Já, my, medicína a umělá inteligence

MUDr. Radkin Honzák, CSc.

Med. praxi. 2024;21(1):3  

Celiac disease today

MUDr. Jitka Prokešová

Med. praxi. 2024;21(1):8-12 | DOI: 10.36290/med.2023.046  

It is a typical representative of autoimmune disease. We know the triggering trigger of the disease, the pathophysiological basis. We can identify genetically susceptible individuals, antibody response and histopathological changes in the small intestinal mucosa. Lifelong adherence to a gluten-free diet remains the only possible treatment. Currently, we observe a sharp increase in prevalence in both the paediatric and adult population. This can certainly be attributed to better and more accessible diagnostics, both endoscopic and laboratory. The wide availability and accessibility of gluten-free foods and the possibility of eating in restaurants has...

How to initiate treatment of arterial hypertension

MUDr. Alena Hrubeš Krajčoviechová, Ph.D.

Med. praxi. 2024;21(1):13-16 | DOI: 10.36290/med.2024.006  

The primary aim of antihypertensive treatment is, beside optimal blood pressure control, to reduce cardiovascular risk and all-cause mortality. Numerous multicenter trials have demonstrated that angiotensin-converting enzyme inhibitors (ACE-I) possess cardioprotective and long-term survival benefits beyond the effect of blood pressure reduction. A meta-analysis of randomized control trials in hypertension which aimed to compare the effect of ACE-I and AT1 blockers on clinical outcomes, demonstrated that while ACE-I reduce all-cause mortality, there was no effect on all-cause mortality with AT1 blockers. The pathophysiological basis of the unique ACE-I...

Histamine intolerance

MUDr. Martin Fuchs

Med. praxi. 2024;21(1):18-25 | DOI: 10.36290/med.2024.002  

Histamine intolerance (HI, HIT) may also be referred to as enteral histaminosis or hypersensitivity to oral/food histamine. It is the inability to degrade exogenous histamine due to impaired diaminooxidase (DAO) activity, resulting in symptoms of histamine excess. HI should be understood as a variable set of symptoms, neither a nosological entity nor a syndrome. The diagnosis of this metabolic disorder is made solely on the basis of clinical criteria and the demonstrated effect of a low histamine diet. No biomarkers are available for HI specificity. Both functional and absolute DAO deficiency can be caused by genetic, pharmacological or a broad heterogeneous...

Non­‑pharmacological treatment of obesity

doc. MUDr. Vladimír Pavlík, Ph.D., MUDr. Václav Šafka, Ph.D., MUDr. Blanka Kupsová, Ph.D., Mgr. Petr Lašák, Jitka Turňová

Med. praxi. 2024;21(1):26-29 | DOI: 10.36290/med.2024.001  

The increasing prevalence of obesity and its associated comorbidities have led to the need for intensive prevention and treatment of this serious disease by primary care physicians. The treatment of obesity is focused on lifestyle modifications based on physical activity and dietary measures. These interventions will be only effective with the full cooperation of a motivated patient. The text gives an overview of the current options for dietary measures and physical activity in obese patients in general practitioners' offices. Special attention is paid to the possibilities of cooperation between general practitioners and nutritional therapists.

The share of selected rehabilitation interventions in improving the quality of life of patients with dementia

PhDr. Iveta Ondriová, PhD., PhDr. Terézia Fertaľová, PhD.

Med. praxi. 2024;21(1):36-39 | DOI: 10.36290/med.2023.047  

Dementia is one of the most serious health and socioeconomic problems today. By knowing the genetic and familial burden of families and a comprehensive assessment of the senior, the general practitioner participates in the early diagnosis of the disease and mediation of the consultation of a competent specialist, as well as in the overall management of the disease in cooperation with members of the multidisciplinary team and the patient's family. The treatment of dementia is complex, in the article the authors make available selected physiotherapy activities used for people suffering from dementia. The latest research shows that physical activity is...

