Medicine for Practice, 2022, issue 3

Editorial

Proč přibývá stresu?

MUDr. Radkin Honzák, CSc.

Med. praxi. 2022;19(3):155

Review articles

Patient with neuropathy in a general practitioner's office

MUDr. Jana Junkerová, MUDr. Eva Kovalová

Med. praxi. 2022;19(3):160-164 | DOI: 10.36290/med.2022.024

Unpleasant feelings in the limbs are a common occurrence in adult patients. In some cases, it may be indicative of peripheral nerve damage ie. neuropathy. This work aims to raise awareness of its symptoms and anamnestic circumstances among general practitioners and allow them to more accurately determine the kind and scope of damage to the nerve. We offer a guide for recognizing such patients and transferring them to the care of specialized neurologists. We would like to thoroughly introduce a diagnostic technique integral to correct assessment of the condition of peripheral nerves - electromyography. This article does not aim to describe individual...

Current issues in pneumococcal infections

doc. MUDr. Václava Bártů, Ph.D.

Med. praxi. 2022;19(3):165-168 | DOI: 10.36290/med.2022.025

Inflammatory bacterial diseases of the respiratory tract are among frequent and serious conditions in both paediatric and adult populations. Streptococcus pneumoniae is the most common causative agent that causes severe infectious diseases, ranging from otitis and pneumonia, sometimes complicated by empyema, to meningitis. If the bacterium reaches the bloodstream, it can cause invasive pneumococcal disease. Transmission occurs through droplet infection when coughing or sneezing. The course of the disease can be negatively affected by chronic, associated conditions and immunosenescence. The risk groups include children, the elderly, and immunosuppressed...

Early symptoms and diagnosis of multiple sclerosis by the general practitioner

MUDr. Radek Ampapa

Med. praxi. 2022;19(3):169-172 | DOI: 10.36290/med.2022.026

Multiple sclerosis is a chronic disease of the central nervous system. The underlying pathophysiology of the disease is an autoimmune inflammation with concomitant neurodegeneration. The clinical manifestations of nervous tissue injury are a variety of neurological symptoms that can regress spontaneously in the early stage of the disease and can be mistaken for another disease. Most frequently, they include optic nerve inflammation, impaired sensitivity, vertigo, movement disorders, diplopia, or sphincter dysfunction. An initial symptom of multiple sclerosis often prompts the patient to visit the general practitioner. Given the nature of the disease...

Differential diagnosis of nephropathy in a general practitioner's office

MUDr. Adéla Maříková, MUDr. Jan Vachek, MHA

Med. praxi. 2022;19(3):175-180 | DOI: 10.36290/med.2022.027

A general practitioner is a person who very often plays a key role in the first detection of kidney disease. Their early detection is made very difficult by the fact that many of these diseases are asymptomatic. However, from the point of view of the possibility of therapeutic influence on the underlying disease or the rate of progression of the decline in renal function, time is a crucial variable. In this article, we will focus on the differential diagnosis of several basic findings associated with kidney disease - decreased glomerular filtration, proteinuria and hematuria. We will briefly mention tubular disorders, diabetic kidney disease (formerly...

Non-interventional therapy in peripheral artery disease

MUDr. Ivo Hofírek

Med. praxi. 2022;19(3):181-186 | DOI: 10.36290/med.2022.028

The article deals with preventive and non-interventional treatments in peripheral artery disease of the lower limbs: physical training, influencing risk factors such as smoking and appropriate therapy for diabetes, hyperlipidemia, and hypertension, antiplatelet (or anticoagulant) therapy, the use of vasoactive drugs, and views on therapeutic angiogenesis (cellular and gene therapy).

Selected vaccinations in general practice

MUDr. Ludmila Bezdíčková, MUDr. Igor Karen, MUDr. Markéta Pivodová

Med. praxi. 2022;19(3):187-192 | DOI: 10.36290/med.2022.029

In the Czech Republic, vaccination, as one of the most effective tools in primary preventive care, is realized mainly in general practices. Vaccination rate against specific infectious diseases in the adults is lower in the Czech Republic, compared to other well developed European countries. The arcticle summarizes information regarding common adult vaccination including specific recommendations for risk groups up to date.

