Medicína musí udělat několik nepopulárních kroků, aby zůstala čistá a užitečná
1. Pojetí ČLOVĚKA ve zdraví a nemoci

MUDr. Radkin Honzák, CSc.

Med. praxi. 2019;16(3):139  

DMARDs-treated patient in the care of a General Practitioner

MUDr. Martina Skácelová, Ph.D., prof. MUDr. Pavel Horák, CSc., MUDr. Eva Lokočová

Med. praxi. 2019;16(3):143-147 | DOI: 10.36290/med.2019.021  

Long-term therapy of rheumatic diseases, such as rheumatoid arthritis, spondyloarthritis or systemic connective tissue diseases,using disease modifying drugs (DMARDs) can be connected with multiple complications. The most common are gastrointestinalcomplications, there is also increased risk of infectious complications, hepatotoxicity and myelotoxicity. In this review the mostcommon complications, their management and recommendations for perioperative care and vaccination are described.

Neuropathic pain treatment

MUDr. Marek Hakl, Ph.D.

Med. praxi. 2019;16(3):148-152 | DOI: 10.36290/med.2019.053  

Neuropathic pain is one of the most difficult pain condition to treat. Many common analgesics are ineffective in treating it. In therapy to the forefront are coming above all mainly a group of drugs from anticonvulsants, anti depressives, opioids with increased affinity to neuropathic pain and lately new topical form of medicaments. Occurrence of the neuropathic pain is increasing exponentially with the age of the patients, and at the same time the tolerance of the patients to anti neuropathic treatment is decreasing. Major benefit to treatment of the neuropathic pain was formation of unified EFNS guidelines on which the national guidelines are based....

Inflammation as a part of the pathophysiology of depression and the possibility of its influence by polyunsaturated fatty acids

PharmDr. Bc. Hana Kotolová, Ph.D., PharmDr. Tomáš Hammer

Med. praxi. 2019;16(3):153-156  

Depression and other affective disorders are among the most prevalent mental disorders. The pathophysiology of this diseaseis complex, and pro-inflammatory processes appear to play an important role in it. The article aims to summarize the existingknowledge of the research of the interconnection of affective disorders and inflammation and their possible influence by recentlyhighly discussed polyunsaturated fatty acids.

Dyslipidemia and diabetic foot syndrome

doc. MUDr. David Karásek, Ph.D., MUDr. Daniela Číhalíková

Med. praxi. 2019;16(3):157-160 | DOI: 10.36290/med.2019.055  

Patients with diabetic foot syndrome represent a high-risk group not only due to the risk of limb amputation, but also becauseof their high cardiovascular mortality. To reduce their cardiovascular risk it is necessary to make use of all available treatmentoptions, including adequate lipid-lowering therapy. This therapy can also positively affect the emergence and development ofown diabetic foot, taking a decision on specific drugs should take into account dominant ethiopathogenesis of the disease.

Armolipid Plus – a bridge between lifestyle changes and pharmacotherapy?

MUDr. Barbora Nussbaumerová, Ph.D.

Med. praxi. 2019;16(3):161-164 | DOI: 10.36290/med.2019.022  

The nutraceutical Armolipid Plus includes substances of plant origin with a positive efect on lipid a glycide metabolism. This nutraceuticalwas investigated in clinical studies and efficacy and tolerability was estimated. The current guidelines recommend thisnutraceutical as an aditive approach to healthy lifestyle in patients with low or moderate cardiovascular risk and with non-severedyslipidemia. Armolipid plus may be used in statin-intolerant or statin-not-willing patients.

Pharmacological prophylaxis of bleeding in urological procedures

MUDr. Michal Balík, MUDr. Jaroslav Pacovský, Ph.D.

Med. praxi. 2019;16(3):176-182  

The rising number of urological procedures and the increasing age and morbidity of urologic patients increase the risk of perioperativebleeding complications. There is no simple recommendation to prevent bleeding. It should be based on the current stateof the patient, who undergo the specific urological procedure. Often, consultation with a specialist (hematologist or angiologist)is useful. In this paper we present an overview of the current possibilities of pharmacological prophylaxis of bleeding duringurological procedures.

