Spironolactone as the first-line treatment for HFrEFPharmacotherapy currently

prof. MUDr. Jiří Vítovec, CSc., FESC

Med. praxi. 2026;23(2):128-130 | DOI: 10.36290/med.2026.010

Heart failure with reduced ejection fraction (HFrEF) is a highly prevalent and prognostically serious disease. Modern treatment is based on the concept of four pillars (ARNI/ACEI/ARB, beta-blocker, MRA, SGLT2 inhibitor). Spironolactone, as a mineralocorticoid receptor antagonist (MRA), has a solid position thanks to robust clinical evidence. The article summarizes its mechanism of action, clinical indications, principles of safe use, and a practical algorithm for initiating treatment.

Biological therapy for migraineInterdisciplinary overviews

MUDr. Petr Polidar

Med. praxi. 2026;23(2):122-127 | DOI: 10.36290/med.2026.002

Migraine is a highly prevalent neurological disorder with substantial impact on quality of life and significant economic consequences. Its pathophysiology involves dysfunction of brainstem structures and activation of neurobiological processes responsible for the clinical manifestation of the disease. Key neuromediators - particularly CGRP - represent major therapeutic targets and form the basis of biological treatment strategies. Conventional therapy is divided into two main approaches: acute and preventive treatment. However, its effectiveness and tolerability are often limited. The central portion of the article focuses on biological therapy - monoclonal...

Current indications for testing for inheritedInterdisciplinary overviews

prof. MUDr. Petr Dulíček, Ph.D.

Med. praxi. 2026;23(2):118-121 | DOI: 10.36290/med.2026.007

Venous thromboembolism is a multifactorial disease. Inherited thrombophilia is one of the causes resulting in increased risk of VTE and we have known about them for more than 60 years. Through a robust thrombophilia work-up at the end of millennium, the criteria for testing have significantly decreased in following years. It is associated with increased amount of robust data about clinical consequences of testing in the term of change patients´ management. In our text, we discuss current recommendations.

Management of gastroesophageal reflux disease - up to dateInterdisciplinary overviews

MUDr. Lucie Zdrhová, MUDr. Karel Balihar, Ph.D.

Med. praxi. 2026;23(2):112-117 | DOI: 10.36290/med.2026.013

Gastroesophageal reflux disease (GERD) is one of the most common diseases encountered by both primary care physicians and gastroenterologists in their specialized outpatient clinics. Reflux symptoms such as heartburn, regurgitation, or chest pain may indicate not only true reflux disease, but also extra-esophageal diseases, including disorders of impaired autonomic nervous system balance. The management of patients with reflux symptoms has changed significantly in recent years, mainly due to the increased use of diagnostic methods such as 24-hour pH metry with impedance, wireless esophageal pH metry, and high-resolution esophageal manometry. These...

Na cestě za ideálním tlakemCongress News

MUDr. Zuzana Zafarová

Med. praxi. 2026;23(2):106-111

Primary prevention of frailty syndromeReview articles

PhDr. Iveta Ondriová, PhD.

Med. praxi. 2026;23(2):101-105 | DOI: 10.36290/med.2026.001

Frailty syndrome is a complex geriatric syndrome characterized by a significant loss of functional reserves, compensatory and adaptive mechanisms and increased vulnerability to external or internal stressors. Frailty syndrome in the narrow sense primarily includes significant and unintentional weight loss, reduction of muscle mass, which is associated with slowed gait, feeling of fatigue or faster fatigue, cognitive functions are also impaired, depression, loss of motivation, sleep disorders occur. The condition is accentuated by sensory disorders. Frailty is the most problematic manifestation of population aging.

Why vitamin D remains a clinically relevant topicReview articles

prof. MUDr. Ondřej Topolčan, Ph.D., Mgr. Bc. Martina Peštová, MUDr. Michal Jirásko

Med. praxi. 2026;23(2):95-100 | DOI: 10.36290/med.2026.012

Vitamin D has traditionally been associated with skeletal health; however, current knowledge indicates that its biological role extends beyond calcium-phosphate metabolism. The active form, 1,25(OH)₂D, acts through the vitamin D receptor expressed in numerous tissues and may be involved in the regulation of immune functions, inflammatory responses, cardiovascular homeostasis, cellular proliferation, and other extraskeletal processes. At the same time, vitamin D deficiency remains highly prevalent, especially in regions with limited seasonal cutaneous synthesis. The clinical relevance of vitamin D therefore lies not only in its pleiotropic biological...

Early detection of lung cancer in the Czech Republic -new hope for potential patientsReview articles

prof. MUDr. Miloš Pešek, CSc.

