Search

Background. To examine the latest guidelines for the diagnostics and treatment of acute diverticulitis and to formulate recommendations for the diagnostics and management of acute diverticulitis based on them. Research material and methods. A selection of the latest guidelines for the diagnostics and treatment of acute diverticulitis in the PubMed medical database in English and German, during 2012–2024 period, was performed based on the requirements criteria of the PRISMA literature review and the PICO data selection me thod. Key words used in the search: “acute”, “diverticulitis”, “guidelines”, “diverticulosis”, “diagnostics”, “treatment”. Results. Although different guidelines disagree on the order of UG and CT with intravenous contrast, 6/6 guidelines agree on UG and 7/7 on the appropriateness of CT with contrast in the diagnostics of acute diverticulitis. 7/8 guidelines agree that routine antibiotic therapy is unwarranted in the treatment of uncomplicated diverticulitis. 6/6 guideline authors agree on the treatment of small abscesses with antibiotic therapy, and 7/7 on the treatment of large abscesses with antibiotic therapy and drainage. 5/7 guidelines support Hinchey III antibiotic therapy and primary anastomosis treatment with/without preventive ileostomy. Hinchey IV recommendations for tactics in the treatment of acute diverticulitis are distinguished. Planned surgery after a complicated episode of diverticulitis is routinely recommended by 3/7 guidelines, 2/7 guidelines – when strictures or fistulas are formed, 2/7 – the decision should be made based on the patient’s condition. Most guidelines do not recommend conservative secondary prophylaxis after an acute episode of diverticulitis. Conclusions. UG and CT with intravenous contrast are the methods of first choice for the diagnostics of acute diverticulitis. In case of uncomplicated diverticulitis, routine antibiotic therapy is not recommended, drainage is used only for large abscesses, and antibiotics for both small and large abscesses. Primary anastomosis with/without preventive ileostomy is preferred for Hinchey III acute diverticulitis. Recommendations for the treatment tactics of Hinchey stage IV AD differ in the literature. [ABSTRACT FROM AUTHOR]

Copyright of Medicina Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Hypertrophic cardiomyopathy (HCM) is a heterogeneous disease with variable phenotypic expression. There has been a significant advancement in the diagnosis, treatment and influencing of the prognosis of patients in recent years. Aim: To describe the characteristics of the patients with sarcomeric hypertrophic cardiomyopathy hospitalized in a tertiary care centre and to evaluate diagnostic and therapeutic interventions in this group of patients. Patients and methods: We retrospectively analyzed data from the Hospital Information System from January 1, 2013 to April 27, 2023. The study included 213 patients who met the criteria for the definition of hypertrophic cardiomyopathy. There were 145 (68.1%) patients with the obstructive form (HOCM) and 68 (31.9%) patients without obstruction. Results: The median age was 55 years (IQR 43-64), with a gender distribution of 108/105 (male/ female). There were a total of 184 patients (86.4%) in the NYHA functional class II-IV. Cardiac magnetic resonance was performed in almost 30% of all patients. The percentage of patients who underwent genetic analysis was 15%. Betablockers were the most frequently indicated drug group (63.8% in total). Septal reduction therapies were performed in 8.5% of patients. Heart transplantation was performed in 15 patients (7%), dominantly in the non-obstructive group (17.6 vs 2.1%, p <.0001). We observed worse survival rate in the non-obstructive versus obstructive group (p=0.04). Conclusion: Based on this analysis, specialized care is required almost exclusively in symptomatic patients, despite the fact that most patients with HCM are asymptomatic and the disease is associated with a risk of sudden cardiac death. The availability/implementation of cardiac magnetic resonance, as well as genetic examination and counseling does not correspond to current recommendations. Patients with a non-obstructive form of HCM had a worse prognosis. Examinations focused on the presence of a specific myocardial hypertrophy etiology is not a standard diagnostic process. Availability of septal reduction therapy is good. [ABSTRACT FROM AUTHOR]

