Medicine for Practice, 2021, issue 4

Editorial

Tabákový průmysl: Na dětech nám záleží!

prof. MUDr. Eva Králíková, CSc.

Med. praxi. 2021;18(4):231

Review articles

Patient with dirrhea in a general practicioner´s office, causes and solutions

MUDr. Helena Ambrožová, Ph.D.

Med. praxi. 2021;18(4):236-242 | DOI: 10.36290/med.2021.040

Diarrheal diseases are among the most commonly reported infectious diseases in the Czech Republic, although in connection with the pandemic covid-19 and a very long lockdown their number decreased last year (in 2020 only 38 803 cases were reported in the Czech Republic). The most common etiological agents include campylobacters (17 786 cases) salmonellas (10 364 cases), Clostridium difficile, rotaviruses and noroviruses. The article describes the epidemiology, clinical picture, diagnosis, differential diagnosis and treatment of diarrheal diseases.

The most common thyroid diseases and their treatment

MUDr. Hana Šarapatková, Ph.D.

Med. praxi. 2021;18(4):244-248

Thyroid gland diseases are among the most common diseases encountered by endocrinologists. In the Czech Republic, they affect as much as 5% of the population, with a female-to-male ratio 6-8 : 1. Their prevalence in middle-aged and older women is approximately 10-15%. Following the diagnosis, a therapeutic strategy is proposed. Most frequently, pharmacotherapy is used; when indicated, surgery and/or radioactive iodine treatment are an option; and a proportion of patients are watched expectantly. An individualized approached is always required, taking into account patient age, comorbidities (particularly cardiovascular ones), future pregnancy plans,...

What to recommend to patients with menstrual pain?

PharmDr. Lenka Dvířková

Med. praxi. 2021;18(4):251-254

In every month, many women around the world experience pain and discomfort in their lower abdomens. These symptoms occur in varying degrees in women and adolescent girls and may even prevent some of the patients from performing their normal daily activities. At the pharmacy, it is of great importance for us to hear from our patients and offer them an adequate therapy. It primarily consists of non-pharmacological procedures, which should be accompanied by pharmacological recommendations. There are many over-the-counter medications, which have the menstrual pain/dysmenorrhea mentioned in the indications. We can choose between medicines containing paracetamol...

Gastroesophageal reflux disease: current state of the issue

MUDr. Eva Mayerová

Med. praxi. 2021;18(4):256-260 | DOI: 10.36290/med.2021.043

Gastroesophageal reflux disease is a frequent gastrointestinal disease characterized by a broad spectrum of symptoms, ranging from mild irregular complaints to the presence of serious Barrett's esophagus. In addition to typical symptoms, i.e., pyrosis and regurgitation, there can be a number of atypical and extraesophageal symptoms. Proton pump inhibitors still play a major role in pharmacotherapy. In the past decade, significant advances were made in endoscopic treatment methods which are particularly used in the management of complications. In the majority of cases, the course of the disease is prolonged requiring long-term maintenance treatment....

Interdisciplinary overviews

Physiotherapy as part of comprehensive treatment in women after breast surgery

PhDr. Kateřina Tichá, Ph.D.

Med. praxi. 2021;18(4):262-265

Breast cancer ranks highest for the number of deaths in women aged 20-54 years. Breast cancer surgery significantly affects the locomotor system. Changes in the locomotor system occur in the area of the upper limb girdle, cervical and thoracic spine, and ribs. Physiotherapy offers a wide choice of physiotherapeutic methods and concepts which can be used successfully in women after breast surgery in both the preoperative and postoperative period as well as during convalescence.

Drug interactions

Herbal preparations and their drug interactions in routine outpatient practice

PharmDr. Alice Sychrová, Ph.D.

Med. praxi. 2021;18(4):266-273 | DOI: 10.36290/med.2021.045

More and more patients are choosing self-medication procedures, including phytotherapy whose popularity is constantly growing. Patients mistakenly believe that the use of herbal preparations is completely safe. In addition to the possible toxicity of the plant itself, there is also a risk of drug interactions. The ones most at risk are people over 65 years old, patients with polypharmacy, polymorbidity, or with severe chronic diseases. Recent scientific studies have highlighted the risks associated with the co-administration of grapefruit, ginkgo, licorice, and St. John's wort with many drugs. These interactions may have fatal consequences, so a general...

Case report

Treatment of sideropenic anaemia by a general practitioner

MUDr. PhDr. Zdeňka Nováková, Ph.D.

Med. praxi. 2021;18(4):274-276 | DOI: 10.36290/med.2021.046

The article deals with sideropenic anaemia, its causes, differential diagnosis, clinical symptoms, and treatment. In the practice, non-specific symptoms of anaemia are often the first sign of gastrointestinal disease. Determining the cause of anaemia is critical for appropriate treatment. Concerning treatment, it is beneficial to administer iron as controlled-release tablets, which reduces the effect of high iron concentrations on the intestinal mucosa. A case report illustrates the options of treatment in a general practitioner's surgery.

The treatment of arterial hypertension in patient with myocardial infaction in recent history, the percutaneous coronary intervention is just the beginning

MUDr. Michaela Šnejdrlová, Ph.D.

Med. praxi. 2021;18(4):278-280 | DOI: 10.36290/med.2021.047

Increased activity of the sympathetic nervous system as well as increased activity of the renin-angiotensin-aldosterone system (RAAS) constitute the pathophysiological basis of the most common cardiac diseases - arterial hypertension, ischemic heart disease and chronic heart failure. According to this, beta-blockers and angiotensin-converting enzyme inhibitors are recommended in the treatment of all these diseases. The short case report demonstrates the case of a patient with acute coronary syndrome treated by percutaneous coronary intervention. After discharge from the hospital, consistent intervention of all cardiovascular risk factors is necessary,...

Severe acute pancreatitis

MUDr. Zuzana Adamová, Ph.D., MUDr. Rostislav Čureček

Med. praxi. 2021;18(4):281-282 | DOI: 10.36290/med.2021.048

Acute pancreatitis is an acute inflammation of the pancreas that varies in severity from mild to life threatening. We report a 49-year-old man presenting for acute sharp abdominal pain, diagnosed as acute pancreatitis. After six days his condition started to deteriorate and within ten days died because of septic shock due to an extensive colon perforation. In our case presentation we aimed to commemorate the possibility of severe complications of acute pancreatitis. Colon perforation is rare complications of peripanceratic necrosis.

Rare cause of rapidly progressive dementia

MUDr. Lucie Pokorná

Med. praxi. 2021;18(4):285-288 | DOI: 10.36290/med.2021.049

Rapidly progressive dementia is difficult to diagnose due to wide spectrum of causes. It is important to make accurate diagnose, because many of them are potentially treatable. This case report presents the pacient with rapidly progressive cognitive decline, who was diagnosed the meningeal carcinomatosis. This article demonstrates the differential diagnosis and clinical workup of the rappidly progressive dementia.