Snažíme se vám být prakticky po ruce

Mgr. Michaela Majerová

Med. praxi. 2011;8(12):495  

Management of hypertension in specific settings and in the presence of comorbidities

prof.MUDr.Jan Bultas, CSc.

Med. praxi. 2011;8(12):500-508  

The management of hypertension lies largely in the hands of the general practitioner, with an occasional need to seek the help of a specialist. However, the primary care physician must treat a patient who has many comorbidities with their own specific features. An optimal therapeutic approach to a hypertensive patient is determined by a number of factors: age, comorbidities, actual level of blood pressure, medications for comorbidities, patient compliance and numerous other factors. The selection of the most appropriate drug which will best contribute to improving the patient’s prognosis and, at the same time, will be well tolerated,...

The patient with thyroid disease in the general practitioner’s surgery

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

Med. praxi. 2011;8(12):510-513  

The incidence of thyroid disease in the population can be compared to that of diabetes. There is clearly no shortage of patients with thyroid disease. Classic propaedeutic approach combined with modern ultrasonography resting on a sufficiently broad spectrum of laboratory methods allows a physician who has an understanding of the issue to determine, with a relatively high degree of precision and reliability, the diagnosis of thyroid disease even in an outpatient setting. The availability and the relative ease with which one can often come to a conclusion may lead to erroneous belief that the diagnostic process is straightforward and free of...

Secondary endocrine hypertension

MUDr.Karolína Drbalová

Med. praxi. 2011;8(12):514-518  

Secondary endocrine hypertension is 1–5 % of all hypertension. Etiology among them one of the primary hyperaldosteronism and other mineralocorticoid hypertension, Cushing syndrome, pheochromocytoma, hyperparathyroidism, acromegaly, hyperthyroidism, hypothyroidism and some other less common endocrine disorders. The first three are often among the causes of resistant hypertension. The detection and elimination of a secondary cause may even mean a complete cure for the patient. cortisol, aldosterone, metanephrines, parathormone, growth hormone.

Do we use antimicrobial therapy?

doc.MUDr.Václav Dostál, CSc.

Med. praxi. 2011;8(12):518-523  

Worldwide situation forces experts to muse above decreasing of the antimicrobial therapy effectivness. The growing antibiotics resistance is becomig a global medical problem. Rational use of antibiotics is necessary presumption to preserve effective antibacterial therapy for future generations. A significant achievements have been reached in the consensus about international co-operation. Inadequate recommended of the antimicrobial therapy along carries the hazard of the microbial resistance, drugs toxicity, undesirable interactions and other therapy complications. Necessary steps to slow down the progress of antibiotics resistance are known,...

Treatment of osteoporosis - current opportunity

MUDr.Petr Hrdý, MUDr.Pavel Novosad

Med. praxi. 2011;8(12):523-527  

Osteoporosis is valid medical problem implicated millions fractures of sicks in the whole world. Currently indications to therapy result from bone density measured by densitometry or result from presence of typical osteoporotic fracture in patient´s anamnesis too. Next decision- making algorithms are detected to indicate therapy (FRAX™). Current therapy consists of non-pharmacological and pharmacological parts, which are complemented necessarily. The pharmacological therapy can be divided into two groups on principle – anticatabolic and osteoanabolic. Financially exacting therapy would be reserved for hardest groups of patiens with...

Chlamydia infection: symptoms, diagnosis, treatment and interpretation of results

MUDr.Blanka Horová

Med. praxi. 2011;8(12):528-531  

Chlamydia infection, their progress, severity and duration depends primarily on macroorganism, a person who undergoes the disease and on the other hand, the virulence own bacteria. Family Chlamydiaceae have unique biological properties, they are intracellular parasites equipment MIP antigen, a protein that facilitates intracellular survival. They gain energy from the host cell. Their pathogenesis is based on the direct destruction of the mucous membranes of cells that attack – mainly urogenital tract, respiratory and ocular conjunctiva. Without laboratory direct detection chlamydial disease is not diagnosed. Indirect card is good and...

