Medicine for Practice - Latest articles
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Ten points in hypertension care in the GP surgery in 2025 (in line with current recommendations)Good advice
MUDr. Zdeněk Ramík
Med. praxi. 2025;22(4):304-306 | DOI: 10.36290/med.2025.031
This article concisely summarizes the current recommendations for the diagnosis and treatment of arterial hypertension as outlined by the European Society of Hypertension in 2023 and the European Society of Cardiology in 2024, presented in 10 key points, with a focus on application in general practice.
Chronické žilní onemocnění - chirurgie versus konzervativní léčbaHeard at a congress
MUDr. David Salát, MUDr. Robert Vlachovský, Ph.D.
Med. praxi. 2025;22(4):299-303
Intravenously administered vitamin C therapy in a patient with Post-covid syndromeCase report
MUDr. Pavla Prandževová
Med. praxi. 2025;22(4):293-296 | DOI: 10.36290/med.2025.058
The author presents a case report of a young man who developed post-covid syndrome. No serious pathological conditions were identified in the differential diagnosis, only post-covid syndrome was suspected. Supportive therapy with intravenously administered vitamin C was indicated. Within 13 months, after a series of vitamin C infusions, there was a significant improvement to complete disappearance of symptoms, including a return to full school workload. The case study shows the possible effect of supportive infusion therapy with vitamin C in a young patient with long-term post-covid syndrome, in whom conventional supportive measures were not helpful
Obstructive sleep apneaInterdisciplinary overviews
MUDr. Martin Pretl, CSc.
Med. praxi. 2025;22(4):286-292 | DOI: 10.36290/med.2025.054
Obstructive sleep apnea (OSA) is a chronic disease with a prevalence in the population estimated between 5 % and 10 %. Due to its occurrence and medical consequences, it ranks among the most significant sleep disorders. Non-restorative fragmented sleep caused by repetitive respiratory events leads to a wide range of daytime symptoms that significantly affect quality of life. The main risk factors include overweight and obesity, male gender, and middle to older age. OSA is primarily associated with cardiovascular and metabolic diseases (especially type 2 diabetes mellitus). Untreated OSA increases the risk of morbidity and mortality in cardiovascular...
Laser correction of refractive errors - news and what to expect from the surgeryInterdisciplinary overviews
MUDr. Róbert Kadlec
Med. praxi. 2025;22(4):280-284 | DOI: 10.36290/med.2025.057
The article provides an overview of the development and principles of laser refractive surgery, the different methods of surgical correction of refractive errors. It describes the historical development from superficial methods (PRK) to modern techniques such as femtoLASIK and ReLEx SMILE. The main principle of the procedure is to change the curvature of the cornea, thereby correcting the refractive error of the eye's optical system. Excimer lasers work on the principle of photoablation, while femtosecond lasers use photodisruption. Each method has its advantages and limitations, and the choice depends on the individual patient's anatomical conditions...
Jak na bolest? Role nesteroidních antirevmatik v léčbě bolestiHeard at a congress
MUDr. Zuzana Zafarová
Med. praxi. 2025;22(4):275-278
National cardiovascular plan 2025-2035 - role of general practitionersReview articles
prof. MUDr. Štěpán Havránek, Ph.D.
Med. praxi. 2025;22(4):270-274 | DOI: 10.36290/med.2025.047
The National cardiovascular plan for 2025-2035 is a strategic document approved by the Government of the Czech Republic, which provides an analysis of the current state of cardiovascular diseases in the Czech Republic and outlines basic strategies for preventing and treating these diseases. General practitioners play a crucial role in the entire concept of care, encompassing prevention, early disease detection, and coordination of care for patients with cardiovascular issues. The main author of the entire document is Prof. MUDr. Aleš Linhart, DrSc.
Approach to the patient with dementia in primary careReview articles
MUDr. Eva Zatloukalová, Ph.D.
Med. praxi. 2025;22(4):264-268 | DOI: 10.36290/med.2025.056
Dementia, defined as an acquired impairment of cognitive functions that limits patients' independence, represents a group of disorders with a steadily increasing prevalence. At the same time, both pharmacological and non-pharmacological options for symptomatic treatment are expanding. The aim of this review is to provide a concise and comprehensive overview of current recommended practices considering screening, diagnostics, therapeutic approaches and other important aspects of care.
Where is the treatment of atherosclerosis heading?Review articles
prof. MUDr. Otto Mayer, CSc.
Med. praxi. 2025;22(4):259-262 | DOI: 10.36290/med.2025.050
The prevention of atherosclerotic vascular diseases remains crucial for global population health. Therefore, it is essential that we have a sufficient number of drug classes with proven benefits for patients in this area. However, it is equally important to consistently use all these new treatment possibilities in real clinical practice and actively pursue to achieve defined treatment goals for individual risk factors.
