Infekční respirační onemocnění 

prof. MUDr. Petr Pazdiora, CSc.

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

Less common manifestations of acute myocardial infarction

MUDr. Tomáš Janota, CSc.

Med. praxi. 2025;22(5):316-318 | DOI: 10.36290/med.2025.052

Acute myocardial infarction has several typical manifestations that lead to further examinations necessary to confirm or exclude it. Even the lay population is educated about these manifestations. However, very often the manifestations of infarction are not typical. However, even patients without characteristic pain should not escape correct and early diagnosis. An infarction should therefore be considered even in the case of atypical pain, dyspnoea itself, nausea to vomiting, sweating attacks, palpitations, sudden general weakness to syncope, unclear anxiety, and restlessness, stroke or transient ischemic attack, sudden confusion to delirium, manifestations...

Immune system - can it be boosted/influenced?

prof. MUDr. Jiřina Bartůňková, DrSc.

Med. praxi. 2025;22(5):319-323 | DOI: 10.36290/med.2025.051

The immune system provides a balance between a defensive response to pathogens and tolerance to harmless stimuli. Disturbances in this balance lead to immunodeficiency, autoimmunity, allergies, or cancer. Recurrent respiratory infections are a frequent problem in clinical practice, especially among general practitioners. Their cause tends to be multifactorial - from anatomical anomalies to allergies, mucosal immunity disorders, and lifestyle errors. Mucosal immunity plays a key role in airway defense and its weakening leads to increased morbidity. The microbiota also plays an important role, the balance of which is often disturbed by inappropriate...

Sudden cardiac death, what we need to know

MUDr. Alice Krebsová, Ph.D., Mgr. Eva Kutílková, Ph.D., Mgr. Šárka Nováková, MUDr. Štěpánka Pohlová Kučerová, Ph.D.

Med. praxi. 2025;22(5):324-328 | DOI: 10.36290/med.2025.063

Sudden cardiac death (SCD) in individuals under 50 years of age is caused in a signifi­cant percentage by hereditary cardiovascular disease. Identification of these cases, post-mortem genetic testing and family cascade screening is the first step towards primary prevention of sudden death in relatives at risk and requires multidisciplinary and multicentric care. Finding a certain hereditary cause of sudden death is generally possible in about 20 % of cases, however, in families with a positive history of sudden death or heart failure and/or malignant arrhythmias, genetic testing is successful in up to half of the families. In the Czech Republic, a...

Inflammatory bowel disease

MUDr. Pavel Svoboda, Ph.D.

Med. praxi. 2025;22(5):329-332 | DOI: 10.36290/med.2025.067

Idiopathic bowel disease, Crohn's disease, and ulcerative colitis are chronic autoimmune diseases whose etiology is unknown. The main symptoms include abdominal pain, diarrhea, weight loss, fever, rectal bleeding, and fatigue. The diagnosis of both diseases is based on a combination of clinical data, laboratory tests, and imaging examinations. Although we are still unable to cure them completely, treatment has made significant progress. Biological and innovative therapies have fundamentally changed the fate of these patients.

Results of the Czech Myeloma group project CRAB II

prof. MUDr. Vladimír Maisnar, Ph.D., MBA, MUDr. Jan Straub

Med. praxi. 2025;22(5):333-337 | DOI: 10.36290/med.2025.075

Multiple myeloma is the second most common hematologic malignancy in the Czech Republic, and its incidence continues to rise. Clinical experience shows that up to half of patients with multiple myeloma begin treatment late due to delayed diagnosis. The original CRAB project by the Czech Myeloma Group was aimed at addressing this issue. The current article summarizes the results of the questionnaire phase of the CRAB II project, which is intended to be followed by a large-scale information campaign about the symptoms of the disease, including recommended diagnostic procedures when a possible connection to this serious condition is suspected. Improving...

Diagnosis of back pain from the perspective of an orthopaedic and a spine surgeon

prof. MUDr. Martin Repko, Ph.D.

