Mýty a fakta kolem vakcinace

MUDr. Ján Dindoš

Med. praxi. 2016;13(4):155  

Novelty in treatment of Type 2 diabetes by oral antidiabetic drugs

MUDr.Jan Škrha jr.

Med. praxi. 2016;13(4):168-170 | DOI: 10.36290/med.2016.036  

The paper highlights basic principles and novelty in treatment of Type 2 diabetes mellitus. Individualization of diabetes therapy is emphasized, both in oral antidiabetic drugs selection, and in reaching of individual targets of diabetes control.

What should a general practitioner know about the diagnosis and treatment of atrial fibrillation

doc.MUDr.Petr Heinc, Ph.D., MUDr.Monika Kamasová, MUDr.Jan Látal, MUDr.František Kováčik, MUDr.Aleš Smékal, Leo Rec

Med. praxi. 2016;13(4):171-174 | DOI: 10.36290/med.2016.035  

Management of nonvalvular atrial fibrillation is recommended by Guidelines for the management of Atrial Fibrillation of the Czech Society of Cardiology (2011) and 2012 focused update of the ESC Guidelines for the management of atrial fibrillation (august 2012). In diagnostics, we try to capture atrial fibrillation according to adequate symptoms or pathological findings suggestive of embolic origin. Antithrombotic therapy is mainly ruled by the new thromboembolic risk stratification, so called CHA2DS2VASC score. New anticoagulants are preferred for anticoagulant therapy unless optimal anticoagulation with warfarin. Presented antiarrhythmic therapy...

Imunology, autoimmune diseases

MUDr.Šárka Lukešová, Ph.D.

Med. praxi. 2016;13(4):171-174 | DOI: 10.36290/med.2016.037  

Article provides a summary of autoimmune diseases that result from the failure of tolerance to self tissues. It discusses the mechanisms if immunological tolerance, principles and stages of formation of autoimmune disease. It provides an overview of the incidence of autoantibodies more or less characteristic for individual autoimmune diseases.

Dangerous drugs in patients with renal injury - when and how to reduce the doses

MUDr.Adéla Hrnčiříková, MUDr.Jan Vachek

Med. praxi. 2016;13(4):176-179 | DOI: 10.36290/med.2016.038  

Chronic kidney disease (CKD) is defined by reduced glomerular filtration rate, albuminuria, and the cause of renal injury. Kidney disease, particularly in the elderly population, is frequent; however, due to its asymptomatic nature, it is often overlooked or undiagnosed. If decreased renal function is not taken into account when pharmacotherapy is chosen, the patient can easily be harmed. Patients with chronic kidney disease are at an increased risk of adverse effects of pharmacotherapy; in them, kidney disease leads to affecting the majority of pharmacokinetic parameters and, at the same time, the comorbidities typically present require the...

Aetiopathogenesis and treatment of acne vulgaris

MUDr.Iva Obstová

Med. praxi. 2016;13(4):180-186  

This article reviews the pathogenesis, clinical picture, and options of topical and systemic treatment of acne vulgaris. Also presented are the methods of corrective dermatology.

Medications, natural substances, and dietary supplements in treating sexual dysfunctions: a sexologist’s perspective

MUDr.Ondřej Trojan

Med. praxi. 2016;13(4):188-190 | DOI: 10.36290/med.2016.040  

Dietary supplements are an important business commodity and source of income of pharmacies and internet shops. In the field of human sexuality, however, they fail to offer a reasonable therapeutic alternative to established medications. This is particularly true in the case of erectile dysfunction in men where phosphodiesterase type 5 inhibitors remain the drug of first choice. Aphrodisiacal effect is usually not demonstrable in natural substances; here, however, even the choice of pharmaceuticals is poor. This is most likely to blame on the fact that sexuality in humans is substantially more complex than in subhuman mammals.

Acute leukemia - what should general practitioners know about

MUDr.Zuzana Šustková, prof.MUDr.Zdeněk Ráčil, Ph.D.

Med. praxi. 2016;13(4):192-195 | DOI: 10.36290/med.2016.041  

Acute leukemia represents a clonal malignant disease of the hematopoiesis, which is characterized by uncontrolled proliferation and by accumulation of leukemic blasts in the bone marrow and also by inhibition of the hematopoiesis with ensuing development of pancytopenia, which is the cause of the clinical manifestations. Based on the classification of the leukemic blasts into either myeloid or lymphoblastic lineage, we can determine two basic types of acute leukemia – acute myeloid leukemia or acute lymphoblastic leukemia. The first symptoms appear suddenly and are unspecific. It is the early diagnosis in the primary care and the following...

Glatiramer acetate and three case reports

MUDr.Zbyšek Pavelek, MUDr.Pavel Ryška, Ph.D., doc.MUDr.Martin Vališ, Ph.D.

Med. praxi. 2016;13(4):196-198  

Multiple sclerosis is a chronic inflammatory demyelinating disease which affect central nervous system. This autoimmune disease manifests itself with various symptoms. Glatiramer acetate (Copaxone) is a drug of the the first line treatment for relaps/remitent type of multiple sclerosis or clinically isolated syndrome. This review explore the mechanism of action of glatiramer acetate in treatment of multiple sclerosis, its indication for treatment, use and possible side effects too. We report three cases from our own patients base through we demonstrate possible use of glatiramer acetate.

Lipertance - a novel agent in comprehensive prevention of cardiovascular events

doc.MUDr.Filip Málek, Ph.D.

Med. praxi. 2016;13(4):200-202 | DOI: 10.36290/med.2016.043  

A high proportion of patients with arterial hypertension have not only high blood pressure, but also impaired lipid metabolism. Hypertension and dyslipidaemia are frequent; therefore, timely and simultaneous intervention on the two significant risk factors for atherosclerosis and cardiovascular events is necessary. A fixed triple combination of two antihypertensive drugs with statin is a modern approach in comprehensive prevention of cardiovascular events.

Obesity - diagnosis and treatment in the general practitioner’s surgery

MUDr.Dita Pichlerová

Med. praxi. 2016;13(4):204-210  

The role of the general practitioner in the field of obesity prevention and treatment is indispensable. The general practitioner is in charge of the care of patients with overweight and grade 1 obesity. The article summarizes the basic diagnostic strategies in the general practitioner’s surgery and reviews the current options of obesity treatment with an emphasis on the collaboration of the general practitioner with nutritional therapists, psychologists, and physiotherapists. The follow-up care is provided by an obesitologist and/or bariatric centres.

Advance directives - as a (possible) instrument for decision-making about health care at the end-of-life

Hana Bláhová

Med. praxi. 2016;13(4):168-180 | DOI: 10.36290/med.2016.045  

This article deals with previously expressed wishes as a potential application of fundamental human rights, which are autonomy, human dignity, and the right to self-determination. The text aims to highlight the issue of previously expressed wishes in the context of decision-making capabilities in end-of-life situations and the possible risks of its use with the elderly population. The decision about the strategy and direction of treatment for elderly patients should appeal primarily towards maintain their ability of autonomy and their quality of care. It is clear that in the process of deciding, the elderly are particularly vulnerable, and...