Celiakie, co o ní víme v roce 2020?

prof. MUDr. Jiří Nevoral, CSc.

Med. praxi. 2020;17(3):139  

New guidelines for the management of dyslipidaemias

prof. MUDr. Eliška Sovová, Ph.D., MBA, MUDr. Markéta Sovová

Med. praxi. 2020;17(3):144-149 | DOI: 10.36290/med.2020.028  

The article provides a summarized overview of the new guidelines for the diagnosis and management of dyslipidaemias that were published in 2019 as a joint effort of the European Society of Cardiology and the European Atherosclerosis Society, and were commented on in a statement of the Czech Society for Atherosclerosis. The new guidelines lower the target LDL cholesterol levels in all risk categories, introduce new SCORE charts for risk assessment, and emphasize the use of calcium score, ultrasound scan of carotid or femoral arteries, and modifying factors (social deprivation, psychiatric comorbidities, left ventricular hypertrophy, atrial fibrillation…)...

Lipid-lowering therapy in selected specific groups of patients

doc. MUDr. Pavel Kraml, Ph.D.

Med. praxi. 2020;17(3):151-156 | DOI: 10.36290/med.2020.029  

The article deals with secondary hyperlipoproteinaemias (dyslipidaemias) in patients with chronic kidney disease (CKD), liver disease, and autoimmune rheumatic disease. In the section devoted to CKD, the pathophysiology of existing dyslipidaemia is discussed first, followed by current treatment recommendations, also taking into account end-stage renal disease patients on haemodialysis therapy and after kidney transplantation. In case of chronic liver disease, the text describes pathophysiology of dyslipidaemia and its treatment in individuals with non-alcoholic fatty liver disease (NAFLD), alcoholic disease, cirrhosis, and after liver transplantation....

Farmacotherapy of headache, mainly migraine

MUDr. Irena Novotná

Med. praxi. 2020;17(3):157-160  

Headache is one of the most common disorders encountered by nearly everyone. It is primarily divided into primary, where the most typical variety is migraine and its forms, and secondary, where headache is a symptom of another illness and it accompanies this illness. After the illness is cured, headache most often disappears. Headaches are distinguished in detail according to International Headache Society classification. In a daily practice of a physician or farmacist, the most important classification is to primary and secondary headache. According to anamnesis, after excluding possible secondary reasons and with normal results of common support...

Thermal injury of skin

doc. MUDr. Karel Ettler, CSc., MUDr. Jiří Ettler

Med. praxi. 2020;17(3):161-164  

High temperatures applied directly on the skin surface for a sufficient amount of time cause thermal burns. Similar damage in skin can be induced by ionising and solar irradiation. Protective measures could prevent both of them. Contact with high temperature for a long period of time provokes livedo (erythema ab igne). Low or freezing temperatures cause frostbites. Exposition to lower temperatures for a long period of time induces perniones.

Early vascular aging and how to influence it

prof. MUDr. Radek Pudil, Ph.D.

Med. praxi. 2020;17(3):165-170 | DOI: 10.36290/med.2020.032  

During life, the structure and function of blood vessels naturally change. These changes subsequently contribute significantly to the onset and manifestation of cardiovascular disease. The basic factors that affect the aging of the vascular system include calendar age, lifestyle, associated diseases, heredity, gender, socioeconomic status, psychological factors and environmental influences. Some patients experience premature aging of the vascular system (early vascular aging syndrome). Many of these factors can be favorably influenced. Among the most significant are lifestyle changes and therapies for associated diseases (especially hypertension and...

Psychopatologic disorders in context of (chronic) lyme borreliosis

RNDr. Helena Nejezchlebová, Ph.D., Bc. Soňa Ševelová, MVDr. Mgr. Monika Dušková, Ph.D., doc. RNDr. Alena Žákovská, Ph.D.

Med. praxi. 2020;17(3):171-173 | DOI: 10.36290/med.2020.033  

Published data indicate that infection with Borrelia burgdorferi sensu lato, a causative agent of Lyme borreliosis, may cause psychological problems and neuropsychiatric symptoms in patients. The number of psychopathological disorders increased with a longer period of infection and most of the affected patients were not correctly diagnosed at the onset of disease. Depression was the most common disorder.

