Internal Medicine for Practice, 2007, issue 11

Editorial

Strasti a slasti práce s lékaři

Mgr. Iva Daňková

Interní Med. 2007; 9(11): 475

Review articles

Current data of the tube enteral nutrition

doc. MUDr. Miroslav Tomíška CSc

Interní Med. 2007; 9(11): 480-485

Maintenance of nutrition status has become an integral part of patient care. Whenever possible enteral feeding is preferable to parenteral nutrition because of the potential to preserve intestinal integrity and function and support immune system. A lot of evidence from clinical studies has enabled to create European Guidelines on Enteral Nutrition in various groups of patients. Optimal way of their introduction into clinical practice is to formulate local hospital protocols for providing enteral nutrition. Promotion of early sufficient provision of enteral feeding to each indicated patient becomes a key factor. Delayed feeding in fully developed undernutrition...

Liver cirrhosis

MUDr. Veronika Příbramská, MUDr. Libuše Husová

Interní Med. 2007; 9(11): 486-489

Liver cirrhosis represents a common diagnosis for general practitioner, internal specialist or gastroenterologist. It is a consequence of chronic liver diseases characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. Complications of portal hypertension are very dangerous and a life threatening. Spending on the treatment is high and it is important to diagnose a liver dammage during the initiative stage and prevent further dammage and complications. In the following article the authors bring back the basic information about pathofysiology, diagnostic and treatment...

Pleural effusions

MUDr. Libor Fila

Interní Med. 2007; 9(11): 490-494

Pleural effusions are common diseases with incidence 300–500 per 100 000. Pleural effusions form when production of fluid exceeds capacity for its absorption. Congestive heart failure, pneumonia, tumors, pulmonary embolization and liver cirrhosis are the most frequent causes of pleural effusions. Clinically suspected fluidothorax is confirmed using imaging methods. Examination of pleural fluid and pleural biopsy are used in diagnostics. Pleural biopsies are usually taken using thoracoscopy. Tumorous and tuberculous effusions, empyemas, hemothoraces and chylothoraces must not be missed in diagnostic process. Therapy of pleural effusions includes...

Risks associated with blood transfusions

MUDr. Dana Galuszková

Interní Med. 2007; 9(11): 495-498

Transfusion medicine is essential partner to many clinical branches in care about their patients. Haemotherapy is still associated with potential health risks despite of continuous development in diagnostic procedures and technologies in processing and storage of blood. Blood transfusion complications can be divided according to different diagrams and criteria. Transfusion-related events can have character of transfusion reactions, transfusion errors and near-miss events. Systematic recording and analysis of these events is called haemovigilance. It is up-to-date Czech health service target to build up functional national haemovigilance system in harmony...

Decubital ulcer - from a geriatrician perspective

MUDr. Hana Meluzínová, doc. MUDr. Pavel Weber CSc, MUDr. Zuzana Navrátilová Ph.D, prof. MUDr. Hana Kubešová CSc

Interní Med. 2007; 9(11): 499-506

Decubial ulcer belongs to important problems of geriatric medicine because 70% of all decubital ulcers manifests in patients older than 70 years. It has a tight relation to immobilization syndrome that together with instability, incontinence and intelectual disorders belong to “great geriatric syndromes”. These syndromes manifest predominantly in the late senium (over 75 years) and accomplish the clinical picture of general polymorbidity. They are usually accompanied by disaptibility. The ethiopathogenesis, clinical picture including classification and complications are discussed. The authors underline a decisive role of malnutrition for...

Nonhypoglycemic effects of oral antidiabetic medications

MUDr. Pavlína Piťhová, prof. MUDr. Jindřiška Perušičová DrSc, MUDr. Michala Pelikánová, MUDr. Eva Žakovičová, MUDr. Erik Hollay

Interní Med. 2007; 9(11): 507-513

Most of oral antidiabetics with respect to mechanism of its effect influence besides sacharide metabolism even risk factors of cardiovascular diseases and may have protective effect on function of pancreatic V-cells, may influence the inflammation and production of imflammatory cytokines, atherosclerosis and stability of atherosclerotic plaques, control of cell cycle, apoptosis and carcinogenesis. The article describes so called pleiotropic effect of thiazolindiones, metformin, acarbosis and sulfonylurea secretagogs.

Tumors of the neuroendocrine system

prof. MUDr. Václav Zamrazil DrSc

Interní Med. 2007; 9(11): 514-519

Neuroendocrinne system (NES) is a complex neuro-endocrine network of non well-defined origic (neural crest cells? pluripotent cells?) with varios function incl. paracrine and endocrine secretion and neuromodulatory function. Clinical importance of disorders of NES is not yet well established. From cells of NES arise neuroendocrine tumors (NETs), NETs secrete many hormonaly active substances that lead to various endocrine syndromes a NETs are malignant in nature, grade of malignity is usuelly low. There are localized predominantly in gastrointestinal system. Diagnosis can be estabilished by morphological methods, for clinical diagnosis estimation of...

Information

6. pracovní konference III. interní kliniky FN a LF UP Olomouc

MUDr. David Karásek Ph.D

Interní Med. 2007; 9(11): 534

Interdisciplinary overviews

Risk and benefit of combined oral contraceptives

doc. MUDr. Peter Koliba CSc

Interní Med. 2007; 9(11): 520-524

The author reports an actual review of the risk and benefit of the combined oral contraceptives (COC). The COC is in the present time the safe method of the birth control. The author discusses the history, pharmacology and metabolism of estrogens, progestins, the benefits and possible adverse events, risk and contraindications of COC. The most serious complication is of thromboembolic event. The risk of adverse events declines by the low-dose therapy. The claim on the safety, reliability and control of the menstrual cycle meet all modern low-dose products. The combination with the drospirenon could have a therapeutic effect especially in women with...

Depression and its treatment in cardiovascular diseases

doc. MUDr. Vladimír Pidrman Ph.D

Interní Med. 2007; 9(11): 525-528

The author describes relations between prevalence of depression and cardiovascular diseases. A substantial part of the article is consecrated to a correct antidepressive treatment. Properties, advantages and eventual side-effects of individual groups of current antidepressive medications are described.