Current issues of tuberculosis

doc. MUDr. Ivan Solovič, CSc.

Med. praxi. 2022;19(3):193-195 | DOI: 10.36290/med.2022.030

The epidemiological situation of tuberculosis in most countries with a low TB incidence is characterized by low transmission rates in the general population and occasional outbreaks. At the time of the COVID-19 pandemic, we must count on its increase in the post-pandemic period. Most cases of active TB are caused by the reactivation of latent tuberculosis. High concentrations of the disease are recorded in certain risk groups (poor people, homeless people, migrants, prisoners, ethnic minorities and people living with HIV infection or other diseases, people with alcohol abuse, drug addicts and other marginalized groups). At a time of increasing population...

Interdisciplinary overviews

Chronic urticaria - differential diagnosis and therapy

MUDr. Eva Švarcová

Med. praxi. 2022;19(3):197-200 | DOI: 10.36290/med.2022.031

Chronic Urticaria (CU) is a skin disease based on the episodic appearance of urticarial lesions with or without angioedema, on most days of the week, for a period of six weeks or longer. The lesions wax and wane rapidly, usually within 24 hours. Chronic spontaneous urticaria occurs more frequently in patients with autoimmune disorders. Triggers such as medications, physical stimuli, and stress can be identified in 10 to 20% of cases. In diagnostics, the typical clinical features and the detailed anamnesis are the most helpful. Laboratory testing should include examination of C-reactive protein, erythrocyte sedimentation rate, complete blood count with...

Pathological changes of a spleen and prevention of infectious complications in asplenic patients

MUDr. Michal Sýkora, MUDr. Kateřina Cimburová

Med. praxi. 2022;19(3):202-206 | DOI: 10.36290/med.2022.032

The most common causes of spleen alteration are liver diseases with portal hypertension, infections, diseases of the hematopoietic or immune system. A multidisciplinary approach is often needed due to wide differential diagnostics. Symptoms, age, epidemiological, travel, and family history should be taken into account. Cornerstones of spleen examination are laboratory and imaging techniques. Splenectomy is dominantly performed urgently due to spleen injury. A hematological disease is a less common cause. In rare cases, splenectomy is done as a diagnostic procedure because of focal lesions. Asplenism is associated with a higher risk of fulminant sepsis...

Case report

Mycotic esophagitis - case interpretation and its suprising conclusion

MUDr. Veronika Wachfaitlová, MUDr. Jiří Stehlík

Med. praxi. 2022;19(3):207-210 | DOI: 10.36290/med.2022.033

In the article, there is basic knowledge of mycotic esophagitis, it discusses etiological agents, risk factors that are characteristic for this type of infection. Describes quite a typical endoscopic image during the examination of the upper digestive system, while endoscopy is a valid method of the final diagnosis. It also pays attention to the therapy of mycotic esophagitis. The article includes case history with an interesting development and pictorial documents.

Tularemia: A series of three case reports

MUDr. Viktor Klementa, prof. MUDr. David Karásek, Ph.D., MUDr. Ester Kurašová

Med. praxi. 2022;19(3):211-214 | DOI: 10.36290/med.2022.034

Tularemia is a rare but potentially fatal infectious disease that can occur in wild and domestic animals, mainly rodents, and is also transmissible to humans. This disease should be considered in the differential diagnosis of acute febrile illness, especially when risk factors such as contact with wild mammals or exposure to blood-sucking arthropods are present. The clinical picture, diagnosis, and treatment of tularemia are described in the text below. Following are three case reports encountered during clinical practice in a general internal medicine department.

Good advice

Novelties of blood glucose monitoring and insulin dosing in diabetes treatment

MUDr. Jan Kopecký

Med. praxi. 2022;19(3):215-219 | DOI: 10.36290/med.2022.035

Insulin therapy is an integral part of the treatment of type 2 diabetes for 100 years. Recent developments of insulins with different kinetics, the evolution of insulin pumps, and the integration of continuous glucose monitoring led to new possibilities and standards of care. This paper focuses on current standards of clinical care with regard to the availability/limitations of these instruments by health insurance providers in the Czech Republic and the implications of these technologies in the treatment of different types of diabetes.