Anaphylaxis and use of adrenalin autoinjectors

MUDr. Irena Krčmová, CSc., MUDr. Adriana Šrotová, doc. MUDr. Vít Petrů, CSc.

Med. praxi. 2020;17(3):174-181 | DOI: 10.36290/med.2020.034  

Anaphylactic symptoms and anaphylactic shock are serious, rapidly developing systemic reactions, followed by release of a number of substances that affect vascular permeability, smooth muscle tone of blood vessels and bronchi with activation of the systemic inflammatory cascade. From a pathophysiological point of view, it can be an IgE-mediated immune response followed by massive release of biologically active mediators from mast cells and basophils (IgE dependent). If the mastocyt/basophil is degranulated via a direct IgE-free pathway, it is non-allergic (non-IgE dependent, anaphylactoid anaphylaxis). Regardless of the etiopathogenesis of anaphylaxis,...

Anticholinergic drugs and cumulation of their side effects in elderly

MUDr. Michal Prokeš, PharmDr. Josef Suchopár

Med. praxi. 2020;17(3):182-189 | DOI: 10.36290/med.2020.035  

The cumulative effect of using multiple medicines with anticholinergic effect is called anticholinergic burden. Such effects may have an adverse impact on the patient's cognition and which can increase the risk of dementia especially in elderly, as has been showen in several large studies. The aim of this review article is to inform physicians of the risk of anticholinergic drugs, as prescribing of anticholinergics is not a rare event even in patients at high risk of dementia. It is desirable that physicians carefully asses the benefits and risks of medicinal products and, if possible, lower the anticholinergic burden in their patients. Lists of anticholinergic...

Trazodone once‑daily in depression

MUDr. Jan Hubeňák, Ph.D.

Med. praxi. 2020;17(3):190-193  

A new extended release formula of trazodone oral tablets is available in the Czech Republic since 2015. It is intended for the treatment of depression of various etiology. It has beneficial effect in cases with comorbid anxiety and insomnia. The maximum potential of the full trazodone dose can be employed in such group of patients. Those could be treated by trazodone monotherapy without the necessity of using additional anxiolytic and hypnotic medication. Here presented case report depicts the full trazodone dose utilization as a first line treatment of depressive disorder. Application of the prolonged release trazodone form led to a fast anxiety and...

Can serological methods be helpful in the diagnosis of COVID-19 in cases of repeated false negative results of PCR tests?

MUDr. Miroslav Kubiska, doc. MUDr. Dalibor Sedláček, CSc., MUDr. Ing. Robin Šín, MBA

Med. praxi. 2020;17(3):194-196 | DOI: 10.36290/med.2020.037  

We present the case report of a patient with classical symptoms of respiratory disease, who has had repeat negative RT-PCR results of the SARS-CoV-2 virus RNA, but a rapid immunochromatographic test detected the presence of IgM class antibodies, later also IgG. A typical picture of viral pneumonia in COVID-19 was also found during a CT scan of the lungs. Even currently, in the era of fully available laboratory and microbiological examinations, a well-collected medical history, clinical examination and assessment of the course of the disease remain imperative.

Smokers' adherence to ischeamic heart disease prevention

prof. MUDr. Eva Králíková, CSc.

Med. praxi. 2020;17(3):197-199  

In general, smokers tend to have lower adherence to treatment, including any medication intake and prevention, as well - in the case of coronary artery disease (CAD), this is primarily due to poorer diet, such as more fat, and less physical activity. However, smoking is also associated with a higher incidence of many other cardiovascular risk factors (CV RF) such as diabetes mellitus, abdominal fat deposition or depression. Although weight can increase after quitting smoking, the CV risk is clearly reduced by about a half.

Risk assessment of falls

PhDr. Jana Horová, doc. Ing. Iva Brabcová, Ph.D., PhDr. Petra Bejvančická

Med. praxi. 2020;17(3):200-202 | DOI: 10.36290/med.2020.039  

Risk factors for patients fall are often multifactorial. As part of the provision of safe health care, risk factors must be detected in a timely and correct manner. In the Czech environment it is recommended to use Morse Fall Scale and The Conley Scale as the most effective scales. There is no clear consensus for evaluating risk factors of falls for pediatric patients.