Prediktivní, preventivní, personalifi kovaná medicína - příslib do budoucnosti?

prof. MUDr. Václav Zamrazil, DrSc.

Interní Med. 2013; 15(2): 47  

Dipeptidyl peptidase-4 inhibitors

MUDr.Marcela Szabó

Interní Med. 2013; 15(2): 49-50  

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 the effects of GLP-1 and GIP have been demonstrated in type 2 diabetics in comparison with nondiabetic 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 when the glucose level is high.

New guidelines for treatment of atrial fibrillation

doc.MUDr.Petr Heinc, Ph.D., MUDr.František Kováčik, MUDr.Ondřej Moravec, MUDr.Jan Přeček, doc.MUDr.Miloš Táborský, CSc., FESC, MBA

Interní Med. 2013; 15(2): 52-58  

Management of nonvalvular atrial fibrillation is recommended by Guidelines for the management of Atrial Fibrillation of the Czech Society of Cardiology (2011), 2012 focused update of the ESC Guidelines for the management of atrial fibrillation (august 2012) with other national limitations. Vernakalant is newly available and recommended for pharmacological cardioversion of atrial fibrillation and dronedarone rhythm-control after cardioversion of paroxysmal or persistent atrial fibrillation. Dabigatran and rivaroxaban are preffered instead of warfarin for anticoagulant therapy in vast majority of patients with its specific limitations.

Gastric disorders in general practice

MUDr.Radek Kroupa, Ph.D., MUDr.Markéta Ječmenová

Interní Med. 2013; 15(2): 60-63  

Symptoms of gastric disorders are miscellaneous. Upper dyspeptic syndrome, including the complex of painful and discomfort troubles associated with gastric digestion, is often part of them. The cause of dyspeptic syndrome is either in organic disorder of the stomach and digestive tract, in any systemic disease or in functional disorder without any organic finding. The prevalence of organic gastric disorders is changing through decades. Incidence of peptic ulcer disease is declining, whereas presence of gastropathy associated with drug injury is increasing. Incidence of serious gastric cancer is a little decreasing through the time, fortunately....

Insulin pump therapy

doc.MUDr.Kateřina Štechová, Ph.D.

Interní Med. 2013; 15(2): 64-68  

The course of glycaemia near to normal values is the key goal in diabetes therapy to improve importantly patient´s long term outcome. Insulin pump therapy which means combination of permanent slow subcutaneous infusion of basal insulin dose according to prepared schema in combination with manually activated prandial boluses represents nowadays the best possibility how to mimic physiological insulin secretion. New insulin pumps have integrated many modern tools (e.g. the possibility to choose different types of basal and bolus doses, bolus calculator or integrated system of continual glucose monitoring). By using these tools a patient can improve...

Clinical experience with a fixed combination of candesartan 32 mg and hydrochlorothiazide

MUDr.Jiří Slíva, Ph.D.

Interní Med. 2013; 15(2): 78-79  

Currently, hypertension is one of the most common disease affecting cardiovascular system. Even if the monotherapy by antihypertensives is used, many patients are not controlled adequately, thus combination treatment has to be started. This article summarizes up to date clinical experience with candesartan in a combination with a thiazide diuretic agent, hydrochlorothiazide.

Changes in patients’ internal enviroment related to administration of blood products

MUDr.Radovan Uvízl, Ph.D., doc.MUDr.Tomáš Gabrhelík, Ph.D., Mgr.Kateřina Langová, Ph.D., MUDr.Bronislav Klementa, MUDr.Petr Šafránek, doc.MUDr.Milan Adamus, Ph.D

Interní Med. 2013; 15(2): 80-83  

During their storage, red blood cells (RBCs) undergo changes resulting from their metabolism and breakdown. Thus, initial concentrations of certain biochemical parameters, in particular potassium, lactate and pH, are changed. In patients with life-threatening bleeding, administration of RBCs, especially in case of multiple transfusions, may lead to undesirable changes in their internal environment. With concurrent failure of multiple organ systems, these changes are mainly accentuated by the effects of renal, circulatory and respiratory insufficiency. The study documents changes in the internal environment in recipients of multiple RBC transfusions....

Diagnosis and treatment of the red eye

MUDr.Markéta Svobodová, MUDr.Michalis Palos

Interní Med. 2013; 15(2): 69-74  

Red eye is a non-specific status, which is the most often reason the patient comes to the eye doctor. It might be the manifestation of different clinical units. In current practice occupies not only ophthalmologists but also pediatricians, physicians and many other specialists. Serious systemic diseases may be presented with red eye. If these disorders aren´t enough compensated or properly diagnosed and treated, they can cause severe problems. The aim is to present the eye diseases which require interdisciplinary cooperation and the findings of the eye, which can make the diagnosis difficult.

Nutrition and Sleep

MUDr.Pavel Dohnal

Interní Med. 2013; 15(2): 75-78  

The change of lifestyle and circadian rhytmicity brings due to arteficial illumination and electronic media hormone-conditioned changes leading to disorders of food intake and energy expenditure. Changes take place in all cascades of neurohumoral management since childhood and have a regressive influence on lifestyle. NPY/AgRP neurons stimulate food intake, in contrast orexin A and B, melatonin and CART/POMC neurons suppress good appetite. Thyroid-stimulating hormone (TSH) supports energy expenditure, Growth hormone (GH) reduces glucose utilization at the level of the hypothalamus. Leptin and ghrelin act on the hypothalamic nuclei feedback,...

Diabetic foot syndrome - diagnosis and treatment

MUDr.Alena Broulíková, CSc.

Interní Med. 2013; 15(2): 84-86  

Diabetes mellitus is the leading cause of nontraumatic lower extremity amputation. Foot ulcers and infections are also a major source of morbidity in individuals with diabetes mellitus. The reasons for the increased incidence of these disorders in diabetes mellitus involve the interaction of several pathogenic factors: neuropathy, abnormal foot biomechanics, peripheral arterial disease, and poor wound healing. These risk factors are summed in patients with syndrome of diabetic foot.