Casopís lékar̆ů c̆eských
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Casopís lékar̆ů c̆eských · Jan 2011
Biography Historical Article[Nobel Prize laureates. Robert William Holley (1922-1993)].
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Casopís lékar̆ů c̆eských · Jan 2011
Review[Hyperglycemia and its control in the critically ill patient].
In the critically ill patient, hyperglycemia was believed to be a response by the body to a stressful situation. Stress-induced hyperglycemia is the consequence of increased levels of cortisol, cytokines, growth hormones, catecholamines, and glucagon resulting in the stimulation of endogenous glucose production through glycogenolysis and gluconeogenesis as well as other mechanisms including central and peripheral insulin resistance. Among other things, hyperglycemia has an effect on inflammation and function of the myocardium, kidney, central nervous system, and the immune system. ⋯ The large multicenter NICE-SUGAR study in 6,022 patients showed higher 90-day mortality in the group with tight glycemic control. The results of NICE-SUGAR led to revision of the guidelines for glycemic control in the critically, recommending to control glycemia below 10 mmol/l. The aim of this overview is to summarize available data on glycemic control in the critically ill patient.
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Casopís lékar̆ů c̆eských · Jan 2011
Case Reports[Problems with placement and using of automated external defibrillators in Czech Republic].
The use of automated external defibrillators improves the survival of adults who suffer from cardiopulmonary arrest. Automated external defibrillators detect ventricular fibrillation with almost perfect sensitivity and specificity. Authors describe the use of automated external defibrillator during cardiopulmonary resuscitation in a patient with sudden cardiac arrest during ice-hockey match. The article reports also the use of automated external defibrillators in children.
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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.