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Asymptomatic high-risk individuals represent one of the highest priorities of cardiovascular prevention, in clinical practice frequently overlooked. We analyzed the real adherence to recommended principles of cardiovascular prevention in primary care subjects.

Our analysis is based on random general population sample, examined in the frame of post-MONICA survey in 2016/17. Each subject was categorized with regard to its individual cardiovascular risk (based on Sixth Joint European Guidelines) and the real adherence to recommended targets was ascertained.

In total 898 subjects aged 25-75 years (47% males) were analyzed. Of them, 16.7% were classified into “very high risk“ and 36.8% into “high risk“ subgroup; remaining 46.5% were only at moderate or low risk. Regarding adherence to recommended principles, in “very high risk“ category only 58.7% abstain from any form of tobacco, 38% reported appropriate physical activity (150 minutes of at least moderate activity weekly), 16.7% had recommended body constitution (BMI 20-25 kg/m2 ), 39.3% appropriate blood pressure (.
In total 898 subjects aged 25-75 years (47% males) were analyzed. Of them, 16.7% were classified into “very high risk“ and 36.8% into “high risk“ subgroup; remaining 46.5% were only at moderate or low risk. Regarding adherence to recommended principles, in “very high risk“ category only 58.7% abstain from any form of tobacco, 38% reported appropriate physical activity (150 minutes of at least moderate activity weekly), 16.7% had recommended body constitution (BMI 20-25 kg/m2 ), 39.3% appropriate blood pressure (.Breath tests for the evaluation liver metabolic function are a non-invasive diagnostic method with high sensitivity and specificity. Syk inhibitor Up today, the issue of liver damage in patients with chronic kidney disease has not been investigated sufficiently, although it might have significant clinical consequences. The following article describes the principles of breath tests, experiences with breath tests in patients with chronic kidney disease (CKD) and the results of our pilot study with methacetin breath tests in patients with CKD and in regular peritoneal dialysis treatment.Cardiac abnormalities associated with hypereosinophilia represent rare diseases and occurs most commonly due to hypersensitivity or allergic reactions, other possible etiologies cover infections, malignancy, vasculitis or hypereosinophilic syndromes. Three stages of cardiac involvement are usually described. Initially, myocardial inflammation occurs, that can continue with a thrombotic stage and eventually progress to the last irreversible stage called endomyocardial fibrosis, which represents one of the acquired forms of restrictive cardiomyopathy. In most patients, increased levels of eosinophils in the blood differential test; however, it may not be present in the initial stages of the disease. Of the imaging methods, magnetic resonance imaging and positron emission tomography combined with CT PET-CT are used in addition to echocardiography. Endomyocardial biopsy may be indicated for definitive evidence of eosinophilic myocarditis. The clarification of the cause of hypereosinophilia is necessary for specific treatment of this disorder.Autoinflammatory diseases represent a group of disorders that are distinct from autoimmune diseases, infections and malignancies. They are characterised by attacks of unprovoked noninfectious inflammation. A key feature of autoinflammatory diseases is dysregulation of innate immune system and overproduction of pro-inflammatory cytokines. The best-characterized group of autoinflammatory diseases arises from mutations in single genes. They are typically manifested by recurrent attacks of fever and serositis as well as arthralgia, myalgia and skin exanthema.Strong negative message of the type „You have been diagnosed with cancer“ produces blustering reaction with specific phases in any individual. Elizabeth Kűbler-Ross was the first who described this reaction to cancer findings. However, her description hit the most distinctive marks only, while less noticeable signs did not occur in the original specification. The goal of this text is to familiarize a reader with complex spectrum of all possible patient reactions to the announcement of cancer as met in real life.Proton pump inhibitors (PPIs) are popular and widely used “gastroprotectives”. More than 10% of our population is treated. In addition to classical indications such as gastroduodenal peptic disease or gastroesophageal reflux disease, they are indicated for the reduction of hemorrhagic complications in the digestive tract during antithrombotic treatment. The effect of PPIs on reducing upper gastrointestinal bleeding in antithrombotic treatment (rivaroxaban, acetylsalicylic acid or a combination) was called into question by a recently published randomised mega-study - COMPASS pantoprazole. Treatment of PPIs is accompanied by a number of significant drug interactions, in particular a severe reduction in the bioactivation of clopidogrel and a reduction in the absorption of acetylsalicylic acid or dabigatran. As a result, the effect of these antithrombotics is reduced. A number of observational studies - in the indication of PPIs in the treatment of gastroduodenal or gastrooesophageal disease or when used in the treatment of PPIs in antithrombotic treatment - found a greater incidence of major vascular events and an increase in mortality. So are PPIs effective in protecting gastrointestinal bleeding and are they safe?Despite the progress in secondary prevention, life expectancy after myocardial infarction is poor for some specific groups of patients. High ischemic risk patients could benefit from some strategies of long-term and aggressive antithrombotic therapy provided that their bleeding risk is acceptably low.The concept of functional revascularization based on proving ischemia has been strongly recommended in the practical guidelines of both European and Czech Societies of Cardiology. In daily practice, application of this concept decreases the rate of coronary interventions. Though the best clinical evidence has been provided in patients with chronic coronary syndromes, recent data strongly advocate its usage also in patients with acute coronary syndromes. Invasive pressure-derived indices hyperemic FFRmyo (fractional flow reserve of myocardium) and resting iFR (instantaneous wave-free ratio) require an interventional procedure by wiring the diseased vessel. FFRmyo 0.80 and iFR 0.89 mean functionally significant coronary disease mostly indicated for revascularization. Besides that, there are several non-invasive functional tests that may be used for detecting ischemia perfusion scintigraphy, cardiovascular magnetic resonance, positron emission tomography and recently developed FFRCT or quantitative flow ratio (QFR).
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