Pravda u lůžka

PaedDr. Mgr. Eva Zacharová Ph.D

Interní Med. 2009; 11(2): 55  

Proper inhalation technique of drugs and errors

prof. MUDr. Vladimír Vondra DrSc

Interní Med. 2009; 11(2): 59-62  

The choice of inhalation device and correct inhalation technique is fundamental for successful treatment of obstructive pulmonary diseases. There were described contemporary devices – meter dose inhalers, dry powder inhalers and nebulisers used in Czech Republic. The improvement of treatment effectiveness could be reached with non fixed or fixed spacers (e.g. JET system). The education of inhalation technique is in the Czech Republic for several years mostly realized through allergology and pneumology organizations. Nevertheless, all patients, children as well as adults, do some significant mistakes in inhalations (38 % and 40 %). Czech results...

Effect of physical activity for management of diabetes mellitus

MUDr. Marcela Szabó

Interní Med. 2009; 11(2): 63-65  

Regular physical activity is considered to be one of the basic behavioral modifications in patients with diabetes mellitus. Although in patients with type 1 diabetes exercise increases mainly a cardiovascular fitness, it has a more extensive therapeutic effects for type 2 diabetics. A majority of type 2 diabetics suffer from another conditions such as abdominal obesity and hypertension and have laboratory abnormalities (diabetic dyslipidemia, elevation of procoagulants), associated with the syndrome of insulin resistance. Physical activity lowers the level of glucose and procoagulants, induces positively changes of lipids in serum, decreases abdominal...

New trends in immunization

prof. MUDr. Roman Prymula DrSc., Ph.D

Interní Med. 2009; 11(2): 66-70  

System of immunization has a long tradition in the Czech Republic. New knowledge is step by step applied and influences particularly paediatric practice, however is projected into new preventive programmes of general practitioners for adults, too. Actual change of immunization calendar introduces the adolescent booster dose against pertussis, moves booster against tetanus and abolishes additional BCG doses beyond the scope of basic schedule. A conjugated pneumococcal vaccine will be introduced in mass, but not obligatory regimen since the next year. Implementation of the next new vaccines is limited particularly with economic aspects. Beside of...

Intestinal inflammatory diseases and irritable bowel syndrome

prof. MUDr. Jiří Ehrmann CSc

Interní Med. 2009; 11(2): 71-76  

Inflammatory and functional intestinal disorders are very frequent diseases with distinct etiology and pathogenesis but similar symptomatology and laboratory findings. Some of tham are only benign events but the course of others can be hard and chronic. The knowledege to differentiate this individual etities is deedful in the clinical practice of general practitioners and specialist in internal medicine and gastroenterology. The article is divided in to universal and special parts. The point of the first are main common symptoms as are diarrhoea, constipation, bloating or others. The special part expose usefulness characterisation of infectious...

Oral mucositis in patients after chemotherapy and radiotherapy in practice

MUDr. Samuel Vokurka

Interní Med. 2009; 11(2): 77-79  

Oral mucositis represents clinically significant damage of both mucosa and submucosa caused by chemotherapy or radiotherapy. It can be accompanied by oral dyscomfort or pain usually lasting several days accompanied by reduced oral intake and higher risk of infectious complications. The severity and extent of mucosal damage varies from slight edema and redness to defects often covered by pseudomembrane. Recently, only a minimum of interventions such as cryotherapy or low-energy laser and keratinocyte growth factor palifermin are to reduce the incidence of this complication significantly. Apart from the fact that various oral solutions and rinses,...

Is pharmacotherapy after myocardial infarction sufficient?

prof. MUDr. Jindřich Špinar CSc

Interní Med. 2009; 11(2): 84-86  

We present a review of pharmacotherapy of patients after myocardial infarction in Europe, in university hospitals in the Czech Republic. A large number of patients is treated with recommended drug groups – ACE – inhibitors, AT1 blockers, beta blockers, antiplatelet therapy and hypolipidemic treatment and data from the Czech Republic are rather better than in other European countries. The reach of target blood pressure and cholesterol is however insufficient and nonpharmacological treatment is probably insufficient, too, mainly prevention of smoking and overweight of patients.

Efficacy of Detralex in venous edema treatment. EDET (Efficacy of Detralex in Edema Treatment) study results

MUDr. Zuzana Navrátilová Ph.D

Interní Med. 2009; 11(2): 87-90  

AIM: In 2007 and 2008, a six-month, open-label, multicentre clinical study evaluating the efficacy of the treatment with Detralex (micronized purified flavonoid fraction, Servier) in reducing edema including alleviation of subjective complaints in patients with chronic venous disease (CVD) was performed in the Czech Republic. Included patients with edema secondary to venous lymphodynamic insufficiency were treated with Detralex, 2 tablets daily for a six months period. METHODS: A total number of 215 patients with CVD suffering from clinical manifestations and signs of degree C3 according to CEAP classification was evaluated in the EDET study. The...

Substitute therapy with androgenes

MUDr. Vladimír Kubíček CSc

Interní Med. 2009; 11(2): 80-83  

Testosterone (androgene) supplementation is only indicated in men with well defined underlying testicular disease, pituitary or hypothalamic disease. The threshold for testosterone supplementation for different symptoms and complaints and/or tissue dysfunctions is still poorly defined. This threshold may show interindividual variation. Supraphysiological testosterone supplementation should be avoided, replacement should be physiological. Monitoring of prostatic disease and haematocrit during testosterone therapy is of utmost importance. New treatment modalities should avoid stimulating the prostate, but should maintain the benefits of androgen receptor...

Inkontinence moči

MUDr. Roman Staněk

Interní Med. 2009; 11(2): 94-95  

How to relieve menstrual pain?

MUDr. Josef Chovanec Ph.D

Interní Med. 2009; 11(2): 92-93  

Menstrual cycles represent a regular preparation for pregnancy occurring in every healthy woman‘s body from menarche to menopause, i.e. approximately between 10–15 and 45–55 years of age in our geographical conditions; this period is referred to as childbearing age. Thirty to fifty percent of women in childbearing age are estimated to suffer from pain and other symptoms during menstruation, a condition referred to as dysmenorrhoea. Menstrual disorders are a very frequent complaint of women, diagnosing and treatment requires a long-term prospective follow-up and, not uncommonly, a multidisciplinary approach. In addition to pharmacological...

Options in positioning of the patients

doc. PhDr. Miroslava Kyasová Ph.D

Interní Med. 2009; 11(2): 96-97  

The aim of the positioning of the patients, providing by the general nurse, is to prevent the emergence of some risc of decline of the statut of patiens – e.g. pressure sores, contractures, deformities etc. Also alleviate pain, relax muscles and ensure the patient comfort. Article inform how to aply positioning of the patients during the treatment process when using appropriate tools. The author does not address the positioning of individuals injured in the first aid.

Autodidaktický test č. 2 / 2009

Interní Med. 2009; 11(2): 98