Casopís lékar̆ů c̆eských
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Casopís lékar̆ů c̆eských · Jan 2010
Review[Drug treatment of obesity--current situation and perspectives].
Pharmacotherapy of obesity should be an integral part of the comprehensive obesity management program which includes diet, exercise and cognitive behavioural intervention. Currently available antiobesity drugs result in only modest weight loss, however it is still accompanied by reduction of cardiometabolic health risks. In the past several antiobesity drugs were removed from the market because of serious adverse effects (psychostimulatory, cardiovascular, pulmonary hypertension, valvular disease, depression, addiction etc.). ⋯ However, previous experiences that antiobesity drug combinations (e.g. fenfluramine/phentermine) may also potentiate adverse events should be carefully considered in the evaluation of recently tested compounds. Administration of physiological doses of gut hormones - derived appetite regulating agents seems to be a promising, efficient, specific and thus, low side-effect approach in the treatment of obesity. To confirm the strong role of antiobesity drugs in the treatment of obesity and its complications further long-term studies evaluating their effect on morbidity and mortality end points in appropriate target populations are needed.
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Casopís lékar̆ů c̆eských · Jan 2010
[Means of early diagnostics and subsequent care for critically ill patient].
The delayed identification of an unstable patient may lead to the delayed management or the delayed transfer of the patient to the Intensive care unit and this can be related to the increase in the risk of death. ⋯ The introducing of the specialized teams as Medical emergency team or more complex Intensive care unit outreach service is related to the increased chance of unstable patient to meet earlier medical support specialized in intensive care. The above mentioned specialized teams may--according to some data--reduce the hospital mortality, incidence of cardiorespiratory arrest as well as the incidence of the unplanned Intensive care unit admissions.
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Casopís lékar̆ů c̆eských · Jan 2010
[Alterations in fatty acid composition of plasma and erythrocyte lipids in critically ill patients during sepsis].
The overall fatty acid (FA) composition, and especially proportions of n-6 and n-3 polyunsaturated fatty acids in plasma and membrane lipids, greatly impacts on cell and organ functions as well as on many biological processes. ⋯ This effect of sepsis was significantly greater in cholesteryl esters and plasma phospholipids of non-surviving septic patients than in surviving ones. Moreover, non-survivors had lower proportions of n-3 polyunsaturated fatty acids in plasma phospholipids compared to survivors. The significant decrease in proportion of polyunsaturated fatty acids in lipids of septic patients in the course of sepsis reflects the severity of their critical state and supports the importance of appropriate nutritional polyunsaturated fatty acids supplementation.