Žilní porucha dolních končetin z nežilních příčinHeard at a congress
MUDr. Zuzana Zafarová
Med. praxi. 2025;22(4):252-257
Colorectal cancer in general practice - how to identify individuals at increased risk and when to screen first degree relativesReview articles
MUDr. Tomáš Grega, Ph.D., prof. MUDr. Jan Bureš, CSc., Mgr. Ondřej Ngo, Ph.D., Ing. Monika Ambrožová, Mgr. Renata Chloupková, RNDr. Ondřej Májek, Ph.D., prof. MUDr. Miroslav Zavoral, Ph.D., doc. MUDr. Štěpán Suchánek, Ph.D.
Med. praxi. 2025;22(4):243-251 | DOI: 10.36290/med.2025.062
Colorectal cancer belongs among the most common malignancies worldwide and ranks the third place in the incidence among all malignant tumors. General practitioners play a crucial role not only in the primary prevention of this disease but also in the early detection of existing neoplastic lesions. The first part of this review discusses in detail the epidemiology of colorectal cancer, current data on incidence and mortality, and the importance and outcomes of the population-based screening program in the Czech Republic. Furthermore, the role of primary care is emphasized in promoting screening participation and in the early identification of asymptomatic...
The effect of noctural heart rate on mortality in patients with arterial hypertensionReview articles
prof. MUDr. Tomáš Kovárník, Ph.D.
Med. praxi. 2025;22(4):236-241 | DOI: 10.36290/med.2025.053
Elevated resting heart rate, particularly during nighttime, is a significant yet often overlooked predictor of all-cause and cardiovascular mortality in patients with arterial hypertension. It reflects the state of autonomic regulation and the balance between sympathetic and parasympathetic activity. Nighttime heart rate has greater prognostic value than daytime rate, and an insufficient nocturnal decline is associated with increased cardiovascular risk, psychological comorbidities, and reduced life expectancy. This review summarizes current evidence on the pathophysiology, diagnosis, and therapeutic strategies for elevated heart rate, including both...
Tobacco/nicotine addiction in daily practiceReview articles#E-version
prof. MUDr. Eva Králíková, CSc., MUDr. Zuzana Adamčeková
Med. praxi. 2025;22(3):E1-E4 | DOI: 10.36290/med.2025.029 
In many practices, interest in the diagnosis of F17 ends with an inquiry about smoking or a recommendation to stop. However, this is a disease for which effective treatments exist and should therefore be offered and available in the same way as treatments for other diseases. For example, there are roughly twice as many smokers (1) as diabetics in the Czech Republic, but the treatment options offered do not match this. In addition, other forms of tobacco or nicotine than cigarettes are now available. As a standard, we should ask about the use of all forms of tobacco or smoking, recommend abstinence, inform about treatment, and offer it where appropriate....
Cestování není jen o rizicích…Editorial
MUDr. Milan Trojánek, Ph.D.
Med. praxi. 2025;22(3):155
Nutraceuticals and their use in the clinical practice of the general practitionerCompany statement
doc. MUDr. Dalibor Pastucha, Ph.D., MBA, Ing. Hana Střítecká, Ph.D.
Med. praxi. 2025;22(3):225-226
Nutraceuticals are natural substances and dietary supplements with potential health benefits, disease prevention, and metabolic balance optimization. While their use is increasing, there is no definition, and regulations across the EU focus primarily on safety. Their recommendation should be evidence-based, as they can interact with medications and affect treatment outcomes. Examples of proven efficacy include vitamin D and lipid-lowering supplements like phytosterols or red yeast rice extract containing monacolin K. It's essential to choose verified products and consult healthcare professionals to avoid adverse effects or improper use. Nutraceuticals...
The most common mistakes in the diagnosis of idiopathic intestinal inflammationThe most common errors in diagnosis
MUDr. Aleš Novotný
Med. praxi. 2025;22(3):223-224 | DOI: 10.36290/med.2025.049
The incidence of idiopathic bowel disease (IBD) is increasing. IBDs are a high patient burden and are becoming a significant socioeconomic problem. Correct and early diagnosis is crucial for adequate treatment, which in the best case should prevent or at least minimize the risk of structural changes in the digestive tract, thus improving the outlook of patients with IBD.
When to refer a patient to a nephrologist - according to what symptomsGood advice
MUDr. Miroslav Ryba
Med. praxi. 2025;22(3):221-222 | DOI: 10.36290/med.2025.040
The number of patients with chronic kidney disease is high worldwide. It is important to focus on those at risk of progression to kidney failure or cardiovascular complications, and refer them to a nephrologist or other specialist. This article aims to provide practitioners with guidance on a simple investigative procedure using available laboratory methods to identify these patients.
