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Heart failure as the first clinical symptom of amyloidosis 心力衰竭是淀粉样变的首要临床症状
Vnitrni lekarstvi Pub Date : 2023-10-10 DOI: 10.36290/vnl.2023.075
František Novák, Jan Václavík
{"title":"Heart failure as the first clinical symptom of amyloidosis","authors":"František Novák, Jan Václavík","doi":"10.36290/vnl.2023.075","DOIUrl":"https://doi.org/10.36290/vnl.2023.075","url":null,"abstract":"Pojem amyloidĂłza zahrnuje skupinu poruch, při kterĂ˝ch dochĂĄzĂ­ k uklĂĄdĂĄnĂ­ proteinĹŻ, přirozenĂ˝ch i mutovanĂ˝ch, do tkĂĄnĂ­. Z těchto proteinĹŻ vznikĂĄ uspořádanĂĄ vlĂĄknitĂĄ, ĹĄpatně rozpustnĂĄ matrix zvanĂĄ amyloid. JejĂ­ uklĂĄdĂĄnĂ­ poĹĄkozuje funkci postiĹženĂ˝ch orgĂĄnĹŻ (1, 2). Diagnostika je obtĂ­ĹžnĂĄ a často pozdnĂ­ (3). PostiĹženĂ­ srdce je velmi častĂŠ a nejvĂ­ce limituje prognĂłzu nemocnĂŠho (4). Popisujeme případ pacientky, u kterĂŠ ani relativně časnĂĄ diagnĂłza srdečnĂ­ amyloidĂłzy nezabrĂĄnila jejĂ­mu nĂĄhlĂŠmu ĂşmrtĂ­.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136295212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Point-of-care ultrasonography: a revolution in a daily routine of an internist? 即时超声检查:内科医生日常工作的一场革命?
Vnitrni lekarstvi Pub Date : 2023-10-10 DOI: 10.36290/vnl.2023.081
Juraj Smaha, Jakub Falat, Anzhelika Shevchuk, Martin Kužma, Peter Jackuliak, Juraj Payer
{"title":"Point-of-care ultrasonography: a revolution in a daily routine of an internist?","authors":"Juraj Smaha, Jakub Falat, Anzhelika Shevchuk, Martin Kužma, Peter Jackuliak, Juraj Payer","doi":"10.36290/vnl.2023.081","DOIUrl":"https://doi.org/10.36290/vnl.2023.081","url":null,"abstract":"Point-of-care ultrasonografia (POCUS) predstavuje formu ultrasonografie, keď oĹĄetrujĂşci lekĂĄr vykonĂĄva ultrasonografickĂŠ vyĹĄetrenie pri lĂ´Ĺžku pacienta v reĂĄlnom čase, čo mu umoŞňuje hodnotiĹĽ aj dynamickĂŠ zmeny USG obrazu a nĂĄlezy priamo korelovaĹĽ so symptĂłmami pacienta. LekĂĄr vykonĂĄvajĂşci POCUS mĂĄ zvyčajne na mysli konkrĂŠtnu klinickĂş otĂĄzku, ktorĂş si chce sonografickĂ˝m vyĹĄetrenĂ­m zodpovedaĹĽ. POCUS mĂĄ potenciĂĄl zefektĂ­vniĹĽ diagnostiku, liečbu, monitoring a skrĂ­ning mnohĂ˝ch ochorenĂ­ u interne chorĂ˝ch pacientov, jeho postavenie v rĂĄmci vnĂştornĂŠho lekĂĄrstva vĹĄak zatiaÄž nie je jasne zadefinovanĂŠ. ČlĂĄnok sa venuje potenciĂĄlnym vĂ˝hodĂĄm POCUS-u v kontexte vnĂştornĂŠho lekĂĄrstva, dĂĄtam o vyuĹžitĂ­ POCUS-u v reĂĄlnej klinickej praxi relevantnej pre internistu a dĂĄtam o vyuĹžitĂ­ tzv. vreckovĂ˝ch USG prĂ­strojov.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136294879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rosacea: skin disease or a systemic disorder? 酒渣鼻:皮肤病还是全身性疾病?
