Nenechávejte lidi samotné a už vůbec ne osamělé!

MUDr. Radkin Honzák, CSc.

Med. praxi. 2022;19(1):3  

Early diagnosis and therapy of rheumatoid arthritis

MUDr. Liliana Šedová, MUDr. Jana Tomasová Studýnková, Ph.D.

Med. praxi. 2022;19(1):10-17 | DOI: 10.36290/med.2022.001  

Rheumatoid arthritis is a chronic inflammatory autoimmune disease that, if untreated soon and adequately enough, leads to irreversible joint destruction, lifelong disability and development of associated comorbidities. The modern approach to this disease includes the early diagnosis, early start of effective therapy within 3 months of symptoms onset and "treat to target" strategy. The aim of this approach is the induction and maintenance of clinical remission, or at least low disease activity and prevention of structural damage. This principle requires "tight control"clinical assessment using composite disease activity index and treatment adjustment...

Fever in adults, differential diagnosis and administration of antipyretics

Benedikt Krížek, MUDr. Petra Matalová, Ph.D.

Med. praxi. 2022;19(1):19-24 | DOI: 10.36290/med.2022.002  

Fever is a symptom, which accompanies many infectious and non-infectious illnesses. Its causes may be various ranging from frequent to very rare. The most common causes are viral or bacterial infections, but fever can also be a sign of other serious diseases, even poisoning or drug intoxication. The following article should briefly summarize essential management of patient with fever.

Vitamins D, C and zinc are essential for function of immune system and enhancement of protective immunity

prof. RNDr. Jan Krejsek, CSc.

Med. praxi. 2022;19(1):25-31 | DOI: 10.36290/med.2022.003  

The immune system is an integral part of protective inflammatory response with aims to eliminate invasion of pathogenic microorganisms and to eliminate self tissue damage. The potential to participate in protective immune reaction is given to all body cells. The protective strategy is multilevels. The first line is physiological microbiota which is inhabiting all epithelial structures of our body and skin. The second line is formed by epithelial linings which are interacting with both physiological microbiota and components of immunity. The third line of defence is innate immunity including its cellular substrate, namely dendritic cells, macrophages,...

Postcovid lung impairment in general practitioner setting

doc. MUDr. Milan Sova, Ph.D., MUDr. Ondřej Zela

Med. praxi. 2022;19(1):32-34 | DOI: 10.36290/med.2022.004  

Different signs and symptoms as a consequence of Covid-19 is present in many patients. There is also variability in symptoms ranging from non-specific symptoms like headache to postcovid ling impairment. This review is focused on the most common signs and symptoms with partial focus on respiratory tract.

Therapeutic approach to the treatment of arterial hypertension in an obese patient

MUDr. Peter Wohlfahrt, Ph.D.

Med. praxi. 2022;19(1):35-38 | DOI: 10.36290/med.2022.005  

Arterial hypertension (AH) and obesity are among the six most important risk factors leading to death in the world. Both risk factors increase the risk not only of cardiovascular disease, but also the risk of cancer and chronic kidney disease. There are close two-way links between obesity and AH. Obesity increases the risk of developing AH two to threefold and in obese patients, blood pressure control is more difficult to achieve. On the other hand, a positive family history of AH predicts development of central obesity. At the same time, people with higher blood pressure have a higher risk of weight gain than people with lower blood pressure. The...

Ophtalmological symptoms of interal diseases

MUDr. Květoslava Ferrová

Med. praxi. 2022;19(1):39-47 | DOI: 10.36290/med.2022.006  

Primary care physians often encounter eye symptoms that may signal serious internal illness. In such cases, information obtained at an eye examination can help not only in the diagnosis but also in the treatment of the underlying disease. Alteranatively, patiens with internal disease may develop eye manifestation that requires diagnosis and treatment by an ophtalmologist. For these reasons, the primary care physician schould be aware of ocular complications of such disease. (1.) A primary care physician schould consider performing an eye examination on each patient with changes of internal state. The aim of this article is to provide basic and cleare...

