Smysl života ve stáří

MUDr. Jiřina Ondrušová

Interní Med. 2010; 12(9): 399  

Latest trends in pharmacotherapy of COPD

MUDr.Norbert Pauk, Ph.D.

Interní Med. 2010; 12(9): 404-406  

Chronic obstructive pulmonary disease (COPD) has become a treatable condition; however, it remains a very serious global problem. Approximately 600 million people suffer from the disease. In Europe, the prevalence ranges from 4 % to 10 % in persons over 40 years of age. However, the condition is largely underdiagnosed and the number of patients is expected to be two-fold and the prevalence has been steadily increasing, particularly among women. Modern pharmacotherapy can affect numerous parameters, improves the quality of life of patients, alleviates the symptoms, reduces exacerbations and appears to positively affect the disease-related mortality.

The irritable colon and functional constipation

MUDr.Karel Hrubant

Interní Med. 2010; 12(9): 407-410  

The irritable colon and functional constipation are the most frequent functional disorders of the digestive system and occur in a high percentage of the population in developed countries. The predominant symptom of the irritable colon is abdominal pain and/or abdominal discomfort, which is eased by defecation or a change in the form or frequency of the stools, and malfunction in evacuation. The main symptom of functional constipation is a permanent difficulty in defecation associated with the infrequent passage of hard stools, often associated with the feeling of incomplete emptying. The pathogenesis of both conditions is not known despite...

News in diagnosis and therapy of chronic venous diseases

MUDr.Alena Broulíková, CSc.

Interní Med. 2010; 12(9): 411-413  

Chronic venous diseases of lower extremities belong to a very common medical disorders that affect a large part of western population. The term „Chronic venous dieseases“ includes all clinical variations (symptoms and signs) resulting from diseases of lower extremity veins. It is a chronic progressive disease during life. At one side it is possible from medical point of view to include medically minor changes, such as intradermal teleangiectasies and on the other side, this includes the major symptoms, which lead to changes in the skin and subcutaneous tissue, with endstage of venous diseases, e.g. lower leg ulcer.

Oxidative stress and its relationship to diabetes compliations

prof.MUDr.Jan Škrha, DrSc.

Interní Med. 2010; 12(9): 414-418  

Oxidative stress in diabetes is considered at present time as a key cause in development of late complications. It is contemporary binding element between separate pathogenic pathways participating at development of vascular changes. Hyperglycemia, which is the main source of accelerated oxidative stress, induces especially in combination with dyslipoproteinemia advanced atherogenesis. Main associations between oxidative stress and mechanisms leading to vascular wall changes are summarized in this overview. The main goal is therefore the intensive diabetes therapy as well as the treatment of associated risk factors which may decrease oxidative...

Chronic fatigue syndrome

RNDr.Petr Šíma, CSc.

Interní Med. 2010; 12(9): 419-423  

Chronic Fatigue Syndrome (CFS) represents a multisystemic disease accompanied by multiple non-specific and frequently uncertain symptoms of unknown etiology. CFS affects more various organs and owing to fluctuating neurotransmitter and hormonal regulations it manifests by varied complaints, sufferings, and impairments of vegetative functions, muscular weakness, psychic and neurological disturbances, and last but not least, a substantial decline of antiinfectious and anticancerous immunity.

Angiotensin-converting enzyme inhibitors and the fixed drug combination in practice

MUDr.Filip Málek, Ph.D., MBA

Interní Med. 2010; 12(9): 424-426  

Angiotensin-converting enzyme inhibitors (ACEIs) have broad indication: ACEIs are widely used in the therapy of arterial hypertension, cardiac dysfunction post myocardial infarction and in the management of chronic heart failure. Research showed other possibilities of ACEIs use. Results of large clinical trials support importance of ACEIs in the cardiovascular event prevention in high risk subjects, secondary prevention of ischemic stroke, and vascular complication in patients with diabetes mellitus. Current guidelines recommend to start medical therapy of moderate to severe arterial hypertension with low dose of drug combination. ACEIs are...

Clinical use of the new antithrombotics

doc.MUDr.Petr Dulíček, Ph.D.

Interní Med. 2010; 12(9): 427-430  

Venous thromboembolism is a major medical and social economical problem. However, it is a big challenge because it is possible to eliminate this disease by appropriate thromboprophylaxis. Unfractionated heparin hase been the therapy of choice for many years, but it was replaced by low molecular heparin in the last 20 years. New antithrombotic have come up in clinical praxis recently. There are 2 new drugs with a different mechanism of action. Dabigatran etexilate is direct trombin inhibitor, rivaroxaban is direct FXa inhibitor. In our article, we discuss current knowledge of these drugs and the possibility of use in the clinical praxis.

Beta blockers in the treatment of acute heart failure

MUDr.Tomáš Janota, CSc.

