Medicine for Practice, 2023, issue 5

Editorial

Slovo úvodem

MUDr. Eliška Bartečková, Ph.D.

Med. praxi. 2023;20(5):255

Review articles

The prevention of dementia should focus on early and consistent treatment of hypertension

prof. MUDr. Miroslav Souček, CSc.

Med. praxi. 2023;20(5):259-263 | DOI: 10.36290/med.2023.051

Hypertension threatens several target organs. An important is the brain, which is at risk of stroke and dementia in hypertensive patients. While stroke is a sudden event, the decline in cognitive function occurs gradually, due to the accumulation of the adverse effect of high blood pressure on the vessel wall, when hypertension is uncompensated. The process starts with the development of hypertension even in individuals of a young age. Subclinical brain damage as changes in the white matter of the brain and gray matter atrophy is visible on magnetic resonance imaging in 44% of hypertensive patients. Therefore, hypertension in younger patients cannot...

Treatment of dyslipidemia in the elderly: understanding cardiovascular risk tables and when to start treatment

MUDr. Jan Matějka, Ph.D., MUDr. Astrid Matějková

Med. praxi. 2023;20(5):264-267 | DOI: 10.36290/med.2023.049

Despite recent decline, cardiovascular diseases remain the main cause of mortality and morbidity and their occurrence is increasing with age. Dyslipidaemia represents a basic risk factor for cardiovascular disease. Dyslipidaemia treatment initiation depends on patient risk stratification. In older patients with documented cardiovascular disease, treatment is recommended in the same way as in younger patients. In older patients without documented cardiovascular disease, treatment should be considered in very-high-risk patients about estimated life expectancy, patient adherence, drug interactions, geriatric frailty and patient preference.

Sudden cardiac death and its prevention

MUDr. Alice Krebsová, Ph.D., Mgr. Bc. Eva Kutílková, Ph.D., prof. MUDr. Milan Macek, DrSc.

Med. praxi. 2023;20(5):269-273 | DOI: 10.36290/med.2023.041

A significant percentage of sudden cardiac death (SCD) in individuals under 50 years of age is caused by hereditary cardiovascular disease. Identifying these cases, performing post-mortem genetic testing and cardiac screening of direct relatives is the first step to primary prevention of cardiac death in survivors and requires multidisciplinary and multicentre collaboration. Hereditary cardiovascular diseases include diseases of the heart muscle (cardiomyopathy), electrical diseases (arrhythmogenic syndromes) and hereditary diseases of the aorta and large vessels, where patients are at risk of premature cardiac arrest or acute dissection of large...

Modern therapy of chronic venous disease - what's new?

MUDr. Robert Vlachovský, Ph.D., MUDr. Jan Novák, Ph.D.

Med. praxi. 2023;20(5):275-281 | DOI: 10.36290/med.2023.050

Chronic venous disease (CVD) is a civilization disease with increasing prevalence in the general population. It arises due to chronic venous wall inflammation and remodeling, resulting in venous hypertension. Clinical features of CVD are highly variable, and given its progressive nature, it is reasonable to initiate adequate treatment as soon as possible. The cornerstones of the best medical therapy for CVD include regimen measures, well-managed and long-term conservative treatment (compression, effective venoactive drugs), and, in indicated cases, surgical intervention. Significant changes have occurred in recent years in the approach to patients...

Anticoagulation therapy

doc. MUDr. Tomáš Kvasnička, CSc.

Med. praxi. 2023;20(5):282-290 | DOI: 10.36290/med.2023.044

Anticoagulation therapy prevents the generation of thrombin and the subsequent conversion of fibrinogen to fibrin by various mechanisms. Heparin is a parenterally administered anticoagulant that indirectly blocks the thrombotic effect of thrombin after activation of antithrombin. Injectable anticoagulants also include low-molecular-weight heparins (LMWH) and fondaparinux, which indirectly, with the participation of antithrombin, inhibit activated F Xa. Oral anticoagulants (OACs) include warfarin, which suppresses the formation of functional procoagulation factors dependent on vitamin K (prothrombin, F VII, F IX, and F X), and so-called direct oral...

Tuberculosis - is this still a 21st century issue?

MUDr. Ján Dindoš

Med. praxi. 2023;20(5):291-294 | DOI: 10.36290/med.2023.052

The article deals with the current issue of tuberculosis, a disease that has accompanied mankind for at least 40 millennia. In the late 20th century, phthisiologists, experts on tuberculosis, optimistically hoped that it would be eradicated by the end of the second millennium. The persistence of poor social conditions in the poor countries of the so-called Third World, with inadequate calmetisation, poor screening, and the emergence of HIV disease, which significantly weakens immunity, have reversed the situation so that even today, in the 21st century, we have to fight this infectious disease, when, moreover, we are faced with a new challenge, strains...

Interdisciplinary overviews

Dialysis - what a general practitioner should know

MUDr. Jiří Faldík, MUDr. Jitka Řehořová

Med. praxi. 2023;20(5):295-299 | DOI: 10.36290/med.2023.038

Dialysis is a method of renal function replacement (RRT - renal replacement therapy), where the blood is purified from the accumulated catabolites and excess water. Approximately 8,000 patients undergo dialysis in the Czech Republic per year. The basis of early diagnosis and treatment of renal failure is the cooperation of the doctor of first contact with the nephrologist and, in the case of terminal kidney failure, with the dialysis center. Dialysis is ideally only a "bridging" therapy to kidney transplantation, which is a causal treatment for renal failure. According to statistics, a total of 449 adult patients underwent it in the Czech Republic...

Urinary incontinence - a problem (not) only for women - the gynecologist's point of view

MUDr. Roman Chmel

Med. praxi. 2023;20(5):300-304 | DOI: 10.36290/med.2023.040

Urinary incontinence is a cause of a significant personal and social handicap. Only a small part of women with urinary incontinence seek professional help. In this review article, the main characteristics of different types of female urinary incontinence about proper diagnosis and optimal treatment are described. Precise diagnostic and therapeutic management improves the quality of life in women with this symptom.