Internal Medicine for Practice, 2010, issue 4

Editorial

Podpůrná péče jako integrální součást individualizované onkologické léčby

doc. MUDr. Petra Tesařová, CSc.

Interní Med. 2010; 12(4): 175

Review articles

New antidiabetic drugs in the treatment of type 2 diabetes mellitus

MUDr.Martina Lášticová, doc.MUDr.Alena Šmahelová, Ph.D.

Interní Med. 2010; 12(4): 178-180

Therapeutical approach to type 2 diabetes has changed over last years. Non-pharmacological intervention, dietary and lifestyle modification, remain mainstay of therapy. At the same time, it is usually necessary to start pharmacological treatment. There are new antidiabetic drug classes targeting different pathogenetic mechanisms, that allow us to individualize therapy to specific needs of a patient with type 2 diabetes.

Current status and perspectives of pharmacotherapy of pulmonary arterial hypertension

MUDr.Pavel Jansa

Interní Med. 2010; 12(4): 182-185

Pulmonary arterial hypertension (PAH) is a primary disease of pulmonary arterioles resulting in progressive precapillary pulmonary hypertension and, if untreated, it relatively rapidly leads to right ventricular failure and death. PAH either occurs due to unknown causes or is associated with a known cause (connective tissue disease, liver disease, congenital heart disease, HIV infection or abuse of some anorectic drugs). Current pharmacotherapy of PAH can be divided into conventional (treatment of heart failure, anticoagulation treatment, calcium channel blockers) and specific (prostanoids, endothelin receptor antagonists, phosphodiesterase-5...

Early diagnostic of chronic obstructive pulmonary disease, therapy and their pharmacoeconomy profits

MUDr.Ján Dindoš

Interní Med. 2010; 12(4): 186-190

Chronic obstructive pulmonary disease (COPD) is currently the fourth cause of mortality in the world and it is predicted to rank third in the year 2020. The prevalence of COPD varies in different regions of the world, but it affects at least 10 % of the adult population. Despite being a chronic disease, that can not be cured, it is preventable disease (reducing tobacco consumption mostly) and treatable. We are indeed capable to improve many manifestation of disease, including symptoms, exacerbations, health status and prognosis.

Pregnacy and thyroid gland

prof.MUDr.Václav Zamrazil, DrSc.

Interní Med. 2010; 12(4): 191-195

Pregnancy is connected with necessity to increase function of the thyroid, as thyroid hormones should supply not only pregnant women, but predominantly fetus. For synthezis of thyroid hormones, increased supply of iodine is necessary. Pregnancy influences diagnosis of thyroid disorders (increased total thyroxine level, changes of secretio of TSH due to effects of placental hormones) as well as therapy (increase of iodine supply, increase of supplementary doses of thyroxine etc.). Even minimal changes of thyroid hormones and of iodine saturation are harmful for optimal development of fetus (esp. its brain) and for course of pregnancy and labor....

Bronchial asthma - practical aspects

MUDr.Irena Krčmová, CSc., MUDr.Jakub Novosad

Interní Med. 2010; 12(4): 196-199

Objective of the article is summarised the basic aspects of ethiopatogenesis, diagnosis, classification and therapy of asthma.

Chronic pain, diagnostics and therapy

MUDr.Pavlína Nosková

Interní Med. 2010; 12(4): 200-204

Chronic pain (CHP) remains unresolved problem of present medicine. 40–60 % patients suffering with CHP do not regard pain release sufficient. The decisive therapeutic approach is optimal differentiation assessment of pain according to its etiology. This point is necessary for successful treatment. Opiate analgetics represent a choice regardless of certain historic reserved distance. Suitable analgetics for long-term treatment are another crucial factor. Adverse events rising from favourite non-steroid analgetics use have to be minimised. When pharmacotherapy, rehabilitation, psychotherapy had been depleted, new invasive analgetic methods...

