Proč pacienty varovat před workoholismem?

Mgr. et Mgr. Jana Vyskočilová

Interní Med. 2019; 21(3): 139  

Dangerous multiresistant bacteria "superbugs" in contemporary medicine

prof. MUDr. Milan Kolář, Ph.D.

Interní Med. 2019; 21(3): 142-148 | DOI: 10.36290/int.2019.021  

In this review article the term „superbugs“ is defined and clinically significant multiresistant bacteria are characterized.

COPD treatment

doc. MUDr. Norbert Pauk, Ph.D.

Interní Med. 2019; 21(3): 149-153  

Chronic Obstructive Pulmonary Disease (COPD) is a treatable, preventable and clinically heterogeneous syndrome which manifests with various lung symptoms and is associated with various comorbidities. This article deals mainly with the pharmacological treatment of stable COPD according to the current recommendations of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and the valid recommendations of the Czech Pneumological and Phthisiological Society. Pharmacotherapy of COPD is primarily based on long-term inhaled bronchodilators (LABD). It is a group of long-term (or ultra-long-term) inhaled anticholinergics (LAMA or U-LAMA) and inhaled...

Central‑acting and alpha-1 adrenoreceptor blocking antihypertensives (fifth‑line antihypertensive agents)

PharmDr. Iva Prokopová, Ph.D.

Interní Med. 2019; 21(3): 154-157 | DOI: 10.36290/int.2019.046  

Central-acting and alpha-1 adrenoreceptor blocking antihypertensive agents are used in praxis more frequently than cardiologicguidelines recommend. In our conditions, rilmenidine, moxonidine, urapidil, methyldopa, doxazosin, and clonidine can be includedinto this group of drugs. This review summarizes why these agents are ranked among fifth-line antihypertensive agents, whatare their benefits, but also limits. We concern with specific types of hypertension where the usage of central-acting and alpha-1adrenoreceptor blocking antihypertensive agents has clinical justification.

Polyomavirus-associated nephropathy

MUDr. Miroslav Fajfr, Ph.D.

Interní Med. 2019; 21(3): 158-161 | DOI: 10.36290/int.2019.023  

Polyomavirus-associated nephropathy belongs in organ transplant patients to the most risky infection after the human cytomegalovirus infections. The incidence of this disease is increasing. While in 1995 the prevalence was reported up to 1%, the up-to-date publications report the prevalence within 5% to 10%. The main causative agents are mainly BK polyomavirus and less frequently also JS polyomavirus. The relationship of other polyomavirus, human polyomavirus 9, to kidney diseases has not been proven yet. The publication summarizes the up-to-date knowledge about the pathogenesis, causative agents, diagnostics and possible treatment of polyomavirus-associated...

Subacute (de Quervain) thyroiditis, „the forgotten disease“ – part I

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

Interní Med. 2019; 21(3): 162-166 | DOI: 10.36290/int.2019.024  

Subacute thyroiditis, also called as de Quervain thyroiditis, is a painful, „self-limited“ inflammatory disease of thyroid gland. Characteristic clinical and laboratory features are used to determine the diagnosis. The primary sign is the pain in the thyroid gland, which often follows a viral infection of the upper respiratory tract. At the same time transient thyrotoxicosis occurs. The ultrasonography in addition to laboratory values is essential to diagnose and monitor the effect of treatment. Disease need to be distinguished from other causes of thyrotoxicosis and then apply the right therapy. Glucocorticoids are the most effective treatment...

Malignant pericardial effusion as a cause of recurrent syncopes

MUDr. Šárka Buřilová, MUDr. Katarína Bielaková, Ph.D.

Interní Med. 2019; 21(3): 171-174 | DOI: 10.36290/int.2019.026  

This case study presents a patient admitted for recurrent syncopes at University Hospital Emergency Unit. Clinical and paraclinicalexamination methods revealed an extensive pericardial effusion with tamponade symptoms, a relatively rare cause of syncopes,in the patient with undiagnosed malignancy. A proper differential diagnosis is essential due to urgent need of treatment ofthis condition.

