Internal Medicine for Practice, 2007, issue 5

Editorial

Humor v medicíně má být laskavý

MUDr. Karel Nešpor CSc

Interní Med. 2007; 9(5)

Review articles

Nonalcoholic steatosis and steatohepatitis

doc. MUDr. Radan Brůha CSc, MUDr. Karel Dvořák

Interní Med. 2007; 9(5): 210-212

Nonalcoholic steatohepatitis (NASH) is characterized by liver impairment, which is morphologically similar to alcoholic liver disease. The most frequent cause of NASH is metabolic syndrome with obesity, insulin resistance and hyperlipidemia. NASH can lead to liver cirrhosis with its serious complications. The diagnosis of NASH is usually based on elevated liver enzymes and exclusion of other causes of liver disease. Liver biopsy is important for evaluation of fibrosis and inflammation but the differentiation from alcoholic aetiology is usually based on clinical data. The treatment is empiric and is directed to the treatment of metabolic syndrome. The...

The development of bacterial resistance and new antimicrobial agents

doc. MUDr. Milan Kolář PhD

Interní Med. 2007; 9(5): 213-216

Application of antibiotics is an important part of antibacterial therapy that can be simply understood as „nonphysiological interaction between bacteria and humans“. The increase of resistance against antimicrobial agents belongs to essential properties of bacteria. Because of this reason very important side effects are development and spreading of bacterial resistance that can be associated with increased morbidity and mortality of infections caused by multiresistant bacteria. This problem has to be solved on all appropriate levels, mainly by increased effort in development of new antibiotics and in the same time by thorough prevention...

News in treatment of chronic viral hepatitis

prof. MUDr. Petr Husa CSc

Interní Med. 2007; 9(5): 217-220

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are among the most frequent viral infections of man and represent a major global public health problem. Hepatitis B virus- and HCV-related chronic hepatitis are the main causes of liver cirrhosis and hepatocellular carcinoma which are responsible for a high rate of mortality. End-stage HBV- and HCV-related liver diseases are the main causes of liver transplantation. Six potent drugs are already approved for treatment of chronic hepatitis B in the United States and some countries in Western Europe - pegylated interferon alfa-2a, conventional interferon alfa, lamivudine, adefovir dipivoxil,...

Screening of sporadic colorectal cancer in Czech republic

prof. MUDr. Přemysl Frič DrSc, doc. MUDr. Miroslav Zavoral Ph.D, MUDr. Bohumil Seifert, MUDr. Petr Pokorný, MUDr. Štěpán Suchánek

Interní Med. 2007; 9(5): 221-224

Czech Republic occupies the top position in world statistics of colorectal cancer (CRC) incidence. Approximately 8 000 new cases and 5 000 deaths are recorded yearly. These losses are unnecessary, because CRC belongs to the best treatable tumors, if disclosed at an early stage. Pilot trials of CRC screening in Czech Republic started in 1979. Two prospective open studies including more than 120 000 probands as well as a cost-benefit evaluation were performed in the years 1985-1991 and 1997-1998. Population screening of CRC was started on July 1st 2000. The two-step testing consists of a guaiac fecal occult blood test (gFOBT) and colonoscopy in gFOBT-positive...

Hypertension - tratment in the elderly

MUDr. Ivan Řiháček Ph.D, doc. MUDr. Miroslav Souček CSc, MUDr. Petr Fráňa

Interní Med. 2007; 9(5): 225-229

The number of people over age 65 is rapidly increasing, and in less than 50 years, one of every three people in Czech Republic will be older than 65. Blood pressure, particularly systolic blood pressure, tends to increase progressively with age. Elderly people with hypertension have a greater risk of cardiovascular disease. The benefits of treating hypertension in the elderly have recently been documented. The choice of antihypertensive therapy should be based on the presence of concomitant conditions and should by individualized. First-line therapy are diuretics, ACE inhibitors, angiotensin II receptor blockers and calcium channel blockers. Therapy...

Antiresoptive and osteoanabolic medications - mechanisms of the effect, therapeutic value

Mgr. Šárka Blažková, Mgr. Magda Vytřísalová, doc. RNDr. Jiří Vlček CSc

Interní Med. 2007; 9(5): 230-232

Osteoporosis is a chronic metabolic disease of skeleton with serious clinical, social and economical consequences. It is possible to prevent and treat it successfully. The treatment goal is to prevent fractures by an increase in amount and quality of bone matrix. The treatment is longstanding and its result depends on patient cooperation. Medications for treatment of postmenopausal osteoporosis that decrease the risk of vertebral and extra vertebral fractures and enable an improvement of bone matrix are available.

Idiopathic pulmonary fibrosis - current concepts in diagnosis and treatment

MUDr. Martina Vašáková

Interní Med. 2007; 9(5): 233-236

Idiopathic pulmonary fibrosis (IPF) is a serious disease with a grim prognosis with median survival 3–5 years despite any known treatment. Etiology of the disease has not been satisfactory ellucidated to date. The imbalance of immune response with prevalence of Th2 type is supposed to play crucial role in uncontrolled fibroproduction as a response to unknown stilumulus. IPF is presenting with progressive exertion dypnea. The typical physical sign is finger – clubbing and bilateral basal crackles on auscultation. The dominant radiologic finding are widening of interlobular septs and honey-combing, lunfg function tests show restrictive ventilatory...

State of the art endoscopic treatment of obesity

MUDr. Evžen Machytka

Interní Med. 2007; 9(5): 237-239

Incidence of obesity increases all around the world. Possibilities of treatment are limited and results varied in time. Surgical modalities are effective, but invasive methods. Last years developed quickly more considerate accesses via endoscopic or endoscopic-surgery.

Case report

Gravidní žena s bolestmi na hrudi

MUDr. Tomáš Fiala, MUDr. Jerguš Mistrík, MUDr. Jiří Tesař Ph.D

Interní Med. 2007; 9(5): 248-250

Interdisciplinary overviews

Treatment of atopic dermatitis in adults

MUDr. Nina Benáková

Interní Med. 2007; 9(5): 240-246

The author informs about new discoveries of skin barrier disorders and their importance in pathogenesis of atopic dermatitis. Guidelines for primary care physicians follow a review of forms of atopic dermatitis, contemporary diagnostics and treatment ant their principals: questions of educations, screening of triggering factors, prophylaxis, use and examples of emolients, local steroids and therapy safety regimes. The text contains also recommendations of educational literature for patients.