AN OBESE PATIENT IN AN INTERNIST OFFICE

MUDr. Robin Urbánek

Interní Med. 2007; 9(2): 59-62  

Obesity is a serous chronic metabolic disease cause by a positive energetic balance. Insufficient physical activity and increased calorie rich diet play a substantial role in its development. It is an important risk factor of civilization diseases. It was proclaimed to be a pandemic disease by World Health Organization (WHO) in 1997. 52 % of the Czech population has and increased body weight. Current network of specialized centers and offices for obesity treatment is not sufficient. It is necessary that also primary care physicians/general practitioners and internists) concentrate on this problem. A thorough history, physical exam and laboratory...

news in the treatment of tobacco dependence

MUDr. Eva Králíková CSc, MUDr. Ludmila Pohlová, MUDr. Lenka Štěpánková

Interní Med. 2007; 9(2): 63-66  

Tobacco dependence is a chronic disease which needs treatment: from the short intervention to intensive and long-time support. Current pharmacotherapy includes except of long time used nicotine and bupropion a new medication, invented especially for the treatment of tobacco dependence: varenicline. Varenicline is a partial agonist of α4β2 subtype of acetylcholin – nicotine receptors, typical for heavy dependent smokers. It does not contain nicotine. A GP should pay attention to each smoker in the frame of his/her time possibilities, to follow-up the patient, to suggest the pharmacotherapy of his/her dependence, and those who need it...

When to consider cardiotoxicity of oncology treatment and how to diagnose it

MUDr. Jan M. Horáček Ph.D

Interní Med. 2007; 9(2): 67-69  

The article treats the problems of cardiotoxicity of antitumorous treatment. The most frequent causes and signs of cardiotoxicity of treatment in oncology are briefly mentioned. Moreover, the present-day diagnostic methods of cardiotoxicity are reviewed. The role and potential of biochemical markers of heart damage is pointed out. Recently, biochemical markers of heart damage are intensively studied, not only in this particular indication.

Approach for the antibiotic therapy of respiratory infections

MUDr. Václava Bártů

Interní Med. 2007; 9(2): 70-74  

Upper and low respiratory tract infections belong among the most frequent diseases of childhood and adults and this situation is connected with high prescription and usage of antibiotics. Knowledge of local bacteriological situation of workplace, local drug resistance, national and international recommendations for therapy of respiratory diseases play important role in the choice of the optimal antibiotic drug. The basis requirement for select drug is its efficiency, safety and quality in the clinical practice which leads to the suppression of the bacterial infection. If the bacterial origin of the disease is documented the rational therapy is based...

TREATMENT OF ARTERIAL HYPERTENSION IN THE ELDERLY

MUDr. Jitka Seidlerová, doc. MUDr. Jan Filipovský CSc

Interní Med. 2007; 9(2): 75-77  

Arterial hypertension is one of most common health problems in the elderly and at the same time is one of the main cardiovascular risk factors. Isolated systolic hypertension with a widened pulse pressure is the most common type of hypertension seen in persons older 65 years of age. This type of hypertension is related to loss of arterial elasticity. Another factor is a rising probability of incidence of other diseases. Therefore, we use cardioprotective drugs with no negative effects on associated diseases. Blood pressure lowering decreases both cardiovascular and total risk.

The contribution of prosthetic care and specialized hygienic footwear in complicated cases of diabetic foot

MUDr. Emil Záhumenský, Ing. Pavel Rádl

Interní Med. 2007; 9(2): 78-83  

Category risk assessment and a choice of adequate hygienic footwear are vital in prevention of ulcers. Shoes should be manufactured already during the ulcer healing. A computer plantoscopy with measuring insoles can rationally assess properties of individual shoes and insoles concerning the distribution of local pressures. Protective home footwear is essential in less mobile diabetics in high risk.

ACUTE RENAL FAILURE

MUDr. Karel Krejčí Ph.D, doc. MUDr. Josef Zadražil CSc, MUDr. Sadek Al-Jabry, MUDr. Vladko Horčička jr, MUDr. Pavel Štrebl, MUDr. Miroslav Hrubý

Interní Med. 2007; 9(2): 84-87  

Acute renal failure (ARF) is a suddenly developing potentially reversible decrease in renal function for pre-renal, renal, or post-renal causes. In addition to better diagnostics ever more frequent occurrence is associated with the increase in the incidence of cases due to a combination of several causes including iatrogenic, cases with associated disease, and increasing age of patients. The morbidity and mortality associated with ARF remains to be high. The published work makes reference to a new classification criteria, most frequent causes and pathophysiology of ARF, laboratory studies allowing quick differential diagnosis. Actually recommended...

The update on treatment of aortic stenosis

prof. MUDr. Roman Čerbák CSc, MUDr. Kateřina Linhartová

Interní Med. 2007; 9(2): 88-90  

Aortic stenosis is after hypertension and ischemic heart disease the third most frequent cardiovascular disease. It is also the most frequently operated valve defect. Statins and inhibitors of renin-angiotensin system are recommended for medical therapy. In spite of quite frequent reports about their beneficial effect on progression of the disease, at present there is no evidence for this treatment. Prospective randomized clinical trials that should ascertain the indication of this treatment are being planned. Surgical replacement of the valve remains the only effective way how to treat hemodynamically significant aortic valve defect (AVA< 0.5 cm2/m2...

Nízkomolekulární hepariny v terapii akutních koronárních syndromů

MUDr. Pavel Sedloň, MUDr. Kateřina Ševčíková, MUDr. Ilja Kotík, MUDr. Ivan Jeřábek

Interní Med. 2007; 9(2): 96-98  

Malígny feochromocytóm

MUDr. Barbora Desatová, MUDr. Eva Hirnerová PhD, doc. MUDr. Izabela Makaiová CSc, doc. MUDr. Andrej Dukát CSc., FESC, MUDr. I. Vranka, RNDr. Soňa Kováčová CSc, MUDr. Jaroslav Veselý

Interní Med. 2007; 9(2): 99-101  

Hypertension in pregnancy

MUDr. Petr Janků

Interní Med. 2007; 9(2): 91-95  

The classification of hypertension in pregnancy is not unified which leads to mistakes not only in differential diagnostics but also in therapy and dispensarisation. We divide hypertension in pregnancy into preeclampsia, preexistent hypertension, preeclampsia superimposed into preexistent hypertension and gestational hypertension. Preeclampsia is a complex disease of pregnant women and hypertension is one of its substantial symptoms. It leads to serious health risks of mother and fetus. It differs in this aspect from other forms of hypertension where the risks for mother and fetus are minimal.