Co přinesl rok 2011 v pneumologii

prof. MUDr. Vítězslav Kolek, DrSc.

Interní Med. 2012; 14(3): 91  

Chronic venous disease: underappreciated and overappreciated, what is new?

doc.MUDr.Dalibor Musil, Ph.D.

Interní Med. 2012; 14(3): 96-100  

Chronic venous disease is a widespread disease of civilization. Currently, the following are considered to be relevant risk factors: age, positive family history, female gender, multiparity (two or more childbirths) and obesity. The diagnosis is based on medical history and clinical examination. Color duplex sonography has become a new standard in laboratory diagnosis. Compressive stockings are the most effective form of conservative therapy, including the treatment for venous leg ulcers, but they often cannot be used for a variety of reasons. Sclerotherapy and surgical treatment are much more effective than conservative therapy that only treats...

Fragility in a geriatric patient: possibilities of management

MUDr.Martina Nováková

Interní Med. 2012; 14(3): 101-103  

The issue of geriatric fragility and the possibilities of its management are defined and discussed, with an emphasis being placed on nutrition, rehabilitation and motivation in geriatric patients. Basic therapeutic strategies using both pharmacological and nonpharmacological treatment are stressed and the need for comprehensive care of fragile elderly persons which should be provided by specialized geriatric units is highlighted.

Barrett´s esophagus, risk factors and management

MUDr.Radek Kroupa, Ph.D.

Interní Med. 2012; 14(3): 104-106  

Barrett´s esophagus (BE) is a premalignant lesion developed due to chronic gastroesophageal reflux. The squamous esophageal mucosa is replaced by columnar epithelium. The squamocolumnar junction is displaced proximally and metaplastic epithelium should be confirmed from biopsy samples. The risk of development of adenocarcinoma is 30–40 times higher in patiens with BE than in patients without this condition. Incidence of cancer in patients with BE is approximatelly 0,2–0,5 % per year. Endoscopic surveillance program has been established to diagnose early dysplasia and cancer. Antireflux therapy by acid suppressant drugs or surgery...

Chronic kidney disease

MUDr.Jan Vachek, MUDr.PhDr.Oskar Zakiyanov, prof.MUDr.Vladimír Tesař, DrSc., MBA

Interní Med. 2012; 14(3): 107-110  

Chronic kidney disease (CKD) is a serious public health issue with far-reaching medical and social consequences including the enormous cost to the public health system. Since the patients with CKD frequently present with small subjective symptomatology, the condition is recognized late in many cases. Given the global demographics and the dramatic expansion in the number of patients with CKD and associated diseases, a working knowledge of this renal disease is a prerequisite for the practicing physicians including primary care physicians and specialists. The present review aims to assist a clinician to day-to-day manage of patients with CKD...

Systemic manifestations of chronic obstructive pulmonary disease (COPD): new treatment options

doc.MUDr.Jaromír Musil, Ph.D.

Interní Med. 2012; 14(3): 111-115  

The view of COPD has changed. COPD is currently seen as a complex disease involving not only bronchial obstruction. COPD is accompanied by systemic inflammation. The inflammation results in the development of comorbidities such as cachexia, muscular weakness, cardiovascular disease, pulmonary hypertension, anaemia, systemic hypertension, osteoporosis, depression, diabetes mellitus, or sleep apnoea syndrome. Patients with COPD have a higher risk of developing bronchogenic carcinoma. Comorbidities must be taken into account when making treatment decisions. It is necessary to relieve bronchial obstruction and suppress lung inflammation in which...

Options of treatment with insulin pumps

MUDr.Zdeněk Jankovec, Ph.D.

Interní Med. 2012; 14(3): 116-118  

Treatment with an insulin pump has gradually become a routine part of care of patients with diabetes mellitus, particularly of those with type 1 diabetes. Currently, approximately 5,500–6,000 patients, primarily centred in diabetes centres, are estimated to be treated with an insulin pump in the Czech Republic. Due to frequent comorbidities, this treatment is not exclusively in the hands of diabetologists, but increasingly involves the participation of physicians in other fields as well. The article aims at presenting a brief overview of the present knowledge on treatment with an insulin pump and current indications and options of treatment....

Studie SOLVETM - včasná iniciace terapie inzulinem detemir u diabetiků 2. typu

MUDr. Alena Adamíková, Ph.D.

Interní Med. 2012; 14(3): 132-134  

A case of acute pericarditis in a patient with malignant mesothelioma

MUDr.Lubica Cibičková, Ph.D.

Interní Med. 2012; 14(3): 122-124  

We report a case of a patient with malignant epithelial mesothelioma who developed acute pericarditis. Pericarditis might be caused by grow of the mesothelioma through pericardial membrane, or by reactive inflammation of pericardium, or by infection – particularly viral (which is the most probable cause).

Parathyroid carcinoma

MUDr.Milan Halenka, Ph.D., doc.MUDr.David Karásek, Ph.D., doc.MUDr.Zdeněk Fryšák, CSc., doc.MUDr.Pavel Koranda, Ph.D.

Interní Med. 2012; 14(3): 125-128  

Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. It may be suspected based on severe clinical signs, significant laboratory findings and the tumor size. The clinical signs of primary hyperparathyroidism are dominated by recurrent nephrolithiasis, bone disease, hypercalcemic syndrome and uncontrollable hypercalcemic crisis may occur. The basic therapeutic approach is radical surgery. ultrasonography, technetium-99m sestamibi.

Vulvovaginal discomfort of fungal origin: current status and therapeutic options

doc.MUDr.Jiří Špaček, Ph.D., doc.RNDr.Vladimír Buchta, CSc., MUDr.Jan Kestřánek

Interní Med. 2012; 14(3): 119-121  

Vulvovaginal candidiasis is the most common vaginal disease and it is also the most frequent cause of vulvovaginal discomfort (itching, burning and discharge). It affects most women at some point in their lives and its sporadic form is usually managed without difficulty. By contrast, in recurrent conditions symptoms escalate and the gynaecological finding is often very poor or completely normal. Sometimes it is possible to determine the inciting moment; however, the actual cause mostly remains undiscovered. Moreover, in a number of cases, the finding of yeast may not necessarily confirm fungal aetiology and the term recurrent vulvovaginal candidiasis...

Rational examinations indication in patients with arterial hypertension

MUDr.Eva Kociánová, MUDr.Jan Václavík, Ph.D., doc.MUDr.Miloš Táborský, CSc., FESC, MBA

Interní Med. 2012; 14(3): 129-131  

The paper presents a practical view on indicating basic and complementary examinations in a patient with arterial hypertension that are the cornerstone for determining cardiovascular risk, degree of organ damage and suspicion for an identifiable secondary cause of hypertension.