Medicine for Practice, 2009, issue 4

Editorial

Uč se, hochu, moudrým býti - nebo bití ?

prof. MUDr. Pavel Barták CSc

Med. Pro Praxi 2009; 6(4): 179

Review articles

Rules for surveillance of diabetic patients

MUDr. František Musil Ph.D

Med. Pro Praxi 2009; 6(4): 182-186

Diabetes mellitus is a group of aetiopathogenetically heterogeneous conditions with a common main feature of hyperglycaemia. In type 1 diabetes, there is an absolute insulin deficiency caused by an autoimmune inflammation which affects pancreatic B-cells. Surveillance of type 1 diabetes patients involves mimicking the physiological insulin secretion pattern (basal-bolus) using an intensified insulin regimen or insulin pump. In addition to insulin resistance, type 2 diabetes is also characterized by impaired insulin secretion with a relative insulin deficiency. Surveillance of type 2 diabetes patients requires repeated assessment of the mutual relation...

Non-alcoholic fatty liver disease: Why to consider it?

MUDr. Dagmar Jackuliaková, prof. MUDr. Helena Vaverková CSc, prof. MUDr. Vlastimil Ščudla CSc

Med. Pro Praxi 2009; 6(4): 187-190

Non-alcoholic fatty liver disease (NAFLD) is worldwide the most common cause of chronic elevation of liver enzymes diagnosed by anamnesis excluding abuse of alcohol (resp. when daily alcohol consumption do not exceed 20 g). It is necessary to exclude another cause of liver disease. NAFLD is a clinicopathological term that encompasses a disease spectrum ranging from simple hepatic steatosis to steatohepatitis, fibrosis, and cirrhosis, which may progress to liver failure or to develop to hepatocellular carcinoma. NAFLD is often associated with insulin resistance and symptoms of metabolic syndrome. NAFLD reflects the coexistence of various cardiovascular...

Present possibilities for heart failure diagnosis in ambulatory care

MUDr. Jan Krupička, MUDr. Tomáš Janota CSc

Med. Pro Praxi 2009; 6(4): 191-194

The number of heart failure (HF) patients is steadily increasing over the past several years, not only due to the population aging, but also due to the improvement in therapy of cardiovascular diseases. With regard to long-term seriousness of HF therapy and adverse prognosis of it’s advanced stages, new trends in cardiology put the accent on early and appropriate diagnosis especially in the ambulatory care. The diagnosis of HF has remained fundamentally unchanged over the past several decades and has been based on the clinical history and physical examination. The recent progress in laboratory and imaging technology facilitated and put forward...

Nutrition disorders - causes, diagnosis, and therapeutic options in field practice

MUDr. Mgr. Drahomíra Vrzalová

Med. Pro Praxi 2009; 6(4): 195-196

Timely diagnosis of nutrition disorders in an outpatient setting, a properly taken history supported by physical as well as laboratory examinations, and securing appropriate treatment in collaboration with outpatient nutritionists all result in improved patient care.

Multiple myeloma - early diagnosis

MUDr. Jan Straub, prof. MUDr. Zdeněk Adam CSc, MUDr. Evžen Gregora, prof. MUDr. Roman Hájek, CSc, MUDr. Petr Kessler, MUDr. Vladimír Maisnar Ph.D, prof. MUDr. Vlastimil Ščudla CSc, MUDr. Miroslava Schützová, doc. MUDr. Ivan Špička, CSc

Med. Pro Praxi 2009; 6(4): 197-199

Multiple myeloma is one of the most frequent haematological malignancies. The prognosis of patients has substantially improved within last decade. However, the early diagnosis is still a crucial factor for the patient´s prognosis. The CMG (Czech Myeloma Group) initiated the early diagnosis program- „CRAB“ – in 2007. Program is focused on family physicians and key out-patients physicians responsible for recognizing the symptoms related to MM. In 2007 46,5 % of patients was diagnosed late. Many patients had serious irreversible damage iniatially (21 % of patients had neurologic deficiency, 36,8 % of patients had patologic fracture...

