Internal Medicine for Practice, 2008, issue 9

Editorial

Stížnosti, žaloby, skandalizování lékařů. Existuje možnost obrany?

MUDr. Jiří Pokorný

Interní Med. 2008; 10(9): 375

Review articles

The choice of antidiabetic medications with regard to metabolic syndrome

doc. MUDr. Alena Šmahelová Ph.D

Interní Med. 2008; 10(9): 380-383

For treatment of diabetes type 2 we dispose of effective antidiabetic medications (metformine, sulphonylurea derivates, glitazones, acarbosa) and soon further medications from group of incretine mimetics will occur. In antidiabetic medications besides the antihyperglycemic effect the effect on weight is announced but other effects are not presented. Nowadays we have evidence that antidiabetic medications have effect on other components of metabolic syndrome – hypertension, dyslipidemia, and even obesity. Even in choice of antidiabetic medications we have to pay attention to more complex effects than only decrease of blood sugar and consider especially...

Nonsteroidal anti-inflammatory drugs, anticoagulation, antiplatelet medications, changes gastric and duodenal mucosa

prof. MUDr. Petr Dítě DrSc, MUDr. Ivo Novotný, prof. MUDr. Miroslav Penka CSc

Interní Med. 2008; 10(9): 384-386

Nonsteroidal anti-inflammatory drugs, anticoagulation and antiplatelet medications belong to the most frequently prescribed medications. In spite of their high therapeutic effectiveness these medications cause serious gastrointestinal complications. Their indication must be carefully considered including the knowledge of their advantages and disadvantages. In the case a patient is on these medications during an endoscopic treatment, this information is important, so that the endoscopic examination is safe and the risk of bleeding complications minimalized. It is always necessary to consider whether patients receiving nonsteroidal anti-inflammatory...

Influenza - always live and novel

doc. MUDr. Roman Chlíbek Ph.D

Interní Med. 2008; 10(9): 388-391

The influenza is one of the most frequent infectious diseases. Every year can be marked as a year of influenza. Its consequences involve not only affected individuals with health problems, but in social area the population in the whole world. The flue epidemic are known by its explosivity and typical spread. Initially the highest morbidity is among children, especially among young scholars. Mortality of this age group is extremely low. These ill children relatively easily transfer the disease further in population and infect especially their own parents. The elderly part of population is usually the last target group of influenza but it has the highest...

The treatment of chronic pulmonary hypertension

MUDr. Pavel Jansa, prof. MUDr. Michael Aschermann DrSc, prof. MUDr. Aleš Linhart CSc

Interní Med. 2008; 10(9): 392-396

Pulmonary hypertension is a heterogenous group of diseases characterized by increase of mean pulmonary arterial pressure. Clinical classification differentiates pulmonary arterial hypertension, pulmonary hypertension in cardiac diseases, pulmonary hypertension in respiratory diseases, chronic thromboembolic pulmonary hypertension and pulmonary hypertension from other causes. The goal of therapeutic intervention is to influence basic pathophysiological mechanisms (vasoconstriction, remodeling and thrombosis). The test of acute pulmonary vasodilatation is essential for decision about the pharmacological treatment. Only patients with a postive test are...

Arrhythmias in seniority

doc. MUDr. Čestmír Číhalík CSc

Interní Med. 2008; 10(9): 397-401

Arrhythmias present a heterogenous group of complications occurring in virtually all heart diseases. Frequency and severity of chronic heart disease increases with age, and heart rhythm disorders come to the fore along with such conditions. While arrhythmias in a younger individual often proceed asymptomatically, in older patients with chronic heart disease, often along with other associated diseases, hemodynamic parameters are significantly worsened by simultaneously occurring arrhythmias. In addition to progressing organic disease the development of arrhythmias in older age is enhanced to a large degree by the degenerative processes in...

ACUTE MYOCARDIAL INFARCTION AND DIABETES MELLITUS

MUDr. Radka Adámková Ph.D

Interní Med. 2008; 10(9): 402-406

Acute myocardial infarction as acute form of ischaemic heart disease represents a serious medical problem. Nearly one-third of all patients with acute myocardial infarction are patients with diabetes mellitus, where as nearly 70 % of patients with acute myocardial infarction already have impaired glucose metabolism (impaired glucose tolerance or diabetes mellitus). With the improvement of acute myocardial infarction therapy the total mortality decreases, but in patients with diabetes mellitus the mortality increases. Also the prevalence of diabetes mellitus increases in the population due to changes of life style. The prognosis of patients with...

Laboratory diagnosis of multiple myeloma

MUDr. Tomáš Šálek

Interní Med. 2008; 10(9): 407-409

Multiple myeloma accounts for 10–15 % hematologic neoplasms. The most common clinical presentatin of multiple myeloma is back pain, anemia, leukopenia, trombocytopenia, proteinuria and neurologic involvement. In the past few years, there have been made some important breakthrough in understanding the biology of multiple myeloma. These findings are now opening the way to new horizons for diagnosing and monitoring of this disease. The first choise test for patients with symptoms of monoclonal gamapaties is serum protein electrophoresis alongside free light chain determination. Free light chain analysis is best for patienst who sufer from...

Case report

Dosažení kompletní remise onemocnění u pacienta s generalizovaným kolorektálním karcinomem léčbou irinotekan/cetuximab

MUDr. Ivo Kocák Ph.D, et. al

Interní Med. 2008; 10(9): 422-425

Interdisciplinary overviews

The local and whole-body cryotherapy - option and supplement to treatment of painful diseases of the locomotive organs

MUDr. Lubomír Šmuk

Interní Med. 2008; 10(9): 410-412

The authors describe the effects of the local and whole-body cryotherapy for acute and chronic painful infolements of locomotive organs both incorporation with medication and separately.

Cardiovascular parameters of erectile dysfunction

MUDr. Taťána Šrámková CSc

Interní Med. 2008; 10(9): 413-417

Erectile dysfunction is a common problem of middle-aged and elderly men. The etiology is organic in about 80 % and the most frequent cause is cardiovascular. Erectile dysfunction and coronary artery disease have the same morphological base and hence the same risk factors. Therefore, coronary artery disease appears in patients with erectile dysfunction and vice versa. Erectile dysfunction can be included in the risk factors of coronary artery disease. That is why we should search for coronary artery disease in patients who have been diagnosed with erectile dysfunction. We should also actively screen these patients and treat them effectively.

Pregnancy and delivery risks

MUDr. Zuzana Dostálová Ph.D, MUDr. Romana Gerychová

Interní Med. 2008; 10(9): 418-421

Pregnancy is a very dynamic situation, most of pregnancies undergo physiologically but in a part of them risk factors, that may complicate the physiological course of pregnancy, do occur. As a result of progress in diagnoses and therapy of serious diseases the number of women with disease that can influence themselves or result in fetal developmental or growth disorders. A multidisciplinary approach is often necessary in treatment of pregnancy pathologies. Because of possible risks it is necessary, that these women are followed in clinics for high risk pregnancies and deliveries are performed in perinatal centers.