Medicine for Practice, 2022, issue 5

Editorial

Slovo úvodem

Dagmar Havlová

Med. praxi. 2022;19(5):315

Review articles

Patient with neuromuscular junction disease in a general practitioner's office

MUDr. Jana Junkerová, MUDr. Eva Kovalová

Med. praxi. 2022;19(5):320-323 | DOI: 10.36290/med.2022.048

Myasthenia gravis is the most important disease caused by a failure of signal transmission from the nerve fiber to the muscle. The most common target of the pathological antibody response is the acetylcholine receptor on the postsynaptic side of the neuromuscular disc. The prevalence of myasthenia gravis is 8-15/100 000, so it is not a rare disease. The article briefly describes the peculiarities of clinical manifestations, recommendations for effective diagnosis, its difficulties and treatment options for this disease. We want to point out the differences between myasthenic pathological fatigue and weakness, as opposed to non-specific fatigue, which...

Endocrinopathy and obesity

prof. MUDr. Štěpán Svačina, DrSc., MBA

Med. praxi. 2022;19(5):324-326 | DOI: 10.36290/med.2022.049

The article deals with the associations between obesity and endocrinopathies, i.e. diseases that are widely prevalent in the population and often co-occur. However, in most cases, there is no clear causal relationship between these two conditions. Excess adipose tissue in obesity can be a source of numerous endocrine-acting substances and, on the contrary, some endocrinopathies can be linked to the development of obesity (hypothalamic and pituitary diseases, Cushing syndrome, polycystic ovary syndrome, hypogonadism). Thyroid gland diseases have a specific effect on body weight. However, blanket screening for endocrinopathies in people with obesity...

Dyslipidemia and arterial hypertension: when to start intervention in primary prevention, use of vascular age

MUDr. Eva Tůmová, Ph.D.

Med. praxi. 2022;19(5):327-333 | DOI: 10.36290/med.2022.050

Dyslipidemia and arterial hypertension - two basic cardiovascular risk factors, which very often occur together in young asymptomatic individuals. We know that early intervention and achieving blood pressure and cholesterol target values fundamentally affects the progression of atherosclerosis. But how to convince the patient without the slightest subjective problems of the necessity of a lifestyle change, let alone the administration of treatment? In clinical practice, do we have the opportunity to clearly explain to patients the effects of long-term high blood pressure and high cholesterol levels on their health and demonstrate the effect of our...

Acute upper respiratory tract infections - diagnosis and treatment

MUDr. Karolina Edelmannová

Med. praxi. 2022;19(5):334-337 | DOI: 10.36290/med.2022.051

Acute upper respiratory tract infections are the most common infectious diseases in children and adults. It includes the common cold, rhinosinusitis, pharyngitis, tonsillitis, tonsillopharyngitis, laryngitis, and epiglottitis. Middle ear infections are also directly related to upper respiratory tract infections. Most of these infections are uncomplicated and will disappear on their own within a week, the cough after the virosis can persist for several weeks. Due to the fact that most acute upper respiratory tract infections are of viral origin, their treatment with antibiotics is neither appropriate nor necessary.

Interdisciplinary overviews

Shoulder joint pain

MUDr. Marek Rouchal

Med. praxi. 2022;19(5):338-348 | DOI: 10.36290/med.2022.052

Shoulder joint pain is relatively common in the population and accounts for a significant part of the clientele in orthopedic outpatient clinics. The following paper summarizes the diagnostic algorithm with emphasis on the clinical examination of the patient, which I am able to perform without any background or special equipment. This section is supplemented by an outline of the diagnostic imaging methods used. The last part is a brief summary of the individual pathologies commonly encountered in the outpatient setting and a suggestion for therapeutic procedures in these cases.

Chronic pain in patients with osteoarthritis

doc. MUDr. Jitka Fricová, Ph.D.

Med. praxi. 2022;19(5):349-353 | DOI: 10.36290/med.2022.053

Osteoarthritis (OA) is one of the leading causes of chronic pain and its prevalence is increasing in line with the global ageing of the population. To date, there are no pharmacological interventions to slow the progression of OA, and pain-relieving therapies are also largely unsuccessful. Local inflammation in the joint may contribute to mechanical sensitization and structural neuroplasticity of joint nociceptors via proinflammatory factors such as nerve growth factor, cytokines, and chemokines. Early and safe pain management according to national recommendations is an essential part of osteoarthritis care.

Erysipelas

MUDr. Lubomír Drlík

Med. praxi. 2022;19(5):354-357 | DOI: 10.36290/med.2022.054

The term erysipelas is conventionally used for describing a skin infection limited predominantly to legs, arms or face. The infection mainly involves the upper dermis and superficial lymphatics, and is typically caused by beta-hemolytic group A Streptococci, beginning from mild wounds, stings or scratches. In several cases, however, the site of entrance of the microorganism cannot be clearly identified. Erysipelas is more superficial than cellulitis, and typically more demarcated

Skin care of patients undergoing radiotherapy

Mgr. Lenka Krupová, Ph.D., doc. MUDr. Ing. Jakub Cvek, Ph.D.

Med. praxi. 2022;19(5):358-361 | DOI: 10.36290/med.2022.055

Radiation dermatitis is a very common reaction in radiotherapy, affecting approximately 95 % of patients with varying intensity. In severe cases, it can significantly impact the quality of life. Appropriate use of clinically proven products protects the patient's skin and achieves excellent results during the treatment of skin reactions. General practitioners can significantly contribute to meeting patients' needs, reassuring them, supporting them, educating them, or supplementing information. Existing GP relationships with their patients are a good precondition for them to be able to inquire and advise without fear. Knowledge of current procedures...

Pharmacotherapy currently

Modern therapeutic modalities in insomnia

MUDr. Jakub Vaněk

Med. praxi. 2022;19(5):362-366 | DOI: 10.36290/med.2022.056

Insomnia in various forms is among the most common complaints that bring patients to the offices of general practitioners and specialists. Prevalence studies indicate the incidence of insomnia in the adult population in a wide range of 6.2-40 % per calendar year. Advances in sleep neurobiology research reveal new cognitive and neurophysiological models of the etiopathogenesis of insomnia. Modern recommended guidelines in the treatment of insomnia emphasize the need to gradually take the steps in the therapy from less burdensome and mainly non-pharmacological interventions to pharmacological treatment. The primary treatment intervention should be psychotherapy,...

The modern therapy of hypertension with combination therapy

MUDr. Barbora Nussbaumerová, Ph.D.

Med. praxi. 2022;19(5):367-369 | DOI: 10.36290/med.2022.057

Arterial hypertension is one of the most important modifiable cardiovascular risk factors. A combination of antihypertensive therapy should be used in most patients to compensate blood pressure values. The guidelines recommend starting the treatment with a combination of a renin-angiotensin - system inhibitor in combination with a calcium channel blocker or a diuretic. The missing drug should be added if needed. The fixed combination should be preferred because of better compliance and effectiveness.

Good advice

A comprehensive view of cardiorehabilitation - what should the cooperation between GP and the cardiologist look like?

prof. MUDr. Eliška Sovová, Ph.D., MBA

Med. praxi. 2022;19(5):370-372 | DOI: 10.36290/med.2022.058

The article summarizes the benefits of complex cardiovascular rehabilitation, analyzes its components, such as physical activity prescription, healthy eating recommendations, help in quitting smoking, psychosocial intervention and looks for points of cooperation between a general practitioner and a cardiologist.