Pozor - pacient není lékař!

prof. RNDr. Stanislav Komenda DrSc

Interní Med. 2006; 8(11): 471  

Treatment of diabetic neuropathy

MUDr. Jindřich Olšovský

Interní Med. 2006; 8(11): 476-480  

The author presents an overview of management issues in diabetic neuropathy. Based on classification, clinical manifestations and diagnosis, he outlines the therapeutic options of diabetic neuropathy. These include both causal and symptomatic approaches.

New british hypertension guidelines update

MUDr. Pavel Havránek

Interní Med. 2006; 8(11): 482-484  

The purpose of this article is to present a review of new BHS/NICE guidelines for the management of hypertension in the form that has been published in July 2006. Based on the analysis of recent clinical trials a new algorithm of antihypertensive treatment is provided. We stress the role of ACE inhibitors and calcium-channel blockers in the new guidelines. The reason for declining role of beta-blockers as first line treatment of uncomplicated hypertension is presented.

Hyperuricemic syndrome

MUDr. Martin Žurek, doc. MUDr. Pavel Horák CSc

Interní Med. 2006; 8(11): 485-488  

Gouty arthritis, the most frequent joint inflammatory disease of middle aged men, is frequently incorrectly diagnosed and treated. The term gout refers to a heterogenic group of metabolic disorders that is characterised by formation of deposits of sodium urate crystals in tissues. In a review article we discuss briefly etiology, pathogenesis of hyperuricemia and gout, the prevalence of hyperuricemia as a part of metabolic syndrome X. Gout manifests clinically as acute gouty arthritis with classical clinical picture, as well as chronic tofus-like gout, in the area of kidneys as acute or chronic gouty nephropathy. The essential of diagnosis is confirmation...

NSAID’s gastropathy and enteropathy

prof. MUDr. Milan Lukáš CSc

Interní Med. 2006; 8(11): 489-492  

NSAID gastropathy is defined by the stomach and (or) duodenal mucosal injuries due to nonsteroidal anti-inflammatory drugs therapy regardless of the clinical symptomatology is present. Currently, the NSAID therapy is leading cause of peptic ulcer complications with high mortality rate which is around 10 %. The most of patients with NSAID gastropathy are without clinical symptomatology and severe complications particularly bleeding or perforation are the first manifestations. The active approach due to selection of the high risk groups of patients is needed, because there is a chance how to minimalize high frequency of NSAID gastropathy. The extremely...

Fever of unclear aetiology

MUDr. Luboš Kotík CSc

Interní Med. 2006; 8(11): 493-495  

A review of definition and major causes of the syndrome of fever of unknown origin is presented. It is explained why the ratio of principle etiopathogenetic units in patients samples changes. It is especially stressed that there is increasing percentage of patients without an established diagnosis with mainly good prognosis. The strategy of approach to patients and principals of differential diagnosis are described. The importance of recently introduced methods e.g. positron emission tomography and ultrasound of temporal arteries are mentioned.

Superficial Thrombophlebitis of the Legs

MUDr. Jana Hirmerová

Interní Med. 2006; 8(11): 496-498  

The article deals with the diagnostics, treatment and possible complications of superficial thrombophlebitis. Though often considered banal, this disease can be complicated, in not quite negligible rate, with deep vein thrombosis or even pulmonary embolism. That is why dupplex ultrasonography is recommended to exclude the involvement of deep venous system. Evidence-based recommendations of optimal treatment are lacking, there is a possibility of either surgical or conservative approach. Controversy also exists about the anticoagulant therapy in superficial thrombophlebitis, most authors agree that it is indicated but recommended dose or length of therapy...

Multidisciplinary approach in the managent of the patients with the cardiorenal failure - first experience

MUDr. Filip Málek, MUDr. Martin Havrda

Interní Med. 2006; 8(11): 499-501  

Renal impairment is identified in the patients with chronic heart failure more often than in general population and than in the subjects with heart disease and preserved left ventricular function. Presence of chronic kidney disease is also an important risk factor of death in the patients with heart failure. Co-existence of heart failure and renal impairment has a bad prognosis. Some authors name this connection as a cardiorenal syndrome. Management of the patients with both heart failure and renal impairment requires the multidisciplinary approach based on the co-operation of cardiologist-heart failure specialist and nefrologist. Preliminary data...

Significance of the evaluation of serum levels of immunoglobulins free light chains in monoclonal gammopathies

MUDr. Elena Šumná, RNDr. Ludmila Nováčková, doc. MUDr. Arnošt Martínek CSc, prof. MUDr. Vlastimil Ščudla CSc

Interní Med. 2006; 8(11): 502-504  

There is a presentation of the most important laboratory methods used for the evidence and quantification of monoclonal immunoglobulins and their structure components in serum and urine. The new applicated automated immunochemical methods allow to evaluate with high sensitivity and specificity the quantitative values of free light chains of immunoglobulins in serum (s-FLC). The estimation of s-FLC concentration, ratio kappa/lambda and their changing allows us significantly to extend the current spectrum of regularly used methods in diagnostics and assessment of results of the treatment of individual types of monoclonal gammopathies.

Primární prevence kardiovaskulárních onemocnění v praxi - kazuistiky dvou pacientů s vysokým rizikem

MUDr. Eliška Sovová Ph.D., MBA, MUDr. Olga Císařová, MUDr. Jiří Ostřanský, MUDr. Marek Richter, prof. MUDr. Jan Lukl CSc

Interní Med. 2006; 8(11): 511-512  

Méně obvyklé nežádoucí účinky amiodaronu

MUDr. Tomáš Janota CSc, MUDr. Jan Malík, MUDr. Robert Holaj, MUDr. Jan Šimek

Interní Med. 2006; 8(11): 513-514  

Prophylactic migraine treatment

MUDr. Rudolf Kotas Ph.D

Interní Med. 2006; 8(11): 506-510  

Migraine is a common episodic headache disorder. A comprehensive management of headache includes the treatment of the acute attack to relieve the pain and prophylactic therapy to reduce the frequency, severity and duration of attacks. In the present article, the clinical picture, pathophysiology and prophylactic treatment are reviewed. Prophylactic agents include beta-blockers, calcium channel antagonists, antiepileptic drugs, serotonin antagonists, anti-depressants and others.