Interní Med. 2010; 12(9): 431-433  

Beta blockers boast a number of advantageous effects. Substantial is a deceleration of heart rate, leading to the decrease in metabolic demands of the myocardium, improvement of left ventricle filling, as well as improvement in the subendocardial blood flow. They also decrease arterial blood pressure, have antiarrhythmic effects and in long term use in chronic heart failure lead to an increase in left ventricle ejection fraction. Beta blockers can also improve myocardial function in acute heart failure. It is nowadays a standard practice to continue chronic beta blocker medication in acute exacerbation of chronic heart failure when possible....

Insulins and cancer

MUDr.Daniel Housa, Ph.D., MUDr.Jitka Housová, Ph.D.2, prof.MUDr.Štěpán Svačina, DrSc., MBA2, prof.MUDr.Martin Haluzík, DrSc.2

Interní Med. 2010; 12(9): 434-438  

The article deals with the relation of insulin to development and progression of cancer and its molecular-biology basis with emphasis on IGF system. Concurrently the article mentions the present hot topic of the relation of insulin glargine to cancer.

Refeeding syndrome - a latent clinic threat

MUDr.Jiří Plášek, MUDr.Vladimír Hrabovský, doc.MUDr.Arnošt Martínek, CSc.

Interní Med. 2010; 12(9): 439-441  

The aim of this article is mention of refeeding syndrome (RFS), as an important component of clinical practice. RFS is metabolic disturbance, resulted from feeding restoration in malnourished and/or starved patients. Hypophosphatemia, hypomagnesaemia, hypokalemia, alteration of carbohydrate and fat metabolism, sodium and fluid retention are typical signs of this syndrome. Rapid decrease of phosphate plasma level under 0,5 mmol/l (or slow decrease under 0,3 mmol/l) is the most important symptom. Hypophosphatemia is connected with consciousness deterioration, cardiac and pulmonary failure, haemolysis and leukocyte dysfunction. Thus, these symptoms...

Early gastric carcinoma

MUDr.Alice Bártková, MUDr.Martin Liberda, MUDr.Ondřej Urban, Ph.D.

Interní Med. 2010; 12(9): 448-449  

The problem of early gastric carcinoma diagnosis and the possibility of its endoscopic treatment is summarized in this article. In our case report we present our own experience with a diagnosis of early gastric carcinoma in a patient with upper gastrointestinal bleeding as a primary indication for endoscopy, and a subsequent endoscopical therapy with an endoscopic submucosal dissection (ESD) as a method of choice.

Metformin in combination with other antidiabetics

prof.MUDr.Jindřiška Perušičová, DrSc.

Interní Med. 2010; 12(9): 454-457  

Metformin is an ideal peroral antidiabetic drug for combining with all hypoglycemic drugs – peroral antidiabetics, incretin-based drugs, as well as with insuline. Very favorable effects of metformin in combination are confirmed also by five available fixed metformin combinations with other peroral antidiabetics in one tablet.

Treatment of ischemic stroke

doc.MUDr.Jiří Bauer, CSc.

Interní Med. 2010; 12(9): 442-444  

Stroke is an emergency, stroke victims must be admitted without delay to the hospital. All stroke patients should be treated in primary or comprehensive stroke centers. Basis of care is general treatment, including intensive rehabilitation. Another treatment is strongly individual. Treatment of ischeamic stroke is focused on recanalisation therapy, early prevention, therapy and prevention of secondary brain injury.

Peripheral facial nerve palsy

prof.MUDr.Zdeněk Ambler, DrSc.

Interní Med. 2010; 12(9): 445-447  

The facial nerve is 7th cranial nerve. The larger portion comprises motor fibers and innervates muscles of the face. The smaller nervus intermedius contains parasympathetic (secretory), sensory (taste) and somatosensory fibers. In a lesion of the facial nerve ipsilateral paresis of mimic muscle develops. This should be distinguished from central mimic palsy that produces weakness only in lower half of the face contralaterally. The most common cause of unilateral facial paralysis is Bell’s palsy – inflammatory mononeuritis. Other causes include herpes zoster (Ramsay Hunt syndrome), Lyme borreliosis, posttraumatic lesions in petrous...

Diet in osteoporosis

MUDr.Irena Kučerová

Interní Med. 2010; 12(9): 450-453  

The article deals with the effect of nutrition on bone mass. Adequate calcium and vitamin D intake along with physical activity play an essential role influencing the level of peak bone mass in young age and bone loss in older age. Bone quality is also affected by other mineral substances and trace elements. The contradictory effect of protein on calcium balance is the subject of debate. Bone loss is also caused by protein-calorie malnutrition in old age that increases the risk of falls and hip fractures.

Autodidaktický test 7/2010

Interní Med. 2010; 12(9): 458