How to assess medical fitness to hold a firearms license?Good advice
Mgr. Bc. Miloš Máca
Med. praxi. 2025;22(3):218-220 | DOI: 10.36290/med.2025.025
The recommended procedure for general physicians in answers to 5 basic questions - firearms license and its groups, jurisdiction to issue an assessment, procedure for issuing an assessment and deadlines, changes in the patient's health, new obligation to verify possession of a firearms license.
ECG in athletes, tips and tricks for evaluationGood advice
prof. MUDr. Eliška Sovová, Ph.D., MBA, MUDr. Markéta Sovová, Ph.D., MUDr. Libor Jelínek, Ph.D., MUDr. Radek Adámek
Med. praxi. 2025;22(3):214-217 | DOI: 10.36290/med.2025.043
This article focuses on the evaluation of ECG in athletes in the context of preparticipation screening (to reduce the risk of sudden death). ECG examination is mandatory according to legal standards for athletes as part of the medical examination. It is necessary to distinguish between physiological, borderline, and abnormal findings on ECG. Abnormal findings then require further examination by a sports cardiologist. We use the 2017 International Criteria for electrocardiographic interpretation in athletes for evaluation.
Correct sample collection as the basis for reliable laboratory diagnostics: avoid common mistakesGood advice
Mgr. Dominika Zhánělová, RNDr. Martina Mrkvicová, Ph.D., prof. RNDr. Lenka Zdražilová-Dubská, Ph.D.
Med. praxi. 2025;22(3):210-213 | DOI: 10.36290/med.2025.041
Proper collection of biological material is essential for obtaining reliable laboratory results. Laboratory testing includes three main phases: pre-analytical, analytical, and post-analytical. The pre-analytical phase is the most frequent source of error. Thorough patient instruction, accurate sample and test identification, appropriate container selection, proper collection procedures, and adherence to the collected material's specific storage and transport conditions are all of particular importance. This article summarises the crucial aspects of the proper collection of various types of biological material (e.g. blood, urine, and sputum) and highlights...
Simulation centres in the Czech RepublicGood advice
Mgr. Jan Dvořáček, DiS., doc. MUDr. Martina Kosinová, Ph.D., prof. MUDr. Petr Štourač, Ph.D., MBA
Med. praxi. 2025;22(3):208-209 | DOI: 10.36290/med.2025.018
As in other parts of the world, medical students and health care professionals are increasingly encountering simulation-based teaching and the term simulation medicine. What is simulation medicine and what are its foundations? Why the number of simulation centres in this country and around the world? And what is the availability of simulation-based education for doctors and nurses in the Czech Republic? The following lines will seek the answer to these questions.
Backache and spine pain as overlooked symptoms in the differential diagnosis of infection of unknown originCase report
MUDr. Petra Huňařová, MUDr. Jan Novák, Ph.D.
Med. praxi. 2025;22(3):202-207 | DOI: 10.36290/med.2025.039
Backache or spine pain are one of the most common symptoms which lead patient to seek out for medical consult. They can be just an accompanying symptoms of muscle overload or degenerative changes of the spine, but in some cases they could signalize much more serious health problems, especially if they associated with fevers or other signs of infection. Spinal infections (spondylitis, spondylodiscitis, etc.) are well-known diseases, but due to their low incidence, they are often overlooked, and back pain as their main symptom, is often disparaged or attributed to another etiology. In the presented case series, we describe three cases of patients with...
Sucrosomial iron - a new way to address iron deficiencyPharmacotherapy currently
PharmDr. Marek Lapka, Ph.D.
Med. praxi. 2025;22(3):196-201 | DOI: 10.36290/med.2025.032
Iron deficiency (ID) is one of the most common nutritional deficiencies worldwide, often leading to anemia and other health complications. Traditional oral iron supplementation using ferrous and ferric salts is associated with low bioavailability and gastrointestinal side effects, limiting patient adherence to treatment. Sucrosomial iron (SI) represents an innovative form of oral iron with improved pharmacokinetic properties, higher tolerability, and better absorption. This article provides a comprehensive review of preclinical and clinical studies evaluating the efficacy and safety of SI in various clinical settings, including pregnancy, oncology,...
Benzodiazepine addictionPharmacotherapy currently
doc. MUDr. Jiří Slíva, Ph.D., MBA
Med. praxi. 2025;22(3):192-195 | DOI: 10.36290/med.2025.023
Benzodiazepines have a number of well-documented pharmacological properties that are widely used in a number of fields of medicine. However, their inappropriate use carries the risk of developing addiction. Treatment often requires a gradual reduction in medication combined with behavioral therapies and support systems that address the psychological aspects of addiction and prevent relapse. The aim of the submitted text is to draw attention to this issue and to point out the relevant context associated with it.