Case report

Treatment and control of hypertension in Czech republic in period 1997/1998-2006/2009

MUDr.Marie Jozífová, prof.MUDr.Renata Cífková, CSc., MUDr.Zdenka Škodová, doc.MUDr.Věra Adámková, CSc., MUDr.Jan Bruthans, CSc., MUDr.Jiří Procházka, MUDr.Jiří Bělohoubek, MUDr.Markéta Galovcová, MUDr.Peter Wohlfahrt, MUDr.Alena Krajčoviechová, RNDr.Věra Lánská, CSc.

Interní Med. 2010; 12(4): 212-217

The study was designed to determine changes in the treatment and control of hypertension in a randomly selected population sample of the Czech Republic over the past 10 years. The prevalence of hypertension rose in a random population sample of the Czech Republic rose over the past 10 years while treatment and control of hypertension improved.

Triple infection due to one parasite or a harm single tick can cause

MUDr.Martina Pýchová, MUDr.Marta Šnelerová, MUDr.Hana Kocourková, MUDr.Michaela Freibergerová, MUDr.Radana Pařízková, prof.MUDr.Petr Husa, CSc.

Interní Med. 2010; 12(4): 218-219

This article presents the case of the 53-years old woman, who was hospitalized in summer 2008 with diagnosis tick-borne encephalitis in combination with Lyme disease. A course of the infection was complicated by incurred paralysis of lower limbs and patient required intensive medical care and long-time rehabilitation therapy. In addition there was diagnosed another tick-borne transmitted disease – ehrlichiosis.

Pharmacological profile

Rosiglitazone in the treatment of diabetes in 2010, what’s new?

prof.MUDr.Martin Haluzík, DrSc.

Interní Med. 2010; 12(4): 223-224

Glitazones are antidiabetic drugs acting through the stimulation of nuclear PPAR (peroxisome proliferator activated receptors) receptors. Due to pleiotropic effects of PPAR activation glitazones not only improve blood glucose and insulin resistance but also exert antiinflammatory, blood pressure lowering and numerous other positive effects. In addition to benefitial effects of glitazones possible cardiovascular side effects in patients with coronary heart disease are discussed especially in connection with rosiglitazone. The aim of this article is to summarize the results of recent trials with rosiglitazone in patients with cardiovascular complications....

Interdisciplinary overviews

Parkinson’s disease and ability to drive

MUDr.Jindra Svátová

Interní Med. 2010; 12(4): 205-208

Parkinson´s disease (PD) is a common neurodegenerative disease that is characterized by tremor, rigidity, bradykinesa and postural instability, cognitive impairment can also be an important feature too. Driving may be negatively influenced by motor and non-motor Parkinson´s disease symptoms, pharmacotherapy and multimorbidity. No evidence-based guidelines exist for assessing driving competency in individuals with PD. Analysis of literature indicates the need of individual judgenent on mental state of patients with PD – the need to pay attention not only to motor but to cognitive function, sleep disturbance and vision disturbance which...

Secondary type of headache

MUDr.Jiří Mastík

Interní Med. 2010; 12(4): 209-211

International Classification of Headache Disorders recognizes primary and secondary type of headache. The attention turns to the problematics of secondary headache in this chapter. Secondary type of headache has its obvious causation. It can be one of the symptoms of major life threatening conditions as cerebrovascular disease, especially subarachnoidal and intracerebral haemorrhage, carotid dissection and venous thrombosis, brain tumours, neuroinfections and major craniocerebral trauma. It is important to follow “red flags” that will lead us to the early and correct diagnosis.

Good advice

Prevention of acute kidney injury: what is available in clinical practice

prof.MUDr.Martin Matějovič, Ph.D.

Interní Med. 2010; 12(4): 220-222

Acute kidney injury (AKI) is a complication that occurs frequently in hospitalized patients. AKI is associated with significant mortality and morbidity. The first step in prevention is to identify persons at high risk for AKI. In this context, patients with chronic kidney disease, atherosclerosis, diabetes mellitus, chronic heart failure and/or poor nutrition are at particular risk. The most common precipitating factors for the development of AKI include sepsis, major surgery (in particular cardiac and vascular surgery), marked hypovolemia, severe pancreatitis, nephrotoxic drugs and radiocontrast media. Renal protection should focus on prompt...