Medicine for Practice - Latest articles
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Že kočka není pes…Editorial
MUDr. Radkin Honzák, CSc.
Med. praxi. 2026;23(3):147
Antihypertensive drugs and their drug interactions in general practicePharmacotherapy currently
MUDr. Karel Lábr, Ph.D., MUDr. Monika Špinarová, Ph.D.
Med. praxi. 2026;23(3):211-214 | DOI: 10.36290/med.2026.011
Drug interactions are a frequent and clinically important cause of poor blood pressure control, adverse effects of antihypertensive treatment and worsening kidney function. In general practice, it is important to consider not only interactions among antihypertensive agents themselves, but also commonly used prescription and over-the-counter drugs that may increase blood pressure or reduce treatment efficacy. The most relevant examples include non-steroidal anti-inflammatory drugs, nasal decongestants with sympathomimetic activity, selected antidepressants, glucocorticoids and hormonal therapy. Particularly important are combinations of renin-angiotensin...
Let's improve prevention: Late diagnosis of patients at the HIV Center Ostrava in 2020-2025Case report
MUDr. Alena Zjevíková, Ph.D., MUDr. Lenka Olbrechtová
Med. praxi. 2026;23(3):205-208 | DOI: 10.36290/med.2026.027
The HIV pandemic has lasted for more than four decades. However, a significant number of people continue to become newly infected. Antiretroviral therapy (ART) can ensure a good quality of life and is also used as prevention. After a certain period of use, ART leads to an undetectable viral load and effectively prevents the transmission of HIV to other people. For this reason, since 2015 it has been initiated in all individuals as soon as possible after an HIV diagnosis is established. Due to the increasing number of newly diagnosed HIV-positive clients with reduced immunity at the HIV Centre in Ostrava, we decided to analyse the percentage of individuals...
Excessively low energy intake during obesity treatment with incretin analogs: clinical risks and management in primary careInterdisciplinary overviews
Mgr. Erika Čermáková, Ph.D.
Med. praxi. 2026;23(3):201-204 | DOI: 10.36290/med.2026.025
Pharmacological treatment of obesity using GLP-1 receptor agonists and dual incretin analogs represents a major advancement in weight loss options. However, in addition to the expected reduction in energy intake, some patients may experience excessive food restriction, which can lead to nutritional and functional complications. This problem, which is often overlooked and not sufficiently addressed in current guidelines, primarily involves protein malnutrition, reduced physical performance, fatigue, the risk of micronutrient deficiencies, and impaired long-term treatment adherence. The article summarizes the main clinical risks of excessively low energy...
Mesenteric ischaemia: an interdisciplinary perspectiveInterdisciplinary overviews
MUDr. Matej Pekař, Ph.D., MBA, MUDr. Lubomír Blaha, MBA
Med. praxi. 2026;23(3):196-199 | DOI: 10.36290/med.2026.008
Acute mesenteric ischaemia (AMI) is a serious clinical condition with overall short-term mortality exceeding 50-60 %. Although the incidence of the acute form surpasses 60/100 000 inhabitants per year in the population of patients over 70, the diagnosis is still established with an alarming frequency of delay or only at autopsy. The key prerequisite for patient survival is not so much the availability of modern treatment as active clinical suspicion on the part of the first-contact physician. This review summarises the pathophysiology, aetiological classification, diagnostic algorithm and therapeutic options for both forms of ischaemia - acute and...
Potřebujeme atypické anxiolytikum?Heard at a congress
MUDr. Zuzana Zafarová
Med. praxi. 2026;23(3):193-194
Climacteric health issues: different diagnosic and treatment optionsReview articles
MUDr. Jana Racková
Med. praxi. 2026;23(3):188-192 | DOI: 10.36290/med.2026.026
Perimenopause and menopause represent key phases of reproductive aging in women, triggering endocrine, metabolic and cellular changes. Traditionally, they have been perceived primarily as hormonally conditioned processes with the occurrence of vasomotor symptoms. Current findings show that menopause reflects a broader biological aging process involving molecular and systemic alterations. The associated hormonal imbalance contributes to bone loss, central fat accumulation, changes in the urogenital, immune and nervous systems with an increased cardiovascular risk. The menopausal period also predisposes women to type 2 diabetes and metabolic syndrome....
