© Borgis - Postępy Nauk Medycznych 5/2009, s. 395-396
Department of Family Medicine and Internal Diseases is one of the clinics at the Medical Center of Postgraduate Education (CMKP) which is providing education courses in internal medicine for specializing doctor as specialists of family medicine. Three years ago, specialists working in this Department began to organize continuous education programs in the field of internal diseases for family physicians and other physicians who work in grand outpatient clinics. They are the authors of the articles presented in „Postępy Nauk Medycznych” (journal under the patronage of CMKP).
In the current issue of the journal you will find nine articles on various topics related to general practice – there are some articles that provide you with basic information, some which are more advances as well as some commentaries.
The article by Orzechowski and Wąsowski deals with the issue of heart failure treatment. The overall prevalence of heart failure (HF) is increasing because of the ageing of the population, the success of prolonging survival in patient with coronary events and the effectiveness of the primary and secondary prevention. Family physicians play a substantial role in medical care of patients with HF. The aim of this article is to provide guidelines for the non- pharmacological and pharmacological management as well as recommendations for use of devices such as cardiac resynchronization therapy (CRT) and implantable cardioverter – defibrillator (ICD) based on European Society of Cardiology guidelines and current references.
The article by Puchalska-Krotki and Marcinowska-Suchowierska deals with pharmacotherapy of stable angina pectoris which has a fundamental significance in modification of atherosclerosis and atherosclerotic plaques development. Under the influence of the medical treatment atherosclerosis does not develop or it even recedes. As myocardial infractions and deaths are prevented, the prognoses for patients improve. The pharmacotherapy improves the patients´ quality of life by eliminating anginal pains, reducing their frequency and the severity of the symptoms. Changing of the lifestyle matters here greatly.
The article by Jasik and Marcinowska-Suchowierska presents provides up-to-date information on the etiology, diagnosis and methods for treatment of chronic obturative pulmonary disease (COPD). The basic method of treatment of COPD exacerbations is the use of inhaled bronchodilators and corticoids. The antibiotics should be used in some cases of exacerbations, but not routinely. One of the important points in acute exacerbation of COPD is treatment of co- morbidities especially cardiovascular disease.
The article by Kapitan-Malinowska and Bogołowska-Stieblich concerning deep vein thrombosis (DVT) and its most severe complication, pulmonary embolism presents one of the most serious problems of modern medicine. The evaluation of probability of pulmonary embolism is a very serious problem. A very important thing is to perform fast diagnosis using lab tests and imaging exams and start immediate treatment. Most of the patients must be treated in hospital, conservatively same times invasive techniques such as embolectomy or percutaneous thrombus removal. In early stages of treatment the thrombolysis or heparins (UFH or LMWH) are used. In treatment continuation or prophylaxis oral anticoagulants or LMWH are applied. The lasting of secondary prophylaxis depends on the presence of reversal factors of DVT. Removal of these factors allows prophylaxis to be shortened to three months.
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