Copyright of Urologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Dermatologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Celiac disease (CD) is a gastrointestinal disorder caused by the immune system’s response to gluten, involving both innate and adaptive immune reactions. It leads to various neurological issues, such as gluten ataxia, gluten neuropathy, epilepsy, and gluten encephalopathy. Although neurological presentations are rare in children, they are observed in up to 36% of adult patients with CD. Recent evidence suggests that these manifestations may be linked to gluten-related mechanisms, including antibody cross-reactions, immune-complex deposition, direct neurotoxicity, and, in severe cases, vitamin or nutrient deficiencies. However, there is still no consensus on whether serological, neurophysiological, or neuroimaging findings can effectively diagnose and monitor CD-associated neurological problems at an early stage. The identification of multimodal biomarkers and suitable neuroimaging tools could aid in the diagnosis, monitoring, and enhancement of the quality of life for individuals with neuroceliac disease. Nonetheless, it is essential to provide appropriate treatment to those with CD and neurological symptoms, as prolonged suffering may lead to irreversible disability. The primary treatment for neurological manifestations of gluten-related disorders is a strict gluten-free diet, although a small number of patients may require additional immunosuppressive therapy, typically using mycophenolate or intravenous immunoglobulins. In this literature review, our aim was to explore the relevant neurological disorders associated with CD, early diagnostic and treatment options to prevent related disability in affected patients. Clinicians should consider CD as a potential cause in individuals presenting with unexplained neurological dysfunction. [ABSTRACT FROM AUTHOR]

Copyright of Onkologija is the property of Institute of Oncology Ljubljana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cancer is a major risk factor for venous thromboembolism (VTE). The incidence of cancer-associated thrombosis (CAT) in cancer patients is increasing due to improved antitumor treatment options and the prolongation of patients’ lives. It constitutes up to 25% of all VTE cases. CAT causes higher morbidity and mortality, as well as a deterioration in the quality of life. Daily subcutaneous low-molecular-weight heparin (LMWH) has been the standard treatment for CAT for years. Data on the safety and efficacy of direct oral anticoagulants (DOACs) in this population have emerged in recent years and have been included in recent international guidelines. For the acute-phase treatment, the anti-Xa inhibitors (apixaban, edoxaban, rivaroxaban) showed better efficacy than LMWH in preventing VTE recurrence; however, rivaroxaban and edoxaban were also associated with an increased risk of bleeding events. Recent guidelines recommend DOACs for the treatment of CAT in selected cancer patients (eg, low bleeding risk, no luminal gastrointestinal or genitourinary malignancies, no interfering medications). [ABSTRACT FROM AUTHOR]

Primary hyperaldosteronism (PH), i.e. Conn syndrome, is considered the most common cause of endocrine hypertension with the prevalence of 5-10% in the general population of hypertensive subjects and 20-30% in patients with resistant and severe hypertension. Therefore its systematic screening among hypertonics is very important. Screening of PH should be a part of differential diagnosis in selected groups of hypertonics, especially those with resistant or severe diastolic hypertension. Because long term aldosterone overproduction may cause severe organ complications such as cardiovascular and cerebrovascular events and renal impairment, it is necessary to recognize and to treat this syndrome very early. This review is focused on clinical management of patients with PH based on current guidelines. [ABSTRACT FROM AUTHOR]

Renal colic is the most common non obstetric cause of hospital admission in pregnancy. Ideal managementof urinary stones which ensure the good condition of the mother and fetus is a challenge to urologists and gynecologists. There are several anatomical and functional changes in the urogenital tract of pregnant women, which lead to calculi formation. The most common symptom of ureteral stone is flank pain with microscopic or macroscopic hematuria. Inonizing imaging modalities should be avoided if is possible in pregnant women. Ultrasound is the first line imaging of choice. It is non invasive, low cost and generally available. Upper urinary tract dilatation can be reliably detected with ultrasound. MRI can be used to detect ureteral stones not seen on ultrasound. When MRI is not available, low dose CT seems to be safe option, but only as last resort when imaging before endoscopic intevention is required by the treating urologist. Conservative managment, with observation and waiting for spontaneous passage is the preferred first line option for ureteral stones in pregnancy. In refractory renal colic, or if febrile UTI develops with stone obstruction, urological intervention (with or without stone treatment) and stent insertion is required. [ABSTRACT FROM AUTHOR]