Vnitrni lekarstvi Pub Date : 2023-10-10 DOI: 10.36290/vnl.2023.082
Štefan Alušík
{"title":"Rosacea: skin disease or a systemic disorder?","authors":"Štefan Alušík","doi":"10.36290/vnl.2023.082","DOIUrl":"https://doi.org/10.36290/vnl.2023.082","url":null,"abstract":"Rosacea (rĹŻĹžovka) je onemocněnĂ­, kterĂŠ mĂĄ multifaktoriĂĄlnĂ­ příčinu a komplexnĂ­ patofyziologii a kterĂĄ se neomezuje pouze na kĹŻĹži. V klinickĂŠ praxi je rosacea spojena s řadou komorbidit a v současnĂŠ době se vede diskuze o tom, zda nenĂ­ rosacea onemocněnĂ­m systĂŠmovĂ˝m.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136294728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic and surgical therapy for obesity 内窥镜和手术治疗肥胖
Vnitrni lekarstvi Pub Date : 2023-10-10 DOI: 10.36290/vnl.2023.079
Jan Král, Filip Doleček, Kateřina Waloszková, Jana Selucká, Evžen Machytka, Julius Špičák, Marek Bužga
{"title":"Endoscopic and surgical therapy for obesity","authors":"Jan Král, Filip Doleček, Kateřina Waloszková, Jana Selucká, Evžen Machytka, Julius Špičák, Marek Bužga","doi":"10.36290/vnl.2023.079","DOIUrl":"https://doi.org/10.36290/vnl.2023.079","url":null,"abstract":"Obezita je zĂĄvaĹžnĂŠ onemocněnĂ­, jehoĹž incidence nadĂĄle celosvětově roste. OnemocněnĂ­ asociovanĂĄ s obezitou vedou ke snĂ­ĹženĂ­ kvality Ĺživota a vyĹĄĹĄĂ­ mortalitě (vysokĂ˝ krevnĂ­ tlak, dyslipidemie, diabetes mellitus 2. typu a dalĹĄĂ­). Léčba obezity je multidisciplinĂĄrnĂ­ a komplexnĂ­ proces, kterĂ˝ vyĹžaduje dĹŻslednou spoluprĂĄci pacienta. Změna ĹživotnĂ­ho stylu je stavebnĂ­m kamenem ĂşspěšnĂŠ terapie obezity. FarmakologickĂĄ terapie zaŞívĂĄ v poslednĂ­ch letech renesanci a jejĂ­ role, jak uĹž v monoterapii, tak i v kombinaci s jinĂ˝mi metodami, bude postupně nabĂ˝vat na vĂ˝znamu. EndoskopickĂĄ terapie je rychle se vyvĂ­jecĂ­ podobor digestivnĂ­ endoskopie, kterĂĄ nabĂ­zĂ­ celou řadu novĂ˝ch metod redukujĂ­cĂ­ch například objem Ĺžaludku nebo bypass tenkĂŠho střeva. Metody jsou efektivnĂ­ a zĂĄroveň majĂ­ nĂ­zkĂŠ riziko komplikacĂ­. ChirurgickĂĄ terapie je na druhou stranu vysoce účinnĂĄ, nicmĂŠně je zatĂ­Ĺžena vyĹĄĹĄĂ­m vĂ˝skytem komplikacĂ­. BariatrickĂĄ chirurgie je určena předevĹĄĂ­m pro pacienty s pokročilĂ˝m stadiem obezity s komorbiditami. CĂ­lem tĂŠto publikace je dĂĄt souhrnnĂ˝ přehled dosavadnĂ­ch endoskopickĂ˝ch a chirurgickĂ˝ch metod v léčbě obezity.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136295030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multimorbidity in acute kidney injury 急性肾损伤的多病性
Vnitrni lekarstvi Pub Date : 2023-10-10 DOI: 10.36290/vnl.2023.074
Vladimír Teplan
{"title":"Multimorbidity in acute kidney injury","authors":"Vladimír Teplan","doi":"10.36290/vnl.2023.074","DOIUrl":"https://doi.org/10.36290/vnl.2023.074","url":null,"abstract":"AkutnĂ­ poĹĄkozenĂ­ a selhĂĄnĂ­ ledvin (AKI) je často spojeno s postiĹženĂ­m dalĹĄĂ­ch orgĂĄnĹŻ. Nejčastěji se jednĂĄ o postiĹženĂ­ kardiĂĄlnĂ­, plicnĂ­, jaternĂ­, gastrointestinĂĄlnĂ­, CNS, cĂŠvnĂ­ či koĹžnĂ­. ZĂĄvaĹžnĂŠ jsou stavy akutnĂ­ho poĹĄkozenĂ­ ledvin při oběhovĂŠm selhĂĄnĂ­ a toxicitě, ale i jako nĂĄsledek poruch vodnĂ­ho a elektrolytovĂŠho metabolismu (hypotenze, krvĂĄcenĂ­, prĹŻjmy, zvracenĂ­). AkutnĂ­ poĹĄkozenĂ­ ledvin mĹŻĹže bĂ˝t spojeno s hypertenzĂ­, předevĹĄĂ­m malignĂ­, ale i s otoky (při velkĂŠ proteinurii), kterĂŠ mohou bĂ˝t i jinĂŠ etiologie (kardiĂĄlnĂ­ selhĂĄnĂ­, cĂŠvnĂ­ zĂĄněty, jaternĂ­ lĂŠze, gastrointestinĂĄlnĂ­ postiĹženĂ­, onkologickĂŠ onemocněnĂ­ apod.). PolĂŠkovĂŠ a infekčnĂ­ poĹĄkozenĂ­ ledvin je takĂŠ často spojeno s postiĹženĂ­m dalĹĄĂ­ch orgĂĄnĹŻ, jako jsou jĂĄtra, plĂ­ce, cĂŠvy, svaly, kostnĂ­ dřeň apod. VĂ­ceorgĂĄnovĂŠ postiĹženĂ­ vĂ˝znamně modifikuje dalĹĄĂ­ léčebnĂŠ postupy.","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136294731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Point‑of‑Care Ultrasound in internal medicine. 内科护理点超声。
Vnitrni lekarstvi Pub Date : 2023-01-01 DOI: 10.36290/vnl.2023.041
Zdeněk Monhart
