Medicine for Practice, 2012, issue 10

Editorial

Práva a povinnosti lékařů

doc. MUDr. Jiří Šimek, CSc.

Med. praxi. 2012;9(10):371

Review articles

Urgent conditions in otorhinolaryngology

MUDr.Jaromír Nasswetter

Med. praxi. 2012;9(10):376-378

The article deals with urgent conditions in otorhinolaryngology that, given their nature, may have serious effects on a patient’s health; in extreme cases, they can even be life-threatening. Their management must not be delayed. These conditions particularly include choking and bleeding. Other acute conditions in otorhinolaryngology are inflammatory diseases and their complications, a sudden hearing impairment and balance disorders – acute vestibular syndrome. The symptomatology of these conditions, their possible causes, diagnosis and treatment options are described.

Effective drug therapy of liver diseases in general practice

doc.MUDr.Radan Brůha, CSc.

Med. praxi. 2012;9(10):379-381

Pharmacotherapy of liver diseases moves from symptomatic treatment toward the specific treatment. Only methods based on relevant clinical studies should be used. This condition does not fill previously widely prescribed “hepatoprotectives”. Apart from viral hepatitis, in clinical praxis we usually deal with alcoholic liver disease, non alcoholic steatohepatitis, chronic cholestatic syndromes and complications of liver cirrhosis. Basic treatment in alcoholic and non alcoholic liver disease is life style changes and diet, in the treatment of chronic cholestasis ursodeoxycholic acid is used. In the treatment of liver cirrhosis pharmacologic...

How to increase analgesic efficacy of paracetamol?

prof.MUDr.Miloslav Kršiak, DrSc.

Med. praxi. 2012;9(10):382-385

A usual single dose of paracetamol (500 mg per os) represents a subthreshold dose (< 10 mg/kg) in patiens with body weight over 50 kg (i. e. in most adults). A single dose of 1 g of paracetamol is therefore recommended in patients over 60 kg in weight. If paracetamol does not inhibit pain sufficiently even at this dose (1 g), then another analgesic is to be selected or combinations of paracetamol with other drugs can be used, e. g. those with opioids, NSAIDs (if possible), caffeine or others. Sometimes it may be helpful to speed up absorption of paracetamol by using effervescent or well soluble paracetamol preparations per os.

Guidelines for the treatment of lower respiratory tract infections for general practitioners

MUDr.Monika Žurková, prof.MUDr.Vítězslav Kolek, DrSc.

Med. praxi. 2012;9(10):385-387

The article deals with the current therapeutic options in lower respiratory tract infections. It mentions optimal empirical use of antibiotics in the most common conditions, such as acute tracheobronchitis, exacerbations of chronic bronchitis, exacerbations of chronic obstructive pulmonary disease, and pneumonia. The choice of drugs is guided by the current knowledge of their efficacy, availability, and with respect to emergent resistances. Valid clinical guidelines that the article is based on are presented. disease, pneumonia, antibiotic therapy.

Clostridium-difficile infection - curent state in the year 2012

MUDr.Ondřej Zela, MUDr.Petr Vítek

Med. praxi. 2012;9(10):391-394

Clostridium difficile-associated diarrhea (CDAD) and pseudomembranous colitis have become a significant challenge in current clinical medicine, posing a serious risk to any patient undergoing treatment with broad-spectrum antibiotics in either inpatient and outpatient setting. Although CDAD still remains relatively unknown to the lay public, the number of patients at risk of developing this condition is growing steadily. Recent treatment approaches seek to maintain normal colonic flora while effectively optimizing host immune response. The following article presents a concise overview of up-to-date guidelines with particular emphasize on recurrent...

Interdisciplinary overviews

Acute urinary tract infections - diagnostic and therapeutic options in the general practitioner’s surgery

MUDr.Jiří Kladenský

Med. praxi. 2012;9(10):395-398

Given the fact that urinary tract infections (UTIs) are the most common bacterial infections in man, every general practitioner encounters patients with urinary tract symptoms in his everyday practice. Due to the anatomical conditions and an upward spread of UTIs, the vast majority of patients are women. For practical and rational reasons, acute urinary tract infections are divided into primary (uncomplicated) and secondary (complicated) ones. The diagnosis and treatment of the former is clearly within the competence of the general practitioner; patients of the latter group should be, even after successful treatment, referred by the general...

Practical management of atopic dermatitis

MUDr.Anna Jiráková, MUDr.Jana Bernardová, prof.MUDr.Jana Hercogová, CSc.

Med. praxi. 2012;9(10):399-402

Atopic dermatitis is a multifactorial non-infectious inflammatory skin disease of the chronic and relapsing character. It is very common disease, its incidence is still growing. Most commonly it affects young children. Prevalence of atopic dermatitis in adults is 2–10 % and in children 15–30 %. Relevance of this disease depends on the extent of its symptoms, frequency of the exacerbations, complications but mostly on the significant impact on the quality of life. It is of a great importance that atopic dermatitis influences quality of life not only of the patient himself but also his family. The aims of the therapy of atopic dermatitis...

At a glance

Cough, diagnostic and therapy

MUDr.Ján Dindoš

Med. praxi. 2012;9(10):403-404

Cough is normal reflex of defense, characterised with his fulminating and forced expirium. His goal is tendency for clean up from foreign bodies and foreign substances. As symptom exist from this time, when persists and this complication is reason for patient to attend his practitioner. Is the one of the most frequent symptoms, for which patient go to the doctor. Often is underestimated sign of very serious disease and then in its diagnostic and therapy needs interdisciplinary cooperation.

For nurses

Home care of patients with movement disorders - rehabilitation aspects

Mgr.Dagmar Dupalová, Ph.D.

Med. praxi. 2012;9(10):406-409

The article describes the basic rehabilitation elements that are used in the care of patients with movement disorders. In particular, patients with more severe movement disorders do not only need medical care but also the care of their family members. It is possible to carry out home care with slight change of home environment conditions. In patients with severe movement disorders it is significant to perform regular positioning, breathing exercises, passive exercises and exercises according to the patient’s actual state of health with the assistance of a therapist and active exercises. It is recommended to perform active movements focused...