Innovative and original Czech cognitive tests Amnesia Light and Brief Assessment and Picture naming and immediate recall and examination tools in the diagnosis of cognitive disorders and dementias

prof. MUDr. Aleš Bartoš, Ph.D.

Med. praxi. 2022;19(1):50-57 | DOI: 10.36290/med.2022.007  

Older people with memory impairment are more frequent with an increasing proportion of the aging population. Memory impairment in old age can be the first symptom of Alzheimer's disease, but also many other diseases. Two innovative and original Czech tests are used for a quick and easy memory examination - Amnesia Light and Brief Assessment (ALBA) and Picture naming and immediate recall (PICNIR) which were developed right in the Czech Republic. The ALBA test consists of repeating a sentence of six words, performing and then recall of six gestures, and finally recall of the words of the original sentence. In the PICNIR test, the first task is to write...

What if or why it is important to start treating chronic venous disease in time

MUDr. Júlia Černohorská, Ph.D.

Med. praxi. 2022;19(1):62-67 | DOI: 10.36290/med.2022.009  

In recent months, an extensive CVD ONLINE project (www.cvdonline.cz) has been set up to remind GPs, internists, dermatologists and other specialists of the need for early initiation and comprehensive treatment of chronic venous disease (CVD). This chronic progressive disease can result in the development of a leg ulcer, which is an advanced stage associated with a significant reduction in patients' quality of life and a significant burden on the health system. We present a case study of a 48-year-old woman who underwent vascular reflux surgery in the area of the saphenous-femoral junction at the age of 40, accompanied by significant subjective symptoms...

How to change cardiovascular prognosis of our patients?

doc. MUDr. Ludmila Brunerová, Ph.D.

Med. praxi. 2022;19(1):68-73 | DOI: 10.36290/med.2022.010  

Hypertension and hyperlipidemia as (usually asymptomatic) risk factors contribute to the progression of cardiovascular diseases since younger adulthood (40 years). These patients are exposed to these risk factors for a long time resulting in accumulation of atherosclerotic damage. Early diagnosis and intervention of these factors together with communication with the patient about the risk have the impact on the occurrence of cardiovascular events. We present the case of a 62-year old smoker with acute myocardial infarction and left ventricle dysfunction who has been refusing the pharmacotherapy of hyperlipidemia and hypertension for 20 years.

Treatment of arterial hypertension in 2022

MUDr. Alena Krajčoviechová, Ph.D.

Med. praxi. 2022;19(1):74-76 | DOI: 10.36290/med.2022.011  

A case report of middle-aged man with grade II hypertension and moderate cardiovascular risk is presented. Combination of angiotensin-converting enzyme inhibitors and calcium channel blockers was used as initial step of the pharmacotherapy. Hypertension control was reached within 3 months. Initiation of the therapy using dual combination of antihypertensive drugs is an essential requirement for the successful treatment endorsed by guidelines, while the choice of the drugs should consider the best possible cardiovascular protection. Combination of perindopril and amlodipine, both free and fixed, is well tolerated, well adhered, and provides long-term...

Direct anticoagulants and general practitioner

doc. MUDr. Petr Dulíček, Ph.D., MUDr. Zuzana Thibaud, MUDr. Anna Mária Pejková, Mgr. Petr Sadílek

Med. praxi. 2022;19(1):58-61 | DOI: 10.36290/med.2022.008  

With regard to the aging population, there are more and more individuals on anticoagulation therapy for atrial fibrillation and venous thromboembolism. Number of patients on direct anticoagulants has been increased in the last 10 years and therefore also general practitioners get into the contact with them. General practitioners cannot prescribe these drugs yet, but it is important to be familiar with correct indications, dosage, monitoring and perioperative management.

Podzim života v zářivých barvách

MUDr. Pavel Rutar

Med. praxi. 2022;19(1):78-82