Lékař, který se nepostará sám o sebe, není zárukou dobré péče o pacienta

MUDr. Radkin Honzák CSc

Interní Med. 2009; 11(10): 435  

Pulmonary arterial hypertension

MUDr. Pavel Jansa, MUDr. David Ambrož, MUDr. Pavel Poláček, MUDr. Jana Marešová, MUDr. Ludmila Jelínková, prof. MUDr. Michael Aschermann DrSc, prof. MUDr. Aleš Linhart, DrSc

Interní Med. 2009; 11(10): 438-445  

Pulmonary arterial hypertension (PAH) is primary diasease of pulmonary arterioles, which arises from unknown causes (idiopathic and familiar PAH) or it is associated with known cause (connective tissue diseases, liver diseases, congenital heart diseases, HIV infection, anorexigen intake). Changes in the pulmonary circulation lead to precapillary pulmonary hypertension, which progresses quickly without therapy, leads to right heart failure and death. Up to the mid-nineties the therapeutic procedures used in PAH (treatment of heart failure, nonspecific vasodilator and anticoagulant therapy) have not been successful. The introduction of intravenous...

Rational diagnostic and therapeutic procedures in case of acute upper gastrointestinal bleeding

MUDr. Michal Konečný Ph.D, doc. MUDr. Vlastimil Procházka Ph.D

Interní Med. 2009; 11(10): 446-448  

Acute upper gastrointestinal bleeding is a life-threatening condition with substantial incidence and relatively high mortality. Typical symptoms include haematemesis and melena. The most often causes of the acute upper gastrointestinal bleeding are disorders of oesophagus, stomach or duodenum. The fundamental principle of the care for such patients is not only the hospitalization with intensive monitoring of life functions, but especially the existence of multi-specialty team, which must be integrated within the system of diagnostic and therapeutic procedures. Endoscopy has a crucial position in this system, as it enables to localize the source...

Is achieving the target LDL cholesterol level enough or is a complex residual risk intervention necessary?

doc. MUDr. Vladimír Soška CSc

Interní Med. 2009; 11(10): 449-451  

Even when the target LDL cholesterol levels are achieved with statins, the residual risk of cardiovascular disease remains high in most patients. In the case of dyslipidaemias, this residual risk is most commonly due to a decreased HDL-cholesterol level, elevated triglycerides, and elevated small LDL3 particle count. The apolipoprotein B level is a good predictor of this risk. The residual risk is often high in persons with insulin resistance, type 2 diabetes mellitus, or metabolic syndrome. Reducing the residual risk mostly requires treatment with a combination of hypolipidaemic drugs aimed at achieving not only the target LDL cholesterol levels,...

Stem cells in cardiology: past, present and future of cellular therapy of heart disease

doc. MUDr. Martin Klabusay, Ph.D, Mgr. Josef Skopalík, prof. MUDr. Jaroslav Meluzín CSc

Interní Med. 2009; 11(10): 452-457  

Stem cells hold the promise – because of their unique properties of self-renewal and differentiation – of treating many severe illnesses, including heart diseases (especially myocardial infarction and heart failure). Stem cells could be divided into two basic categories: embryonic stem cells and adult stem cells. While the use of the first type in clinical medicine is restricted because of ethical, legal, religious and technical issues, the use of the other cell type is not limited by these problems. It could be followed that many clinical studies, which used various cell types for treatment of myocardial damage, emerged during last...

Prevention of venous thromboembolism

MUDr. Jaromír Gumulec

Interní Med. 2009; 11(10): 458-462  

Deep vein thrombosis and pulmonary embolism are a major health problem with potentially fatal sequelae. The risk of venous thromboembolism increases with advancing age, and it has been confirmed that most hospitalized patients have at least one risk factor for venous thromboembolism. When there is no thromboprophylaxis, the incidence of objectively confirmed, hospital-acquired deep vein thrombosis in internal medicine and general surgery patients is approximately 10 to 40 percent, and in patients undergoing elective orthopaedic procedures it is 40 to 60 percent. Furthermore, primary thromboprophylaxis, using low-dose unfractionated heparin, lowmolecular- weight...

Churg-Strauss syndrome

MUDr. Monika Žurková, prof. MUDr. Vítězslav Kolek DrSc, MUDr. Kateřina Musilová

Interní Med. 2009; 11(10): 463-465  

Churg-Strauss syndrome is a very rare disease. The incidence is about 2.4/1,000,000 and men are involved more frequently. It usually has three phases. The first phase is characterized by allergic manifestations, allergic rhinitis, nasal polyps, and bronchial asthma. In the second phase, eosinophils appear in the blood and tissues; in the respiratory system eosinophilic lung infiltrates and pleural effusion, mostly exudate, with a high eosinophil count are described, in the gastrointestinal tract eosinophilic gastroenteritis occurs. The third phase is the stage of systemic vasculitis with manifestations of individual organ damage. The biochemical...

Kongres Evropské kardiologické společnosti

MUDr. Filip Málek, Ph.D., MBA

Interní Med. 2009; 11(10): 474  

A scabies epidemic combined with other infectious skin diseases

MUDr. Dáša Němcová, MUDr. Alexandra Mateřanková

Interní Med. 2009; 11(10): 472-473  

The paper presents practical procedures for managing larger and long-lasting scabies epidemics in closed communities complicated by other infectious diseases. The principles that need to be adhered to in order to stop the spread are generally well-known, however, it is always necessary to assess the particular situation on a case-by-case basis in the focus of infection and to determine the tactics and strategy of treatment. Team work is essential from the very beginning with the involvement of the health authorities relating to hygiene issues, appropriate health insurance companies, and the health authorities of the Regional Council being an essential...

Sleep disorders

MUDr. Miroslav Moráň

Interní Med. 2009; 11(10): 466-470  

The basic information on the most severe and most common sleep disorders encountered in the sleep laboratory, diagnostic and therapeutic options, and information on relations to other conditions are briefly reviewed. Potential health and socioeconomic implications of sleep disorders commonly encountered by GPs, internists, neurologists as well as psychiatrists at all health care levels are highlighted.

Aggressive patient in paramedical workers‘ clinical practice

PaedDr. Mgr. Eva Zacharová Ph.D

Interní Med. 2009; 11(10): 471  

Communication and dealing with a mentally labile, nearly aggressive patient, is a very demanding challenge for all the paramedical workers. In the course of management of this problematic situation it is necessary to follow some particular rules summarily called professional conduct.

Autodidaktický test 9/09

Interní Med. 2009; 11(10): 475