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News Perioperative Thromboprophylaxis in Elderly Patients
Thromboembolic disease (TED) is among the most common causes of death in hospitalized patients and also constitutes a significant portion of complications following surgical procedures. Without prophylaxis, thrombosis would develop in the perioperative period in almost 25% of patients. The risk of TED significantly increases with age, as does mortality. Over 21% of thrombotic complications occur in individuals over 65 years of age, and up to 16% of patients over 80 years old die shortly after being diagnosed with TED. It is crucial to focus on appropriate prevention and prophylaxis of TED in geriatric patients. However, studies have shown that thromboprophylaxis in hospitals in Europe and the USA is inadequate. Reasons may include concerns about increased bleeding during surgical procedures.
News Initial Treatment for Newly Diagnosed ITP Patients at a Glance
The revised international consensus on the management of primary immune thrombocytopenia (ITP) from 2019 outlines several points summarizing suitable initial treatment for newly diagnosed individuals with ITP.
News Possibilities of Using Metamizole in the Treatment of Acute Primary Headaches
The aim of the review article by Brazilian authors was to summarize the efficacy and safety of metamizole in the treatment of acute primary headaches, such as migraine, episodic tension-type headache (ETTH), cluster headache, and unclassified primary pain in adults and children.
News Cardio-Renal-Metabolic Syndrome?
The association between type 2 diabetes (DM2) and atherosclerotic cardiovascular disease (ASCVD) is often referred to as cardiometabolic syndrome, while the relationship between chronic kidney disease (CKD) and heart failure (HF) is known as cardiorenal syndrome. Additionally, an increased prevalence of ASCVD, CKD, and HF is known among patients with type 2 diabetes. A recent study investigated the hypothesis that both syndromes constitute a single entity − the so-called cardio-renal-metabolic syndrome.
News Cardiovascular System Affection in Children with Noonan Syndrome
Noonan syndrome is a genetically conditioned disease classified among the so-called RASopathies, caused by a germline mutation in the genes of the RAS/MAPK signaling pathway. Among other things, children with this disease typically present with cardiovascular system involvement.
News Adherence to Treatment of Multiple Sclerosis: How to Enhance It and What Interesting Insights Emerged from Current Research?
Therapeutic options for patients with multiple sclerosis (MS) utilizing disease-modifying drugs (DMDs) have continued to expand in recent years. However, achieving their full benefit is critically dependent on adherence to treatment. Nonadherence is demonstrably linked to an increased risk of relapses, faster progression of disability, higher treatment costs, and higher mortality. We present a summary of factors affecting adherence to treatment in MS patients, including the influence of the chosen therapy from a 2022 review and subsequent studies.
News Candesartan is beneficial in heart failure with mildly reduced ejection fraction
Analysis of data from the CHARM study showed that in patients with heart failure with mildly reduced ejection fraction (HFmrEF 0.40–0.49), candesartan compared to placebo reduces the risk of death from cardiovascular (CV) causes or hospitalization for heart failure similarly to patients with reduced ejection fraction (HFrEF < 0.40).
News Dual therapy improves not only lung function but also quality of life in COPD patients
Chronic obstructive pulmonary disease (COPD) reduces the quality of life of patients and is one of the main causes of morbidity and mortality. According to international recommendations, the initial pharmacotherapy is recommended as monotherapy with LAMA (long-acting muscarinic antagonists) or LABA (long-acting beta-agonists), or their combination. A pooled analysis of 4 studies compared the early addition of LABA to LAMA in patients with moderate to severe COPD.
News Current Insights into the Etiology of Community Pneumonia: Pneumococci Still Leading?
The etiology of community-acquired pneumonias has undergone certain changes since the beginning of the antibiotic era. According to current guidelines, it is still recommended to initiate empirical antibiotic therapy upon diagnosing community-acquired pneumonia. However, there are certain concerns associated with the recommendation of empirical antibiotic therapy, especially regarding the increasing occurrence of bacterial antibiotic resistance. The aim of the study presented below was to specify the most frequently isolated pathogens of community-acquired pneumonia between 1945 and 2020.
News Variability of COPD Symptoms During the Day and Impact on Patients' Morning Routine – Survey Results
Chronic obstructive pulmonary disease (COPD) is viewed, unlike bronchial asthma, as a condition with a more chronic course and less variability of symptoms throughout the day. The study presented below aimed to clarify whether these patients experience deterioration at certain times of the day and how this affects their daily lives.