Copyright of Dermatologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Folia Pharmaceutica Cassoviensia is the property of University of Veterinary Medicine & Pharmacy in Kosice and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Neurologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Dermatologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Dermatologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Neurologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The authors provide an overview of the current terminology and etiopathology of allergic inflammation and current options for the diagnosis and treatment of allergic diseases with a focus on practical activities in the outpatient clinics of general practitioners and specialists in other fields who come into contact with allergic patients. From pharmacotherapy are high‑ lighted antihistamines – the most frequently prescribed drugs in allergology and biological treatment – as the latest ap‑ proach to the treatment of allergic inflammation. [ABSTRACT FROM AUTHOR]

Copyright of Psychiatrie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Praktické Lékárenství is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Dermatologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Laryngocele is a cystic dilatation of laryngeal ventricle which communicates with laryngeal lumen. The disease is rare, often asymptomatic and benign. It can also manifest as an acute obstruction of the respiratory tract with the necessity of an urgent tracheostomy. We can divide laryngoceles into internal and mixed. The old classification of laryngoceles into internal, external, and mixed is incorrect, because the existence of an external laryngocele is anatomically impossible. Diagnostics is difficult and symptoms are usually non-specific. Patients are often treated for different diseases of the larynx and a proper diagnosis is assigned only in the operation theatre. In this publication, we focus on the latest trends in the diagnostics and treatment of laryngoceles. We also present the treatment results of patients with laryngocele at our hospital. [ABSTRACT FROM AUTHOR]

Copyright of Urologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by progressive airway obstruction and an accelerated decline in lung function. Well-timed and correct diagnosis is crucial for treatment. Pharmacological and non-pharmacological procedures are used in the treatment of COPD. The pillar of pharmacotherapy is mainly inhalation bronchodilator treatment. In addition, inhaled corticosteroids (ICS) are indicated in patients with frequent exacerbations (GOLD D category) and in patients with COPD and asthma overlap (ACO). Most cases of COPD can be prevented by reducing exposure to risk factors. This is mainly about smoking cigarettes and improving the quality of indoor and outdoor air. While treatment can now slow the worsening of the disease, cure is not yet possible. In advanced COPD, long-term oxygen or pulmonary transplantation is indicated. Sometimes, all that remains is a symptomatic therapy terminal stage COPD. Today, the main emphasis is on individualization of therapy with respect to the patient's specific phenotype, presence of exacerbations and comorbidities. [ABSTRACT FROM AUTHOR]

Copyright of Onkologija is the property of Institute of Oncology Ljubljana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Neurologie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cough is the most common nonspecific symptom of respiratory disease in the general practitioner's office. Cough is not a disease in itself, but only a manifestation of upper and lower respiratory tract diseases, which try to keep the airways free. Chronic cough exacerbates the quality of life not only of the child but also of adults. In pathophysiology, immune, neurosecretory and biochemical processes combine with morphological damage to the bronchial mucosa and respiratory disorders. The differential diagnosis of the causes of pathological cough is often not simple, and a multidisciplinary approach is needed. [ABSTRACT FROM AUTHOR]

Neuroendocrine tumors are rare tumors with different oncological potential, prognosis, and varied symptomatology. They are most often detected in the gastrointes- tinal tract and in the lungs. Authors present 2 patients with neuroendocrine carcinoma of the larynx who were treated at the Department of Otorhinolaryngology, FD Roosevelt Faculty Hospital, Banska Bystrica, Slovakia. Management of patients with this rare disease is discussed. [ABSTRACT FROM AUTHOR]

This article reviews the clinical presentation, diagnostic evaluation, risk stratification, and treatment of acute pericarditis. [ABSTRACT FROM AUTHOR]