Management of most cammon trauma in General practitioner´s ambulance

MUDr. Jiří Moláček

Med. Pro Praxi 2009; 6(4): 200-201

The aim of this paper is to summarize a brief list of most common trauma in the General practitioner´s ambulance. To present the management of primery treatment and accent some more complicated cases.

Case report

Cushing‘s syndrome as a manifestation of generalized gastric carcinoid

MUDr. Hana Sýkorová

Med. Pro Praxi 2009; 6(4): 203-205

Cushing‘s syndrome occurs as a result of autonomous overproduction of glucocorticoids. Primary Cushing‘s syndrome is caused by glucocorticoid overproduction by an adenoma, carcinoma, or adrenal hyperplasia. ACTH secretion is suppressed. In the case of secondary Cushing‘s syndrome, there is primary ACTH overproduction in the hypothalamic-pituitary region or ectopically. The level of ACTH is normal or high. Ectopic overproduction is less common, the sources most typically include small-cell lung carcinoma and thymoma, less frequently carcinoids and other malignancies. The incidence of carcinoids ranges from 0.7 to 2.1 per 100,000 people....

At a glance

The trends in abdominal and groin hernia treatment

MUDr. Jan Doležel, Ph.D, MUDr. Petr Vlček, Ph.D, doc. MUDr. Lenka Veverková, Ph.D, MUDr. Václav Jedlička, Ph.D, MUDr. Jiří Jeřábek

Med. Pro Praxi 2009; 6(4): 209-213

The people were already engagged in treatment problems of abdominal and especialy groin hernia in the age before Christ. The surgery for incarcerated hernia followed the conservative treatment with hernia band. The progressively gained anatomical knowleges were on the top with complete describtion of inguinal channel in 19th century. The surgery procedures progressed with development of surgery experiences, anesthesy and technics. They are mostly visible on groin hernia repair. Here we can follow the development of treatment strategy up, from prefunicular repair, anuloplasty, retrofunicular repair, tension free repair with usage of synthetic material to...

Nutrition in &

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Fiber

MUDr. Zuzana Grofová

Med. Pro Praxi 2009; 6(4): 206-208

A fiber is a very important part of our nutrition that used to be consumed in big amounts. Men tried to remove a fiber from their food through ages. Currently we return to a fiber because of its benefits. The fiber is created by undigestible saccharides of a plant origin. In the human digestive tractus these polysaccharides and oligosaccharides cannot be splitted and absorbed. The fiber can be however fermentated by gut bacteria with short chain fatty acids as products that can be utilised as a fuel in a liver. The fiber is able to regulate gut functions and to bring benefits to our overall health status. It is addded also to many kinds of enteral...

For nurses

Secondary prevention of colorectal cancer from the perspective of an endoscopy nurse

Lenka Pracná

Med. Pro Praxi 2009; 6(4): 214-216

The Czech Republic occupies the leading place in the worldwide statistics of colorectal cancer (CRC) incidence that has been steadily increasing. Unfortunately, this disease is commonly diagnosed in an advanced stage even though it is very well treatable and susceptible to prevention. In the year 2000, a nationwide programme for secondary prevention of CRC was launched in the Czech Republic which has been among the priorities of the Czech health sector. CRC is a significant health problem of our population and secondary prevention should result in a decrease in the high mortality and morbidity rates of this disease.

The primary treatment of amputation injuries of the upper limb

Bc. Kateřina Jeřábková, DiS, prof. MUDr. Jiří Veselý, CSc, doc. PhDr. Miroslava Kyasová Ph.D

Med. Pro Praxi 2009; 6(4): 217-219

The article is focused on the issue of injury to the hands and fingers replantace. It describes the course of transport the patient to a medical facility, proper treatment and the imposition of amputate and affected limbs. The article is to raise awareness of health and contribute to the quality of care in this field.