Slovo úvodem

MUDr. Hana Šarapatková

Med. praxi. 2022;19(4):235  

Trends in the tick-borne encephalitis incidence in the Czech Republic, approach to the disease in selected European countries

MUDr. Jan Kynčl, Ph.D., MUDr. Hana Orlíková, Mgr. Iva Vlčková, MUDr. Zdenka Manďáková

Med. praxi. 2022;19(4):240-244 | DOI: 10.36290/med.2022.036  

The Czech Republic belongs to the countries with the highest incidence of tick-borne encephalitis in Europe. The infection occurs in practically all districts of the Czech Republic in rural and urban areas, including Prague. The disease affects both children and adults with the highest incidence observed in the age group between 50 and 75 years. The trend in tick-borne encephalitis incidence is increasing in age groups over 35 years and the trend in the disease incidence is also significantly rising in school-age and pre-school children. Frequently occurring sequelae of tick-borne encephalitis can affect quality of life. Given the severity of this...

Patient with myopathy in a general practitioner's office

MUDr. Jana Junkerová, MUDr. Eva Kovalová

Med. praxi. 2022;19(4):245-250 | DOI: 10.36290/med.2022.037  

Primary myogenic lesions, or myopathies, are a cause of reduction in muscle strength associated with muscle fiber damage. The motor nerve supplying the muscle is intact in this case. Its most commonly reported symptoms are weakness and fatigue and the general practitioner faces the task of differentiating non-specific weakness and fatigue from pathological conditions related to damage to myofibrils or structures at the neuromuscular junction. We offer practical advice on how to clinically identify myopathy, substantiate the diagnosis with findings of paraclinical methods and estimate the etiology of myopathy. The task of the neurologist is to complete...

Latent autoimmune diabetes of adults

prof. MUDr. Kateřina Štechová, Ph.D.

Med. praxi. 2022;19(4):251-254 | DOI: 10.36290/med.2022.038  

LADA or Latent Autoimmune Diabetes in Adults is characterized by age at the onset of the disease over 30 years, by positivity of at least one diabetes-associated autoantibody (most common is isolated positivity of antibodies against GAD65 - glutamic acid decarboxylase) and by the fact that insulin therapy is not required at least for six months after diagnosis. LADA represents a significant part of adult-onset diabetes. Autoimmune insulitis in LADA patients has slightly different immunological characteristics and its progression is less rapid than in type 1 diabetes mellitus (DM) patients. Two LADA subtypes can be distinguished, where LADA 1 is more...

Inflammatory bowel diseases from the perspective of general practitioners

MUDr. Tomáš Douda, Ph.D.

Med. praxi. 2022;19(4):255-258 | DOI: 10.36290/med.2022.039  

Inflammatory bowel diseases (IBD) are immune-mediated systemic chronic inflammation. The etiology of the two main representatives - ulcerative colitis and Crohn's disease are unknown and the pathogenesis of both diseases is incomplete. The disease is heterogeneous, with a wide range of intestinal and extraintestinal manifestations. The incidence and prevalence of idiopathic intestinal inflammation are increasing and mainly affect young people of reproductive age. The diagnosis of idiopathic intestinal inflammation is based on a detailed history and a combination of clinical and biochemical examinations, stool tests, endoscopy, and cross-sectional radiological...

Cervical lymphadenopathy

MUDr. Veronika Glumbíková, doc. MUDr. Richard Salzman, Ph.D.

Med. praxi. 2022;19(4):259-263 | DOI: 10.36290/med.2022.040  

Cervical lymphadenopathy is an abnormal enlargement of cervical lymph nodes, that is associated with many medical conditions. The most frequent causes of cervical lymphadenopathy are inflammatory and malignant lesions. Types of lymphadenopathy, their clinical symptoms, diagnostics, and therapy are discussed in this article.

Ocular manifestations of systemic diseases

MUDr. Zuzana Schreiberová, MUDr. Barbora Pašková, MUDr. Miroslava Malušková, MUDr. Marta Karhanová, Ph.D., FEBO

Med. praxi. 2022;19(4):264-271 | DOI: 10.36290/med.2022.041  

Many systemic diseases can be manifested by damage to the ocular tissue, whether it is the first manifestation of a hitherto unknown disease or a complication of an already known, often long-term decompensated disease. The largest group are internal diseases, which include mainly vascular, metabolic, endocrine, rheumatological and hematological diseases, a smaller part are pulmonary and skin diseases. The success of early detection of ocular complications depends on interdisciplinary cooperation, which is the cornerstone of comprehensive patient care. Regular check-ups by an ophthalmologist in case of illness such as diabetes mellitus or arterial hypertension...