Copyright of Interní Medicína pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Infectious encephalitis in immunosuppressed patients is a common and urgent condition that requires rapid diagnosis and early treatment. The disease can lead to severe neurological deficit and eventually result in the death of the patient. Usually infectious encephalitis presents with fever, headache, focal neurological deficits, and altered state of consciousness. Immunosuppressed patients pose a great differential diagnostic challenge since clinical symptoms, laboratory findings, and imaging tests are often attenuated and may imitate stroke or other non-infectious diseases. Therefore, infectious meningoencephalitis should be suspected in all immunosuppressed patients with acute focal neurological symptoms, even in the absence of fever and meningeal signs. Accordingly, physician should thoroughly evaluate patient's history, perform detailed physical examination, and carefully interpret test results. Early diagnosis and initiation of appropriate treatment of bacterial meningoencephalitis correlates with better prognosis for the patient. This article describes an atypical clinical case of a bacterial meningoencephalitis with stroke-like symptoms in a patient with multiple myeloma. In addition, the article reviews clinical presentation, diagnostic and treatment recommendations of infectious encephalitis in immunosuppressed patients. [ABSTRACT FROM AUTHOR]

Leber heredttary optic neuropathy (LHON) is one of the most common inherited mitochondrial optic neuropathies, caused by mitochondrial DNA mutations. Three most common mutations, namely m.11778G>A, m.14484T>G, and m.3460G>A, account for the majority of LHON cases. These mutations lead to mitochondrial respiratory chain complex I damage. Typically, LHON presents at the age of 15-35 years, with male predommance. LHON is associated with severe, subacute, and painless bilateral vision loss and accounts for one of the most common causes of legal blindness in young individuals. Spontanious visual acuity recovery has been reported in patients harbouring m.14484T>C mutation, however, this inherited optic neuropathy results in irrevers ible vi sion loss. Up to date LHON treatment is limited. Idebenone has been approved by EMA to treat LHON. However, better understanding of disease mechanisms and ongoing treatment trials are promissing and brings hope for patients. In this article we summarise clinical presentation, diagnostic features, and treatment of LHON. [ABSTRACT FROM AUTHOR]

Anorexia nervosa has a negative impact on the physical and psychosocial development of children and adolescents. Although it occurs most often during adolescence, however, the increasing incidence of disorder at an early age highlights the need to study an early-onset group. Developmental approach should be applied both in the diagnostics and the effective treatment. The authors deal with mental anorexia with early onset and the message is illustrated by case reports. [ABSTRACT FROM AUTHOR]

Chronic lymphocytic leukaemia has a remarkably heterogeneous clinical course. The diagnostic procedures and therapeutic interventions need to be individually tailored according to patient age, comorbidities and therapeutic aims. There have been crucial developments in prognostication and therapy in recent years (e.g., significance of TP53 mutations, introduction of novel monoclonal antibodies, B-cell receptor signalling and Bcl-2 inhibitors). Therefore, the Czech CLL Study Group, the working group of the Czech Haematological Society, has developed these updated guidelines to facilitate the decision-making process for diagnosis and treatment in clinical practice. The guidelines are based on a comprehensive analysis of current literature and the principles of evidence-based medicine. [ABSTRACT FROM AUTHOR]

Introduction: Endometriosis is one of the most common gynaecological diseases amongst women in reproductive age. The main clinical manifestations include pain and infertility, which can subsequently adversely affect the physical, mental and emotional well being and the overall quality of life of the woman. The aim of the presented review is to summarize the current knowledge about endometriosis with focus on epidemiology, risk factors, aetiology, diagnostics, classification, treatment and the effect on fertility and quality of life of women. Methodology: For a non-systematic literature review, the search was performed based on predefined keywords. The individual keywords were combined using Boolean operators. Foreign and Czech sources in the PubMed, EBSCO, UpToDate and Medvik databases were used. The search was not given a strict time limit and language limit. However, we focused mainly on articles from 2008 to December 2017 in English and Czech. Women with endometriosis was the only inclusion criterion. Results: A total of 55 sources were used to generate results, 2 of which are systematic reviews (10, 36), 3 guidelines (29, 32, 54), 7 prospective cohort studies (2, 4, 37, 38, 46, 53), 6 case studies and controls (3, 7, 11, 14, 34, 52), 7 cross-sectional studies (9, 13, 25, 39, 41, 47, 49), 18 references (8, 12, 15, 16, 17, 20, 22, 23, 24, 26, 33, 34, 40, 49, 51, 55), 4 series of case studies (18, 19, 44, 48) (grounded theory) (27) and 6 books (6, 21, 30, 31, 43, 45). Conclusion: Endometriosis is a common gynaecological disorder affecting women in reproductive age. It largely involves infertility and at the same time it affects women's psychological health and quality of life in many areas. Patients should be treated individually according to the prevailing symptoms. It is recommended that patients be sent to treatment centres, which offer more advanced care for endometriosis. At present, none of the therapy options at hand guarantees a full cure and recurrence of the disease is still high. [ABSTRACT FROM AUTHOR]

