthcare. One area where this technology can improve current practice is the printing of tracheostomy tubes for use in patients after laryngectomy. However, it is crucial to ensure the biocompatibility of the materials used for printing. In November 2023, a study comparing 3D printer materials in terms of their susceptibility to the growth of bacterial biofilms from Staphylococcus aureus was published in the journal 3D Printing in Medicine.
News Diosmin and its application in the treatment of venous insufficiency
A number of procedures, including pharmacotherapy, are used in the treatment of chronic venous insufficiency, in which diosmin, for example, is applied. The report by pharmacologist MUDr. Jiří Slíva, Ph.D., summarizes the mechanism of action and pharmacological properties of this substance.
News Can Thyroid Hormone Supplementation Reduce the Risk of Cognitive Disorders?
The recent systematic literature review presented below, published by authors from the California Institute of Behavioral Neurosciences and Psychology (CIBNP), focused, among other things, on potential associations between hypothyroidism and dementia and the impact of related therapeutic interventions in terms of improving cognitive functions.
News Advances in the Treatment of Myasthenia Gravis on the Horizon
The research of new drugs for the generalized form of myasthenia gravis has made significant progress in recent years. How is the new specific therapy performing? And are we heading towards a radical change in treatment strategy?
News Can SGLT2 Inhibition Also Reduce the Risk of Nephrolithiasis?
Diabetes mellitus (DM) is a risk factor for the development of nephrolithiasis. Recent studies associated with nephrolithiasis suggest a possible beneficial effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i, also known as gliflozins), a significant group of modern antidiabetics. Below we summarize findings from a study that explored this potential in empagliflozin using conducted phase I–IV studies, including EMPA-REG OUTCOME.
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 Incontinence Dermatitis - Common, Yet Often Overlooked Diagnosis
Incontinence dermatitis is an inflammatory skin reaction with a prevalence between 3 and 25%, caused by prolonged skin contact with urine or feces. It is classified among contact irritant dermatitis. It causes significant discomfort to patients and can also require difficult and prolonged treatment.
News Frequency of Mutations in Genes Predisposing to Ovarian Cancer in the Czech Population
The authors of a Czech study evaluating the occurrence of mutations in tumor-predisposing genes for ovarian cancer hypothesized that if their occurrence in patients with this diagnosis was significant, identifying carriers of these mutations could help reduce the prevalence and mortality of this disease given the absence of other screening tools.
News Current Recommendations of the American Society of Hematology for the Prevention of Thromboembolic Disease and Duration of Prophylaxis in Patients Undergoing Major Surgery
At the end of 2019, new recommendations were published by the American Society of Hematology (ASH) for the prevention of thromboembolic disease (VTE) in hospitalized patients. The new guidelines also addressed the duration of VTE prophylaxis in patients undergoing major surgical procedures.