Diabetologické minimum pro internisty - současné trendy v terapii diabetu 2. typu

Interní Med. 2009; 11(6)  

Zamyšlení nad etickými problémy v péči o osoby vyššího věku

MUDr. Květuše Zikmundová CSc

Interní Med. 2009; 11(6): 255  

Paget‘s disease of bone - new therapeutic options

MUDr. Jiří Jenšovský

Interní Med. 2009; 11(6): 258-262  

Paget‘s disease of bone is the second most common metabolic bone disease. It is a chronic condition which requires long-term, if not life-long, treatment, and it decreases the quality of life. The disease aetiology remains unclear; however, it most likely results from a combination of a viral infection and an underlying genetic predisposition. The disease is most commonly detected on an incidental radiological or biochemical finding. Given the primary disorder at osteoclast level, the treatment is based on drugs inhibiting osteoclast action or reducing their number. Until recently, the treatment for Paget‘s disease involved both calcitonin...

New anticoagulants in the treatment of cardiovascular diseases

doc. MUDr. Debora Karetová CSc, prof. MUDr. Jan Bultas CSc

Interní Med. 2009; 11(6): 263-266  

Antithrombotics, i.e. antiplatelet drugs and anticoagulants are important pharmacologic groups, that are usefull for treatment of pandemy of diseases on the base of atherothrombosis and thrombophilia. First part of this revue was dedicated to antiplatelet drugs in previous issue (Interní Med 2009; 11(4): 174-177). The topics of this copy is inscribed to anticoagulants.

Renovascular disease - clinical manifestation, diagnosis, therapy

prof. MUDr. Jan Peregrin, CSc, MUDr. Marcela Bürgelová, Ph.D

Interní Med. 2009; 11(6): 267-271  

Renovascular disease presents clinically by two main symptoms – renovascular hypertension and ischemic nephropathy. It is caused by renal artery/arteries stenosis (RAS), mainly due to atherosclerosis. Less frequent cause of RAS is fibromuscular dysplasia (it affects mainly younger females), rarely arteritis, neurofibromatosis or other diseases. Renovascular hypertension is the determinant of approximately 1–5 % of all hypertensions, but there is no positive proof, that in all patients with RAS, the stenosis is the cause of hypertension. The therapy is either conservative (medical treatment together with lifestyle modifications) or...

Current situation and advances in diagnosing and treatment of bronchogenic carcinoma

prof. MUDr. Miloš Pešek CSc

Interní Med. 2009; 11(6): 272-275  

In a systematic overwiev, lung cancer epidemiology, risk factors, morphology, symptoms, diagnostic procedures and therapeutic schedules are presented. Actual situation in Czech republic is compared with other countries. In Czech republic, there is higher percentage of every day smokers in population, Czech republic belongs to the countries having highest lung cancer incidence. There is also very high incidence of advanced and metastatic stages of disease (81 %) and consequently low resectability rate of this disease (12 %).

Ulcerative colitis - classification, diagnosis, therapy and quality of life

MUDr. Libor Gabalec

Interní Med. 2009; 11(6): 276-281  

Etiology and pathogenesis of ulcerative colitis is still unknown. It is a result of a combination of environmental, genetic and immunological factors in which an uncontrolled immune response within the intestinal lumen leeds to inflammation. Defect of innate immune response to microbial agents is involved in ulcerative colitis. Induction and maintenance of remission, mucosal healing, the avoidance of surgical intervention and decreasing the likelyhood of cancer developing are the primary therapeutic goals in ulcerative colitis.

How to improve hypertension control in primary care?

MUDr. Jan Peleška CSc

Interní Med. 2009; 11(6): 282-287  

Simplifying the diagnostic and therapeutic procedures within valid recommendations and using the hypertension specialist‘s algorithm should result in saved time that the GP should devote to improving communication with the patient in order to achieve better participation of the patient in the treatment of his hypertension. Participation of the patient would mainly involve home blood pressure measurements and a dialogue with the physician over the daytime blood pressure values and their potential relationship to even mild adverse reactions to treatment. However, this requires mass use of home blood pressure measurements. By three months at...

