Síla křehkosti

Martina Špinková

Interní Med. 2014; 16(6): 219  

Effect of blood pressure decrease and glycaemia control in diabetes type 2:

prof.MUDr.Vladimír Teplan, DrSc.

Interní Med. 2014; 16(6): 222-226  

6 years follow after ADVANCE Study (Study ADVANCE ON) ADVANCE ON trial is recently published observation study following ADVANCE trial analysing blood pressure lowering and glucose control in type2 of diabetes on the risk of death from any cause and cardiovascular causes as well as renal function during 6 years of follow- up with an enrollment of 8494 patients. The reductions in the risk of death from any cause and of death from cardiovascular cause that had been observed in the group receiving active blood-pressure-lowering treatment during the trial were attenuated but significant at the end of the post – trial follow-up; the hazard...

Single pill combination therapy - the future of antihypertensive treatment?

doc.MUDr.Jan Václavík, Ph.D.

Interní Med. 2014; 16(6): 228-230  

This article reviews the current principles of antihypertensive combination therapy and recommended drug combinations. Causes of inadequate hypertension control both on patient and physician side are discussed. A growing palette of fixed combinations of two antihypertensive drugs and now also a fixed combination of three drugs in one pill opens new horizons in the antihypertensive therapy. A new concept of antihypertensive treatment is presented – treatment of hypertension by a single pill. This concept seems to be suitable and applicable to the majority of hypertensive patients encountered in daily practice.

Hyperthyroidism from the perspective of clinician

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

Interní Med. 2014; 16(6): 232-235  

Thyroid diseases affect at least 4 times more women than men. The patients represent over 80% of those searching for the outpatient care. Part of them suffer from some type of chronic inflammatory process, better the autoimmune, chronic thyroiditis, also known as the lymphocytic thyroiditis, the goiter of Hashimoto. A substantial percentage of the affected patients meet the criteria of the standard protocol as for the normal function. Scrutinizing laboratory parameters one can record suppressed TSH levels not exceptionally accompanied by increased levels of free thyroid hormones. Sometimes there might appear a danger of being stuck at an impasse...

New respiratory pathogens: influenza A/H7N9 and coronavirus MERS CoV

RNDr.Helena Jiřincová

Interní Med. 2014; 16(6): 236-240  

The group of human respiratory pathogens of viral origin is taxonomically diverse. Influenza A viruses and coronaviruses are frequent types of newly emerging agents due to genome plasticity and zoonotic occurrence. The population of migrating waterfowl is the main reservoir of influenza A virus. In the recent years, the incidence of infection with the H7 subtype has increased, and in March last year the first human infection with a novel combination of the A(H7N 9) subtype was detected in China. The infection often manifested with a severe course, including death. During the so-called first wave (March to May 2013), 137 diseases and 45 deaths...

Colitis due to Clostridium difficile in broader context

MUDr.Pavel Polák, prof.MUDr.Petr Husa, CSc., MUDr.Michaela Freibergerová

Interní Med. 2014; 16(6): 241-244  

Colitis due to Clostridium difficile is currently serious disease. Exact causes of its epidemic outbreak worldwide are not known. The onset of this disease is manifestation of a disturbed microbial ecosystem at individual as well as at global level. In this context, the authors present current treatment possibilities with antibiotics and faecal bacteriotherapy of the colitis due to Clostridium difficile.

Whipple disease

MUDr.Marcela Vysloužilová, MUDr.Zdeněk Vlk, MUDr.Dagmar Šindelářová, MUDr.Kateřina Musilová

Interní Med. 2014; 16(6): 251-253  

Case study describes 43 years old women, who was examined for lower dyspeptic syndrome accompanied by lack of appetite and weight loss. Mucosa samples were collected during endoscopic examination and histology confirmed the diagnosis of Whipple disease. The patient was treated by one year long antibiotic therapy after which the clinical state improved, laboratory valves returned to normal and medication was discontinued except substitution for hypothyreosis during follow-up there was no relace of the disease.

Acute abdominal aortic occlusion as a manifestation of heparin-induced thrombocytopenia

MUDr.Jiří Holý, Ph.D., MUDr.Michal Sýkora, MUDr.Petr Pták, MUDr.Pavel Havránek

Interní Med. 2014; 16(6): 254-256  

Acute occlusion of the abdominal aorta is a life-threatening event with possible fatal outcomes in spite of urgent surgical management. Heparin-induced thrombocytopenia (HIT) occurs in 1 to 3% of patients treated with heparin including low-molecular-weight heparin. Rare type II HIT is also manifested by ischemia due to peripheral arterial thrombosis. The mainstay of therapy is termination of heparin treatment and change of anticoagulant medication. Fondaparinux or hirudin-type anticoagulants do not cause HIT. The authors present a case history of a 67-year-old male patient admitted to hospitalization at the department of internal medicine because...

Stomatological symptoms of patients with dysfunction of gastrointestinal tract

Stomatolog Julia Morozova, Ph.D., MUDr.Zdeňka Zapletalová, Ph.D., MUDr.Eva Míšová

Interní Med. 2014; 16(6): 244-246  

The gastrointestinal tract is closely related to the oral cavity, therefore its disorders may manifest among other oral symptoms. Gastrointestinal dysfunctions are often accompanied by episodes of reflux or vomiting during which the acidic stomach content comes into contact with the oral cavity. Frequent or chronic reflux episodes or vomiting can lead to pathological changes in the oral cavity. These include mainly erosive defects of hard dental tissues, burning or sour taste in the mouth and malodour, which may occur before the typical symptoms of the disease. In our paper we describe the most common oral manifestations of gastroesophageal...

Role of multidisciplinary team in the treatment of the advanced colorectal cancer

prof.MUDr.Miroslav Ryska, CSc.

Interní Med. 2014; 16(6): 247-250  

Effective diagnostic – therapeutic approach to patients with metastatic colorectal carcinoma leads to more than 50 % 5 year survival. Most effective treatment is curable liver resection with primary indication in 20 % of patients. Other 15–20 % patients reach resection after conversion systemic antitumor therapy. There are special techniques (combined procedures, two stages operations) or portal venous embolisation followed by resection after hypertrophy of liver remnant. Multidisciplinary approach is only the condition for successful treatment on the base of personalized medicine principles in these patients.

Several notices to the serological diagnostics with emphasis on lyme borreliosis

MUDr.Pavel Polák, prof.MUDr.Petr Husa, CSc.

Interní Med. 2014; 16(6): 257-258  

The authors present several notices to the practical indication and evaluation of serological methods. Detailed pathophysiology neither treatment are aim of the paper; the most frequent mistakes with emphasis on actually emerging disease – lyme borreliosis are discussed.