Změní globální pandemie naše priority?

prof. MUDr. Vladimír Mihál, CSc.

Med. praxi. 2021;18(1):3  

Importance of digital rectal exam inhemorrhoidal disease

MUDr. Filip Sasínek, MUDr. Alena Berková, Ph.D., MUDr. Petr Vlček, Ph.D., MUDr. Tamara Vystrčilová, MUDr. Vladimír Červeňák

Med. praxi. 2021;18(1):8-12  

Haemorrhoidal disease is quite common condition. It occurs among up to 60 % of adult population. Too often is this condition treated without proper diagnostics thus leading to misdiagnosis and overlooking more serious medical condition such as colorectal carcinoma. In Czech Republic, colorectal carcinoma is listed on top ranks in incidence of malignant oncological diseases. Despite established screening programme there is still big portion of patients that are diagnosed in advanced stage. Complex clinical examination with emphasis on specific symptoms is a key element for determining the final diagnosis. As is inspection of oral cavity standard clinical...

Differential diagnosis and treatment of anemia

MUDr. Jan Válka, Ph.D., MUDr. Markéta Sobotková, MUDr. Monika Krutská, MUDr. Petr Soukup, MHA

Med. praxi. 2021;18(1):14-20  

This work presents an overwiev od the differential diagnosis of anaemia - one of the most frequent clinical symptom in all fields of medicine. Anaemia is defined as an hemoglobin concentration in erythrocytes lower than normal range. There are various criteria for categorising anaemia and we have selected the morfological classification based on erythorocyte size, i.e. macrocytic, microcytic, normocytic. We have also included a special group of anaemia associated with peripheral reticulocytosis. This article thus mainly focuses pathophysiology and diagnostic tools, while treatment is discussed only at key points. Given the multi - disciplinary implications...

Simultaneous intervention for arterial hypertension and dyslipidaemia

MUDr. Eva Tůmová, Ph.D.

Med. praxi. 2021;18(1):22-28  

Arterial hypertension and dyslipidaemia are two widespread risk factors of cardiovascular diseases that can be well managed pharmacologically. They often co-occur, even in relatively young individuals in whom it is necessary to carry out a targeted search for all risk factors and initiate their management early. Particularly in younger age groups, this is associated with inadequate compliance that can be improved by proper doctor-patient communication, ranging from explaining the cardiovascular risk to the patient to describing a positive effect of the proposed long-term treatment to choosing, if possible, a fixed combination of drugs which is known...

Acute upper respiratory tract infections and its management

prof. MUDr. Miloš Jeseňák, Ph.D., MBA, MHA, FAAAAI, doc. PharmDr. Daniela Mináriková, PhD., MSc.

Med. praxi. 2021;18(1):29-36  

Acute upper respiratory tract (URT) infections are the most common diseases in which assisted self-medication is used with active participation of pharmacists. The article describes clinical signs and differential diagnosis of acute URT infections. The basis of rational management is early immunomodulatory treatment using support of body´s own natural antiviral immune mechanisms, symptomatic treatment, hygiene of the nasal mucosa together with regime and general hygiene measures. Zinc has complex immunomodulatory and antiviral effects.

Acute uncomplicated urinary tract infection in womans

MUDr. Miroslava Ryšánková

Med. praxi. 2021;18(1):38-40  

Lower urinary tract infections are the most common diseases in urological ambulance. Their treatment usually does not take long, usually 1-5 days. Diagnosis is mainly reflected in the symptoms of illness and examination of patient's urine. Although the treatment is not long, it accounts for almost 15 % of antibiotic prescriptions at all.

Idiopathic pulmonary fibrosis: how a general practitioner can help

MUDr. Martina Šterclová, Ph.D.

Med. praxi. 2021;18(1):41-43 | DOI: 10.36290/med.2021.006  

Idiopathic pulmonary fibrosis is a fatal lung disease whose diagnosis and treatment present a number of pitfalls. Using a proactive approach, the general practitioner (GP) can significantly affect early determination of diagnosis - it is essential not to underestimate the patient's complaints and to examine those with signs and symptoms suggestive of respiratory tract disease by auscultation. The GP is involved in the comprehensive approach to the patient, being able to aid in diagnosing and managing side effects of the treatment. The GP plays a substantial role in providing palliative care and can help the patient and their loved ones cope with the...

