Kombinovaná hypolipidemická léčba u pacientů

prof. MUDr. Vladimír Bláha CSc

Interní Med. 2009; 11(1): 7-14  

Monotherapy with statins is frequently a very successful strategy to reach target plasma levels of LDL (low density lipoprotein) cholesterol (LDL-C) nevertheless in patients with mixed dyslipidemy and high cardiovascular risk which are typical for patients with metabolic syndrome and type 2 diabetes mellitus may not lead this therapy to target levels for compensation of dyslipidemy. To reach treatment goals it is necessary to use double or triple combination and hypolipidemics that can simultaneously influence complex abnormalities of lipid profile. The most frequently used option is combination of a statin with fenofibrate or niacine (nicotinic...

Vitamin D - an essential component of osteoporosis treatment

MUDr. Jiří Jenšovský

Interní Med. 2009; 11(1): 13-16  

Pandemic of osteoporosis is becoming more and more evident with aging of population and increasing longevity. A very persuading numbers about fractures, mainly of femoral neck, are alarming and are becoming a population problem. The basic preventive measure is an effort to reach optimal and as great as possible peak bone mass that is determined genetically and influenced by a number of modifiable external factors. The condition for a successful development, skeletal maintenance and osteopenia or osteoporosis treatment effect is sufficient saturation with calcium and vitamin D in every age. Besides pandemic of osteoporosis aging population worldwide...

Crohn´s disease - classification, diagnosis, therapy and quality of life

MUDr. Libor Gabalec

Interní Med. 2009; 11(1): 16-20  

Etiology and pathogenesis of Crohn´s disease remains not completely understood. It is unquestionable interaction between the environmental and genetically susceptible individual. New genes are being describe, but the functional consequences of gene mutations are not known. New classifications of Crohn´s disease are searching interaction between fenotype and genotype of the disease and serological markers. Capsule endoscopy and enteroscopy improved detection of small intestinal lesions. In medical therapy the early use of imunosuppresives and biologic therapy have significant effect on quality of life.

The elderly patient with chronic renal insufficiency

prof. MUDr. Václav MONHART CSc

Interní Med. 2009; 11(1): 21-24  

Diabetic nephropathy, hypertonic and atherosclerotic kidney injury, chronic glomerulonephritis, chronic intersticial nephritis and obstructive uropathy represent the most frequent causation of chronic renal insufficiency in elderly patients. The risk factors for high incidence of chronic kidney diseases are aging of population, increasing numbers of diabetes mellitus, obesity and hypertension. The topical problem of vast bulk of chronic kidney diseases is progression to end-stage renal disease and increased cardiovascular morbidity. The goal of treatment is to modify classical and renal specific risk factors for cardiovascular disease. The most...

The place of probiotics in the treatment of (not only) gastrointestinal diseases

MUDr. Oldřich Stibůrek

Interní Med. 2009; 11(1): 25-28  

The history of probiotic use by man dates back to the remote past. The human intestine is colonized by microorganisms the number of which far exceeds that of the human body cells, and the proper composition of the microflora plays a very important role. By both local and systemic effects, probiotics positively affect numerous organs and their function while being very safe with minimum adverse effects. There is a wide range of various probiotic preparations. However, their specific effects are often difficult to observe and assess exactly, which results from the fact that they are not precisely defined chemical substances but live (micro)organisms.

Parathyorid carcinoma as a cause of hypercalcemia in patient with B-NHL

MUDr. Milan Halenka Ph.D

Interní Med. 2009; 11(1): 42-44  

In our case is described the finding of large parathyroid carcinoma in patient with B-non-Hodgkin‘s lymphoma as a cause of hypercalcemia. Hypercalcemia is concomitant paraneoplastic phenomenon. Primary hyperparathyroidism is less common cause of hypercalcemia of malignancy. Coincidental occurrence of another malignancy – parathyroid carcinoma – is rare. The large neck mass, hypercalcemia and high serum level of parathyroid hormone are nonspecific but suspicious.

Free radicals, antioxidants and ageing

MUDr. Jan Pláteník Ph.D

Interní Med. 2009; 11(1): 30-33  

The aerobic metabolism inevitably involves production of oxygen radicals. Oxidative damage to biomolecules has to be counteracted by antioxidant defense. Oxidative stress has been implicated in pathogenesis of many inflammatory and degenerative diseases; and accumulation of errors of body antioxidant defense and repair systems is the very mechanism of physiological ageing. However, dietary supplementation of antioxidant vitamins C, E and also beta-carotene and selenium, which was subject of large and repetitive studies, brings clear benefits only in cases of dietary deficiencies, otherwise is either ineffective, or even harmful. The reasons for...

Facial dermatoses - review and treatment (part II)

doc. MUDr. Jarmila Rulcová CSc

Interní Med. 2009; 11(1): 34-35  

The following second par of the article about facial dermatoses focuses mainly on those disease that occur not only in dermatology clinics but also in other specialities. Rosacea, demodikosis, perioral dermatitis and seborhoic dermatitis belong to those diseases. Effective local and systemic therapeutic strategies are discussed.

What is new in the treatment of haemorrhoids in terms of surgery?

prof. MUDr. Ivan Čapov CSc

Interní Med. 2009; 11(1): 36-41  

Haemorrhoids affect a large proportion of the population. Not only surgeons, but also gastroenterologists and GPs are involved in diagnosing and treating this condition. A major breakthrough in the treatment of grade III and IV haemorrhoids was the introduction of stapled haemorrhoidopexy (Long method). However, even today, ten years after its introduction, the method is not entirely free of complications even if correctly indicated. Likewise, no method of treatment for haemorrhoids can presently be considered optimal; therefore, numerous methods exist and new ones are being developed.

Patient‘s nutritional status and ways of its assessment

doc. MUDr. Roman Zazula Ph.D

Interní Med. 2009; 11(1): 45-47  

Assessment of nutritional status is a part of an overall clinical approach. There is no single method based on which it would be possible to establish a definitive diagnosis of malnutrition; a set of examinations always has to be performed in the clinical context. Combinations of several examination methods are routinely performed. The aim of the paper is to present an overview of current trends in the clinical diagnosis of malnutrition.

What is new in andrological endocrinology

prof. MUDr. RNDr. Luboslav Stárka DrSc

Interní Med. 2009; 11(1): 48-50  

The aim of the paper is to highlight some current issues and recent findings concerning andrological endocrinology.

Autodidaktický test č. 1/09

Interní Med. 2009; 11(1): 50