Medicine for Practice, 2019, issue 4

Editorial

Moderní paliativní medicína

MUDr. Irena Závadová

Med. praxi. 2019;16(4):207

Review articles

Inflammatory bowel disease and the importance of probiotics treatment

MUDr. Barbora Pipek

Med. praxi. 2019;16(4):215-219 | DOI: 10.36290/med.2019.032

Crohn´s disease and ulcerative colitis are inflammatory bowel diseases, whose cause is not clear. We expected, that genetic and external factors participate in to their origin. The treatment of Crohn´s disease and ulcerative colitis is complicated and aminosalicylates, corticosteroids, immunosuppressants, and recently also biological therapy are the basis of the treatment of inflammatory bowel diseases (IBD). Probiotics are living microorganisms of the human origin, that can influence human health, if they are used in sufficient quantities. Their position in IBD treatment is not dominant, but they are important in the long-term treatment of ulcerative...

Specifics of approach to the patients with unsatisfactory bowel preparation before colonoscopy

MUDr. Vladimír Kojecký, Ph.D.

Med. praxi. 2019;16(4):220-222 | DOI: 10.36290/med.2019.033

There are situations requiring specific approach to the preparation before colonoscopy. This the case of poor bowel preparation orassociated co-morbidity, especially cardiac and renal. Insufficient preparation requires low-residue diet and use of the split-doseregimen. Alternatively, preparation may be repeated on the next day, or a laxative added. Oral sulphates appear to be a promisingalternative. Polyethyleneglycol is formula of choice in renal insufficiency. Low volume solutions are suitable for elderly patients.

Functional digestive disorders, phytotherapy by preparation STW 5 (Iberogast®)

MUDr. Vít Navrátil

Med. praxi. 2019;16(4):224-228

Dyspepsia is one of the most common cause of visiting a pharmacy or a physician. It is a heterogenous group of unpleasant symptoms concerning the digestive tract, abdomen, intake of food and bowel movement. Subject of the first part of the article is a brief review of digestive disorders, especially functional disorders, and a brief classification of them. Moreover it contains a summary of treatment possibilities. STW 5 (Iberogast®) is a fixed herbal combination product, available as a over-the-counter medicine. It is an effective, safe and well tolerated medicine. The second part of the article concerns with composition and data summary about...

Topical treatment of pain – The current OTC products overview

Mgr. Jana Martinásková

Med. praxi. 2019;16(4):229-233

Self-medications of musculosceletal tract painful conditions represent frequent visits of the pharmacy by the patients. This type of pain can be treated by either an oral or topical forms of non-steroidal anti-inflammatory drugs (NSAIDs). In view of the fact that oral NSAIDs have systemic side effects and possible drug interactions, in most cases it is suitable to recommend the topical form as a first choice. The advantage of topical formulations of NSAIDs include the selective acting in affected area and minimization of the risks of systemic side effects, for example gastrointestinal complications. In the pharmacy the advising is provided associated...

Rational treatment of acute respiratory infections in adults

MUDr. Michal Švarc

Med. praxi. 2019;16(4):234-238 | DOI: 10.36290/med.2019.036

Acute respitatory infections are very common in our population. Most of these infections are viral and there is usually no need forantibiotic treatment. Several scoring systems (as CENTOR, CRB65, PSI PORT and others) or C reactive protein measurement can helpclinicians to evaluate next steps and whether or not to use antibiotics. Pneumonias and Pertussis however require antibiotics assoon as possible.

Paracetamol: looking for an optimal dose

MUDr. Jiří Slíva, Ph.D.

Med. praxi. 2019;16(4):239-242

Analgesics are among the most commonly used drug classes. Each of them has its specific features, advantages as well asweaknesses in terms of possible adverse effects or drug interactions. In order to achieve the therapeutic response required, it isessential to choose the correct therapeutic dose. This also applies to paracetamol, a non-opioid analgesic. The present text placesthis agent into a historical context as well as highlights the situation in the Czech Republic in terms of its use – the preferencesregarding the dose, risks of underdose, overdose, etc.

