Ať žijou mikrouti!

MUDr. Radkin Honzák

Med. praxi. 2018;15(4)  

Patient with lower limb swelling – frequent problem in GP surgery

MUDr. Miroslav Chochola, CSc.

Med. praxi. 2018;15(4):182-188 | DOI: 10.36290/med.2018.035  

Lower limb edema is a frequently encountered problem in clinical practice, it can be a manifestation of many pathophysiologicalconditions in the development of which a number of factors are involved. They affect the pressure balance between the vascularbed and the interstitium. Chronic lower limb edema may be associated with systemic disease or may have a local cause, confinedonly to the lower limbs. In the clinical practice are important differentiate chronic venous inufficiency, deep vein trombosis andlymfatic edema from other possible causes. This review article focuses on quick orientation in the etiology, differential diagnosisand treatment of...

Pharmacotherapy of back and joint pain in general practitioner’s office

MUDr. Libuše Ircingová

Med. praxi. 2018;15(4):189-193 | DOI: 10.36290/med.2018.036  

General physicians as well as many specialists in both ambulatory and hospital care need to deal with joint – and back – painon daily basis. The aim of this paper is to summarize the possibilities of pain pharmacotherapy, distinguising between the acuteand the chronic pain, the nociceptive and neuropathic chracter of the pain, and also to reflect on specifics of treating pain in theelderly. It also includes a stratégy for the rational opioid treatment in patients with chronic noncancerous pain.

Viral hepatitis in the office of G.P.

prof. MUDr. Petr Husa, CSc.

Med. praxi. 2018;15(4):194-196 | DOI: 10.36290/med.2018.037  

Chronic hepatitis C therapy using Directly Acting Antivirals (DAA) has high efficacy (till 100 %), minimum contra-indications andextraordinarily favorable safety profile. Primarily, it is necessary to pay attention to drug-drug interactions. However they arewell documented and successfully resolvable already in general clinical practice. Current possibilities of interferon-free therapyrepresent combinations of sofosbuvir with other DAA (velpatasvir, velpatasvir + voxilaprevir, ledipasvir), combination of paritaprevirboosted by ritonavir + ombitasvir ± dasabuvir, and fixed combinaton of elbasvir and grazoprevir. Fixed combinations ofglecaprevir...

Care of a patient after PCI at the general practitioner’s surgery

doc. MUDr. Vilém Danzig, Ph.D., FESC

Med. praxi. 2018;15(4):197-202 | DOI: 10.36290/med.2018.065  

A patient after PCI, whether performed in association with ACS or not, will always remain a patient with IHD who is supposedto follow all the principles of secondary prevention. These include lifestyle and pharmacological measures. Ideally, the care isprovided by a cardiologist in collaboration with the general practitioner whose role is irreplaceable. Particular attention has tobe paid to the immediate postoperative period.

Elevated liver tests in the field practice

MUDr. Anna Hovorková, MUDr. Karel Dvořák, Ph.D.

Med. praxi. 2018;15(4):203-208 | DOI: 10.36290/med.2018.038  

The aim of the article is to summarize essential information concerning the interpretation of elevated liver tests in the clinicalpractice, highlight some of the pitfalls, and use examples to demonstrate common types of hepatic lesions. The introductionsection deals with basic theoretical information regarding liver tests as well as certain specific signs and medical history data thataid in interpreting liver tests and performing differential diagnosis. The final section presents examples of particular patients,their liver tests, and the diagnostic conclusions.

Arterial hypertension and pulse pressure

MUDr. Marek Vícha, doc. MUDr. Jan Václavík, Ph.D., FESC

Med. praxi. 2018;15(4):211-214 | DOI: 10.36290/med.2018.039  

Arterial hypertension is one of the most frequent diseases in outpatient clinical practice and also the most important risk factor forcoronary heart disease, stroke, heart failure, end-stage renal disease or atrial fibrillation. It is defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥ 90 mmHg on repeated office measurements. Pulse pressure is defined as the systolicminus the diastolic blood pressure. It is a good predictor of cardiovascular events among older adult patients and the value ≥ 60mmHg is regarded as asymptomatic organ damage. The main goal of therapy is to reach target blood pressure and its...

Management of osteoarthritis in general practice

MUDr. Luděk Ryba, Ph.D., doc. MUDr. Richard Chaloupka, CSc., doc. MUDr. Martin Repko, Ph.D., PhDr. Iva Marková

Med. praxi. 2018;15(4):215-220 | DOI: 10.36290/med.2018.040  

Osteoarthritis is the most common joint disease caused by degeneration of cartilage with subsequent reaction and remodelingof surrounding joint tissue. In the primary form it is caused by aging and increases with higher age. In the secondary form, mainlythe influence of congenital changes, accidents and general systemic disease driven by a host of inflammatory mediators withinthe affected joint accelerate degeneration. Subjectively, it is manifested mainly in the form of pain, gradual swelling and limitedrange of movement of a particular joint. It is a long-term process with varying intensity. It mainly affects the hip and knee jointbut can occur on...

Antiparkinsonian drugs, mental disorders in patients with Parkinson’s disease and drug‑drug

MUDr. Michal Prokeš, PharmDr. Josef Suchopár

Med. praxi. 2018;15(4):222-227  

Patients with Parkinson´s disease (PN), a common neurodegenerative disorder, suffer not only from movement disorder, but alsofrom mental disorders including behavioral disorders and psychosis. These disorders are closely related to dopaminergic treatmentof PN. Despite knowledge of the clinical features of these disorders, many patients may not be diagnosed in time. Anotherissue are drug-drug interactions, because patients with PN are treated for associated diseases usually by other physicians, whomay not always be aware, that the antiparkinsonian or antipsychotic drugs interact with other commonly prescribed drugs. Thisarticle introduces the medical...

Treatment of an HIV-positive patient in the home environment

Mgr. Veronika Kulířová

Med. praxi. 2018;15(4):231-234 | DOI: 10.36290/med.2018.043  

Specialists now consider HIV to be a chronic illness. Aged HIV patients, or HIV patients whose condition deteriorates, may belooked after by their loved ones, who are increasingly willing to undertake this task. The biggest obstacles in their endeavour arefear of contracting HIV and lack of expertise required for this type of care. A nurse can play a positive role in helping the family.

Současné možnosti v léčbě neuropatické bolesti

MUDr. Pavel Rutar

Med. praxi. 2018;15(4):228-230