Depersonalizace v medicíně, příčiny, průběh, důsledky

MUDr. Radkin Honzák CSc

Interní Med. 2009; 11(9): 363  

Treatment of hypertension with a fixed combination. New evidence.

prof. MUDr. Miroslav Souček, CSc

Interní Med. 2009; 11(9): 369-375  

The guidelines for treatment of hypertension list combinations of various antihypertensives. The effect of these drugs is commonly potentiated. However, one needs to realize the risk of lower patient adherence while having to take multiple tablets. A number of fixed combinations are available that are easier to use and, thus, patient adherence to treatment is more likely. Adherence certainly is a problem in hypertensives since the condition is chronic, often symptomless, and reaching the target pressure mostly requires combination therapy. In 2008, new studies concerning the combination therapy for hypertension were published that have a major...

Antibiotic therapy of respiratory infections

MUDr. Václava Bártů

Interní Med. 2009; 11(9): 376-379  

Upper and low respiratory tract infections belong among the most frequent diseases of childhood and adults. Although many of them are of viral aetiology, they are treated by antibiotics. But it is necessary the use of antibiotics reserves for bacterial infections. Knowledge of local bacteriological situation of workplace, local drug resistance, national and international recommendations for therapy of respiratory diseases play important role in the choice of the optimal antibiotic drug. The basis requirement for select drug is its efficiency, safety and quality in the clinical practice which leads to the suppression of the bacterial infection....

Diarrhoeal diseases - from a clinical point of view

MUDr. Helena Ambrožová Ph.D

Interní Med. 2009; 11(9): 380-383  

Diarrhoeal diseases rang among the most frequent infectious diseases. 44330 cases of diarrhoeal diseases (EPIDAT) were noted in the Czech Republic in the year 2008 bacterial infections dominated, but viral diarrhoeal diseases have been underreported in the long term. Differential diagnosis, clinical picture, complications, diagnostics and treatment of diarrhoeal diseases are described in the article.

Aspirin resistance - recent concepts and guidelines for practice

MUDr. Jana Hirmerová

Interní Med. 2009; 11(9): 384-388  

In spite of proven efficacy in the prevention of atherothrombotic vascular events, aspirin is not able to prevent thrombosis in all patients. “Aspirin resistance” is not a precise descriptor, the term is used in clinical sense (as a failure to prevent a thrombotic complication), as well as in laboratory sense (impossibility to prove the effect of aspirin by some laboratory assay). Diagnostic methods for aspirin resistance are poorly standardized, there are number of assays that do not correlate well with each other and only some of them have been tested for clinical relevance. Because of heterogeneous methodology, the prevalence of...

Macrovascular complications in diabetes mellitus

MUDr. Vladimíra Fejfarová Ph.D

Interní Med. 2009; 11(9): 390-394  

Diabetes mellitus often leads to an acceleration of atherosclerosis via a range of pathophysiological mechanisms. In diabetes mellitus macrovascular complications such as coronary artery disease, peripheral arterial disease and ischemic strokes could develop based on atherosclerotic process. Their occurrences could be partially influenced by preventive precautions including adjustment of lifestyle and treatment of risk factors.

PsA - recent knowledge on pathogenesis, prognosis, assessment, and therapy

MUDr. Jiří Štolfa

Interní Med. 2009; 11(9): 395-401  

Recently, major advances have been made in the research of psoriatic arthritis at the histological, pathophysiological, and clinical levels. This has allowed the development of new pharmaceutical drugs, particularly biologics. Based on histological and immunohistochemical studies, the issues of including psoriatic arthritis in spondylarthritides and the relation to rheumatoid arthritis have been definitively solved. At the clinical level, new classification criteria abbreviated as CASPAR have been outlined. The efficacy of TNFa inhibitors (infliximab, etanercept, adalimumab) has been confirmed and the results of long-term studies have been published....

Selected updates on immunosuppressant indications

MUDr. Jan Strojil, MUDr. Hana Ciferská, Ph.D

Interní Med. 2009; 11(9): 402-404  

The article presents selected updates on the use of immunosuppressants in “off-label” indications. It presents several recent studies and updates, with focus on adalimumab in Crohn’s disease, rituximab and mycophenolate-mofetil in SLE, natalizumab in Crohn’s disease, and also mentions the possible use of infliximab or etanercept in bronchial asthma or alcoholic hepatitis.