News Bimekizumab in the treatment of moderate to severe hidradenitis suppurativa – another approved indication for this biological agent
In May, the primary results of the BE HEARD I and II studies evaluating the efficacy and safety of the IL-17A and IL-17F inhibitor bimekizumab in the treatment of moderate to severe hidradenitis suppurativa (HS) in adults were published in The Lancet. This is the first publication of the results of these Phase III studies. Based on these findings, the European Medicines Agency (EMA) approved bimekizumab (which is currently approved for the treatment of plaque psoriasis, psoriatic arthritis, and axial spondyloarthritis) for the treatment of HS in adults who have not responded adequately to conventional systemic therapy.
News Optimization of Enoxaparin Dosing in Obese Patients
Obesity is a risk factor for venous thromboembolism; however, there is uncertainty regarding the optimal dose of enoxaparin for treating acute episodes in the obese population. Two observational studies published last year focused on the efficacy and safety of enoxaparin depending on the dose. The standard dose of 1 mg/kg may be too high for some patients, and fixed dosing without monitoring Xa levels may not be adequate.
News Cenobamate in the Therapy of Pharmacoresistant Epilepsy in a Warfarinized Patient – A Case Study
A case study from Czech practice presents a patient with pharmacoresistant epilepsy and concurrent warfarin medication for heart valve replacement, where the INR value remained within the cardiologist’s recommended range without further adjustments to anticoagulant therapy during combined antiepileptic therapy with cenobamate (CNB) under the recommended dose titration.
News One Step Closer to Understanding the Placebo Effect in Pain Treatment
Neuroscientists from the USA appear to have advanced our understanding of the placebo effect in pain relief. Their findings, recently published in Nature, open the possibility of influencing the described pain control pathway using drugs or neurostimulation.
News Kadcyla in a New Indication – Adjuvant Therapy for Early HER2+ Breast Cancer
In December, the European Commission approved the expansion of the indication for Roche's medicinal product Kadcyla, which contains the active substance trastuzumab emtansine. This expansion makes adjuvant treatment accessible to a much larger number of patients with early HER2-positive breast cancer and reduces the likelihood of disease recurrence or progression.
News TTR amyloidosis – at the crossroads of cardiology and orthopedics
In wild-type transthyretin amyloid cardiomyopathy, extra-cardiac symptoms occur in addition to cardiac symptoms. Common and characteristic orthopedic manifestations include bilateral carpal tunnel syndrome, spinal canal stenosis in the lumbar region, or atraumatic rupture of the m. biceps brachii tendon. These extra-cardiac symptoms often precede the actual heart involvement. Recognizing them can thus increase diagnostic suspicion for cardiac amyloidosis and help in the timely establishment of the correct diagnosis and initiation of specific treatment. For example, even a rheumatologist or orthopedist can direct an elderly patient with an otherwise unexplained constellation of musculoskeletal symptoms to cardiology examination early, thereby significantly improving the patient's prognosis.
News Venous Insufficiency of the Lower Extremities – A Diverse Range of Risks, Manifestations, and Complications
Although initially often asymptomatic, chronic venous insufficiency includes a variety of symptoms. Some of its manifestations can be irreversible, increasing the socio-economic burden that this disease, especially in its advanced stages, represents. German authors have summarized the latest findings on the epidemiology, risks, pathogenesis, manifestations, and complications of CVI in their review.
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 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 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 Bimekizumab – Higher Chance of Complete Skin Healing in Moderate to Severe Psoriasis?
In August 2021, the European Medicines Agency (EMA) approved bimekizumab (Bimzelx LP) as the first psoriasis treatment that selectively and directly inhibits interleukins IL-17A and IL-17F. It is intended for the treatment of moderate to severe plaque psoriasis in adults for whom systemic treatment is appropriate. The approval is based on three Phase III clinical studies in which bimekizumab demonstrated a very high rate of skin healing compared to placebo and active treatments like ustekinumab and adalimumab, as well as good tolerability.
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 Chairwoman of Revma Liga ČR: I Hope We Improve Our Approach and Treatment of Osteoporosis in the Czech Republic
Patients with inflammatory rheumatic diseases have a significantly increased risk of developing osteoporosis and related fractures. At the same time, this disease is considerably underestimated in the Czech Republic, and more attention is given to it only at the stage of osteoporotic fractures. To what extent does the patient organization Revma Liga ČR, which unites patients with rheumatic diseases, engage in this issue? We asked its chairwoman Edita Müllerová.
News New Hematological Biomarker for Early Diagnosis of Sepsis
Sepsis is one of the leading causes of mortality and healthcare expenditure worldwide. Early diagnosis and treatment of septic conditions improve patient prognosis. However, the initial symptoms of sepsis can be difficult to distinguish from other acute conditions due to similar symptomatology. The results of the study presented below indicate that a new hematological biomarker has the potential to facilitate the early diagnosis of sepsis.