Med. praxi. 2025;22(5):338-342 | DOI: 10.36290/med.2025.068

Back pain, with its increasing incidence and socioeconomic importance, is a real medical problem that requires accurate diagnosis with optimization of subsequent treatment. Of particular importance in the diagnosis of these problems is the diffe­rentiation of non-specific back pain from structural organic disorders of the spine. The knowledge and use of clinical and imaging methods allow accurate differentiation of the origin and nature of specific back pain. Interdisciplinary collaboration between general practitioners and specialists from different disciplines provides effective health care for joint patients. Patients with non-specific back pain,...

Benefits and risk of bone mineral density measurement in osteoporosis diagnosis

prof. MUDr. Vladimír Palička, CSc., dr.h.c.

Med. praxi. 2025;22(5):343-346 | DOI: 10.36290/med.2025.065

One of the fundamental diagnostic methods for monitoring disorders of bone metabolism is the measurement of bone mineral density using dual-energy X-ray absorptiometry. This method allows the determination of bone mineral content at key diagnostic sites, specifically the lumbar spine and the proximal femur, and in some cases, the distal forearm. It is a rapid, non-invasive, and well-standardized technique that uses a global reference database for interpreting results. Despite its apparent simplicity, the measurement requires great care and proper execution. The results can be easily compromised by incorrect measurement procedures or improper interpretation....

Tattoo - health risks

doc. MUDr. Karel Ettler, CSc.

Med. praxi. 2025;22(5):347-352 | DOI: 10.36290/med.2025.064

Tattoos, once confined to subcultures, have permeated mainstream society, transforming from symbols of rebellion to forms of personal expression. While their artistic and cultural significance is undeniable, it's crucial to examine tattoos through a medical lens, understanding their history, the science behind their creation, their biological impact, and the psychological motivations that drive individuals to mark their skin.

Senile cataract - is genetics or lifestyle to blame?

MUDr. Dorota Stodůlková

Med. praxi. 2025;22(5):353-356 | DOI: 10.36290/med.2025.060

Cataract - lens opacity, is defined as clouding of the crystalline lens resulting in its refractive index change and subsequent decrease in visual acuity. The development of senile cataract is multifactorial, involving both preventable and non-preventable factors. Genetic predisposition may increase the vulnerability of the lens to exogenous cataractogenic influences. However, adherence to a healthy lifestyle can partly compensate for this susceptibility. In cataract prevention, it is important to identify hereditary risks based on family history, whilst reducing modifiable lifestyle-related risk factors is essential.

Vitamin D in senior in institutional care: personal experiences

prof. MUDr. Ondřej Topolčan, CSc., MUDr. Hedvika Mikolášová, Mgr. Bc. Martina Peštová, doc. MUDr. Václav Šimánek, Ph.D., doc. MUDr. Šárka Svobodová, Ph.D., prof. PharmDr. Radek Kučera, Ph.D., MUDr. Michal Jirásko, Ph.D.

Med. praxi. 2025;22(5):358-361 | DOI: 10.36290/med.2025.077

Vitamin D plays a key role in regulating bone metabolism, immune function, and overall health. In seniors, especially those in institutional care, vitamin D deficiency is common due to limited exposure to sunlight, poor diet, and polypharmacy, among other factors. As part of a study conducted at the Municipal Social Services Institute in Pilsen (Městský ústav sociálních služeb), the serum vitamin D levels of clients were assessed, and the results confirmed a high prevalence of hypovitaminosis. Regular monitoring and adequate vitamin D supplementation should be an integral part of senior care, as they represent a simple and effective means of improving...

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

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.

Myocarditis in the differential diagnosis of dyspnea

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

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...

Anabolic steroid abuse as a significant risk factor for cardiovascular morbidity

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.

Vaccination of adults in the Czech public health insurance system

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).

General principles for assessing fitness to drive -framework guidelines for general practitioners

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...