Internal Medicine for Practice, 2006, issue 7

Editorial

Pán tvorstva…?

prof. RNDr. Stanislav Komenda DrSc

Interní Med. 2006; 8(7)

Review articles

Combination therapy of dyslipidemia

prof. MUDr. Jan Bultas CSc

Interní Med. 2006; 8(7): 314-322

Dyslipidemia is a multifactorial disease participating in etiopathogenesis of cardiovascular diseases. The treatment targeted on lipid spectrum adjustment belongs together with antihypertensive medications, to the most effective, but also the most expensive treatment options improving prognosis of patients. Because of various combinations of abnormalities in lipid spectrum and a narrow therapeutic spectrum of individual hypolipidemics it is frequently necessary to combine individual hypolipidemics. In the review different combinations suitable for a decrease of LDL-cholesterol (statins+ezetimib, statins+resins), decrease of LDL- cholesterol and triglycerides...

The diagnosis and treatment of celiac disease

doc. MUDr. Pavel Kohout CSc

Interní Med. 2006; 8(7): 324-326

The celiac disease is a disease with a history dating back to antique period or Egypt. It was described for the first time at the end of 19th century and its aetiology was discovered only in the middle of 20th century, after the World War II. (see below). The prevalence of the disease is greater than expected 10-20 year ago, in spite of this fact the diagnosis in adults usually takes more than 10 years even in cases with typical symptoms. The diagnosis of oligosymptomatic or latent forms is even more complicated. That is why an Expert panel lead by professor Přemysl Frič was found in the Czech Republic in 2004. The panel united experts who were interested...

New antitrombotic drugs

MUDr. Jan Novotný Ph.D

Interní Med. 2006; 8(7): 327-329

The hypercoagulable states belong among the most frequent causes of morbidity and mortality in the developed countries worldwide. The hemostasis plays an important role not only in stopping of bleeding, but takes part also in immunity, wound healing, and in the processes of growing, progression, and metastasing of malignant tumors. This is the cause why many research teams pay great attention to the problematics of hemostasis, including the development of new antithrombotic drugs. The hemostasis is being explored in details on many levels, creating so the basis of developing and testing of new drugs in both the preclinical and clinical trials. The...

Ace inhibitors with dual elimination pathway

MUDr. Vlastimil Ráček

Interní Med. 2006; 8(7): 330-335

Most ACE inhibitors (ACE-I) and their metabolites are mainly excreted by the renal route, whereas fosinopril, trandolapril, spirapril, moexipril and ramipril display elimination through hepatic and renal routes and have dual elimination pathway. For most ACE inhibitors, dosage adjustment is recommended in moderate and severe impairment of renal function. Dosage recommendation for treatment depend on the specific pharmacokinetics properties of the various ACE-I.

Breath tests - the modern, non-invasive diagnostics

MUDr. Petr Kocna CSc

Interní Med. 2006; 8(7): 336-341

Breath tests present moderne, non-invasive diagnostic tool in gastroenterology and hepatology. Both the hydrogen breath tests (H2) and tests with stable isotope of carbon (13C) are clinically helpful in the wide range of diagnostic indications. In this review there are discussed prinicples of hydrogen and 13C-breath tests, methods and test procedures, analytical instruments and selected clinical applications. The range of diseases that can be identified include Helicobacter pylori infection, lactose and fructose intolerance, bacterial overgrowth, abnormal small bowel transit, gastric emptying, pancreatic insufficiency, liver dysfunction. Five years...

Information

XX. Olomoucké hematologické dny s mezinárodní účastí

MUDr. Tomáš Papajík CSc

Interní Med. 2006; 8(7): 364

II. Mezinárodní kongres prevence nozokomiálních nákaz

MUDr. Rastislav Maďar Ph.D, RNDr. Renata Podstatová

Interní Med. 2006; 8(7): 365

Case report

Centrální tyreotoxikóza a non-compliance

MUDr. Marek Slaměník

Interní Med. 2006; 8(7): 358-359

Závažná němá ischemie myokardu u mladého pacienta s paroxyzmální formou fibrilace síní

MUDr. Vladimír Čech, MUDr. Antonín Dufka, MUDr. Robert Náplava

Interní Med. 2006; 8(7): 360-362

Interdisciplinary overviews

The relation of sleep disorders and quality of life

prof. MUDr. Soňa Nevšímalová DrSc

Interní Med. 2006; 8(7): 342-347

We spent almost 1/3 of life sleeping and quality of sleep significantly influences quality of life. Physiologic sleep is necessary not only for regeneration of mental and physical capacity, for formation of memory traces, i.e. cognitive functions, but also for a number of metabolic processes. Common basis for most of sleep disorders are frequent awakening reactions (of cortical and subcortical origin) that lead to release of stress hormones (mainly kortizol) and acceleration of atherosclerotic changes. The consequence is and increased risk of infarctions, strokes, and other complications. Fragmentation of sleep accompanied by a frequent change of sleep...

Depression, metabolic syndrome and diabetes mellitus

MUDr. Jiří Podlipný, MUDr. Zdeněk Hess

Interní Med. 2006; 8(7): 348-351

We usually focus our attention on adverse events of antipsychotic medication when thinking of metabolic syndrome and type 2 diabetes in psychiatry. We want to show another important issue in the following article, which is the increased comorbidity of depression and type 2 diabetes. Depression usually precedes the development of type 2 diabetes and therefore it is necessary to monitor the metabolic risk factors in depressive patients.

Malignant melanoma - the most severe skin tumor

doc. MUDr. Dagmar Ditrichová CSc, MUDr. Martin Tichý Ph.D

Interní Med. 2006; 8(7): 352-354

Malignant melanoma belongs to the most severe skin tumors with permanently growing incidence. Although it is very well accesible only by aspection from the first stages, approximately 70% of patients come to dermatologist with a vertical tumor thickness bigger than 1 mm, predicting less favourable prognosis. The authors describe basic types of malignant melanoma according to clinical picture and biological behaviour as well as risk factors and options for their modification. Prognostic factors are overviewed. Diagnostic guidelines including differential diagnosis are summarised. Recommendation how to deal with suspicious pigmented skin lesion...