Začněme výživou …

Ing. Ivan Mach, CSc.

Interní Med. 2014; 16(1): 3  

News in the pharmacotherapy of venous disease

MUDr.Karel Roztočil, CSc.

Interní Med. 2014; 16(1): 5-10  

Recently, new knowledge has been gained in the field of both chronic and acute venous disease that has an impact on the care of patients with these conditions. The incidence of chronic venous disease has been shown to be globally high, in both industrialized and developing countries. The rate of the most severe cases with an advanced stage of venous failure is approximately twice as high in the population as has been assumed so far. Among venopharmaceuticals, micronized purified flavonoid fraction remains the agent with the highest degree of recommendation and is also indicated to pharmacological support of leg ulcer healing, along with pentoxifylline...

Absolute alcohol sclerotherapy under ultrasonographic control in the treatment of primary hyperparathyroidism

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

Interní Med. 2014; 16(1): 11-14  

Primary hyperparathyroidism ranks third in frequency of endocrine diseases. More frequent testing ensues is why it is currently the primary hyperparathyroidism revealed at a time when no clinical symptoms, the disease is asymptomatic form. The most common cause is a solitary parathyroid adenoma. The basic method of treatment is surgery of course – parathyroidectomy. In some very specific situations can be patients as an alternative to offer non-surgical intervention – absolute alcohol sclerotherapy under ultrasonographic control. First of all, it can be recommended in severely ill patients, significantly less often after unsuccessful...

Comprehensive care of patients with diabetic foot syndrome.

MUDr.Jana Pecová

Interní Med. 2014; 16(1): 15-19  

Diabetic foot syndrome is one of the long-term complications of diabetes mellitus. Diabetics with DFS are endangered by foot ulcer occurrence. The crucial source of the ulcer is polyneuropathy and/or ischemia. During the DFS therapy it is important to have a multifactorial approach and a more conservative attitude residing in podiatric care, the early administration of antibiotics in case of foot infection and metabolic parameters correction. It is vital to attempt revascularisation in case of ischemia and surgically treat the foot (incision, drainage, nephrectomy, small amputation). The prevention consists of watching problematic patients...

Atypical haemolytic-uraemic syndrome and new treatment options

prof.MUDr.Romana Ryšavá, CSc.

Interní Med. 2014; 16(1): 22-25  

Haemolytic-uraemic syndrome (HUS) is a relatively rare cause of thrombotic microangiopathy (TMA). It is typically manifested by haemolytic anaemia with a negative Coombs test, the presence of schistocytes, thrombocytopenia, and multiple organ failure, particularly renal failure. Damage to other organs, particularly the myocardium and organs of the alimentary tract, is frequent, as is neurological symptomatology. Typical forms of HUS result from endothelial damage induced by Shiga toxin, produced by some E. coli serotypes in intestinal infections. Approximately 10% of HUS result from a different cause. Secondary forms of HUS can be induced by...

Young patient with recurrent deep vein thrombosis - causes and consequences

doc.MUDr.Jana Hirmerová, Ph.D.

Interní Med. 2014; 16(1): 31-34  

The article describes a case report of a complicated course of venous thromboembolic disease. A young man was hospitalized in our department in 2003 with suspected recurrence of deep vein thrombosis. Ultrasonograpy found multiple thrombotic changes in the deep veins of both legs, probably of various duration. X-ray venography revealed chronic venous occlusion in pelvic veins bilaterally. We started administration of low-molecular-weight heparin with transition to warfarin. However, drug-induced liver damage occurred as a consequence of warfarin use. Moreover, we confirmed a strong combined hypercoagulable state. We recommended a long-term anticoagulation...

Differential diagnosis of unconsciousness from the perspective of an endocrinologist

MUDr.Ľubica Cibičková, Ph.D., doc.MUDr.Zdeněk Fryšák, CSc., MUDr.Igor Tozzi, Ph.D., prim.doc.MUDr.David Karásek, Ph.D.

Interní Med. 2014; 16(1): 35-37  

Present case report describes young patient with repeated unconsciousness which were considered to be of epileptic origin. The real cause of unconsciousness was severe hypoglycemia caused by pancreatic insulinoma. Finding out the cause of unconsciousness enabled their targeted therapy – surgical resection and expressive improvement of quality of life.

High-energy trauma in a pregnant woman - case report

Mgr.Zdeňka Blažková, RNDr.Jana Březinová, Ph.D., doc.MUDr.Ivana Oborná, Ph.D., MUDr.Petr Hubáček, MUDr.Libor Machálek, MUDr.Petr Chromec

Interní Med. 2014; 16(1): 38-40  

High-energy trauma of pregnant women in traffic accidents is usually associated with miscarriage or fetal death. We present a case report of such an accident and its consequences for the woman and fetus at 33rd gestational week.

Erectile- endothelial dysfunction in patient with type 2 diabetes mellitus

MUDr.Taťána Šrámková, CSc.

Interní Med. 2014; 16(1): 26-30  

Number of patiens suffering from type 2 diabetes mellitus dramatically increases. Its effects on sexuality are serious sexual dysfunction and infertility. Erectile dysfunction is highly prevalent in type two diabetes mellitus, and is associated with the endothelial dysfunction and/or with the atherosclerosis and silent myocardial ischemia. Case report describes a diabetic man suffering from ED and endothelial dysfunction. The treatment of erectile dysfunction with PDE5 inhibitors was unsuccessfully. The treatment with intracavernosal Alprostadil (prostaglandin E1) 20 μcg was successfull. Diagnosis of the endothelial dysfunction and the...

How to recognize a patient in danger of renal failure?

doc.MUDr.Věra Čertíková Chábová, Ph.D.

Interní Med. 2014; 16(1): 41-42  

Those who have a negative family and personal history, have got normal urea and creatinine, negative urine chemistry and sediment and normal sonography of the kidneys and urinary tract, are not in danger of renal failure at present. All others should be closely supervised, referred to a nephrologist or even urgently sent to hospital if a systemic disease is suspected.