Lze efektivně snížit kardiovaskulární riziko diabetika s dyslipidemií?

MUDr. Pavel Rutar

Interní Med. 2019; 21(3): 167-168  

Včasná intervence vysokého krevního tlaku dle nových guidelines

MUDr. Pavel Rutar

Interní Med. 2019; 21(3): 176-179  

Reasonable support of aging – prevention of osteoporosis

PharmDr. Jitka Rychlíčková, Ph.D.

Interní Med. 2019; 21(3): 180-183  

The process of streamlining and rationalization of pharmacotherapy is usually complicated, especially in elderly patients. It is mostly oriented on the elimination of the non-essential and unnecessary drugs, which are potentially risky in terms of adverse effects. On the other hand, introduction of calcium and vitamin D supplementation is reasonable in patients with low bone mass density. The prevalence of osteoporosis and low bone mass increases with age in men and in women, although the pattern is slightly different. What is the right dose of calcium for substitution, which types of calcium salts exist and which properties they have, what length...

How to deal with non-specificity of tumor markers?

RNDr. Lenka Zdražilová‑Dubská, Ph.D., MUDr. Beatrix Bencsiková, Ph.D., doc. MUDr. Dalibor Valík, Ph.D.

Interní Med. 2019; 21(3): 184-186  

Here we aim to review sources of unspecific or false elevation of soluble tumour markers. We suggest how to approach results ofelevated tumour markers in clinical practice.

Thrombophilias – to test or not to test?

doc. MUDr. Jana Hirmerová, Ph.D.

Interní Med. 2019; 21(3): 187-191 | DOI: 10.36290/int.2019.030  

Thrombophilia, i.e. disposition to thrombosis (usually meant venous thrombosis) is caused by the shift of haemostatic balance towards a prothrombotic direction. These disorders are inherited or acquired and are associated with various degree of the risk. Their usual pathogenetic mechanism is the deficiency of natural inhibitors of coagulant factors or, conversely, the elevated level or activity of coagulant factors. Laboratory tests for the diagnostics of thrombophilia are often ordered as a part of differential diagnostic process in idiopathic venous thromboembolism. However, thrombophilia testing should be rational, ordered in selected patients only,...

Quality of life from the perspective of patients treated with hemodialysis, peritoneal dialysis and kidney transplant

Mgr. Veronika Di Cara, Ph.D., Mgr. Dita Horníková

Interní Med. 2019; 21(3): e1-e4 | DOI: 10.36290/int.2019.047  

According to ÚZIS, at the end of 2015, there were 6 668 patients treated in 106 hemodialysis centers in the Czech Republic. It is known from the literature that starting treatment with elimination methods is very difficult for the patients. Qualitative research in the form of individual interviews was used, followed by a content analysis. The participants cope with the difficulties of the treatment by: „having a positive attitude“, and setting small goals for themselves, but they are fully aware of their serious condition and unpleasant complications of their treatment. The participants described their effort to keep physically active,...

Management of acute coronary syndrome in the setting of an emergency

Mgr. Marinella Danosová, DiS., Mgr. Radka Filipčíková, Ph.D., MBA, LL. M., MPA, MUDr. Petr Hubáček, MBA, LL. M., Ing. Karel Bílek, Ph.D., PhDr. Lenka Machálková, Ph.D.

Interní Med. 2019; 21(3): e5-e7  

During an emergency, higher casualty rates can be anticipated, with the injured being classified into groups using colour codesbased on various methodologies. Medical providers who deliver advanced trauma life support work according to special algorithmsunder severe time pressure, and even if their care is highly effective, an injured can still wait for medical attention at the assemblypoint for dozens of minutes. Fear and stress are natural responses to threat which, in combination with a noxious substance, cancause further complications, such as acute coronary syndrome. Chest pain is one of the most frequent reasons for an...