Swallowing disorders - diagnosis, therapy and aids

Mgr. Naděžda Lasotová, MBA, doc. PhDr. Ilona Bytešníková, Ph.D., Mgr. Radka Florianová

Med. praxi. 2024;21(1):40-46 | DOI: 10.36290/med.2024.003  

Dysphagia (swallowing disorder) can occur at different stages of life. In some cases it may only be temporary, while in other cases it may persist from childhood into adulthood. Therefore we consider it important that both general practitioners for children and adolescents, as well as general practitioners providing care for adult patients and the elderly, are familiar with this issue. Dysphagia always means a serious condition associated with significant risks of complications and consequences for patients' health. The article presents the division of dysphagia, the etiology of the disorder, the possibilities of diagnosis and therapy in a multidisciplinary...

The significance of highly dangerous infections in the context of potential biological weapons

MUDr. Eva Pernicová, MBA

Med. praxi. 2024;21(1):47-52 | DOI: 10.36290/med.2023.045  

Highly dangerous infections (HDIs) represent a heterogeneous group of infectious diseases. The common feature is the safety hazard they pose to human society if accidentally or intentionally disseminated. Diseases classified as HDIs may either have a severe clinical course and a high mortality rate or be highly infectious and easily transmissible among susceptible individuals. Some HDIs fulfill both conditions. The aim of the following text is to provide an overview of the most significant HDIs, highlight the potential threat as biological weapons, and present measures designed to reduce these risks or the consequences of such an attack.

Syncope during the head-up tilt testing in relation to pharmacotherapy potentially influencing orthostatic intolerance in persons under investigation

MUDr. Jan Galuszka, Ph.D., doc. MUDr. Michaela Kaiserová, Ph.D., Mgr. Jana Zapletalová, Ph.D., prof. MUDr. Miloš Táborský, CSc., FESC, FACC, MBA

Med. praxi. 2024;21(1):30-35 | DOI: 10.36290/med.2023.053  

Aim: To evaluate pharmacotherapy affecting hemodynamic stability in subjects with syncope during the head-up tilt test. The group of patients: Patients with a history of orthostatic intolerance or syncope examined by the head-up tilt test at the Department of Internal Medicine I - Cardiology, University Hospital Olomouc from 2017 to 2022. Methods: Retrospective analysis of medication and findings in a total of 280 patients with reflex syncope during testing. Two groups of patients were evaluated based on the use or non-use of medications affecting cardiac output concerning age, and comorbidities. The results were statistically processed. Results: The...

Current recommendations to patients for self-treatment of seasonal respiratory diseases

Mgr. Karel Hrnčiarik, Mgr. Martina Kůtková

Med. praxi. 2024;21(1):53-59  

Common seasonal respiratory disease suitable for self-treatment is an uncomplicated upper respiratory tract disease caused by common viruses. The most effective treatment for seasonal respiratory disease is comprehensive therapy, i.e. not only suppression of symptoms with active agents, but also an often neglected appropriate regimen.

What to consider when choosing the most appropriate anticoagulant for a particular patient?

prof. MUDr. Jan Bultas, CSc.

Med. praxi. 2024;21(1):61-66 | DOI: 10.36290/med.2024.004  

There are currently several oral anticoagulants available for the treatment and prevention of thrombotic and thromboembolic conditions: antivitamin K - warfarin, and four direct anticoagulants - apixaban, edoxaban, rivaroxaban, and dabigatran. For several years, the prescription of direct anticoagulants has not been relaxed for general practitioners for economic reasons. Now that generic products are coming in and the price is inevitably decreasing, it is highly likely to extend the prescription, respectively to leave only the indication limitation. This article aims to summarize the basic properties, advantages, and weaknesses and the selection of...

New clinical recommendations in the prevention and treatment of pressure ulcers

prof. PhDr. Andrea Pokorná, Ph.D., PhDr. Petra Búřilová, BBA

Med. praxi. 2024;21(1):67-70 | DOI: 10.36290/med.2023.043  

Pressure lesions (decubitus) are a serious complication, especially in chronically ill patients with mobility limitations. The risk of pressure ulcers increases with the number of comorbidities and the severity of impaired mobility. The risk is highest in intensive care patients due to frequent impaired consciousness, in immature newborns or, conversely, in elderly persons or patients with spinal cord injury and subsequent mobility in a wheelchair or completely immobile (para and tetraplegic patients). The prevalence of pressure lesions is increasing, related to the ability to save the lives of critically ill children and adults, but often at the cost...