Urgentní medicína - obor pro třetí tisíciletí

MUDr. Jana Šeblová, Ph.D.

Interní Med. 2010; 12(1): 3  

Is hypertension treatment affected by the presence of comorbidities?

prof.MUDr.Jan Bultas, CSc.

Interní Med. 2010; 12(1): 8-17  

Hypertension treatment is not invariably a simple task with the optimal treatment strategy being affected by a number of factors: age, associated conditions, blood pressure level, concurrent medications, patient compliance and numerous other variables. Selecting the most appropriate medication, which on the one hand will best contribute to improving the patient‘s prognosis and on the other hand will be well tolerated, depends on determining and respecting these features. The present review is concerned with the current opinions on the treatment of hypertension in diabetics, in patients with kidney disease, heart failure and heart valve...

Drug therapy in patients with impaired renal function

MUDr.Jan Vachek, prof.MUDr.Vladimír Tesař, DrSc.

Interní Med. 2010; 12(1): 18-21  

Patients with chronic kidney disease (CKD) are more threatened by drug adverse effects and interactions. Pathophysiological changes caused by CKD influence many pharmacokinetics properties, resulting in diminished glomerural filtration rate (GF) and altered tubular secretion and reabsorbtion. Before setting a patient on a new drug, next scheme is recommended: estimating renal functions (preferably creatinine clearance), evaluation of drug clearance and estimating initial and maintenance dose, checking of plasma level, and dose revision, if appropriate. In renal-excreted drugs, dosing scheme may be adjusted by dose reducing, interval prolongation...

Management of (resistant) dyslipidaemia

MUDr.Jan Piťha, CSc.

Interní Med. 2010; 12(1): 22-25  

Successful treatment of dyslipidemias is a cornerstone in prevention of cardiovascular diseases. In high risk patients, especially diabetics with history of cardiovascular disease, aggressive lowering of all atherogenic lipid components is definitely crucial for their destiny. The achievement of desired blood lipids is therefore more challenging and demands intensive life style counselling together with judicious use of higher doses and combinations of lipid lowering drugs, especially statins and fibrates. On the other hand, with increasing number of patients treated with hypolipemic drugs, increasing doses of mainly statins and in addition...

How to proceed when the acute phase of myocardial infarction is not treated in time

MUDr.Jozef Jakabčin, doc.MUDr.Pavel Červinka, Ph.D.

Interní Med. 2010; 12(1): 41-43  

Subacute phase myocardial infarction as well as angina pectoris or manifestations of heart failure following a recent myocardial infarction are encountered in internal medicine and cardiological practice. It is not uncommon that coronary revascularization is no longer technically feasible. The case report describes the management of invasive diagnostic procedures and subsequent pharmacotherapy of myocardial infarction. The pharmacotherapy of the patient combines prognostic drugs as well as drugs improving the quality of life by affecting the symptoms, but also drugs affecting the metabolism of ischaemic myocardium.

Rivaroxaban (XARELTO) - an orally administered anticoagulant for thromboprophylaxis in orthopedic surgery

doc.MUDr.Otto Mayer, CSc.

Interní Med. 2010; 12(1): 44-46  

Thromboprophylaxis in orthopedic surgery is recently realized using low molecular heparins applied parenterally followed by warfarin with the necessity of laboratory monitoring. New orally administered anticoagulants are now available. Substances are of the character so-called „small molecules” being direct inhibitors of coagulation enzymes. Rivaroxaban is direct inhibitor of factor Xa which represents a common product of the external and internal branch of coagulation cascade. Its inhibition slows down catalytic processes in whole cascade reducing thrombin production as following step. There is presented a review of studies of...

Breast cancer - the major problem also in the 21. century

MUDr.Jana Prausová, Ph.D., MBA

Interní Med. 2010; 12(1): 26-32  

The paper summarised current knowledge from epidemiology and aetiology of breast cancer, emphasized risk factors of sporadic and hereditary cancer. Different types of histology and imunohistological classification are described. Baseline diagnostic procedures for staging of the disease are reviewed. Treatment strategy based on different risk factors reflecting the stage of the disease, prognostic and predictive factor is featured. The importance of the prevention is highlighted for early detection of breast cancer.

Combination treatment in neovascular macular degeneration

doc.MUDr.Petr Souček, Ph.D., MUDr.Ilona Součková, Ph.D.

Interní Med. 2010; 12(1): 33-35  

This article reviews pathogenesis, symptoms and clinical picture of neovascular age related macular degeneration. The most modern treatment is combination of verteporfin and ranibizumab. Its principles are described using citations. Results were evaluated on own study group of 82 eyes of 80 patients. Improvement of functional and anatomical features was statistically significant. The activity of the disease was halted for more than 4 months in 68 % of cases. fluorescein angiography.

Diagnosis and treatment of lymphoedema

MUDr.Kateřina Klauzová, MBA

Interní Med. 2010; 12(1): 36-40  

The lymphatic system is part of the circulatory and immune system. Clinical failure of the lymphatic system arises lymphedema and is caused by imbalances between the transport capacity of the lymphatic system and the resulting volume of lymph. Lymphoedema is a serious, ongoing chronic disease, and are particularly affected limb. The causes of lymphoedema are congenital (primary) and acquired (secondary). Reliable and objective method is the three-phase radionuclide lymphography (lymphoscintigraphy). Treatment of lympho edema is complex, includes manual lymph drainage, intermittent pneumatic compression, bandaging and rehabilitation. Lymphoedema...

How to relieve muscle spasms of the lower extremitie

MUDr.Iva Tomášková, MUDr.Richard Souček

Interní Med. 2010; 12(1): 47-49  

Leg muscle cramps are very common symptoms of the indicated patients of different ages and gender. This can occur to the healthy young subjects as well as to the group of elderly patients. From this wide range of patients follows that leg muscle cramps can have different causes and their diagnosis and treatment will vary accordingly.

Autodidaktický test 1/2010

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Interní Med. 2010; 12(1): 50