Toxic shock syndrome

MUDr. Jana Táborská Ph.D

Interní Med. 2009; 11(9): 405-409  

The overwiev of current knowledges of toxic shock syndrome. Toxic shock syndrome is a multiorgan disease caused by toxins that is characterized by rapid onset of shock and significant lethality. Two microbes are included in the etiology of the disease. Staphylococcus aureus producing TSST-1 and enterotoxins cause staphylococcal toxic shock syndrome. Strains of Streptococcus pyogenes that involve some M proteins and produce pyrogen exotoxins cause streptococcal toxic shock syndrome. The pathogenesis of both types of infection, clinical picture, diagnosis and differential diagnosis, treatment and possible prophylactic measures are described.

Wegener´s granulomatosis from point of view of the pulmologist

MUDr. Vladimíra Lošťáková, Ph.D, prof. MUDr. Vítězslav Kolek DrSc, MUDr. Stanislav Losse, doc. MUDr. Pavel Horák CSc, MUDr. Tomáš Tichý, MUDr. Vladimír Benýšek

Interní Med. 2009; 11(9): 414-417  

There are presented the basic principles of diagnostic and treatment of Wegener´s granulomatosis. The authors present the group of 23 pacients with Wegener´s granulomatosis who were treated at Department of pneumology and tubeculosis LF Olomouc in the period of 1980–2009. The diagnosis was determined on the basis of current clasiffication, histological examination supported with characteristic clinical and radiologic findings. The treatment was proceed by actual standards. The authors underline interdepartmental aproach towards care of this multiorgan disease.

Rectal tumor as a manifestation of extrapulmonary tuberculosis

MUDr. Eva Houšťková, MUDr. Jiří Koskuba, MUDr. Blanka Horová, MUDr. Robert Kulač

Interní Med. 2009; 11(9): 418-421  

Following case report describes relatively protracted diagnosis of a patient, who was admitted for suspicion of rectal neoplasma. The course exemplifies need of complex history, wide differential diagnostics and sort of lengthy identification of extrapulmonary tuberculosis even nowadays. It also documents old clinical truth, that „diagnosis can be made, if we think of it“.

Headache diagnosis and treatment in the Czech Republic

MUDr. Jolana Marková

Interní Med. 2009; 11(9): 410-413  

In the introduction, the author describes the history of the Czech Headache Society which has played an important role in developing the knowledge of headaches in the Czech Republic. Next, the IHS headache classification is briefly mentioned and an overview is given of the most commonly occurring primary as well as secondary headaches – migraine, tension headache, cluster headache syndrome, headaches related to head and/or neck injury, headaches related to cerebrovascular disease, headaches related to intracranial involvement of other than vascular aetiology, headaches related to the use or discontinuation of a pharmacologically active substance,...

What to expect from lymph drainage?

MUDr. Jana Štrinclová

Interní Med. 2009; 11(9): 422-424  

The article summarizes the potential pitfalls of the care of patients with lymphedema and phlebedema during therapy with an emphasis on adhering to the principles of compression therapy, not on possible inflammatory complications (erysipelas, mycoses). It is based on our center‘s 7-year experience with both outpatient and inpatient care.

When to recommend HPV vaccination to female patients?

MUDr. Marta Nováčková

Interní Med. 2009; 11(9): 425-426  

Currently, human papillomavirus (HPV) infection is considered to be the most common sexually transmitted disease. The lifetime prevalence of this infection is as much as 80 %. The majority of infected individuals achieve so-called spontaneous clearance of the infection due to immune mechanisms. The period during which the body clears the HPV infection, the clearance time, is usually between 8 and 24 months. HPV infection is most common in early adulthood between 18 and 25 years of age; it is rarer in later life. In women over 35 years of age, the infection is diagnosed in only about three to five percent. Vaccination is the most recent and reliable...

Inflammation and its modification by diet

doc. MUDr. Jan Kábrt, CSc

Interní Med. 2009; 11(9): 427-428  

Nutrition enriched with glutamine, arginine, nucleotides, polyunsaturated fatty acids and some antioxidants can improve the immune system of patients in stress conditions. Such a nutrition strategy can reduce late postoperative infections, wound complications, days on ventilator, hospital length of stay and treatment cost in patients with severe injury, inflammation or major surgery. It is likely that other studies will uncover important roles for other nutrients for use in clinical practice.

Autodidaktický test 8/2009

Interní Med. 2009; 11(9): 430