Léto v ordinaci praktického lékaře

Med. Pro Praxi 2009; 6(3)  

Spiritus

JUDr. MUDr. Igor Ulč, Ph.D

Med. Pro Praxi 2009; 6(3): 119  

The endocrine hypertension in primary care - focused od primary aldosteronism

MUDr. Ondřej Petrák, Ph.D, doc. MUDr. Tomáš Zelinka, CSc, MUDr. Branislav Štrauch, Ph.D, doc. MUDr. Robert Holaj, CSc, MUDr. Jan Rosa, prof. MUDr. Jiří Widimský jr., CSc

Med. Pro Praxi 2009; 6(3): 122-125  

The endocrine hypertension represents one of the causes of secondary hypertension. The early recognition of the condition is important as this condition may predispose to the increased mortality from cardiovascular disease, and is often reversible with target therapy. It is necessary to consider this diagnose and in case of any suspicion send patients to a diagnostic centre. This part is focused on diagnostic and therapeutic aspects of primary aldosteronism.

Pharmacological treatment of postmenopausal osteoporosis

MUDr. Vít Zikán Ph.D

Med. Pro Praxi 2009; 6(3): 126-134  

The goal of the treatment of postmenopausal osteoporosis is to reduce the risk of fractures and improve the quality of life of patients with fractures. The fracture risk is multifactorial and bone strength is affected by other parameters of bone quality (e. g., bone microarchitecture). According to current WHO guidelines, pharmacological treatment should be considered in patients with risk of osteoporotic fractures. Thus, in a given patient, additional, BMD-independent risk factors for fractures (age, fractures suffered in parents, long-term treatment with glucocorticoids) are considered. In addition to the fracture risk and osteoporosis aetio...

Probiotics at practitioners

doc. MUDr. Pavel Kohout Ph.D

Med. Pro Praxi 2009; 6(3): 135-139  

Probiotics are living bacterias positively influenced health status of man giving in sufficient amount. Today there are widely given by physicians in ambulatory tract or in inpatients departments. Practitioners should recommend probiotics to patients treated by antibiotics, in patients with constipation, diarrhoe, dyspepsia, chronic infections, mycotic complications, better in prevention, than treatment of postantibiotic dysmikrobia. There are used various bacterias (mostly Lactobacilli, Bifidobacteria, Streptococcus thermophilus, Escherichia coli (Nissle 1917), Bacillus subtilis) or yeasts (Saccharomyces boullardii). There is recommended to use...

Oral antidiabetics in type 2 DM treatment

MUDr. Milan Flekač, Ph.D

Med. Pro Praxi 2009; 6(3): 140-143  

Type 2 diabetes mellitus (T2D) is chronic disease with progressive character, characterised by relative insufficiency of insulin, leading to the inadequate utilization of glucose manifesting with hyperglycaemia. Therapy of patients with T2D is global and includes therapy of arterial hypertension, hyperlipoproteinaemia, obesity and another symptoms of metabolic syndrome. There is a variety of oral antidiabetic agents for use to this time, affecting insulin secretion and/or insulin resistance. Pharmacological therapy has to be started at the same time of clinical diagnosis.

Alcoholic liver disease

doc. MUDr. Radan Brůha CSc, MUDr. Karel Dvořák, MUDr. Jaromír Petrtýl CSc, MUDr. Tomislav Švestka CSc

Med. Pro Praxi 2009; 6(3): 144-146  

Chronic alcohol abuse leads to impairment of many organs – most frequent organ involved in chronic alcoholism is liver. Liver disease mortality in western countries is directly connected with alcohol abuse. The risk of alcoholic liver disease (ALD) increases in individuals consuming more than 30 g of alcohol per day. ALD could manifested as chronic disease (steatosis, steatohepatitis, fibrosis, cirrhosis) or acute disorder (acute alcoholic hepatitis). While steatosis is benign disease, cirrhosis is linked with shortened survival. The severity of cirrhosis depends on complications – portal hypertension with variceal bleeding, ascites...