{"title":"Point‑of‑Care Ultrasound in internal medicine.","authors":"Zdeněk Monhart","doi":"10.36290/vnl.2023.041","DOIUrl":"10.36290/vnl.2023.041","url":null,"abstract":"<p><p>Point-of-Care ultrasound (POCUS) is bedside ultrasound examination performed by a clinician. POCUS is a suitable tool for rapid diagnosis and monitoring of the condition of many patients examined by internists in emergency departments and inpatient departments. POCUS allows the examining physician to supplement the physical examination with additional information obtained in real time, and is a useful tool for differential diagnosis of a number of acute conditions (shock, shortness of breath, etc.). Chest POCUS includes an indicative assessment of cardiac function and evaluation of the lung parenchyma, including exclusion of pericardial effusion, pneumothorax or fluidothorax. One of the most common applications of POCUS is to assess the state of the venous filling by examining the inferior vena cava. When examining the abdomen, the internist should at least be able to diagnose fluid in the abdominal cavity and exclude congestion in the hollow system of the kidney. POCUS for internists also includes examination of main venous trunks to rule out proximal venous thrombosis. Even when performing conventional invasive procedures, we cannot do without ultrasound at the bedside, whether it is a puncture of ascites or pleural effusion, or cannulation of the central vein. The advantage of POCUS is the immediate availability of the examination and the possibility to repeat scans when needed for monitoring the patient's condition.</p>","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9898888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethical aspects in oncology. 肿瘤学的伦理问题
Vnitrni lekarstvi Pub Date : 2023-01-01 DOI: 10.36290/vnl.2023.009
Anetta Jedličková
{"title":"Ethical aspects in oncology.","authors":"Anetta Jedličková","doi":"10.36290/vnl.2023.009","DOIUrl":"10.36290/vnl.2023.009","url":null,"abstract":"<p><p>Decisions related to the treatment of oncological diseases bring various ethical dilemmas to healthcare providers caring for cancer patients. Along with the development of medicine and new therapeutic methods, there are also increased demands on the appropriate selection of eligible patients for allocation to a particular treatment method, which causes a number of ethical connotations. The paper deals with ethical issues in the course of oncology treatment, with theoretical bases for ethical decision-making and with ethical aspects of communication with patients suffering from oncological diseases. The paper also contains results of studies that dealt with methods of ethical reasoning of health professionals in relation with the Do Not Resuscitate (DNR) decision in oncology, and with understanding of the concept of ethical competence of health professionals in order to make, or be involved in, DNR decisions, and how relevant skills can be developed. Among others, the results of the studies pointed out that in order to make ethically based DNR decisions in oncology, physicians and nurses need to improve their knowledge of ethical theories.</p>","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9144217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Osteoporosis in adults in clinical practice (1): diagnosis and differential diagnosis. 临床实践中的成人骨质疏松症（1）：诊断与鉴别诊断。
Vnitrni lekarstvi Pub Date : 2023-01-01 DOI: 10.36290/vnl.2023.052
Vít Zikán