Patients with amyotrophic lateral sclerosis (ALS) go to specialized neuromuscular centres during the advanced stages, when severe multiple muscle atrophies, dysphagia and respiratory insuffi ciency are present. Its insidious onset is the main reason. Various factors may play a role - caused either by physicians (wrong dia gnostic approaches, obscure electromyography fi ndings, wrong interpretation, etc.), or by patients (delayed decision to seek medical consultation). The aim of our study was to identify certain factors aff ecting the time from ALS symptom onset to its dia gnosis [ABSTRACT FROM AUTHOR]

Infective endocarditis (IE) remains a serious illness. The incidence is rising slowly, the mortality has not improved and approaches 30%. The main characteristics of the disease have changed significantly. The patients are older, frailer, and with increasing comorbidities. The proportion of health care associated with IE has been increasing, too. Staphylococci have become the predominant causative organisms, particularly Staphylococcus aureus. Blood cultures and echocardiography are still the cornerstones in the diagnosis of IE. Especially in patients with suspected prosthetic valve endocarditis and cardiac device infections additional methods have proved to be useful (cardiac CT, nuclear imaging). In blood culture-negative cases some of the serological assays are recommended. Molecular methods (polymerase chain reaction /PCR/) may be beneficial particularly in valvular biopsies. Longterm antibiotic treatment is the mainstay of IE treatment; nevertheless, surgery is indicated in approximately half of the cases. Unfortunately, there is a lack of evidence-based data and many questions remain to be resolved (antibiotic protocols, duration of treatment, switch to oral antibiotics, outpatient parenteral antibiotic therapy, timing of surgery). Because of the complexity of IE, a multidisciplinary approach can improve the prognosis of IE patients. [ABSTRACT FROM AUTHOR]

Disseminated intravascular coagulation is a severe complication of vide a spectrum of different pathologic statements, which is goes with high degree of morbidity and mortality. The authors summarize recent knowledge in pathophysiology, diagnosis and differential diagnosis at these statements and bring some options in treatment strategy. [ABSTRACT FROM AUTHOR]

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We describe a rare case of a woman, in whom dis section of both carotides, as well as both vertebral arteries occur red in the period between 2005 and 2015 (for the fi rst time at the age of 32 years). Occlusive dis section developed in all occasions except the right internal carotid artery that was treated with angioplasty and stenting. In spite of this, the patient developed no cerebral lesion and neurological defi cit remained limited to the left-side Horner syndrome due to a damage of the cervical sympathetic trunk. Digital subtraction angiography revealed alternat ing segments of stenoses and aneurysmal dilatation of arteries, i.e. changes typical for fi bromuscular dysplasia. Aff ection of neither renal, nor coronary bloodstream was proven in the patient. The case report demonstrates well the wide variability of clinical manifestations of cervical artery dis sections. [ABSTRACT FROM AUTHOR]