Drug-drug interactions of frequently prescribed antidepressants

MUDr. Michal Prokeš, PharmDr. Josef Suchopár

Med. praxi. 2019;16(3):169-175  

This article describes drug-drug interactions of antidepressants. Potentially fatal pharmacodynamic interactions include serotonin syndrome, whose diagnosis is difficult. QT prolongation is a marker of increased risk of ventricular tachycardia. Administration of SSRIs and NSAs increases the risk of bleeding, especially from GIT. From pharmacodynamic interactions, the article highligts interactions via CYP2D6. Many antidepressants and antipsychotics are CYP2D6 substrates, with paroxetine, fluoxetine and fluvoxamine being CYP2D6 inhibitors. Some of the interactions are contraindicated, in other cases doctor should consider pros and cons, and patients...

Patient with hypertension and type 2 diabetes mellitus – case report

MUDr. Ivan Řiháček, Ph.D.

Med. praxi. 2019;16(3):191-192 | DOI: 10.36290/med.2019.027  

Hypertension is a major risk factor for developing cardiovascular disease. Diabetes mellitus is a very common associated disorderand significantly increases the risk of complications. Treatment of hypertension in diabetes includes lifestyle interventions, theright choice of antihypertensive medication and the achievement of blood pressure target values.

Sepsis caused by Pasteurella

MUDr. Petr Konvička, doc. MUDr. Dan Marek, Ph.D., MUDr. Mgr. Ivana Kohnová, MUDr. Miriam Chlupová, MUDr. Zuzana Baňasová

Med. praxi. 2019;16(3):193-195  

Pasteurella species is a common bacteria in oral cavity of dogs or other animals, but it can causealso zoonotic infections in humans. Human Pasteurella infections usually manifest as a local skin or soft tissue infection following an animal bite or scratch. Systemic infections are less common and they are usually limited to newbornes and elderly patients, or those who have serious underlying disorders or who are immunocompromized. We report a case of Pasteurella dagmatis related flegmona in patient with recently diagnosed heart failure,a case of sepsis in a healthy middle-aged woman with discrete panaritium inflicted by a pet dog, and sepsis in a senior...

Colon and rectal cancer

MUDr. Jiří Tomášek, Ph.D.

Med. praxi. 2019;16(3):186-189 | DOI: 10.36290/med.2019.026  

Colorectal cancer (CRC) are histologically adenocarcinomas originating from the colon and rectal mucosa. CRC does not includeanal cancer which are mostly squamous cell. CRC screening is used to detect a polyp or early cancer in individuals without signsor symptoms of that disease. Early cancer can be treated curatively. Therapy of the metastatic disease is much more complicated.Multidisciplinary approach is needed. Curative approach is possible only in minority of the patients with metastatic CRC.

Reasonable support of aging – prevention of osteoporosis

PharmDr. Jitka Rychlíčková, Ph.D.

Med. praxi. 2019;16(3):199-202  

The process of streamlining and rationalization of pharmacotherapy is usually complicated, especially in elderly patients. It is mostly oriented on the elimination of the non-essential and unnecessary drugs, which are potentially risky in terms of adverse effects. On the other hand, introduction of calcium and vitamin D supplementation is reasonable in patients with low bone mass density. The prevalence of osteoporosis and low bone mass increases with age in men and in women, although the pattern is slightly different. What is the right dose of calcium for substitution, which types of calcium salts exist and which properties they have, what length...

Lze efektivně snížit kardiovaskulární riziko diabetika s dyslipidemií?

MUDr. Pavel Rutar

Med. praxi. 2019;16(3):165-166  

Pacient s ICHS v ordinaci praktického lékaře

MUDr. Pavel Rutar

Med. praxi. 2019;16(3):183-184  

Recidivující infekce močových cest

MUDr. Pavel Rutar

Med. praxi. 2019;16(3):196-198