Combination treatment of ACE inhibitors and angiotensin receptors blockers in nephrology

MUDr. Soňa Štěpánková, MUDr. Jitka Řehořová, MUDr. Jakub Ševčík, MUDr. Stanislav Šurel, MUDr. Assadullah Zharfbin

Med. Pro Praxi 2009; 6(3): 147-149  

Both ACE inhibitors and angiotensin receptors blockers belong for several years to basic treatment of the chronic kidney diseases. Both classes of drugs were shown to prevention of progression of chronic kidney disease. The effect is provided by lowering blood pressure and concomitant blood pressure independent renoprotective effect. Based on clinical studies we can declare that ACE inhibitors and angiotensin receptors blockers are comparable in respect to efficacy and safeness. In this regard the results of studies in cardiology correspond to those in nephrology. There is not general agreement in the assessment of desired effect of combination...

Possibilities of treatment of chronic pain

MUDr. Jan Lejčko

Med. Pro Praxi 2009; 6(3): 150-154  

Chronic pain is a common health problem. It is pain that has persisted for at least 3 month and cannot be fully relieved by standard pain medication. 40–60 % of patients do not have adequate relief of their pain. Paramount in the management of chronic pain patiens is assesment of the pain an its impact on physical and psychosocial functioning. Multidisciplinary and multimodal aapproach is of vital importance. Due to opiophobia, opioids are insufficiently used treatment modality. Knowledge about pain and its management, as well as an awareness of barriers to effective pain therapy, are important not only for pain specialists but also primary...

Current therapy of skin and mucosal mycoses

doc. RNDr. Vladimír Buchta CSc, doc. MUDr. Radovan Slezák CSc, doc. MUDr. Jiří Špaček, Ph.D, MUDr. Marie Košťálová, Ph.D, Mgr. Marcela Vejsová, doc. PharmDr. Martin Doležal Ph.D

Med. Pro Praxi 2009; 6(3): 155-164  

Superficial fungal infections are common, particularly dermatophytoses, onychomycoses, and vulvovaginal Candida infections. Most of these mycoses are treated with topical antimycotic drugs unless the infection involves an extensive area or is resistant to initial therapy. The use of griseofulvin in dermatology is limited to a few indications (tinea capitis in children), ketoconazole is replaced by other triazole drugs with a better pharmacological profile (no risk of idiopathic hepatitis) in most indications. Onychomycosis – one of the most difficultto- treat dermatomycosis largely requires systemic therapy with terbinafine or itraconazole...

Diabetes mellitus and ischaemic stroke

MUDr. Jiří Neumann

Med. Pro Praxi 2009; 6(3): 165-166  

There are more than 700,000 patients with diabetes mellitus (DM) in the Czech Republic, out of whom over 90 % are classified as type 2 diabetics. Vascular complications of type 2 DM are currently a common cause of morbidity and mortality in diabetic patients. DM is one of the diseases closely related to ischaemic stroke. In persons with DM, the prevalence of ischaemic stroke is threefold higher compared to that in the nondiabetic population, and the mortality of diabetics with stroke is also threefold higher. Insufficient compensation of DM positively correlates with the risk of developing ischaemic stroke. In addition, DM adversely affects the...

Care of a patient following hip replacement

MUDr. Pavel Přikryl, MUDr. Jiří Selucký, MUDr. Jana Fialová

Med. Pro Praxi 2009; 6(3): 167-168  

At present, total hip replacement (THR) is a common and very effective procedure. For it to occur without complications and to be of major benefit to the patient‘s quality of life, its preparation, the procedure itself as well as follow-up treatment must meet rather strict criteria. Every orthopaedic centre is specific in certain aspects, however, some generally accepted rules are clearly established and the aim of the article is to highlight them.

Ischemická choroba dolních končetin

MUDr. Miroslav Chochola CSc

Med. Pro Praxi 2009; 6(3): 172-173  

An overview of enteral nutrition preparations for home use

MUDr. Zuzana Grofová

Med. Pro Praxi 2009; 6(3): 169-171  

With advances in research and pharmaceutical industry, progress has been made in virtually all branches of medicine. Clinical nutrition is not an exception. Owing to a large number of various enteral nutrition preparations, patient feeding at home is not only possible, but also relatively simple. Oral nutritional supplements represent nutritionally defined preparations intended for drinking that have a high energy and nutrient content in a small volume. Formulas designed for probes and „stomies“ allow home care in patients who would otherwise have to stay in a health care facility or nursing home. Thus, enteral nutrition contributes...

Praktičtí lékaři jsou nejdůležitější součástí zdravotnického systému

Med. Pro Praxi 2009; 6(3): 174  

Autodidaktický test 3/09

Med. Pro Praxi 2009; 6(3): 164