Prasečí chřipka - nová potencionální infekční hrozba

prof. MUDr. Petr Husa CSc

Interní Med. 2009; 11(5): 203  

Cardiovascular risk and hormonal replacement therapy at menopause

MUDr. Michal Vrablík Ph.D

Interní Med. 2009; 11(5): 207-210  

Based on observational studies in the 1990s, hormonal replacement therapy (HRT) was considered clearly beneficial in terms of prevention of cardiovascular disease in postmenopausal women. A major surprise have been the results of well-conducted intervention studies (e.g., HERS and WHI) that failed to demonstrate beneficial effects of HRT in both secondary and primary prevention of atherosclerosis and its complications. However, recent research, development of novel types of HRT, and new practical approaches to its use may change the attitude of internists and cardiologists toward indicating HRT. Obviously, individually selected and, in particular,...

Sudden cardiac death

MUDr. Milan Kozák Ph.D

Interní Med. 2009; 11(5): 211-214  

More than 2.500 persons from European population die of sudden cardiac death every day. Nearly 90 % of these cases are caused by malignant ventricular arrhythmias, which develope most frequently on the basement of structural heart disease. Some subpopulations of patients can be marked as a high risk for sudden cardiac death according to the today stratification procedures and can be treated in a pharmacological or nonpharmacological ways. The ways are as follows: a chronic therapy with betablockers agents, therapy of congestive heart failure, myocardial revascularisation and implantation of cardioverter-defibrillator. The prognosis of patients...

Viral hemorrhagic fevers

doc. MUDr. Ladislav Machala Ph.D

Interní Med. 2009; 11(5): 215-217  

Viral hemorrhagic fevers (VHF) are severe viral infections characterized by occurrence of hemorrhagic complications and high mortality. They occur in mainly in tropical regions and are caused by virus of the families Filoviridae, Arenaviridae, Flaviviridae and Bunyaviridae. The risk of import of VHF is in our conditions not high, but diagnostics of VHF would be difficult because of lack of experience among our physicians. Also the possibilities of therapy, prophylaxis and vaccination are still very limited.

Anorectal dysfunction

MUDr. Jitka Prokešová, MUDr. Jiří Dolina Ph.D

Interní Med. 2009; 11(5): 218-220  

Anorectal dysfunction (ARD) is a common term referring to anorectal muscle discoordination resulting in continence or rectal evacuation failure. Clinically, it is most commonly manifested as a defecation disorder or fecal incontinence. Approximately 10–20 percent of patients are affected (80 % of which are women) and they are cared for by gastroenterologists. ARD can occur at any age, however, most often as a result of obstetric injury, following radical gynecological procedures, or in old age. A clear distinction needs to be made between fecal incontinence and so-called pseudoincontinence due to acute diarrheal disease. Diagnosing requires...

Acromegaly - current limitations of therapy

doc. MUDr. Zdeněk Fryšák CSc, MUDr. David Karásek Ph.D, MUDr. Milan Halenka Ph.D, MUDr. Josef Machač

Interní Med. 2009; 11(5): 221-223  

First of all, acromegaly needs to be borne in mind. The disease develops slowly, insidiously, changing the patient‘s appearance, so it is no wonder that it typically may take a long time of ten, or sometimes as many as 35 years before the diagnosis is confirmed. The autonomous and, in particular, excessive growth hormone secretion produces numerous adverse effects that complicate and demonstrably shorten the patient‘s life. The typical appearance characteristic for acromegaly or the local compression signs due to macroadenoma are merely an external manifestation of the disease. Even if costly, medication therapy has markedly improved...

Advanced forms of insulinotherapy patients with type 2 diabetes mellitus

MUDr. Dagmar Bartášková

Interní Med. 2009; 11(5): 224-227  

Type 2. diabetes mellitus is connected with growing number late diabetics macrovascular complications as well as with higher expenditures for the treatment. There are clinical studies, which evaluate influence of tight diabetic control on macrovasular complications development. The conclusion is new recommendation concerning final level HbA1c and present macrovasular complications. This article presents new possibilities in insulin treatment type 2. diabetes mellitus relating individual diabetics patient.

Dietary supplements in clinical practice

doc. MUDr. Eliška Sovová Ph.D., MBA, Milan Sova

Interní Med. 2009; 11(5): 228-232  

Optimal nutrition with the right proportion of essential nutrients (proteins, saccharides, and fats) and adequate amount of vitamins, minerals, and other antioxidants is the cornerstone of prevention of all civilization diseases. Antioxidants contained in food decrease the occurrence of both cardiovascular and cancerous diseases. No study has confirmed a positive effect of vitamin supplementation (vitamin C, vitamin E, folic acid) in tablet form in the prevention of civilization diseases. Vitamin and mineral supplementation can be recommended in the case of deficiency or when there is an increased demand for them. Other substances for which studies...

Pneumoconioses

prof. MUDr. Daniela Pelclová CSc

Interní Med. 2009; 11(5): 232-235  

Pneumoconiosis is a term for occupational respiratory disorder caused by inhalation of inorganic dusts, their macrophages ingestion and response by releasing tumor necrosis factors, and cytokines leading finally to the stimulation of fibroblasts to proliferate and produce collagen. Silicosis is caused by inhalation of crystalline silica dust, and is marked by inflammation and scarring in forms of nodular lesions especially in the upper lobes of the lungs. It is the most common occupational lung disease worldwide. Coal worker’s pneumoconiosis is caused by long-term black coal mining in deep coal mines. Both the radiological finding and symptoms...

Anomalous course of the venous system as a complication of pacemaker implantation

MUDr. Jolana Lipoldová

Interní Med. 2009; 11(5): 240-242  

Authors present a case of difficult endovasal implantation of pacing leads due to venous system anomaly, persistent left superior vena cava with atresia right one. It is relatively rare anomaly which is usually asymptomatic but can lead to difficulties during right-sided catheterization or implantation of pacing lead. Authors present possible diagnostic tools and management.

Tiotropium in COPD - the early therapy, the better results

MUDr. Vratislav Sedlák, MUDr. Vladimír Koblížek

Interní Med. 2009; 11(5): 245-249  

COPD is chronic progresive disease associated with high morbidity and mortality and increasing prevalence. Management of COPD is based on prevention and treatment of exacerbations, decreasing of mortality, aleviating of symptoms and influence of long-term prognosis. The most important part of this strategy is to identify patients with early stages, where is a potential for slowing the disease progression. This review summarizes role of long-acting muscarinic antagonist tiotropium in current COPD management and especially its impact on declination of lung function.

Factor influencing aging of the human organism: genes and life style

prof. MUDr. František Šťastný CSc

Interní Med. 2009; 11(5): 236-239  

The paper informs about possibilities of present medicine, but also individual life style, to influence the length and quality of our life.

Enteral tube feeding

MUDr. Milana Šachlová CSc. et Ph.D

Interní Med. 2009; 11(5): 243-245  

If a patient has a functioning gut but is unable or unwilling to eat sufficient to meet his/her nutrional needs, various options of enteral feeding can be considered. Feeding solutions should be introduces to the gastrointestinal tract at the point where it is possible to absorb them. Enteral feeding methods are more physiological and costly than parenteral feedings. Adequate nutrition support may improve nutrition status and quality of life, decrease morbidity and in some cases may even lower mortality.

Autodidaktický test č. 5/2009

Interní Med. 2009; 11(5): 250