Je třeba změnit paradigma

MUDr. Radkin Honzák, CSc.

Med. praxi. 2020;17(1):3  

Increasing antibiotic resistance and rational use of antibiotics

Mgr. Eva Krejčí, Ph.D.

Med. praxi. 2020;17(1):8-12  

Generally, the term of bacterial resistance refers to the ability of bacteria to survive a specified concentration of a given antibiotic. The current increase in antibiotic resistance is a serious problem, jeopardizing further use of antibiotics for treatment of infections. Resistance to reserve drugs used for serious cases caused by Gram-positive and Gram-negative bacteria (vancomycin, carbapenems) is on a steady increase, recently including also resistance to colistin, being the last antibiotic drug tested as effective against some strains of pseudomonas. Excessive administration of antibiotics leads to elevated incidence of resistant strains (so-called...

Influenza and its complications

MUDr. Pavel Novotný, Ph.D., MUDr. Dana Hedlová, Ph.D.

Med. praxi. 2020;17(1):13-17 | DOI: 10.36290/med.2020.002  

Influenza is a well-known viral disease of the respiratory tract. It must be distinguished from influenza-like illnesses and other acute respiratory infections. Influenza may have a complicated course, with some cases requiring hospitalization and initiation of antiviral therapy. Influenza complications are divided into pulmonary and extrapulmonary. Complications can further be divided into primary (caused by an influenza virus) and secondary (caused by secondary bacterial infection). Prevention of influenza is both passive (maintaining personal hygiene) and active (vaccination).

Modern therapy of cough

MUDr. Stanislav Kos, CSc., FCCP

Med. praxi. 2020;17(1):18-22 | DOI: 10.36290/med.2020.008  

Cough is the mechanism of airways defence. According to its duration can divided in adults in: acute with duration of up to 3 weeks, prolonged with intermittent duration from 3 do 8 weeks, chronic - lasting over 8 weeks. According to its character cough may be divided in dry, irritating cough that could develop in hoarse, husky voice - should be treated with antitussives with central or peripheral effects; paroxysmal cough - predominantly during the night, or exercise induced, may be the sign of astma. The relief could be reached by inhaled bronchodilators or antiinflammatives; cough with sputum production is often connected with chronic bronchitis...

Chronic venous disease underestimated by both patients and physicians: surprising results of a Czech survey

MUDr. Júlia Černohorská, Ph.D.

Med. praxi. 2020;17(1):25-30 | DOI: 10.36290/med.2020.003  

Chronic venous disease (CVD) is underestimated by both patients and physicians. Various surveys suggest that patients underestimate their symptoms and often seek medical attention late in the course of the disease, i.e. either with advanced varices or with permanent skin changes resulting from severe haemodynamic disturbances in the venous system. Moreover, there are increasing numbers of patients with a non-healing wound of venous aetiology. In fact, more advanced stages of CVD significantly reduce the quality of life of patients. The 2019 CVD control survey carried out in the Czech Republic indicates that, particularly among younger patients, there...

Latest developments in the management of resistant hypertension

prof. MUDr. Renata Cífková, CSc.

Med. praxi. 2020;17(1):31-34  

Hypertension resistant to treatment is currently defined as a situation when the recommended treatment strategy fails to lower office blood pressure to values < 140/90 mmHg, and inadequate control of blood pressure is confirmed by ambulatory blood pressure monitoring or home blood pressure measurement. The recommended treatment strategy should include treatment with optimal or best-tolerated doses of three or more drugs that should include a diuretic and, typically, an ACE inhibitor or angiotensin receptor blocker and a calcium-channel blocker. The estimated prevalence using the above definition is likely to be < 10% of treated...

Beta blockers in the treatment of heart failure in the patients with co-morbidities and adverse effects limiting their use

MUDr. Tomáš Janota, CSc.