Med. praxi. 2026;23(2):90-93 | DOI: 10.36290/med.2025.073

The author provides a brief overview of clinical trials focused on detecting early-stage lung cancer and screening programs that have already been conducted or are currently underway around the world. In the Czech Republic, this program was launched at the beginning of 2022, and initial findings indicate its value in detecting early-stage lung cancers and thereby increasing patients' chances of successful curative treatment. A key role is played here by the collaboration between general practitioners, pulmonologists, radiologists, and, last but not least, centers providing highly specialized pulmonary oncology care.

Travel medicine in general practiceReview articles

doc. MUDr. Rastislav Maďar, Ph.D., MBA

Med. praxi. 2026;23(2):82-84 | DOI: 10.36290/med.2026.016  

Travel medicine is an interdisciplinary field focused on the prevention, diagnosis, and treatment of health complications associated with travel. International travel entails a range of health risks that can largely be minimized through appropriate prevention. The general practitioner plays a key role in this system, as they are often the first healthcare professional a traveler consults. In addition to providing basic advice, the GP can also arrange vaccination, prophylaxis against certain infections, and identification of risk factors. A general practitioner should be able to take a basic travel history, identify destination-specific risks, recommend...

Cítím s tebou aneb úvaha o empatiiEditorial

MUDr. Radkin Honzák, CSc.

Med. praxi. 2026;23(1):3

An unusual cause of hypercalcemia from an endocrinologist's perspectiveCase reports

MUDr. Lucie Lysková, MUDr. Daniela Číhalíková, prof. MUDr. David Karásek, Ph.D., prof. MUDr. Jaroslav Michálek, Ph.D.

Med. praxi. 2026;23(1):68-71

Calcium is an essential element that plays a crucial role in bone mineralization, neuromuscular transmission, and is involved in many cellular signaling processes. Its serum concentration (total albumin-corrected concentration) should range between 2.15 and 2.55 mmol/L and is strictly regulated by several mechanisms. Hypercalcemia is defined as an elevated level of serum calcium above 2.55 mmol/L. It has various causes, ranging from parathyroid gland dysfunction, most commonly in the form of primary hyperparathyroidism, through granulomatous diseases, to serious malignancies with skeletal invasion or paraneoplastic syndromes, such as ectopic production...

Farmakologické ovlivnění nežádoucích účinků GLP-1 agonistů v horní části GITHeard at a congress

MUDr. Zuzana Zafarová

Med. praxi. 2026;23(1):64-67

Medication and baveragesPharmacological profile

PharmDr. Josef Suchopár, MUDr. Štěpán Suchopár

Med. praxi. 2026;23(1):57-63 | DOI: 10.36290/med.2025.079

Proper co-ingestion of oral medications with an appropriate beverage is crucial to ensure their efficacy and safety. However, studies have shown that most patients do not take their medications with water as recommended, but instead use other drinks such as tea, fruit juices, or alcohol. This practice can lead to clinically significant drug interactions. These interactions most commonly arise from the inhibition of transporters such as OATP1A2 and OATP2B1, or the CYP3A4 enzyme, resulting in decreased or increased bioavailability of medications. For example, green tea, grapefruit juice, or orange juice may reduce the absorption of fexofenadine, lisinopril,...

Kardiovaskulární prevence v linii s národním kardiovaskulárním plánemHeard at a congress

MUDr. Zuzana Zafarová

Med. praxi. 2026;23(1):52-56

Dermatoscopy in general practiceInterdisciplinary overviews

MUDr. Lubomír Drlík

Med. praxi. 2026;23(1):47-51 | DOI: 10.36290/med.2025.061

Dermocopy is a higly useful method enhancing accuracy in diagnosis of skin diseases. It is based between clinical and histologic examination. The method has developed in the last 30 years. Beside crucial role in pigmented lesions and malignant melanoma diagnosis, dermoscopy encompasses a broad field of indications.

Macular diseasesInterdisciplinary overviews

doc. MUDr. Tomáš Sosna, Ph.D., MUDr. Bc. Tomáš Novotný, FEBO, MUDr. Kateřina Myslík Manethová, Ph.D., FEBO

Med. praxi. 2026;23(1):38-46 | DOI: 10.36290/med.2025.076

Maculopathies are a diverse group of diseases that affect the central area of the retina, the yellow spot - macula lutea, which is responsible for central vision. If this part of the retina is damaged by any disease, visual acuity often deteriorates to the point of practical blindness. The macula is a very specific part of the retina from a histoanatomical point of view. In the article, we deal with the most common diseases of the macula, age-related macular degeneration, diabetic macular edema and central serous chorioretinopathy. We also mention other causes of maculopathies such as genetic, vascular, hematological diseases, paraneoplastic syndromes...