Current trends in the treatment of pain

MUDr.Marek Hakl, Ph.D., MUDr.Boris Leštianský

Med. praxi. 2011;8(12):532-536  

In the last year we were in the area of pain management met with a number of innovations. They were published new recommended practices for the treatment of neuropathic pain EFNS, there were new active substances and new formulations. The news for systemic administration are mainly new transmucosal fentanyl for the treatment of breakthrough pain in cancer patients and a new active substance tapentadol, which should appear first retarded form and subsequently in the form of a quick release. Is enriched by a group of steroid anti-inflammatory drugs lornoxicam a new molecule. Interesting news appeared in the local treatment of neuropathic pain,...

Patient with medically unexplained symptoms in primary health care

MUDr.Radkin Honzák, CSc.

Med. praxi. 2011;8(12):537-540  

Medically unexplained physical symptoms present one of common problems in modern medical practice but often prove difficult to manage. Mutual understanding between physician and patient is essential for good quality of care; however, both parties have different views on health complaints and treatment. The author summarizes principles of work with such patients, offers algorithm for diagnosis using the recent Diagnostic Criteria for Psychosomatic Research, and treatment.

Vulvovaginitides - inflammations of the vulva and vagina

MUDr.Zuzana Dostálová, Ph.D., MUDr.Romana Gerychová

Med. praxi. 2011;8(12):540-543  

Vulvovaginitis, an inflammation of the vulva and vagina, is one of the most common diseases in sexually active women. Typical symptoms of vulvovaginitides include vulvovaginal discomfort, i.e. discharge, vulvar itching and burning, and dyspareunia. Vulvovaginitis occurs when the balance of the vaginal ecosystem is disturbed. Successful treatment must be based on correct diagnosis and adequate treatment. Not uncommonly, chronic and recurrent vulvar and vaginal infections remain a challenging problem. Thus, strict adherence to hygiene and lifestyle measures is essential. Furthermore, products to restore the natural vaginal flora, systemic enzyme...

Modern Trends in hormonal contraception

MUDr.Martina Novotná

Med. praxi. 2011;8(12):544-546  

The basic task is to help a woman gynecologist for her to find the most effective and safe form of contraception. The article provides basic instructions on how to approach carefully to minimize the risks associated with hormonal (especially combined) and contraceptive how to optimize the selection of a particular contraceptive according to user requirements and their potential health problems. It also includes information about the latest trends in hormonal contraception.

Acute phosphate nehropathy as the complication of bowel cleansing for colonoscopy.

MUDr.Iva Hoffmanová, MUDr.Martin Havrda, MUDr.Dana Janotová, CSc., PharmDr.Dobroslav Šrámek, doc.MUDr.Milan Kment, CSc.

Med. praxi. 2011;8(12):548-551  

We describe case of patient which developed a high level of serum kreatinin, after phosphate administration for bowel cleansing before coloscopy and irigography. Normal urine volume and frequency was observed. Renal biopsy showed acute phosphate tubular nephropathy. After 6 months due to dehydration high serum kreatinin level appeared again and patients was introduced into chronic haemodialysis program. The authors point to danger of phosphate cleansing bowel solution before endoscopy and radiography in patients with stones or infection of urinary tract, diabetes mellitus and using drug influencing calcium phosphate metabolism etc. This nephropathy...

Nutrition in liver disease

prof.MUDr.Marie Brodanová, DrSc.

Med. praxi. 2011;8(12):552-554  

The liver is the metabolic centre of nutrients. Liver diseases can interfere with the metabolism of the whole organism. It can have a negative impact on the nutritional status, and frequentlly lead to marked malnutrition. On the other hand, attemps to influence liver diseases by dietetic provisions have an old tradition while actual evidence of a marked benefits of the these prescriptions is lacking. Therefore we wittness at present rather regression from strick dietetic provisions, and favored individual diets vhere frequently in main orientation is the tolerance and suitable technology. From own praxis attention is drawn to pittfalls which...