Idiopathic bowel diseases (IBD) comprise chronic inflammatory conditions affecting the alimentary tract, and include Crohn's disease, and ulcerative colitis. Current trends in IBD diagnostics are represented by objective and regular inflammatory activity monitoring with fecal markers and ultrasonography being the preferred non‑invasive methods. However, in the key moments during the disease management the endoscopic investigation - mainly colonoscopy due to the disease localisation - is still considered irreplaceable. Regarding the radiological methods MRI is being more and more preferred technique compared to computed tomography due to the lack of radiation burden. Treatment of comlicated IBD cases still represents a big challenge. It seems that a group of patients at risk of aggresive disease course may benefit from earlier commencement of immunosuppressive, and biological treatment. When considering appropriate therapy, it is necessary to take into account not only the current disease activity as before, but also its history, and preexisting irreversible alimentary tract changes. The introduction of novel biological agents with difrerent mechanism of action, and more favorable safety profile compared to established TNF‑α blockers vedolizumab, and ustekinumab, is considered the biggest step forward in the conservative management of complicated IBD forms. [ABSTRACT FROM AUTHOR]

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Reactive arthritis (ReA) is an arthritis of the spondyloarthritis group, which develops following an infection of the gastrointestinal or urogenital tract caused by specific bacterial pathogens. Diagnosis of ReA is based on the clinical picture of oligoarthritis of large joints, especially the lower limbs, the exclusion of other possible differential diagnosis options and evidence of infection. In the treatment of ReA, nonsteroidal anti-rheumatic drugs are used in first line, whereas in refractory cases glucocorticoids and disease modifying anti-rheumatic drugs are administered. The results of studies and meta-analyses of ATB treatment in ReA appear to be rather ambiguous in the case of chlamydia-induced ReA and negative for ReA associated with enterobacterial infection. The prognosis of ReA is favorable in a large proportion of patients. In some patients the disease course may be prolonged and signs characteristic of other diseases of the spondyloarthritis group may develop. [ABSTRACT FROM AUTHOR]

Pulmonary embolism (PE) is the leading cause of maternal mortality in the developed world. During gravidity the incidence of deep vein thrombosis (DVT) is five to seven times higher and can be increased by other risk factors. Despite concerns for foetal teratogenicity and oncogenicity and maternal risks associated with diagnostic testing, and potential adverse effects of pharmacological treatment, an accurate diagnosis of pulmonary embolism and a timely therapeutic intervention are crucial. Compression ultrasonography is a non-invasive test with high sensitivity for the diagnosis of symptomatic deep vein thrombosis. For the diagnosis of pulmonary embolism, D-Dimer testing has only limited diagnostic value in gravidity. V/Q scans are generally preferred because of lower radiation dose to the mother, on the other hand, CT pulmonary angiography is the first-line test to detect PE in the haemodynamically unstable pregnant women. Low-molecular-weight heparin is currently the therapy of choice for venous thromboembolism. Thrombolysis is reserved for massive life-threatening pulmonary embolism with haemodynamic compromise. The peripartum management of pulmonary embolism in pregnant women is always a great challenge for the multidisciplinary team. When venous thromboembolism (VTE) is diagnosed near term, consideration should be given to the placement of a retrievable inferior vena cava (IVC) filter. Reversal of anticoagulation without IVC filter protection is strongly discouraged in the 2-week period after VTE diagnosis. If the therapy of pulmonary embolism is started earlier, planned delivery with induction of labour or Caesarean Section at term with short-term discontinuation of low-molecular-weight heparin minimizes the risk of bleeding and permits neuroaxial anaesthesia / analgesia. [ABSTRACT FROM AUTHOR]

Nocturnal enuresis (NE) is a common condition in childhood. Aim of this article is to present a practical and rational approach to diagnosis and management NE in primary and secondary pediatric care. This approach is connected by higher efficacy and is based on consensual guidelines of the International Children's Continence Society (ICCS), the authors´ own clinical experiences and their mutual discussion. Enuresis can be on the basis of anamnestic and physical examination divided into monosymptomatic and non-monosymptomatic forms. In the monosymptomatic form, additional evaluation of functional bladder capacity and amount of nocturnal dieresis provide important information for rational selection of evidence based treatment modalities (enuretic alarm versus desmopressin). Non-monosymptomatic enuresis in children is usually connected with bladder dysfunction, in these cases it is suggested to start treatment of nocturnal enuresis only after the daytime complaints were solved. Analysis of non-monosymptomatic enuresis is not a topic of this article, diagnosis and treatment in these patients is in the competence of specialized enuretic centers. [ABSTRACT FROM AUTHOR]