Differential diagnosis of back pain, indications for physiotherapy

MUDr. Luděk Ryba, Ph.D., MUDr. Robert Vyskočil, PhDr. Iva Marková

Med. praxi. 2022;19(4):272-278 | DOI: 10.36290/med.2022.042  

Back pain remains one of the most common reasons for patients to seek primary and emergency medical care. Risk factors with a potential impact on the development of back pain can generally be divided into individual factors (weight, height, age, genetic predispositions, smoking, general health, fitness, physical activity, history of previous back pain), psychosocial (inappropriate stress management patterns, stress, emotional problems) and work (job dissatisfaction, hard repetitive work). In the differential diagnosis, it is necessary to distinguish the pain transmitted from the skin and internal organs of the chest, pelvic abdomen, and also the degenerative...

Early initiation and intensification of antihypertensive treatment in order to prevent target organ damage in a young patient

MUDr. Helena Sládková

Med. praxi. 2022;19(4):299-303 | DOI: 10.36290/med.2022.045  

We describe a case of a patient with positive family history who was diagnosed with arterial hypertension at the age of 42, with signs of target organ damage. After initial control with antihypertensive monotherapy, treatment intensification to a double combination and soon to a triple combination of antihypertensive drugs using a fixed combination of active substances in a single tablet (Triplixam®) was necessary after 3 years. This product has been shown to reduce blood pressure to the recommended target in 93% of hypertensive patients in real practice, with the combination of perindopril, indapamide and amlodipine being associated with a greater...

The role of pioglitazon in modern treatment of type 2 diabetes

MUDr. Pavlína Piťhová, Ph.D.

Med. praxi. 2022;19(4):279-283 | DOI: 10.36290/med.2022.043  

Type 2 diabetes patients are at high risk for macrovascular complications and suffer from very high cardiovascular mortality. Recent trials have demonstrated that agents in two antidiabetic classes (SGLT2 inhibitors and GLP-1 receptor agonists) are able to reduce cardiovascular complications in diabetics. People have forgotten that very similar evidence is available also in an older preparation - pioglitazone, which can retard the atherosclerotic process and reduce cardiovascular events. Pioglitazone is an insulin sensitizer, that causes durable improvement of metabolic control and improves multiple components of metabolic syndrome including non-alcoholic...

Pharmaceutical care in self-treatment of patients with common cold or influenza

PharmDr. Lenka Ťupová, Ph.D., PharmDr. Martin Doseděl, Ph.D.

Med. praxi. 2022;19(4):284-297  

Upper respiratory tract infections belong to the most common diseases that patients come to the pharmacy with. Based on the available and gathered information, the pharmacist or pharmaceutical assistant (PA) should assess the patient's condition and risk factors and determine the suitability for self-treatment. In that case, the pharmacist or PA should recommend an appropriate medicine based on the individual patient's symptoms. He or she should also explain how to administer the medication in order to maximize its effect or minimize its potential risks.

Vitamin D supplementation - current knowledge

prof. MUDr. Eliška Sovová, Ph.D., MBA

Med. praxi. 2022;19(4):304-307 | DOI: 10.36290/med.2022.046  

Vitamin D hypovitaminosis - deficiency and insufficiency - is a global health problem that affects more than a billion children and adults. The optimal level of vitamin D plays an essential role in the regulation of calcium and phosphate metabolism and is necessary not only for proper bone metabolism, but also has other functions in the body, such as influencing muscle function, stimulating cell differentiation, insulin secretion and stimulating the immune system. Hypovitaminosis of vitamin D is then associated not only with a disorder of bone metabolism, but also with the occurrence of cardiovascular diseases, arterial hypertension, dyslipidemia,...

Komentář ke studii Lymfotonická aktivita extraktu z Ruscusu, hesperidin methylchalconu a vitaminu C na lidských lymfatických buňkách hladkého svalstva

doc. MUDr. Jiří Slíva, Ph.D.

Med. praxi. 2022;19(4):308-310 | DOI: 10.36290/med.2022.047