Med. praxi. 2020;17(1):35-38 | DOI: 10.36290/med.2020.004  

Beta blockers have been an important drug for many clinical situations and diseases for many years. Counteracting excessive stimulation of β-adrenoreceptors leads especially to the heart rate slowing, decrease in metabolic demands of the myocardium, improvement of left ventricle filling, as well as improvement in the subendocardial blood flow. Ultimately, despite its negative inotropic effect, beta blockers have a positive effect in the treatment of chronic and often acute heart failure. However, in a number of situations beta blockers administration is feared or considered contraindicated, such as decompensated heart failure, tachyarrhythmia...

Drug‑induced bloating and treatment

PharmDr. Eliška Kolmanová, Ph.D.

Med. praxi. 2020;17(1):41-46  

Bloating occurs in patients for many reasons. One of them is the use of drugs, which by various mechanisms lead to increased intestinal gas production or a breakdown in their passage. This article summarizes the basics of gut physiology, the pathogenesis of flatulence, gives examples of most common drugs associated with bloating and offers therapeutic interventions in self-medication as well as lifestyle and diet adjustment.

Pitfalls of systemic and local corticosteroid treatment

prof. MUDr. Hana Matějovská Kubešová, CSc., MUDr. Ondřej Výška, MUDr. Jiří Nakládal, Jan Matějovský

Med. praxi. 2020;17(1):49-53 | DOI: 10.36290/med.2020.006  

Corticosteroids were first used for therapeutic purposes in patients with rheumatoid arthritis and topically for relief in the case of skin exanthem. With increasing medical knowledge, the indications for their administration have been expanded to include a broad spectrum of clinical conditions. In an acute single-use setting, there is no contraindication to the administration of corticosteroids which can often be life-saving. With long-term treatment, one has to take into consideration the possible risks of adverse side effects resulting from the nature of corticosteroids as agents that provide coping with stress situations, thus increasing blood...

Bleeding stomal varices as a rare presentation of portal hypertension

MUDr. Jiří Dyntr, MUDr. Monika Černá, MUDr. Jiří Stehlík, MUDr. Lenka Kinštová

Med. praxi. 2020;17(1):63-65  

Variceal bleeding is of the most usual complications of portal hypertension in patients with liver cirhosis. Besides gastroesophaeal region, varices can also be seen in other parts of gastrointestinal tract - most frequently in stomas. In our case report, we present a patient with reccurent stomal bleeding due to unrecognised liver cirhosis with portal hypertension. Therapeutic approach to such patients usually combines local methods to stop acute bleeding and decompression methods, such as transjugular intrahepatic portosystemic shunt (TIPS).

Hypoglycaemia - how to recognize, treat and prevent

MUDr. Barbora Doležalová

Med. praxi. 2020;17(1):66-68  

Hypoglycaemia remains an important barrier in achieving glycemic targets in people with diabetes. Understanding pathophysiologic principles of hypoglycemia in diabetes enables correct patient education and proper target setting. Hypoglycaemia prevention can be accomplished through patient education, blood glucose self-monitoring as well as modern pharmacotherapy of diabetes.

Cévní věk: účinný nástroj pro komunikaci s pacienty aneb "čím dříve, tím lépe a čím déle, tím lépe"

MUDr. Jaromír Ožana

Med. praxi. 2020;17(1):69-70  

Zaznělo na VI. kongrese Medicíny pro praxi Plzeň, 22.-23. listopadu 2019 – Neurozánět a deprese

MUDr. Pavel Rutar

Med. praxi. 2020;17(1):47-48  

Zaznělo na VI. kongrese Medicíny pro praxi Plzeň, 22.-23. listopadu 2019 – Bolesti zad z pohledu revmatologa

MUDr. Pavel Rutar

Med. praxi. 2020;17(1):58-60  

Common diseases of the nasal mucosa and their self-healing using OTC medication

Mgr. Filip Škarda

Med. praxi. 2020;17(1):54-57  

An appropriate treatment of nasal mucosa depends very often on the correct specification of the disease agent and right choice of medicinal product and complementary treatment. The exact incidence of diseases of nasal mucosa is difficult to detect. Rhinitis and similar diseases are one of the most common type of self-healing diseases (only with the help of a pharmacist or a pharmaceutical assistant without the intervention of a practitioner or a specialist). In this text I summarize the common diseases of the nasal mucosa and outline the treatment by using medicine available in the Czech Republic.