Diseases of the scalp: an overview for general practitionersInterdisciplinary overviews

MUDr. Kristýna Papajíková, MUDr. Renata Kučerová, Ph.D.

Med. praxi. 2026;23(1):33-37 | DOI: 10.36290/med.2025.078

Diseases of the scalp are a common reason for visits not only to specialized dermatology clinics but also to general practitioners. This review article provides general practitioners with comprehensive information on the most common scalp conditions - dandruff, seborrheic dermatitis, psoriasis, and tinea capitis. It discusses their etiology, pathogenesis, clinical presentation, differential diagnosis, diagnostic options, and current therapeutic approaches. Emphasis is placed on distinguishing between individual conditions and on the personalization of treatment, including relapse prevention. The article also reflects current insights into the role...

Adrenal incidentalomas: management approachInterdisciplinary overviews

doc. MUDr. Ondřej Petrák Ph.D., prof. MUDr. Tomáš Zelinka, CSc.

Med. praxi. 2026;23(1):28-32 | DOI: 10.36290/med.2025.072

Incidentalomas are adrenal masses detected on imaging performer for reasons other than suspected adrenal disease. They include a wide spectrum of diagnoses from completely benign and insignificant findings to hormonally active tumors, to possible rare adrenal cortex carcinoma or metastatic disease. The following article contains a basic diagnostic and therapeutic approach considering currently valid European guidelines on management of adrenal incidentalomas. It includes several basic considerations, namely when to think about malignancy and hormonally active form, when to operate and how follow up the patient.

Beta-blokátory/blokátory kalciových kanálů již nejsou jedinou léčebnou možností u pacientů s obstrukční hypertrofickou kardiomyopatiíHeard at a congress

MUDr. Zuzana Zafarová

Med. praxi. 2026;23(1):23-27

Vegetarianism and veganism - what's the right attitude?Review articles

Mgr. Martin Krobot, Ph.D., Mgr. Marina Jeřábková, MUDr. Eliška Selinger, MSc

Med. praxi. 2026;23(1):17-21 | DOI: 10.36290/med.2026.003

Plant-based diets are gaining popularity due to health, environmental and ethical factors, and an increasingly broad segment of the Czech population is adopting them. Evidence shows that a well-planned plant-based diet can offer substantial health benefits, especially in preventing non-communicable diseases, and can be appropriate across all life stages with adequate supplementation. Poorly planned plant-based diets, however, may pose nutritional risks, particularly for vulnerable groups such as children and pregnant women. Recent position statements increasingly recognise plant-based diets as suitable, while emphasising the need for supervision in...

New from the new year: NT-proBNP in preventive health check-upsReview articles

MUDr. Helena Kostková, Mgr. Tereza Kubecová

Med. praxi. 2026;23(1):12-16 | DOI: 10.36290/med.2025.081

Heart failure is a common and prognostically serious syndrome, where early detection in primary care significantly impacts mortality, morbidity, and patients' quality of life. Natriuretic peptides, particularly NT-proBNP, have become a standard component in the diagnosis of heart failure. An amendment to the preventive check-up regulation, effective from January 1, 2026, introduces NT-proBNP testing into preventive examinations for selected risk groups. This broadens the opportunities for general practitioners to actively identify early stages of heart failure. The article outlines the key principles of NT-proBNP interpretation and highlights the main...

Breast cancer - when to genetically test first-degree relatives of patients with hereditary predispositionReview articles

doc. MUDr. Ing. Jakub Cvek, Ph.D., MUDr. Zlatuše Bravencová

Med. praxi. 2026;23(1):8-11 | DOI: 10.36290/med.2025.074

The familial form of breast cancer constitutes a clinically significant subgroup of the disease, associated with germline mutations in BRCA1, BRCA2, and other susceptibility genes. This article reviews current recommendations for genetic testing in relatives of patients with confirmed or suspected hereditary breast cancer, including testing indications, genetic counseling procedures, and risk stratification strategies. It further discusses surveillance and individualized screening protocols aimed at early cancer detection and reduction of mortality in high-risk populations. The importance of interdisciplinary collaboration and the integration of genetic...

