Problémy geriatrie jsou výzvou pro všechny medicínské obory

prof. MUDr. Jaroslav Rybka DrSc

Interní Med. 2007; 9(9): 367  

Tuberculosis and its resistant forms

MUDr. Václava Bártů

Interní Med. 2007; 9(9): 372-373  

PANCREATIC PAIN

prof. MUDr. Přemysl Frič DrSc

Interní Med. 2007; 9(9): 374-377  

Pancreatic pain accompanies acute and chronic pancreatitis as well as pancreatic cancer. In chronic pancreatitis (CP) pain deserves special attention. Its causes include destruction of parenchymal tissue, fibroproduction and their consequences. Pancreatic stellate cells play an important role in these processes. Pain is triggered by meals, alcohol and disturbances of pancreatic secretions passage through the duct system. More than 90% of CP subjects suffer from pain which is the main factor affecting the quality of life. Pain therapy is a complex problem and some procedures are considered controversial. Therapeutic methods are non-invasive (life style,...

The treatment of diabetes in elderly type 2 diabetics in outpatient care

doc. MUDr. Alena Šmahelová Ph.D

Interní Med. 2007; 9(9): 378-380  

Diabetes is one of the most frequent diseases of higher age. Carefully selected medical therapy and life style changes can significantly improve the prognosis of patients with diabetes. Both metformin and insulin should be chosen more frequently than in the past. Dyslipidemia and hypertension should be also treated vigorously, and by this way we could prevent the most frequent complications of diabetes – vascular involvement. Because of a lower adherence to therapy it is necessary to pay and increased attention to an elderly diabetic patient.

New approaches to the treatment of glomerulonephritis

MUDr. Jan Svojanovský, doc. MUDr. Kamil Ševela CSc, doc. MUDr. Miroslav Souček CSc

Interní Med. 2007; 9(9): 382-384  

At present, beside corticoids, cytostatics (cyclophosphamide, chlorambucil) and more recent immunosuppressants (cyclosporine, mycophenolate), biological therapy has also been coming into use in the treatment of glomerulonephritides. The most extensive experience has been made with high doses of intravenous immunoglobulins and with anti-TNF therapy in ANCA-associated vasculitis. The therapy with rituximab in patients with ANCA-associated vasculitis, lupus nephritis, and membranous nephropathy is also promising. The main goal of these new approaches is primarily to decrease the risk of chronic toxicity caused by the cytostatic therapy. Thus, current...

The impact of smoking on morphology and function of cardiovascular system

MUDr. Lubor Goláň

Interní Med. 2007; 9(9): 386-388  

Smoking is a major cardiovascular risk factor. It affects adversely morphology and function of cardiovascular system. Endothelial dysfunction, disturbances of hemostasis based on platelet activation and decreased function of endogenous fibrinolytic system, activation of inflammation, hemodynamic changes and increased oxygen demand are triggered by tobacco smoke. Smokers tend to be insulin resistant and suffer from disorders of lipid metabolism. The result of complex changes is acceleration of atherosclerosis with all negative consequences. Passive smoking also constitutes a significant risk. Non-smokers can be exposed to environmental tobacco smoke...

Microflora of the gastrointestinal tract and probiotics

MUDr. Tomislav Švestka CSc

Interní Med. 2007; 9(9): 389-391  

The human microflora has a central role in health and disease, being unique in its complexity and range of function. In the last decades there has been an increasing interest in the manipulation of intestinal microbs with probiotics for the prevention and treatment of the most diseases, especially of the gastrointestinal tract.

Precanserous of oesophagus and gastric

MUDr. Jiří Dolina Ph.D, MUDr. Jitka Prokešová, MUDr. Radek Kroupa, prof. MUDr. Aleš Hep CSc

Interní Med. 2007; 9(9): 392-393  

Specialised intestinal metaplasia within the oesophagus (Barrett´s osesophagus) is known to have malignant potential, predisposing patients to subsequent development of oesophageal adenocarcinoma. The incidence of oesophageal adenocarcinoma is rising. Detection of dysplasia in biopsy specimens is a pathological criterion for identifying patients who are at increased risk for developing adenocarcinoma. Gastric cancer was the most common malignant disease as recently as 1950s. Since then, there has been a dramatic decrease in the death rate from this disease. There is a marked variation in the incidence of gastric cancer throughout the world.

Autoimmune thyroiditis and infertility

MUDr. David Karásek Ph.D, doc. MUDr. Ivana Oborná Ph.D, doc. MUDr. Zdeněk Fryšák CSc

Interní Med. 2007; 9(9): 394-397  

Thyroid gland plays an important role in reproduction. Autoimmune thyroiditis with, or without thyroid dysfunction could be associated with infertility, pregnancy loss, and assisted reproduction failure. The prevalence of autoimmune thyroiditis in women of infertile couples is significantly higher compared to fertile controls, particularly in women with ovarian factor of infertility, tubal factor of infertility and in women with endometriosis. Thus, systemic assessment not only of thyroid function, but also of antibodies against thyroid gland seems to be necessary in these women. If the diagnosis of autoimmune thyroiditis is made out, a close collaboration...

Lyme disease and musculoskeletal system

MUDr. Martin Žurek

Interní Med. 2007; 9(9): 398-400  

Lyme disease is an infectious disease caused by spirochetes of Borrelia strain. The disease course has several phases and its manifestation is diverse. Musculoskeletal complains may present in any phase of Lyme disease. Artralgias occur in early phase together with erythema migrans without any objective finding on joints and may persist for many months or years. Intermittent arthritis that manifests already in early phase of borreliosis is usually monoarticular or oligoarticular and asymmetric. The frequency of flares of intermittent articular inflammations decreases with time. Chronic lyme arthiritis is very frequently limited to one joint, typically...

Vývoj rezistence komunitních respiračních patogenů k antimikrobním přípravkům v olomouckém regionu

Mgr. Luboslava Čekanová, doc. MUDr. Milan Kolář PhD

Interní Med. 2007; 9(9): 405-407  

Chronic daily headache, diagnosis and treatment

MUDr. Ingrid Niedermayerová

Interní Med. 2007; 9(9): 401-404  

Chronic daily headache (CDH) is a heterogenic group including both primary and secondary headache (BH) caused by various organic reasons. Primary CDH is caused by chronification of migraine, tension BH or cluster headache. It is often associated with overuse of analgetics or other acute medications, with depression and anxiety. The treatment depends on the underlying type of BH and present complications. More serious cases require hospitalisation.

What is the treatment of choice for hypertension in the year 2007?

prof. MUDr. Jiří Vítovec CSc, prof. MUDr. Jindřich Špinar CSc., FESC

Interní Med. 2007; 9(9): 408-410  

We present a review of 5 basic groups of antihypertensive medications, thiazide diuretics, betablockers, calcium channel blockers, angiotensin converting enzyme inhibitors and angiotensin II receptor blockers. In each group we describe suitable indications, contraindications and inappropriate use. The review is based on ESH/ESC guidelines from 2007.