Co čeká české lázně?

MUDr. Eduard Bláha

Interní Med. 2012; 14(4): 139  

Incretins - intestinal hormones affecting not only insulin secretion

MUDr.Marcela Szabó

Interní Med. 2012; 14(4): 143-146  

The cells of the small intestine produce two hormones belonging to the incretin system – glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP). Their secretion increases mainly postprandially. Reduced postprandial increase in GLP-1 and reduced sensitivity of pancreatic beta cells to GLP-1 and GIP effects have been demonstrated in type 2 diabetics compared to non-diabetic individuals. In type 2 diabetes mellitus, the enzyme dipeptidyl peptidase-4 (DPP-4) known to rapidly degrade incretins also contributes to the insufficient effect of incretins even with high glucose levels. Incretins result not only in increased insulin...

News in allergic disorders treatment

MUDr.Zuzana Humlová, Ph.D.

Interní Med. 2012; 14(4): 147-151  

Increasing prevalence of allergic disorders is an important public health problem that needs a new therapeutical approaches and new molecules for treatment. The knowledge about mechanisms of allergic inflammation is yearly broaden and offer new insights how this process can be treated and symptoms can be mitigated. We have a large scale of antihistaminics including disperse form of tablets and also new molecules from corticosteroids for treatment of allergic rhinitis and asthma. People suffering from asthma can be treated today by powder or aerosol inhalators with combination of corticosteroids and long-acting beta-2-agonists. Patients suffering...

Enteral nutrition in clinical practice

MUDr.Milan Dastych

Interní Med. 2012; 14(4): 152-156  

Enteral nutrition (EN) is defined as delivery of balanced solutions by sipping or tube into the gastrointestinal tract. EN is indicated when the patient is unable to eat for any reason and has a functional gastrointestinal tract. Contraindications for administering EN are: acute abdomen, gastrointestinal bleeding, ileus, high-output intestinal fistulae, and complete loss of bowel function (mucositis, severe enteritis and colitis). Currently, a number of enteral formulas are available: with an energy density of 0.6–2.0 kcal/mL, with or without fibre, with increased protein content, enriched with omega-3 fatty acids, glutamine, and arginine....

Treatment of lower respiratory tract infections in outpatient practice

MUDr.Monika Žurková

Interní Med. 2012; 14(4): 157-160  

The most common lower respiratory tract infections include acute tracheobronchitis, acute exacerbations of chronic bronchitis or of chronic obstructive pulmonary disease, and pneumonias. A wide range of viruses, bacteria and higher forms of microorganisms may be the causative agents. Recently, there has been an increased incidence of atypical bacteria as well as MRSA (methicillin-resistant Staphylococcus aureus) and multidrug-resistant gram-negative bacteria that can cause serious septic conditions. Their clinical manifestations range from diseases with a mild course in otherwise healthy individuals to severe or sometimes even life-threatening...

Hypertension in the elderly: It‘s never too late for treatment

MUDr.Jiří Zajíc

Interní Med. 2012; 14(4): 161-164  

Arterial hypertension is the most common cardiovascular disease. Its high prevalence in the adult population of industrialized countries in particular, represents a serious health problem. The incidence of hypertension increases with increasing age. Population aged over 80 years represents the fastest growing population subgroup. For healthcare worldwide will be necessary to reduce the morbidity associated with older age and the associated dependence of these persons. Arterial hypertension is a risk factor not only for the „classical“ cardiovascular disease but also associated with higher risk of dementia.

Hypertension caused by primary aldosteronism. Is diagnostics always easy?

MUDr.Jitka Seidlerová, Ph.D., prof.MUDr.Jan Filipovský, CSc.

Interní Med. 2012; 14(4): 169-170  

Endocrine diseases cause approximately one third of secondary hypertension cases. Primary aldosteronism is group of diseases characterized by autonomous hypersecretion of aldosterone independent on renin production and unsuppressed by salt intake. We report case of women with resistant hypertension and hypokalemia with diagnosed Conn syndrome.

An atypical cause of Ileus

MUDr.Pavel Sychra, MUDr.Petra Krumpholcová

Interní Med. 2012; 14(4): 171-172  

We describe the case of an elderly male, who visited our clinic with abdominal pain, weight loss and a lack of appetite. Casuistry describes a frequent difficult diagnosis and also a surprising and rare etiology of ileus. Key word: ileus.

Treatment of ocular allergy

MUDr.Alena Feuermannová, Ph.D.

Interní Med. 2012; 14(4): 165-168  

Ocular allergy is inflammatory response of anterior segment of the eye. Allergic disease includes seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), gigant papillary conjunctivitis (GPC) vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis (AKC) and contact allergy (CA). There is a summary of various diagnosis and possibilities of the treatment in this article.

Rheumatoid arthritis

MUDr.Heřman Mann

Interní Med. 2012; 14(4): 177-181  

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by symmetrical polyarthritis. A new classification criteria allowing earlier diagnosis and initiation of treatment were published in 2010. The goal of RA treatment is to achieve clinical remission and to prevent irreversible joint damage. Effective treatment probably also favorably affects increased mortality in patients with RA.

Handling of personal data in connection with health care provision

Mgr.et Mgr.Eva Prošková

Interní Med. 2012; 14(4): 182-185  

The article deals with selected issues concerning the handling of medical records with respect to the legal regulation of protection of personal data. The subject is not dealt with in an exhaustive way; the article addresses selected issues including the basic concepts (personal data, sensitive personal data), obligations of health care facilities as managers of personal data, transfer of medical records to another health care facility, and disposing of medical records. Emphasis is placed on practical examples from the administrative practice of the Office for Personal Data Protection. of medical records, disposing of medical records.

How to prepare a patient treated with warfarin for surgery?

MUDr.Petr Kessler

Interní Med. 2012; 14(4): 173-176  

The perioperative management of patients treated with warfarin should be based on the evaluation of the individual risk of thrombotic complications and bleeding. The patients undergoing procedures associated with low risk of major bleeding (dental procedures, cataract surgery, etc.) don‘t need any alteration of the anticoagulation; it’s however prudent to ascertain the INR seven days and one day prior to the procedure to avoid the overanticoagulation. In patients undergoing all other invasive procedures the therapy with warfarin should be stopped; bridging with low molecular weight heparin is required in some of them. The inherent...