Slovo úvodem

MUDr. Kamil Sedláček

Med. praxi. 2019;16(1):3-4  

Which of thyroid disorders should be managed by general practitioner?

doc. MUDr. Jan Jiskra, Ph.D.

Med. praxi. 2019;16(1):7-13 | DOI: 10.36290/med.2019.002  

Prevalence of thyroid diseases is high and reaches up to 15% in specific populations. Current health care system does not have capacity enough to provide all patients with thyroid disorder especial management by endocrinologist. It is prerequisite, general practitioner would achieve appropriate education and experience to be eligible to diagnose common thyroid disorder, to distinguish it from transient non-thyroid abnormalities in thyroid functional tests, to assess adequately the severity of the functional thyroid disease and malignancy risk of thyroid nodule, and then refer the patient to endocrinologist or introduce a treatment and continue with...

What are the changes brought by the new CSH guidelines?

prof. MUDr. Miroslav Souček, CSc.

Med. praxi. 2019;16(1):14-19 | DOI: 10.36290/med.2019.003  

Since the latest Czech Society of Hypertension (CSH) guidelines were published five years ago, there has been an opinion shift onsome issues concerning the diagnosis and treatment of hypertension, which is a reason for issuing new guidelines. (1) This documentaims to summarize the current knowledge based on the results of the most recent trials and show what is new comparedwith the previous version. This article deals with some chapters where changes have been made.

Hepatoprotectives and their use in general practice

doc. MUDr. Bohumil Seifert, Ph.D.

Med. praxi. 2019;16(1):20-22 | DOI: 10.36290/med.2019.046  

Hepatoprotectives are a large group of natural compounds with a presumed positive, protective, and regenerative effect on the liver cell. They are characterized by very good tolerance and safety profile, corroborated by thousands of years of use. The efficacy of some hepatoprotectives, such as silymarin or vitamin E, is well evidenced in the literature. The efficacy and role of other potentially hepatoprotective agents have been the subject of medical research all over the world. In modern hepatology, primarily aimed at effective causal treatment of chronic hepatitides and other clinical entities, the position of hepatoprotectives is weakened. In the...

Treating arterial hypertension in patients with metabolic syndrome

doc. MUDr. Filip Málek, Ph.D., MBA

Med. praxi. 2019;16(1):23-26 | DOI: 10.36290/med.2019.004  

Metabolic syndrome is defined by the presence of several factors that share a common pathophysiological basis. The presence of metabolic syndrome is associated with a high risk of fatal cardiovascular and cerebrovascular events. The prevalence of metabolic syndrome is high. The management of metabolic syndrome is always comprehensive. The treatment of arterial hypertension as part of metabolic syndrome has its specific features. Metabolically neutral and metabolically positive drugs are preferred, particularly those of the renin-angiotensin system inhibitor group. A combination with statins is beneficial for their potential to reduce the risk of cardiovascular...

Efficacy of topical nonsteroidal anti‑inflammatory

doc. PharmDr. Mgr. David Vetchý, Ph.D.

Med. praxi. 2019;16(1):28-30  

Drugs from topical formulations should be able to penetrate into the skin and target areas in sufficient amounts to achieve a therapeutic effect. Factors influencing the ability of the topical drug to penetrate optimally into the skin and subcutaneous layers include the drug molecule size, its solubility in aqueous and lipophilic media, protein binding, acidity, the presence of the permeation enhancer in the topical formulation, and the type of medical form and its application. By analyzing randomized, blinded clinical studies, it was found that the best clinical effect was obtained after diclofenac administration in the form of emulgel. Diclofenac...

Therapy of acute upper respiratory tract infections

MUDr. Petr Schalek, Ph.D.

Med. praxi. 2019;16(1):31-34  

Acute upper respiratory tract infections affect both children and adults and for their frequency represent a serious health andsocio-economic problem. The main goal of treatment for these infections is to alleviate symptoms, shorten the duration of illness,avoid complications, and reduce school or work absenteeism. The following brief overview lists the groups of drugs that are oftenrecommended or prescribed for patients with acute upper respiratory infections, with an emphasis on evidence-based medicine.

Why do we fail when treating dyslipidemia?

MUDr. Tereza Altschmiedová, prof. MUDr. Michal Vrablík, Ph.D.

Med. praxi. 2019;16(1):36-42  

Dyslipidemia represents a risk factor in many diseases, of which atherosclerosis is considered to be the most serious cause of the later development of cardiovascular disease, which is still the most significant cause of death worldwide. At present, almost nobody disputes the treatment of dyslipidemias as an effective means of preventing cardiovascular disease. Its basis in all patients is non-pharmacological, with the drug of first choice being statins, for the benefits and the safety of which we have long-term evidence. However, in order that the treatment of dyslipidemias achieves its goal of decreasing cardiovascular morbidity and mortality, it...

Evaluation of a neck mass in adults: suspicion of malignity

MUDr. Martin Formánek, Ph.D., MUDr. Karol Zeleník, Ph.D., prof. MUDr. Pavel Komínek, Ph.D., MBA

Med. praxi. 2019;16(1):53-55 | DOI: 10.36290/med.2019.008  

The neck mass in adults has a varied etiology. Severity varies from "banal" conditions, such as reactive lymphadenitis or lipoma, to severe malignancies such as metastasis of carcinoma originating from the mucosa of the head and neck or lymphoma. The biggest mistake is if a possible malignancy is not considered and the diagnosis is unnecessarily prolonged, which may lead to a worsening of the outcome of the treatment. Differential diagnosis and decision-making should be based on age, duration and magnitude of resistance, rate of onset, size, pain, localization, symmetry/asymmetry and other symptoms. The asymmetry must always cause suspicion of a possible...

Prostate cancer – what should we know about diagnostics

MUDr. Milan Král, Ph.D., MUDr. Šárka Kudláčková

Med. praxi. 2019;16(1):48-52 | DOI: 10.36290/med.2019.007  

During the last few decades we can see increasing incidence of prostate cancer. This is caused partially due to increased activity of medical stuff and partially due to higher information level of patients about potential risk of harbouring prostate cancer. Contrary to other oncological diagnosis (breast cancer, colorectal cancer), in prostate cancer the reason for screening programmes is widely discussed. Many multicentric projects assessed screening influence on prostate cancer mortality reduction. Conclusions both European and U.S. studies uniformly show that despite increased detection of prostate cancer, neither the cancer specific mortality nor...

Errors while collecting and sending biological material

Ing. Luděk Šprongl

Med. praxi. 2019;16(1):59-62 | DOI: 10.36290/med.2019.010  

The paper deals with the sources of errors occurring during the collection and transport of biological material. The individualphases of the collection process are discussed, ranging from patient preparation to collection termination. Possible sources oferrors in the individual phases and their effect on laboratory results are presented. Also described are the sources of errors duringtransport – the effect of time and conditions.

Osteoartróza

MUDr. Pavel Rutar

Med. praxi. 2019;16(1):45-46  

Život není jen sen

MUDr. Pavel Rutar

Med. praxi. 2019;16(1):56-58