Jaro je tady i se svými riziky

MUDr. Radkin Honzák, CSc.

Med. praxi. 2025;22(1):3

Polypharmacy - how to reduce medication in patients

MUDr. Petr Grenar, PharmDr. Petra Rozsívalová, MUDr. Dan Rakušan, MUDr. Jiří Nový, doc. MUDr. Radovan Malý, Ph.D., MUDr. Jiří Cyrany, Ph.D.

Med. praxi. 2025;22(1):10-14 | DOI: 10.36290/med.2024.049

According to the World Health Organization, polypharmacy represents one of the greatest risks in medicine. Its increasing prevalence is undoubtedly linked to the growing number of multimorbid geriatric patients, as well as the expanding range of medications and therapeutic options. It is also a direct consequence of defensive medicine, which generates low-value care that provides little or no benefit to the patient and can even be harmful, as is often the case with polypharmacy. This article explores the causes of polypharmacy and discusses current trends in addressing it, including deprescribing and the implementation of sick day rules.

New psychoactive substances in the Czech environment

Mgr. Tomáš Jandáč, Ph.D.

Med. praxi. 2025;22(1):16-19 | DOI: 10.36290/med.2025.001

The main objective of this text is to introduce new psychoactive substances, which encompass a broad and diverse group of substances, mostly of synthetic origin, with primarily stimulating, sedative, and hallucinogenic effects. These substances were developed or reintroduced to the market to replace traditional addictive substances, and their production often aims to circumvent legislation. The text discusses various subgroups of these substances, such as synthetic cannabinoids and opioids, and their serious health risks, including neurotoxic and cardiovascular complications. It also focuses on specific user groups who prefer these substances and their...

Acquired syphilis in adults

MUDr. Filip Skokan

Med. praxi. 2025;22(1):20-25 | DOI: 10.36290/med.2025.005

Syphilis is a systemic, chronic, and worldwide spread infectious disease caused by the bacterium Treponema pallidum, and its only natural host is man. The disease is transmitted predominantly through sexual contact (90%), but transplacental infection and blood transmission are also possible; other routes of infection are rare. The severity of syphilis is determined by the risk of various organs, particularly the skin, eye, CNS, cardiovascular and musculoskeletal systems and the risk of transmission to the foetus during pregnancy or birth in an untreated mother. The article aims to provide comprehensive and concise information on acquired syphilis...

Estrogenic treatment and liver functions

doc. MUDr. Jiří Slíva, Ph.D., MBA

Med. praxi. 2025;22(1):27-29

Estrogens are key hormones that play a vital role in the physiology of the reproductive system in women. However, their therapeutic use in hormonal treatment, contraception and the treatment of hormone-dependent diseases may be associated with a number of side effects, especially on the liver. This article focuses on the mechanisms of action of estrogens and their potential hepatotoxic effects, as well as risk factors and possible differences between representatives.

The importance of dietary fibre

Mgr. Bc. Martina Karbanová, Mgr. Ing. Tereza Vágnerová, Ph.D.

Med. praxi. 2025;22(1):E1-E9 | DOI: 10.36290/med.2024.039

Dietary fiber, a crucial component of plant-based foods, is essential for maintaining health and preventing various diseases. Despite its well-documented benefits, fiber intake in Western populations is significantly below recommended levels, averaging only 15-16 g per day compared to the advised 25–35 g. This deficiency is associated with a higher risk of obesity, type 2 diabetes, cardiovascular diseases, and certain types of cancer. This article provides a comprehensive overview of the impact of dietary fiber on health, including its effects on satiety, blood sugar regulation, cholesterol levels, inflammation reduction, and gastrointestinal...

Drowning in adults: First aid and subsequent management

MUDr. Jakub Jonáš, Ph.D.

Med. praxi. 2025;22(1):30-34 | DOI: 10.36290/med.2025.007

Drowning is one of the preventable injuries. Its consequences are often serious or even fatal. For the quality of life after drowning, it is important to restore the oxygen supply to the body as quickly as possible. Early initiation of cardiopulmonary resuscitation is therefore crucial. This article provides a basic overview of the causes and pathophysiology of drowning, emphasizes the early provision of first aid and the correct performance of cardiopulmonary resuscitation, and also provides an overview of the important aspects of intensive and resuscitation care of the patient after drowning.

Primary osteoporosis in the general practitioner's office: treatment and prevention

prof. MUDr. Jan Štěpán, DrSc.