Abstrakta: 4. kongres Medicíny pro praxi v Českých Budějovicích, 28. 2. – 1. 3. 2025, Clarion Congress Hotel České BudějoviceSupplementum

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Med. praxi. 2025;22(Suppl.B)  

Abstrakta: 11. kongres Medicíny pro praxi v Ostravě, 14.–15. února 2025, Clarion Congress Hotel OstravaSupplementum

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Med. praxi. 2025;22(Suppl.A)  

Infekční respirační onemocnění Editorial

prof. MUDr. Petr Pazdiora, CSc.

Med. praxi. 2025;22(5):311

General principles for assessing fitness to drive -framework guidelines for general practitionersGood advice

PhDr. Roman Hradil, Mgr. Veronika Kurečková, MUDr. Pavel Řezáč

Med. praxi. 2025;22(5):380-382 | DOI: 10.36290/med.2025.066

The assessment of fitness to drive represents a critical responsibility for general practitioners (GPs), requiring a careful balance between ensuring road safety and consideringthebroaderimplicationsofrestrictinganindividual'sability to drive. Driving is a multifaceted task that extends beyond the mechanical control of a vehicle; it encompasses traffic navigation, strategic decision-making, planning, and is strongly influenced by the driver's lifestyle. These domains must be integrated into the GP's clinical judgement. Particular challenges arise when assessing drivers from high-risk groups, including elderly adults, individuals with mild cognitive...

Vaccination of adults in the Czech public health insurance systemGood advice

MUDr. Daniela Fránová

Med. praxi. 2025;22(5):375-379 | DOI: 10.36290/med.2025.037

Vaccination of adults in the public health insurance system has rules given by legi­slation and conditions of health insurance companies for reimbursement of those types of vaccinations that are covered by public health insurance. It is necessary to use the correct terminology, have an overview of the legislative standards governing the conditions of vaccination, have professional information on the use of vaccines and have knowledge of the correct reporting of vaccinations both for reimbursement to health insurance companies and for the central registration of vaccinations in the Czech Republic through the Information System of Infectious Diseases (ISIN).

Anabolic steroid abuse as a significant risk factor for cardiovascular morbidityCase report

MUDr. Filip Král, MUDr. Karel Lábr, Ph.D., doc. MUDr. Roman Panovský, Ph.D., MUDr. Monika Špinarová, Ph.D., MSc., MUDr. Veronika Bednárová, Ph.D., MUDr. Jiří Seménka, MUDr. Roland Oravský, MUDr. Andrej Nagy, MUDr. Katarína Doležalová, MUDr. Blanka Fisherová, Ph.D., prof. MUDr. Jan Krejčí, Ph.D.

Med. praxi. 2025;22(5):371-373 | DOI: 10.36290/med.2025.036

This case report highlights the cardiovascular risks associated with the use of anabolic androgenic steroids (AAS) through the example of a previously healthy male without known risk factors for ischemic heart disease (IHD). Chronic AAS use led to the development of heart failure with reduced ejection fraction (HFrEF) due to IHD, complicated by recurrent arrhythmias and requiring cardiac resynchronization therapy with defibrillator (CRT-D). The case underscores the importance of early detection of risky behavior, the need for interdisciplinary care, and education of the target population.

Myocarditis in the differential diagnosis of dyspneaCase report

MUDr. Petra Appeltauerová, MUDr. Julius Godava, MUDr. Hana Poloczková, Ph.D., MUDr. Karel Lábr, Ph.D., prof. MUDr. Jan Krejčí, Ph.D.

Med. praxi. 2025;22(5):366-370 | DOI: 10.36290/med.2025.044

Myocarditis is an inflammatory disease of the heart muscle that can have infectious (most commonly viral) or non-infectious origins, including autoimmune or toxic causes. The disease is characterized by a wide spectrum of clinical manifestations, ranging from a subclinical course to fulminant forms ending in acute heart failure or sudden cardiac death. Diagnosis requires a comprehensive approach, including history, laboratory tests, imaging, and in some cases, endomyocardial biopsy. Treatment depends on the severity of the course and may include targeted immunosuppression or antiviral therapy in addition to symptomatic therapy and treatment of heart...

Risk of rapid heart rate in atrial fibrillation - case report with discussionCase report

prof. MUDr. Štěpán Havránek, Ph.D.

Med. praxi. 2025;22(5):362-365 | DOI: 10.36290/med.2025.059

The article presents a case study of a patient with untreated arterial hypertension and atrial fibrillation with a rapid ventricular response. The patient's condition was complicated by the development of heart failure due to arrhythmia-induced cardiomyopathy. The case study is followed by an analysis focusing on the appropriate treatment of arterial hypertension in patients with atrial fibrillation and the importance of heart rate-lowering therapy for the prevention and treatment of heart failure.