Whipple's disease

MUDr. Daniel Bakši

Med. praxi. 2021;18(1):68-70 | DOI: 10.36290/med.2021.011  

Whipple's disease is a rare systemic disease of infectious etiology caused by the bacterium Tropheryma whipplei. Typical symptoms of this disease are chronic diarrhea, abdominalgia, weight loss, polyarthralgia and fever. In our case report, we present a 52 - year old patient, who was sent by a general practitioner for examination at our department for significant weight loss, weakness and prolonged lower dyspeptic syndrome. Gastroscopy with biopsy from the duodenal mucosa helped us to diagnose Whipple's disease, which led to the early initiation of targeted therapy, which is based mainly on long-term antibiotic treatment.

An unexpected cause of delirium

MUDr. Jiří Holý, Ph.D., MUDr. Martin Holý, MUDr. Zdeněk Beneš, MUDr. Marie Pešková

Med. praxi. 2021;18(1):71-74  

The authors document case history of an 70 years old male patient with hypertension, diabetes mellitus of 2^nd type and dyslipidaemia, after a potentially curative treatment of carcinoma of the prostate gland, suffering from a contusion of right lower extremity followed by a lesion of nervus ischiadicus. The patient took glimepiride 2 mg daily, rosuvastatin 20 mg daily, ramiprilum 5 mg and amlodipine 10 mg in fixed- dose combination and escitalopram 10 mg daily before an admission. The wounded man suffers from the development of rhabdomyolysis with acute renal failure. Repeated delirious status caused by hypoglycaemia appears by the patient...

Nebivolol, a unique beta blocker for treating arterial hypertension and chronic heart failure (not only) in primary care

MUDr. Pavel Rutar

Med. praxi. 2021;18(1):51-54  

Nebivolol is a third-generation beta blocker, a molecule with a higher degree of selectivity for β1 receptors than any other beta blocker. It is due to this ultra-selectivity that nebivolol has a low rate of adverse events and excellent clinical tolerance. Moreover, nebivolol possesses another unique property: the capacity to induce NO production in the vessel wall, thus causing peripheral vasodilation and improving endothelial dysfunction. Nebivolol is indicated for the treatment of arterial hypertension and chronic heart failure, and its use is safe even in diabetic patients, patients with dyslipidaemia, or those with chronic obstructive pulmonary...

Alpha-lipoic acid and neuropatic pain

MUDr. Pavlína Nosková, Ph.D.

Med. praxi. 2021;18(1):55-58  

Alpha-lipoic acid, a potent antioxidant, has been associated with support treatment for symptomatic diabetic neuropathy in several clinical trials. In the other indications is a subject for further research.

Current therapeutic options of erdosteine

PharmDr. Marek Lapka

Med. praxi. 2021;18(1):59-60  

Erdosteine belongs to the commonly used mucolytic. The mechanism of action of this substance lies in regulating the mucus viscosity, its formation and also mucociliary transport. However, the peculiarity of erdosteine consists in its antioxidant, anti-inflammatory and antibacterial effect. The article discusses these characteristics in the context of current information with a focus also on the paediatric population.

What a general practitioner should know about bronchogenic carcinoma

MUDr. Jaromír Roubec, Ph.D.

Med. praxi. 2021;18(1):63-67 | DOI: 10.36290/med.2021.010  

The review provides essential information on the epidemiology, diagnosis, and treatment of bronchogenic carcinoma in accordance with standard procedures in the Czech Republic, utilizing all treatment modalities based on histology and disease extent according to the stages of TNM classification. Using additional results of laboratory diagnostic procedures, the article discusses options of treatment with biological agents and personalization of treatment of this serious disease in line with current knowledge.

The most common errors in the use of personal protective equipment

PhDr. Simona Saibertová, Ph.D., prof. PhDr. Andrea Pokorná, Ph.D.

Med. praxi. 2021;18(1):75-78 | DOI: 10.36290/med.2021.013  

Care for patients suffering from the covid-19 infection is difficult for healthcare professionals because of the need to use all the recommended personal protective equipment (PPE). When PPE is used, fundamental errors occur. The errors potentially lead to a spread of the infection through contamination or even to occurrence of the disease in healthcare professionals. The paper summarizes the basic recommendations for the appropriate use of PPE as well as the most common mistakes that healthcare professionals can make in the clinical practice.

Zaznělo na 1. podzimním on-line kongresu Medicíny pro praxi prosinec 2020 – listopad 2021: Venofarmaka ve světle nových guidelines a na pozadí kazuistik – MUDr. Tomáš Hauer, Cévní centrum České Budějovice

MUDr. Zuzana Zafarová

Med. praxi. 2021;18(1):44-46  

Zaznělo na on-line webinářích září–listopad 2020: Infekce HIV a HCV – testujte nyní, testujte včas!

MUDr. Pavel Rutar

Med. praxi. 2021;18(1):47-50