Interdisciplinary overviews

General practitioner and dementia

doc. MUDr. Iva Holmerová, Ph.D.

Med. praxi. 2019;16(4):247-253 | DOI: 10.36290/med.2019.038

The article focuses on the role of general practitioner in the care of patients with dementia. It is based on recently published recommendations, consensus, reviews and evidence-based recommendations as well as information and discussions within Alzheimer Europe. We understand the role of general practitioner as a key and irreplaceable one. In prevention, it is a practitioner, who can intervene in time and influence important risk factors, as well as in diagnostic process and therapy. The practitioner should be the first to recognize the symptoms of dementia and accompany the patient through the diagnostic process, care planning, symptom management...

Current options of treating vulvovaginal discomfort

doc. MUDr. Tomáš Fait, Ph.D.

Med. praxi. 2019;16(4):254-256 | DOI: 10.36290/med.2019.039

Vulvovaginal discomfort is a common complaint in gynaecological patients. More frequently, the cause is dysbacteriosis ratherthan infection. The condition tends to recur. In addition to anti-infective therapy, restoration of the vaginal milieu with probioticsis recommended for both treatment and prevention.

Novelties in the treatment of obesity

MUDr. Pavol Holéczy, CSc.

Med. praxi. 2019;16(4):259-262 | DOI: 10.36290/med.2019.058

Obesity is a phenomenon of modern times. It is associated with numerous comorbidities. It affects virtually the entire planet. Treatment of obesity, both conservative and surgical, aims not only at weight reduction, but also, or, in particular, on the positive effect of comorbidities. Traditional procedures are well known to both lay and professional public. There are new definition of type and duration of physical acitivty. Newer possibilities in drug therapy provide recently introduced drugs on the Czech market (Mysimba® and Saxenda®). New surgical procedures also focus not only on weight reduction, but also on changes in body composition...

Case report

Meningococcal pyomyositis due to Neisseria meningitidis group C in a healthy young man as an unusual form of invasive meningococcal disease

MUDr. Jana Kulichová, MUDr. Pavla Křížová, CSc., Mgr. Zuzana Okonjii, MUDr. Šárka Lásiková

Med. praxi. 2019;16(4):270-274 | DOI: 10.36290/med.2019.059

A case report is presented of a 25-year-old healthy man with a feverish disease accompanied by joint swelling and pain in the left forearm muscles with petechiae on the skin in the same area. The condition was initially diagnosed as a left forearm phlegmon and treated empirically with clindamycin. Due to the development of sepsis and septic shock with DIC manifestations, on the second day of hospitalization he was referred to the ICU and the antibiotic treatment was strengthened empirically with ceftriaxone. Pain in the muscles continued to spread and was accompanied by their edema and reddening of the skin above them. Because of an unknown disease...

Serial: What should a general practitioner know of the most common types of carcinoma?

How to approach limited specificity of tumor markers

RNDr. Lenka Zdražilová‑Dubská, Ph.D., MUDr. Beatrix Bencsiková, Ph.D., doc. MUDr. Dalibor Valík, Ph.D.

Med. praxi. 2019;16(4):267-269

Here we aim to review sources of unspecific or false elevation of soluble tumour markers. We suggest how to approach results ofelevated tumour markers in clinical practice.

Good advice

Preadmission preparation in surgical oncology – ERAS recommendation in primary care

MUDr. Zuzana Adamová, Ph.D.

Med. praxi. 2019;16(4):277-279

The concept of the enhanced recovery after surgery (ERAS) is a complex of strategies intended to reduce the perioperative stressresponse and achieve faster postoperative rehabilitation and rapid recovery of normal physiologic functions. The effect of ERASshould be in the reduction of length of stay and postoperative complications. The object of this article is the part of ERAS recommendationsconcerning the preadmission care.