Světlo světa

Mgr. Jan Pomykacz

Med. praxi. 2012;9(12):467  

Upper dyspeptic syndrome

doc.MUDr.Bohumil Seifert, Ph.D.

Med. praxi. 2012;9(12):470-473  

Dyspepsia is a group of symptoms, usually of long-term nature, that are related to digestion and localized by the patient in the area of the digestive system. A more detailed definition and principles of approach in the practice can be found in the Society of General Practice of the Czech Medical Association of J. E. Purkyně 2012 Guideline Update. Dyspeptic complaints are among the most common reasons for self-treatment as well as for seeing a doctor and considerable amounts of money are spent on their diagnosis and treatment. The epidemiological background of dyspeptic complaints has been changing; there has been a significant reduction in...

Chronic pain in the GP's surgery

MUDr.Marek Hakl, Ph.D.

Med. praxi. 2012;9(12):474-476  

Pain is among the first sensations that a person encounters in life and that accompanies them throughout their existence. The World Health Organization (WHO) and the International Association for the Study of Pain (IASP) define pain as: “An unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is always subjective“. In order to choose the right analgesic or analgesic combination, it is important to distinguish between acute and chronic, nociceptive and neuropathic, mixed and psychogenic pain.

Diabetic neuropathy from the perspective of diabetologist

MUDr.Martina Lášticová

Med. praxi. 2012;9(12):477-479  

Diabetes mellitus is the most common cause of neuropathy in developed countries of the world. Diabetic neuropathy is not a single entity, but encompasses several neuropathic syndromes including focal/multifocal neuropathies, typical and atypical (acute) varieties of distal symmetrical polyneuropathies. The most common types are symmetric distal sensorimotor polyneuropathy and autonomic neuropathy. Care of a patient with diabetic neuropathy is interdisciplinary with a diabetologist and a neurologist taking part. Good glycaemic control is a basic principle of prevention and therapy. Early disturbances can be reversible; chronic neuropathy develops...

Is there a time for change and for unifying the strategy for treating arterial hypertension in patients

MUDr.Igor Karen

Med. praxi. 2012;9(12):480-481  

with diabetes mellitus and ischemic heart disease? In patients over 65 years of age who have no serious comorbidity (post-stroke condition, diabetes mellitus, etc.), it is not necessary to really strictly observe the target blood pressure below 140/90 mm Hg; therefore an individual approach to the patient is required. Target BP around 130/80 mmHg in all patients with AH and present other comorbidities such as CHD, DM, PVD and more. Antihypertensive therapy is indicated even in the oldest age groups since it has been shown that treatment of AH (particularly that with indapamide and ACEi) significantly reduces cardiac failure and overall mortality...

Hemorrhoids - a common and unpleasant condition - conservative treatment, surgical methods

MUDr.Jiří Korbička, Ph.D., MUDr.Šťěpán Chalupník, MUDr.Jan Cagaš, prof.MUDr.Ivan Čapov, CSc., PharmDr.Pavla Fuksová

Med. praxi. 2012;9(12):482-489  

Hemorrhoidal complaints very often make the patient attend a pharmacy and/or a physician. They are diverse involving not only the area of the rectum, but also defecation. Contemporary medicine does not use the term "hemorrhoids" to refer to pathology, but only to describe the normal anatomical structures present around the anal canal since birth. They have an indispensable function in maintaining continence of bowel contents. Only when hemorrhoidal venous plexuses, due to their involvement, cause various, frequently nonspecific complaints, this is referred to, technically, as "hemorrhoidal disease" (1) and requires examination and treatment....

Current perspectives on diagnosis and treatment of prostate diseases

MUDr.Kamil Belej, Ph.D., FEBU

Med. praxi. 2012;9(12):490-495  

Prostate diseases – prostate inflammations, benign prostatic hyperplasia, or malignant cancer – have a high incidence in the population; therefore, they are encountered by physicians of all specialities. This area of urology is developing dynamically, with new knowledge emerging and new strategies resulting. The article summarizes the current trends and also includes practical information on the management of prostate diseases. These conditions are, as a rule, diagnosed by a urologist. Nevertheless, fundamental knowledge of etiopathogenesis, diagnosis, and treatment can facilitate the care of these patients for the general practitioner...

Vagaries of the thyroid gland

MUDr.Ľubica Cibičková, Ph.D., MUDr.Ľubica Víchová

Med. praxi. 2012;9(12):496-498  

We present a case of a young woman with alternating hyper- and hypothyroidism. During the treatment of her infertility, the outpatient gynaecologist revealed subclinical hyperthyroidism (diagnosed as a hyperthyroid period of chronic lymphocytic thyroiditis) which subsequently switched to hypothyroidism. Following thyroxin supplementation the patient became pregnant and bore a full-term child. Four months after the delivery a post-partum thyroiditis sprang up and vanished spontaneously without treatment. This case-report demonstrates how thyroid gland function may alternate in an immunologically predisposed terrain (positive thyreoglobulin antibodies)...

A case of resistant arterial hypertension in a 37-year-old man

MUDr.Pavel Lang, MUDr.Ondřej Petrák, Ph.D., MUDr.Pavel Nedbal

Med. praxi. 2012;9(12):499-501  

Arterial hypertension affects an average of 30 % of patients over 60 years of age and is one of the major health concerns. Despite modern pharmacotherapy and the use of combination therapy, some patients are unable to achieve optimal blood pressure control. Hypertension is typically defined as resistant, or refractory, to treatment when the blood pressure value is 140/90 or higher despite complying with a therapeutic plan, including both nonpharmacological measures, such as lifestyle and dietary measures, and pharmacotherapy containing at least a triple combination of drugs in adequate doses, including a diuretic (1). The estimated prevalence...

Addisonova nemoc

MUDr. Eva Motyková

Med. praxi. 2012;9(12):502