Current approaches to symptomatic treatment of multiple sclerosis in the primary care settingReview articles
MUDr. Lenka Perecová, MUDr. Zuzana Rous, Ph.D., MUDr. Mária Czakóová
Med. praxi. 2026;23(3):182-186 | DOI: 10.36290/med.2026.022
Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system. Although the exact cause of MS is still unknown, advances in both diagnostics and treatment - particularly the introduction of disease-modifying drugs (DMDs) - have significantly improved patient outcomes and enable individuals to lead more fulfilling lives. Despite the ability of these modern therapies to slow disease activity, many patients, especially after years of disease progression, develop symptoms that substantially impair their quality of life, ranging from fatigue, spasticity, and gait disturbances to autonomic dysfunction, pain, and cognitive deficits....
Abdominal pain in general practice - warning signs and atypical presentations of acute abdominal emergenciesReview articles
MUDr. Maxim Sirotin, MUDr. Tomáš Vidim, MUDr. Karel Veškrňa
Med. praxi. 2026;23(3):176-180 | DOI: 10.36290/med.2026.009
Abdominal pain is one of the most common symptoms that brings patients to a physician's office. Although not every case of abdominal pain requires urgent surgical care, in patients with an acute abdomen it is a time-sensitive issue. This article provides an overview of warning signs, atypical presentations of common acute abdominal conditions, and less common but extremely urgent surgical diagnoses. The aim of the article is not to provide a comprehensive differential diagnosis of abdominal pain or a definitive diagnostic algorithm. Rather, it is intended to present a practical framework for recognizing situations in which delay may lead to serious...
Anemia - which conditions can be managed in general practiceReview articles
MUDr. Eva Havlová
Med. praxi. 2026;23(3):169-175 | DOI: 10.36290/med.2026.023
Anemia is a common finding in primary care and is defined in adults over 15 years of age as a hemoglobin concentration below 135 g/L in men and below 120 g/L in women. Initial evaluation should include a complete blood count with leukocyte differential and reticulocyte count. Classification according to mean corpuscular volume (MCV) into microcytic, normocytic, and macrocytic anemia helps guide further diagnostics. The article focuses mainly on iron deficiency anemia and megaloblastic anemia caused by vitamin B12 or folate deficiency, which can frequently be diagnosed and treated in general practice. Diagnostic algorithms, treatment principles, and...
When rhinitis is more than just rhinitis: rhinitis in clinical practice -diagnosis, treatment and warning signsReview articles
MUDr. Barbora Podmajerská
Med. praxi. 2026;23(3):164-168 | DOI: 10.36290/med.2026.021
Rhinitis represents a heterogeneous group of disorders characterized by rhinorrhea, nasal obstruction, sneezing, and itching of the nasal mucosa. The most common forms include allergic, non-allergic, and infectious rhinitis. Allergic rhinitis is an IgE-mediated, Th2-driven inflammatory disease with a significant impact on quality of life and is closely associated with bronchial asthma. The ARIA classification distinguishes intermittent and persistent forms and assesses severity according to impairment of sleep and daily activities. Non-allergic rhinitis comprises multiple phenotypes without evidence of systemic allergy, and their recognition is essential...
