Práva a povinnosti lékařů

doc. MUDr. Jiří Šimek, CSc.

Interní Med. 2012; 14(8-9): 295  

Stable angina pectoris: new trends in the treatment

doc.MUDr.Eliška Sovová, Ph.D., MBA

Interní Med. 2012; 14(8-9): 298-303  

Cardiovascular diseases are an important cause of morbidity and mortality in European countries and in the USA. In this review we discuss the importance of the management of symptomatic stable angina pectoris. The main therapeutic target is improvement of prognosis and quality of live with subsequent reduction of symptoms and improvement of exercise capacity. The treatment of stable angina has improved as a result of be tter understanding of pathogenic mechanisms, the implementation of life style changes, aggressive management of risk factors, better pharmacological and revascularization therapy.

Specific features of treatment of diabetes in the elderly

prof.MUDr.Jaroslav Rybka, DrSc.

Interní Med. 2012; 14(8-9): 303-308  

Diabetes mellitus is the most significant metabolic disease in older age. The course of diabetes and its manifestations, however, are frequently different in comparison with those in the middle age. The current Czech Diabetes Society (CDS) guidelines are used in the treatment of diabetes in older age. Emphasis is placed on individualization of treatment that has to be adapted to the health condition of the elderly patient, particularly in the case of comorbidities. Even in elderly patients with diabetes, achieving glycemic control is a cornerstone of the therapeutic strategy; however, in elderly diabetics, circumstances need to be taken into...

New perspectives of the treatment of osteoporosis

MUDr.Dana Michalská, Ph.D.

Interní Med. 2012; 14(8-9): 309-311  

The bone loss after menopause contributes to increased bone resorption (due to estrogen deficiency and vitamin D deficiency in the elderly) and decreasing with age reduced activity of osteoblasts and bone formation. The agents that suppress bone resorption can stabilize bone mass, but do not stimulate bone formation and do not prevent loss of bone quality due to aging. In contrast, agents that target the osteoblast can increase bone formation and bone mass. Novel antiresorptive agents focus attention on effective and revesible effect on osteoclastogenesis and osteoclast aktivity (they include denosumab, an antibody for receptor activator of...

Hyponatremia: diagnostic process and new therapeutic approaches

MUDr.Jan Jiskra, Ph.D.

Interní Med. 2012; 14(8-9): 312-317  

Hyponatremia (decreased serum Na+ bellow low limit of a laboratory method – usually 135–137 mmol/l) is frequent abnormality. Even asymptomatic, hyponatremia is linked with increased morbidity and mortality. Correct diagnosis is based on evaluation of serum osmolality and tonicity, volume of extracellular fluid and concentration of Na+ in urine. Acute severe hyponatremia (

New anticoagulants - possibilities monitoring of dabigatran therapy

doc.MUDr.Věra Krčová, CSc., MUDr.Antonín Hluší, Ph.D., MUDr.Miroslava Palová, Mgr.Luděk Slavík, MUDr.Jana Úlehlová

Interní Med. 2012; 14(8-9): 318-322  

Thromboembolic diseases belong to the most frequent causes of morbidity and mortality worldwide. Their occurrence is now approximately 6.5 million cases per year. During many years before, our therapeutic possibilities were restricted and consisted only of parenteral use of heparins, oral vitamin K antagonists (warfarin) and some less efficient drugs. In the last decade, new antithrombotic drugs were introduced in clinical practice. However, their mechanism of action in contrast to the previous substances is different. The targets are mainly either direct inhibition of trombin (dabigatran) or inhibition of factor Xa (rivaroxaban, apixaban,...

Changes in the lipid spectrum in women with polycystic ovary syndrome (PCOS) and their correlation

MUDr.Hana Šarapatková, MUDr.Yvona Hrčková, MUDr.Romana Šarapatková

Interní Med. 2012; 14(8-9): 327-330  

to anthropometric parameters Objective: Pathological changes in blood lipids are more common in women with PCOS than in the general population. The aim of the study was to compare blood lipid levels in women with polycystic ovary syndrome (PCOS) in the Olomouc region to those in a group of healthy women. Methods: Anthropometric parameters (BMI – body mass index, waist circumference, waist–hip ratio), blood lipid levels (total cholesterol, HDL – high density and LDL – low density cholesterol, triglycerides – TAG), and androgens (total and free testosterone, androstenedione, DHEAS – dehydroepiandrosterone...

Elevated level of creatine kinase

MUDr.Stanislav Voháňka, CSc., MBA

Interní Med. 2012; 14(8-9): 322-326  

Creatine kinase is one of the key enzymes of the energy cell system. Creatine kinase catalyses the conversion of creatine and consumes adenosine triphosphate (ATP) to create phosphocreatine and adenosine diphosphate (ADP) and vice versa. Phosphocreatine serves as an energy reservoir, especially in active tissues. Cytosolic CK consist of three, mitochondrial is created by two isoenzymes. Creatine kinase serum level is considered as the most sensitive laboratory parameter of the muscle damage. The elevation could be found also in other circumstances such physical exercise, muscle injury, pregnancy, malignancy, heavy drinking, drugs abuse, diabetes,...

Sugar substitutes, their role in current diabetology

MUDr.Eva Račická

Interní Med. 2012; 14(8-9): 331-335  

Sweeteners are substances that provide a sweet taste to food. The term sweeteners is usually used to refer to substances that possess a higher sweetness than sucrose, but provide less energy. Sugar substitutes (also referred to as sugar alternatives) can be natural or synthetically manufactured substances. The term artificial sweeteners is used for those manufactured synthetically.

Principles of active immunization. Is vaccination a stress on the immune system?

MUDr.Eva Jílková

Interní Med. 2012; 14(8-9): 336-338  

The article provides a brief overview of immune mechanisms developed as a result of vaccination. A key role in vaccination is played by the character of the antigen applied. Based on the type of antigen the immune system reacts to the vaccine in three different ways of processing the antigen. There is not an objective way for assessment of the stress on the immune system so that we are not able to say whether vaccination is a stress or not. A careful consideration of risks and contraindications and individual approach are basic conditions for a reasonable approach to this issue.

Nutritional support before surgery

MUDr.Eduard Havel, Ph.D.

Interní Med. 2012; 14(8-9): 339-342  

Malnutrition before surgery is common and adversely affects the postoperative course. Risk groups are cancer and geriatric patients, patients with inflammatory bowel disease or other chronic catabolic diseases. Nutritional risk assessment is a required component of pre-operative examination. To identify risk patient is nutritionally suitable NRS 2002 ≥ 3 points (Nutritional Risk Score) or SGA (Subject Global Assessment). Nutritional care before surgery involves first improving the nutritional status of the appropriate interventions for malnourished patients with elective surgery, 2. short-term nutritional support for risk people in length...