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Hradec Králové, Czech Republic

Sobotka L.,Klinika Gerontologicka A Metabolicka
Vnitrni Lekarstvi | Year: 2010

Skin defects and wounds are rather frequent in diabetic population. They most frequently occur on lower limbs and their origins are often multifaceted. If vascular perfusion is not damaged, it is important to secure perfect drainage with sufficient incision and to use local treatment modalities such as hyaluronan-iodine complex, now well-established at our clinic. It is always essential to save the vascular system if this is damaged. Careful examination by an angiologist is normally followed by angioplasty or vascular bypass. Amputation is an extreme solution that, nevertheless, may save the limb functionality if done in a patient with ischemic damage that cannot be resolved. Source

Hendrychova T.,Katedra Socialni a Klinicke Farmacie | Matoulkova P.,Katedra Socialni a Klinicke Farmacie | Vlcek J.,Katedra Socialni a Klinicke Farmacie | Smahelova A.,Klinika Gerontologicka A Metabolicka
Vnitrni Lekarstvi | Year: 2012

The paper brings an overview of published systematic reviews and meta-analyses concerning the evaluation of the effectiveness of the treatment with insulin pump (CSII) in comparison with multiple daily injections (MDI) in type 1 diabetes mellitus. According to found works CSII leads to slightly lower levels of glycosylated hemoglobin (HbA1c) in patients with type 1 diabetes mellitus against MDI. The levels of HbA1c and the variability of glycaemia during the day on MDI before an initiation of CSII should serve for the prediction of an effect of CSII in particular patient. Type 1 diabetics on CSII have less often hypoglycaemia, higher flexibility of their daily regime and thus higher satisfaction with their treatment against MDI. The daily doses of insulin decrease. The weight of patients is the same or slightly higher after the initiation of CSII. There were not enough information for the assesment of the frequency of adverse reactions. It is necessary to educate each patient not only how to manipulate the particular insulin pump, but also about general recommendations for the treatment of diabetes and the application of insulin. Source

Zajic J.,Klinika Gerontologicka A Metabolicka
Interni Medicina pro Praxi | Year: 2012

Arterial hypertension is the most common cardiovascular disease. Its high prevalence in the adult population of industrialized countries in particular, represents a serious health problem. The incidence of hypertension increases with increasing age. Population aged over 80 years represents the fastest growing population subgroup. For healthcare worldwide will be necessary to reduce the morbidity associated with older age and the associated dependence of these persons. Arterial hypertension is a risk factor not only for the "classical" cardiovascular disease but also associated with higher risk of dementia. Source

Zadak Z.,Centrum pro vyzkum a vyvoj | Ticha A.,Centrum pro vyzkum a vyvoj | Hronek M.,Centrum pro vyzkum a vyvoj | Hyspler R.,Klinika Gerontologicka A Metabolicka
Vnitrni Lekarstvi | Year: 2011

Summary: Current model of metabolic and nutritional disorders management utilizes modern techniques that promote some of the nutritional techniques to pharmacoteherapy. This approach is demonstrated on an example of multiple organ failure and systemic inflammatory reaction managed with pharmacologically active nutritional substrates, such as arginine, glutamine, taurine, threonine and cysteine. Treatment of sarcopenia in older age is also discussed. Personalized nourishment as a component part of a wider term personalized medicine represents a new approach that requires recognition of individual differences in human genome and its expression. However, this approach also requires a change of attitude towards laboratory diagnostics and clinical practice, with patients and clinical prediction as the focal point. From this perspective, there is a need to replace current traditional laboratory tests with a new system that utilizes molecular biology and bioinformatics. Source

Hrabovsky V.,Interni Klinika LF OU | Mendlova A.,Metabolicka JIP | Zadak Z.,Centrum Pro Vidu A Vyzkum | Blaha V.,Klinika Gerontologicka A Metabolicka | And 3 more authors.
Gastroenterologie a Hepatologie | Year: 2013

Purpose of the study: The aim of this pilot study was to describe changes in lipid metabolism in patients with acute gastrointestinal (GI) bleeding and to assess possible influence of hemodilution and changes in the cholesterol synthesis/absorption process. Material and methods: In 12 patients with gastrointestinal bleeding, the levels of lipid metabolism (total, LDL and HDL cholesterol and triglycerides) were determined on days 0, 3 and 6. On the same days, levels of the cholesterol synthesis indexes (lathosterol, squalene) and absorption (campesterol, sitosterol) were determined. The results were evaluated in comparison with the control set, and cirrhotic and non-cirrhotic patients were compared. At the same time, correlations of lipids and haemoglobin, hematocrit levels anduse of transfusions were evaluated. Results: The patients had significantly lower levels of total cholesterol (p 0.001). Decrease of LDL and HDL cholesterol was not significant. Concentrations of triglycerides were normal. Decrease of lathosterol was significant (p 0.05), but decrease in squalene, campesterol and sitosterol levels was insignificant. Comparing patients with cirrhosis and without cirrhosis showed statistically significant difference in levels of cholesterol and lathosterol (p 0.05). Correlations did not show any statistically significant findings. Conclusion: In patients with acute GI bleeding, changes is lipid metabolism including alteration of the process of synthesis and absorption were proved. Therefore, hypocholesterolemia cannot be explained by blood loss only. However, more detailed studies need to be carried out. Source

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