Med. praxi. 2025;22(1):36-43 | DOI: 10.36290/med.2024.040

General practitioners and gynecologists provide treatment with oral aminobisphosphonates in people who, according to their medical history and results of clinical, laboratory, and bone densitometry examinations have primary (involutionary or postmenopausal) osteoporosis, or have suffered a low-traumatic fracture but do not have a very high risk of fractures. Patients who are diagnosed or suspected of secondary osteoporosis and patients with a very high risk of fractures in primary osteoporosis are referred to outpatient specialists. In particular, however, general practitioners and gynecologists have an unmistakable position in the early prevention...

The quality of life in old age, self­‑care

MUDr. Martina Nováková, doc. MUDr. Iva Holmerová, Ph.D., prof. MUDr. Milan Kvapil, CSc., MBA

Med. praxi. 2025;22(1):E10-E13 | DOI: 10.36290/med.2025.004

The quality of life of the elderly is determined and influenced by several physical, psychological, and social factors and aspects that determine the patient‘s needs. Among the key factors are: polymorbidity, polypragmasia, sarcopenia and hypomobility, malnutrition, chronic pain, incontinence, cognitive disorders and dementia, depression, sleep disorders, loneliness, and social isolation. Modern geriatrics should focus on solving and influencing these aspects. The goal is not to live as long as possible for the elderly patient but to live in the best possible state of health and function while maintaining self-sufficiency and autonomy for as...

Uncompensated 64-year­‑old hypertensive patient with acute MI

MUDr. Milan Plíva

Med. praxi. 2025;22(1):54-58 | DOI: 10.36290/med.2025.012

The Czech Republic is one of the countries with a high prevalence of cardiovascular diseases. Arterial hypertension is the most important risk factor. Hypertension pre­valence in the Czech Republic is approximately 40% of the adult population. However, target blood pressure values or reduction of overall cardiovascular risk are still not achieved by the majority of those treated. The current guidelines for managing high blood pressure and arterial hypertension now recommend a target blood pressure of 120 - 129 mmHg systolic blood pressure within three months of starting treatment for most hypertensive patients. Fixed combinations of antihypertensive...

Prevention of cardiovascular diseases by reducing blood pressure variability with a fixed combination of antihypertensive drugs, case studies

MUDr. Ivan Řiháček, Ph.D.

Med. praxi. 2025;22(1):59-64 | DOI: 10.36290/med.2024.055

Hypertension is the most important risk factor for cardiovascular diseases. Increased blood pressure variability worsens cardiovascular risk. Long-acting calcium channel blockers and thiazide or thiazide-like diuretics reduce blood pressure variability. Target blood pressure values in the new recommendations are 120-129/70-79 mmHg. To achieve them, we use in the first step a fixed combination of long-acting calcium channel blockers or diuretics with renin-angiotensin blockers. In the second step a fixed triple combination of all three drugs.

Pharmacotherapy in pregnancy - striving for balance

MUDr. Roman Chmel, Ph.D.

Med. praxi. 2025;22(1):44-47 | DOI: 10.36290/med.2025.002

The basic prerequisite for safe pharmacotherapy during pregnancy is a knowledge of the specifics that apply to the individual trimesters of pregnancy. This review article presents the main principles of pharmacotherapy of the most common diseases in pregnancy.

Current possibilities and practical aspects of antiobesity therapy in the general practitioner's office

MUDr. Petra Karnosová, Ph.D.

Med. praxi. 2025;22(1):48-53 | DOI: 10.36290/med.2025.003

A general practitioner can initiate the adequate therapeutic management of obesity. The first line of treatment should include lifestyle change recommendations such as a calorie-restricted diet (referral to a nutrition professional may be prescribed) and physical activity prescription. The pharmacological treatment can be indicated for all individuals with a BMI ≥ 30 kg/m² or ≥ 27 kg/m² with comorbidities (prediabetes, type 2 diabetes, arterial hypertension, sleep apnea). Anti-obesity medication use and selection should be individualized based on a clinical weight loss goal, weight-related conditions, and food intake...

HIV pre­‑exposure prophylaxis (PrEP)

MUDr. Pavel Dlouhý

Med. praxi. 2025;22(1):66-70 | DOI: 10.36290/med.2025.008

Thanks to modern treatment, HIV infection is now seen as a chronic disease with a survival rate comparable to the general population. Early diagnosis and the use of antiviral drugs, which stop the virus from multiplying and making the patient infectious (treatment as prevention), is essential. Another way to prevent HIV/AIDS is pre-exposure prophylaxis (PrEP), which is when HIV-negative people who are at high risk of infection take antiviral drugs. This review article talks about the clinical trials, the right drugs, how they are used (daily, on-demand and injectable), counselling and testing needed to make this a safe and effective way to prevent HIV.