{"title":"Osteoporosis in adults in clinical practice (1): diagnosis and differential diagnosis.","authors":"Vít Zikán","doi":"10.36290/vnl.2023.052","DOIUrl":"10.36290/vnl.2023.052","url":null,"abstract":"<p><p>Osteoporosis is a systemic metabolic disease of the skeleton characterized by low bone strength that results in an increased risk of fracture. Fractures are associated with serious clinical consequences, including pain, disability, loss of independence, and death, as well as high healthcare costs. Early identification and intervention with patients at high risk for fracture is needed to reduce the burden of osteoporotic fractures. The identification of a patient at high risk of fracture should be followed by evaluation for factors contributing to low bone mineral density (BMD) and/or low bone quality, falls, and fractures. Components of the osteological evaluation include an assessment of BMD by dual-energy X-ray absorptiometry, osteoporosis-directed medical history and physical exam, laboratory studies, and possibly skeletal imaging. Disorders other than osteoporosis, requiring other types of treatment, may be found. This overview summarizes the basic procedures for the diagnosis and differential diagnosis of osteoporosis, which are necessary before starting treatment.</p>","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9841910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What is new in 2022 ESC guidelines on cardiovascular assessment and management of patients undergoing non‑cardiac surgery. 2022年ESC指南中关于接受非心脏手术患者心血管评估和管理的新内容。
Vnitrni lekarstvi Pub Date : 2023-01-01 DOI: 10.36290/vnl.2023.002
Bronislav Čapek, Jan Václavík
{"title":"What is new in 2022 ESC guidelines on cardiovascular assessment and management of patients undergoing non‑cardiac surgery.","authors":"Bronislav Čapek, Jan Václavík","doi":"10.36290/vnl.2023.002","DOIUrl":"10.36290/vnl.2023.002","url":null,"abstract":"<p><p>In 2022, the European Society of Cardiology has published updated guidelines for the cardiovascular evaluation and management of patients undergoing non-cardiac surgery. In this article we briefly summarize the most important recommendations with an emphasis on their use in everyday clinical practice - from the complex assessment of cardiovascular risk and prediction of cardiovascular complications, through the indication of basic paraclinical examinations, the importance of biomarkers, adjustments to pharmacotherapy of heart failure, adjustments to anticoagulant and antiplatelet therapy, to other specifics of individual cardiovascular and other diseases and their importance in the perioperative period. Knowledge and use of these recommendations have the potential to improve the prognosis of patients undergoing various types of surgical procedures.</p>","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9144222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical assessment and management of patients with multimorbidity. 多病患者的临床评估与管理。
Vnitrni lekarstvi Pub Date : 2023-01-01 DOI: 10.36290/vnl.2023.030
Zdeněk Monhart
{"title":"Clinical assessment and management of patients with multimorbidity.","authors":"Zdeněk Monhart","doi":"10.36290/vnl.2023.030","DOIUrl":"10.36290/vnl.2023.030","url":null,"abstract":"<p><p>Internal medicine specialists, also known as general internal medicine specialists are specialist physicians trained to manage particularly complex or multisystem disease conditions that single-organ-disease specialists may not be trained to deal with. The management of multimorbidity, however, is often complex, and requires specific clinical skills and corresponding experience in appropriate diagnostic and therapeutic procedures. Multimorbidity is associated with a decline in many aspects of health and in consequence with an increase in hospital admissions, polypharmacy, and use of health care and social resouces. When prescribing medicine to patients with multimorbidity, all the risks and benefits, as well as possible interactions should be carefully considered. The prescription appropriateness can be assessed by validated tools like STOPP-START criteria. Beneficial part of good prescribing is deprescribing - planned and supervised process of dose reduction or withdrawal of medications that are no longer needed in the circumstances of the patient.</p>","PeriodicalId":23501,"journal":{"name":"Vnitrni lekarstvi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9845280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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