Chronic venous insufficiency and venotonics

MUDr. Ivo Hofírek

Interní Med. 2009; 11(6): 288-290  

The paper deals with chronic venous insufficiency, its incidence, causes, and treatment options including the administration of venotonics. They are evaluated by comparing information from the literature, actual clinical papers, and the practice. Venotonics play a supplemental role in the treatment of chronic venous insufficiency which consists in managing edema, reducing unpleasant sensations in individual cases, and, secondarily, improving the perceived quality of life.

Significance of combined hypolipidemic therapy for patients with metabolic syndrome

MUDr. Renáta Palmajová

Interní Med. 2009; 11(6): 298-300  

Metabolic syndrome represents a complex of metabolic disorders of serious nature in which lipid disorders are among significant risk factors for developing cardiovascular disease with high morbidity and mortality. Treatment of dyslipidemia with statins or fibrates is among the most widely used therapies. Statin-fibrate combination therapy has been shown to not have an increased risk of adverse effects and to be pharmacologically complementary. However, not even a positive, laboratory-based, therapeutic effect can eliminate the risk of developing a serious cardiovascular disease completely. Diabetic/metabolic dyslipidemia is more susceptible to...

Hearing loss in the age

MUDr. Monika Vohlídková

Interní Med. 2009; 11(6): 291-293  

Hearing is the important sense. In the age often have been coming its damage by factors of civilization. The damage of hearing in the age is caused by the bad function of hair cells of inner ear together with the damage of central hearing analysis system. We can hear from patient about their the biggest problem: “I can hear, but I can´t understand.” The disorder of hearing is very often connected with the tinnitus, which can be more inconvenienced then disorder of hearing. The hearing is examined by pure tone audiometry in the silent room, the speech recognition score by means of speech audiometry. We can´t treat the hearing disorder...

Quality of life of patients receiving oral oncological treatment

Mgr. Zuzana Spurná, MUDr. Dagmar Brančíková, MUDr. Jana Katolická

Interní Med. 2009; 11(6): 294-298  

The findings of numerous studies investigating oral chemotherapy in oncological patients have proved that patients prefer oral chemotherapy to intravenous application. Advantages of oral chemotherapy mainly include patient comfort, possible continuous administration without being limited by long-term hospitalization and related economic advantages for the health care facility, and good combinability with radiotherapy. Another advantage of oral preparations is that they can be combined with parenteral agents in suitable regimens. Practical disadvantages of oral treatment include a limited possibility of physician supervision over regular administration...

Suspected of haemorrhoid - what to do?

MUDr. Jiří Korbička, Ph.D, MUDr. Petr Vlček, Ph.D, MUDr. Štěpán Chalupník, MUDr. Jan Doležel, Ph.D, prof. MUDr. Ivan Čapov CSc, MUDr. Radek Tomčík

Interní Med. 2009; 11(6): 301-303  

Patiens having some problems with anorectum or defecation comming very often to their physicians asked them for something against haemorrhoid. Term haemorrhoid marking normal anatomic structures essential for fecal continence. Only when haemorroid nodes are cause of different troubeles, there is talking about haemorrhoid disease which needs firstly investigations especially for risk of rectal cancer camouflage. After it some modality of treatment begins if there is necessary.

Czech pneumology in the third millenium

prof. MUDr. Vítězslav Kolek DrSc

Interní Med. 2009; 11(6): 304-305  

Present work is a overview of the contemporary situation and perspectives in pneumology. Several topics are discussed: diagnostic approaches to the most frequent lung diseases, tertiary care and new therapeutic potential. The term „respiratory medicine“ and ist content is a leading direction to the management of the a wide group of respiratory diseases in European and American areas.

Autodidaktický test č. 6/2009

Interní Med. 2009; 11(6): 306