Je potřebná znalost multikulturní zdravotní péče

doc. PaedDr. et Mgr. Eva Zacharová, Ph.D.

Interní Med. 2013; 15(8-9): 243  

Fixed combinations in the management of arterial hypertension

MUDr.Jan Přeček, MUDr.František Kováčik

Interní Med. 2013; 15(8-9): 245-247  

Arterial hypertension is a significant cardiovascular risk factor. Monotherapy fails to result in the expected therapeutic effect in the majority of patients. To achieve target blood pressure levels, about two thirds of patients require the use of combination therapy. However, compliance with treatment decreases with the increasing number of medications. The studies performed suggest that fixed combinations lead to improved patient adherence and compliance. According to the current guidelines for the management of arterial hypertension, the use of fixed combinations has its role as early as initiation of treatment.

Current treatment options for osteoporosis

MUDr.Martina Skácelová, prof.MUDr.Pavel Horák, CSc., MUDr.Martin Žurek

Interní Med. 2013; 15(8-9): 249-253  

Osteoporosis is the most common metabolic bone disease which leads to an increased risk of fractures. The products which reduce bone resorption or stimulate bone formation are used in therapy. Bisphosponates are mainly used, besides them therapy with denosumab, stroncium ranelate and parathormon is used in osteoporosis treatment. Hormonal therapy, tibolone and raloxifen play some role in osteoporosis treatment.

Hepatorenal syndrome

prof.MUDr.Jan Lata, CSc.

Interní Med. 2013; 15(8-9): 253-255  

Hepatorenal syndrome (HRS) is defined as a functional renal failure in patients with liver disease with portal hypertension and it constitutes the climax of systemic circulatory changes associated with portal hypertension. This term refers to a precisely specified syndrome featuring in particular morphologically intact kidneys. The syndrome occurs almost exclusively in patients with ascites. Liver transplantation is the most appropriate therapeutic method, nevertheless, only few patients can receive it. The most suitable „bridge treatments“ or treatment for patients ineligible for a liver transplant include terlipressin plus albumin....

Vitamin D in practical medicine

prof.MUDr.Petr Broulík, DrSc., MUDr.Karolína Broulíková

Interní Med. 2013; 15(8-9): 256-260  

Currently, 30% to 50% of the population are at risk of vitamin D deficiency in Europe and in the United States. Recently, vitamin D has been enormously cited. One the one hand, it is because we realize how important it is for health; on the other hand, it is due to the fact that researchers continue to discover new activities of this essential vitamin and its metabolites that have a number of properties of hormones. A good indicator of vitamin D status in the body is plasma calcidiol concentration that reflects vitamin D from food, sun exposure of the skin, and vitamin D conversion from fat deposits in the liver. Low calcidiol level is associated...

Interestitial lung diseases - why the diagnosis matters?

MUDr.Martina Šterclová, Ph.D., doc.MUDr.Martina Vašáková, Ph.D.

Interní Med. 2013; 15(8-9): 261-262  

Interstitial lung fibrosis is a term used to generally descibe wide group of disorders with different etiology, treatment possibilities and prognosis. In the cases, where any of either patients internal diseases or medication may lead to lung involvement, new manifestation or worsening of preexisting dyspnoea should lead to lung investigation. Because diagnosis establishment and treatment is quite specific in patients with interstitial lung disorders, they should be concentrated into specialized centers. Past treatment modalities were based mainly on systemic corticosteroids. Recently new treatment possibilities including biologics have emerged...

Diabetic nephropathy

MUDr.Tomáš Pokrivčák, MUDr.Petra Milošová, doc.MUDr.Kamil Ševela, CSc., MUDr.Eva Kotulánová, MUDr.Michal Tichý, prof.MUDr.Miroslav Souček, CSc.

Interní Med. 2013; 15(8-9): 277-279  

Diabetic nephropathy is one of the common complications of diabetes mellitus 1st and 2nd type, and is the leading cause of chronic renal failure. In the case report is described a case of diabetic patient with macro- and microvascular complications already developed. An interesting finding is liver focus which is initially impressed as a subcapsular hematoma, in the differential diagnosis is also considered parasitic cyst mainly due to a significant number of eosinophils in the blood. However, biopsy-diagnosed liver abscess. Subsequently, they are also found immature lung abscesses and ovarian abscess. As you can see, in addition to typical...

Treatment of large complex thyroid cysts with ethanol sclerotherapy

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

Interní Med. 2013; 15(8-9): 280-282  

as an alternative to surgical management in multimorbid patients Ultrasound-guided ethanol sclerotherapy is used as an alternative to surgery in the treatment of thyroid cysts. The method is effective, reproducible, cheap, and can be done on an outpatient basis. It involves certain risks related to alcohol leakage to the surrounding areas, but serious complications have been reported in a small proportion of procedures. The approach is successfully used to treat small- and medium-sized cysts of less than 50 ml of volume. It can also be tried in large, mostly complex cysts causing significant mechanical complaints. Two cases are described...

Is the role of ivabradine clear?

prof.MUDr.Jaromír Hradec, CSc., FESC

Interní Med. 2013; 15(8-9): 273-276  

Ivabradine is the first clinically used drug of the new class – so called sinus node inhibitors or bradins. Its only pharmacological effect is heart rate lowering. The mechanism of it is blockade of the If channels in the sinoatrial node cells, therefore it is effective in sinus rhythm only. In this country ivabradine is registered for the treatment of stable angina pectoris in patiens who have contraindications or intolerance to betablockers or who are on betablockers in maximal tolerated daily dose and in spite of this are still symptomatic. The combination of betablocker and ivabradine is safe, if the patient’s heart rate is...

Polypharmacy - an untortunate phenomenom not only in psychotherapy

MUDr.Richard Krombholz, MUDr.Hana Drástová

Interní Med. 2013; 15(8-9): 263-266  

The pharmacological treatment in old age has its specifics and the polypharmacy belongs among the most common problematic situations in gerontopsychiatric patients. A number of older patients are experiencing the chaining of the multiple somatic and psychological disorders which creates a need of greater use of pharmacotherapy. Moreover, in old age, adverse drug effects and drug interactions are more frequent than in the younger population, the most endangered group are just the polymorbid old patients. Moreover, there is known a number of drugs that have the ability to induce the secondary psychiatric symptomatology within their side effects....

Eating disorders in terms of internists

MUDr.Eva Meisnerová

Interní Med. 2013; 15(8-9): 266-268  

Eating disorders affect the entire body with secondary organ complications. When biochemical tests see heavy mineral deficiency, when vomiting is a common metabolic alkalosis. Urinary deficit precedes serum mineral deficiency.Treatment of eating disorders are in the hands of a specialist in psychiatry in collaboration with a psychologist. Intern for the treatment of life-threatening complications and organ. Often the patient monitors eating disorder under another diagnosis.

Apixaban is more effective than warfarin in reduction of the incidence of strokes and bleeding in patients with atrial

MUDr.Petr Janský

Interní Med. 2013; 15(8-9): 269-272  

fibrillation irrespective of their risk profiles: subanalysis of ARISTOTLE trial ARISTOTLE trial compared efficacy and safety of apixaban 5 mg twice daily with warfarin in 18 201 patients with atrial fibrillation. The risk of arterial thromboembolism and bleeding according to CHADS2, CHA2DS2VASc, and HAS-BLED scores was calculated for all study subjects. Apixaban significantly lowered the rate of stroke a systemic embolisation, decreased mortality and reduced the incidence of bleeding complications irrespective of the patients risk profiles.