Migraine and the cervical spine - is neck pain related to migraine, and vice versa?Review articles
MUDr. Petra Migaľová
Med. praxi. 2026;23(3):158-163 | DOI: 10.36290/med.2026.024
Migraine is the third most common neurological disease. It is also one of the most disabling diseases in the world. Migraine, especially chronic, can be mistaken for tension or cervicogenic headache. Neck pain is common in patients with migraine. It occurs as a prodrome, can be present during an attack or between attacks. It can be a trigger for migraine, but also a concomitant disease. Coexisting cervical spine pain in migraine is associated with greater disability and poorer response to treatment. Patients are often misdiagnosed, leave the doctor with a diagnosis of cervical spine pain and are not adequately treated. The aim of this work is to describe...
Photoprotection: key concepts, special patient groups, and current trendsReview articles
MUDr. Kristýna Sokolová
Med. praxi. 2026;23(3):153-157 | DOI: 10.36290/med.2026.020
Sun protection is a key preventive tool in dermatology. The text summarizes the basic principles of protection against UV radiation and describes the acute and chronic consequences of UV exposure, such as solar dermatitis, photoaging, and skin tumors. Special attention is paid to specific patient groups, particularly children, patients with photosensitivity, and immunosuppressed individuals, for whom consistent photoprotection is essential. Photoprotection is presented as a comprehensive long-term strategy with a significant impact on the prevention of skin diseases and carcinogenesis.
The role of cytisinicline in the treatment of nicotine dependenceReview articles
doc. MUDr. Jiří Slíva, Ph.D., MBA
Med. praxi. 2026;23(2):85-89 | DOI: 10.36290/med.2026.018
Cytisinicline is a plant‑derived alkaloid with a long history of pharmacological use, primarily acting through modulation of nicotinic acetylcholine receptors. Initially employed as a respiratory stimulant, it has been used since the mid‑20th century for the treatment of tobacco dependence, particularly in Central and Eastern Europe. As a partial agonist of α4β2 and α6β2 nicotinic receptors, cytisinicline reduces withdrawal symptoms while attenuating the reinforcing effects of inhaled nicotine. Its clinical efficacy in smoking cessation has been demonstrated in multiple randomized controlled trials and meta‑analyses,...
Slovo úvodemEditorial
Viktorija Ragénaité-Mrnka, MD.
Med. praxi. 2026;23(2):75
A practical guide to depression screening in clinical practiceGood advice
prof. MUDr. Eva Češková, CSc.
Med. praxi. 2026;23(2):141-142 | DOI: 10.36290/med.2026.017
This article begins with a summary of the basic information on depressive disorder. It then addresses the possibilities of screening and diagnosis in a general practitioner's office. Among treatment approaches, particular attention is devoted mainly to pharmacotherapy with SSRI antidepressants.
Hemorrhoidal disease - an overview for clinical practiceAt a glance
MUDr. Soňa Hořínková
Med. praxi. 2026;23(2):135-139 | DOI: 10.36290/med.2026.015
Hemorrhoidal disease is one of the most common benign disorders of the anorectal region and significantly affects patients' quality of life. Although hemorrhoids are a physiological component of the anal canal, pathological changes can lead to symptomatic hemorrhoidal disease. The etiology is multifactorial and includes genetic predisposition, impaired venous outflow, weakening of the connective-tissue support apparatus, and chronic inflammation of the vascular wall. The clinical presentation is variable - from mild anal discomfort to marked bleeding, prolapse, and painful complications. This article provides a comprehensive overview of the anatomy,...
Shared medication record in general practice - a tool for improving pharmacotherapy safetyPharmacotherapy currently
MUDr. Marek Pecha
Med. praxi. 2026;23(2):131-133 | DOI: 10.36290/med.2026.014
The shared medication record represents a key functionality of the eRecept system, which was officially launched in the Czech Republic on June 1, 2020. Despite its earlier launch, full deployment and effective utilization in practice were limited by the gradual integration into information systems of healthcare facilities and general practitioners' offices. This article provides an overview of the practical use of the shared medication record in outpatient practice, with emphasis on patient safety in polypharmacy, prevention of drug interactions and duplicate prescribing. The shared medication record allows physicians, pharmacists and clinical pharmacists...
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