Vzdělávání lékařů - včera - dnes - zítra?

prof. MUDr. Václav Zamrazil, DrSc.

Interní Med. 2014; 16(2): 47  

Delaying vascular complications of diabetes

doc.MUDr.Michal Vrablík, Ph.D.

Interní Med. 2014; 16(2): 50-53  

Vascular complications are among the most common chronic complications of type 2 diabetes mellitus and the major cause of morbidity and mortality in these patients. The risk of coronary events is increased threefold in male diabetics and even fivefold in female diabetics in comparison with non-diabetics. In order to reduce a (very) high cardiovascular risk in diabetic patients, a combination of lifestyle measures and medication therapy is used. Lifestyle measures favourably affect hyperglycaemic control as well as other risk factors associated with insulin resistance. Pharmacological treatment to prevent macrovascular changes involves renin-angiotensin-aldosterone...

Cystic fibrosis in adults

MUDr.Libor Fila, Ph.D.

Interní Med. 2014; 16(2): 54-60  

Cystic fibrosis (CF) is an inherited disease caused by mutations in the transmembrane conductance regulator (CFTR) gene. The disease leads to dysfunction of the exocrine glands with high concentration of chloride in the sweat and formation of abnormally viscous mucus in the respiratory, digestive and reproductive tract. Chronic sinopulmonary disease, involvement of the digestive tract with impaired nutritional status, salt loss syndrome and male infertility dominates in the clinical presentation. The examination of sweat chloride concentration and mutations in the CFTR gene is used in CF diagnostics for detection of CFTR protein dysfunction....

Efficiency and safety of linagliptin - relevance to clinical practice

doc.MUDr.Martin Prázný, CSc., Ph.D., MUDr.Jan Šoupal

Interní Med. 2014; 16(2): 62-66  

Treatment of type 2 diabetes is based on lifestyle adjustments in combination with pharmacotherapy. Metformin is the first line therapy and after metformin there are several groups of drugs that can be chosen. Dipeptidyl peptidase 4 inhibitors (gliptins) are modern antidiabetic drugs affecting incretin system. All gliptins are effective and relatively safe. For most gliptins it is necessary to continuously monitor renal and hepatic function. Linagliptin has advantages in minimal hepatic metabolism and minimal renal excretion. In daily practice, it is not necessary to monitor liver and renal function during the treatment with linagliptin and...

Metformin and its position in the treatment of type 2 diabetes mellitus

prof.MUDr.Martin Haluzík, DrSc.

Interní Med. 2014; 16(2): 67-69  

The prevalence of type diabetes mellitus, in particular type 2, is currently increasing worldwide. Recent large scale studies have shown that the most important factor influencing the rate of long term complications in patients with diabetes is its timely diagnosis and early intensive treatment starting immediately after diagnosis combined with efficacious intervention of other cardiovascular risk factors. Metformin, the drug from the biguanide group, represents the first choice treatment in all patients with type 2 diabetes who do not have contraindications of its use. Metformin treatment should be started right after the diagnosis of diabetes...

Intracerebral hemorrhage as a complication of Henoch-Schönlein Purpura in an Elderly Women: A case report

MUDr.Martin Harazim, MUDr.Ivo Hofírek

Interní Med. 2014; 16(2): 74-77  

The authors describe a case of intracerebral hemorrhage in 83-year-old patient with Henoch-Schönlein purpura. During hospitalization for gradually progressive renal insufficiency on the basis of autoimmune vasculitis spontaneous intracranial hemorrhage occured. Despite the very early neurosurgical intervention to evacuate the hematoma no clinical improvement came and patient expired. There has been presented only a few cases of this serious, life-threatening complication.

Multiple myeloma - let us not forget what is long known

MUDr.Anna Žlabová, MUDr.Petr Pavlíček, MUDr.Helena Dvořáková, MUDr.Jan Kykal

Interní Med. 2014; 16(2): 78-79  

Multiple myeloma (plasmacytoma, m. Kahler) is a diagnosis that patients still occasionally receive late, although its diagnosis is not too difficult in the vast majority of cases. This is proven by our case report of a woman who completed six cycle of rehabilitation for back pain, after which an x-ray of her spine was taken and basic laboratory tests were performed with a characteristic picture of multiple myeloma, which includes anemia, renal insufficiency, hyperproteinemia, and hypercalcemia. Finally, our paper points out that by determining a correct diagnosis, though often in advanced stages, the patient is given a chance to receive causal...

Ocular manifestations of inflammatory bowel disease

MUDr.Helena Štrofová, doc.MUDr.Petra Svozílková, Ph.D., MUDr.Alena Hosová, MUDr.Vladimíra Fialová

Interní Med. 2014; 16(2): 70-72  

Extraintestinal manifestations of inflammatory bowel disease occur in one third of patients. Ocular complications are infrequent, occurring in less than 10 % of cases, but can be associated with significant morbidity. Ocular complaints are often nonspecific and include watery, burning or itchy eyes, ocular pain, photophobia, conjunctival or scleral hyperemia, decrease of visual acuity. Ocular inflammation often affects episclera – episcleritis, next scleritis and uveitis can be diagnosed. Eye investigation should be a routine part in the care of patients with inflammatory bowel disease. Ocular symptoms may rarely precede a diagnosis of...

Hojení chronických ran v závislosti na zlepšení mikrocirkulace pomocí léčby metodou MDM

MUDr. Emil Záhumenský, prof. MUDr. Milan Kvapil, CSc., MBA

Interní Med. 2014; 16(2): 83-84  

Mladý muž s těžkým potrombotickým syndromem na obou dolních končetinách po nepoznané rozsáhlé hluboké žilní trombóze

doc. MUDr. Dalibor Musil, Ph.D.

Interní Med. 2014; 16(2): 85-86  

Preparing a steroid-dependent patient for surgery

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

Interní Med. 2014; 16(2): 80-82  

A surgical procedure imposes a substantial burden to which an otherwise healthy body responds primarily by increased secretion of cortisol, a steroid hormone, particularly with a glucocorticoid, and a less mineralocorticoid effect. However, this is only a substantial part of a very complex process. Adrenal insufficiency, whether primary or secondary (impaired hypothalamic-pituitary-adrenal axis function), poses an immediate life-threatening risk for the patient. Consequently, the management is in the hands of the attending physician who must aid the patient in creating the conditions to manage this crisis situation.