Casopís lékar̆ů c̆eských
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Casopís lékar̆ů c̆eských · Jan 2008
[Experience with early enteral nutrition application in critically ill patients in medical intensive care unit].
Early enteral nutrition is recommended in patients with critical illness. Generally implementing of nutritional support algorithm is advised. The aim of study was evaluation of early enteral nutrition application in critically ill patients in medical intensive care unit. ⋯ Early enteral nutrition applied according to protocol was given succesfully to the substantial number of the critical patients. In 18% of the patients enteral nutrition had to be replaced for parenteral one due to complications. The caloric intake 25-30 calories/kg was reached in 60% of patients.
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Casopís lékar̆ů c̆eských · Jan 2008
Historical Article[Rationality and irrationality in the medicine and in the life].
The spiritual life of man has a rational and irrational component. Both have positive as well as negative effects and under normal circumstances they are well balanced. In medicine rationality is an essential feature of the medical science and the basis of medical practice but it is not sufficient for fulfilling all curative needs. In the practice, gaps in knowledge must be complemented by empiricism and empathy which originate in the personality of the physician.
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Casopís lékar̆ů c̆eských · Jan 2008
[Decrease of the prevalence of Helicobacter pylori infection in the Czech Republic].
Helicobacter pylori (Hp) is the most common chronic bacterial infection in humans. Hp has been demonstrated worldwide and in individuals of all ages. ⋯ This decrease can be explained mostly by the relatively favourable and improving socioeconomic conditions after the fall of communist regime. However, it is necessary to consider also the fundamental determinants of "modern times" that could cause gradual disappearing of Hp from the human "microbiome".
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Casopís lékar̆ů c̆eských · Jan 2007
Review[Obesity based on mutation of genes involved in energy balance].
Within the last decade an intensive research led to an identification of several genes which are involved in a regulation of energy balance. In most cases, carriers of these gene mutations do not exhibit further characteristic phenotypic features except for a severe obesity. Obesity based on mutation of one gene product is called monogenic obesity. ⋯ Mutations of the other genes involved in energy homeostasis are very rare. Although these mutations are sporadic we assume that further research of monogenic forms of obesity might lead to our understanding of physiology and pathophysiology of regulation of the energy homeostasis and eating behaviour. Additionally, they may open new approach to the management of eating behaviour and to the treatment of obesity.
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Sepsis represents an important infectious process with systemic manifestation. The incidence of sepsis is continuously increasing. This epidemiologic trend reflects the aging population, increasing number of chronically ill patients and invasiveness of the modern medicine. ⋯ As an example is a failure of clinical study with monoclonal antibody against TNF-a. Thus, the search for new clinically effective therapeutic agents is aimed at pathogenetic mechanisms activated in longer time frame after the primary insult. Currently, out of drugs modulating the already known immunopathophysiological mechanisms of sepsis corticosteroids and activated protein C are used.