Female sexual dysfunctionsInterdisciplinary overviews
MUDr. Pavel Turčan, Ph.D., FECSM, MUDr. Peter Kepič, MUDr. Jozef Hambálek, MUDr. Pavla Entnerová
Med. praxi. 2025;22(3):187-191 | DOI: 10.36290/med.2025.038
This review provides an overview of a relatively wide range of female sexual dysfunctions. It focuses on their classification, etiology, risk factors, diagnosis, and treatment to be as practical and beneficial as possible for physicians in practice. Since female sexual dysfunctions often arise as a result of multiple factors simultaneously, their resolution can sometimes be more complex and usually requires the cooperation of several specialists in various medical fields and psychology. Treatment is always highly individualized. An integral part of treatment is ensuring a safe and trustworthy environment for the woman. In many cases, therapy for the...
Hereditary angioedema and its differential diagnosisInterdisciplinary overviews
MUDr. Irena Krčmová, CSc.
Med. praxi. 2025;22(3):181-186 | DOI: 10.36290/med.2025.048
Angioedema is swelling involving the subcutaneous and/or submucosal layers of tissue that affects the face, lips, neck and extremities, oral cavity, larynx, and/or intestinal mucosa. The differential diagnosis of angioedema is interdisciplinary. From a pathophysiological perspective, angioedema can be classified as histamine-mediated angioedema and bradykinin-mediated angioedema. Histamine-mediated angioedema is more common and is associated with activation and degranulation of mast cells and basophils, and is often accompanied by pruritic and erythematous urticaria. Bradykinin-mediated angioedema can include forms of hereditary angioedema, acquired...
Myths and facts about antisecretory therapyInterdisciplinary overviews
MUDr. Tomáš Skutil, doc. MUDr. Radek Kroupa, Ph.D., doc. MUDr. Jiří Dolina, Ph.D.
Med. praxi. 2025;22(3):176-180 | DOI: 10.36290/med.2025.027
Antisecretory therapy, including proton pump inhibitors and H2-blockers, plays a key role in the treatment of gastroesophageal reflux disease and other upper gastrointestinal diseases. Although this therapy is widely used, there are many misconceptions that can influence the decision-making of primary care physicians. This article aims to shed light on the myths and facts regarding antisecretory therapy, provide practical information for physicians, and promote a rational approach to its use.
When to consider secondary hypertension?Review articles
MUDr. Barbora Nussbaumerová, Ph.D.
Med. praxi. 2025;22(3):173-175 | DOI: 10.36290/med.2025.042
Secondary arterial hypertension has a specific and, in some cases, treatable underlying cause. Secondary hypertension should be considered in young hypertensive patients, in those with resistant arterial hypertension, and when typical signs suggestive of a secondary cause are present. Secondary hypertension may account for up to 15 % of all hypertension cases. Excluding pseudoresistance due to non-adherence to treatment, the most common causes include primary hyperaldosteronism, renoparenchymal or renovascular hypertension, hypercortisolism, pheochromocytoma, sleep apnea syndrome, aortic coarctation, substance or alcohol abuse, the use of certain...
Recurrent varicosities. Basic definition, causes, and their solutionReview articles
MUDr. Lukáš Hnátek, Ph.D.
Med. praxi. 2025;22(3):168-172 | DOI: 10.36290/med.2025.046
Recurrence of varicosities is a relatively common phenomenon accompanying interventional treatment of varicose veins. A number of scientific papers deals with this problem. For its evaluation, it is necessary to respect precisely defined terms such as true recurrence, technical error during the primary procedure, or newly formed source of reflux. To evaluate the extent of CVD involvement with recurrent varicosities, duplex ultrasonography is the best diagnostic procedure. Its detailed performance is crucial to determine the cause of recurrence and also to plan the necessary intervention. The ultrasonographic findings must then be respected when performing...
The path to slowing the heart failure epidemic in the Czech Republic -how the ESC 2024 recommendations for the treatment of arterial hypertension can be helpfulReview articles
MUDr. Peter Wohlfahrt, PhD.
Med. praxi. 2025;22(3):164-167 | DOI: 10.36290/med.2025.035
In the next 15 years, the prevalence of heart failure in the Czech Republic is expected to increase significantly to double the current number of patients. Heart failure is already a significant burden to the healthcare system, especially due to frequent hospitalisations and high costs of treatment. Effective control of arterial hypertension (AH), the most common cause of heart failure, is a key preventive step to curb this trend. The aim of this article is to present the current epidemiological situation in the Czech Republic, to outline the main points of the new European Society of Cardiology (ESC) recommendations and to show how they can contribute...