Medicine for Practice - Latest articles
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Chronické žilní onemocnění jako modifikátor kardiovaskulárního rizikaHeard at a congress
MUDr. Zuzana Zafarová
Med. praxi. 2026;23(4):275-280
Mild cognitive impairment in the era of biological therapy: the importance of early interventionInterdisciplinary overviews
MUDr. Jiří Cerman, Ph.D., MUDr. Ing. Klára Knápková, prof. MUDr. Jakub Hort, Ph.D., FEAN
Med. praxi. 2026;23(4):259-262
Mild cognitive impairment (MCI) is a heterogeneous clinical syndrome that is currently gaining attention due to the advent of new biological treatments for Alzheimer’s disease. Although these therapies open up new possibilities for causal intervention, their use in real-world practice remains limited to a relatively narrow group of patients for whom this treatment is appropriate. This article summarizes current options for the management of MCI in routine clinical practice and focuses primarily on rational approaches to early intervention in patients who are not candidates for biologic therapy.
Tiché setkání s kolegou z roku 1943Editorial
Mgr. Olga Klepáčková
Med. praxi. 2026;23(4):219
On-line romance scamCase report
MUDr. Jakub Šimon
Med. praxi. 2026;23(4):287-294
The article examines a hidden, and serious phenomenon that has devastating psychological, social, and financial impacts. It is a relatively new type of crime that deliberately targets the fundamental human need for love and connection. The article debunks common misconceptions about the profile of victims. It explains the techniques of psychological manipulation, such as love bombing, mirroring, and the creation of a trauma bond. Through two case studies, it demonstrates how psychological manipulation and trauma manifest in the clinical presentation of victims. It addresses the challenges of differential diagnosis and argues that the seemingly delusional...
NT-proBNP in general practice: a new era of heart failure screeningGood advice
PharmDr. Karolína Nálevková
Med. praxi. 2026;23(4):281-286 | DOI: 10.36290/med.2026.036
Chronic heart failure (CHF) represents a major medical and socioeconomic burden that has been long underdiagnosed in primary care. Approximately 80% of patients are correctly identified only at an advanced stage following acute hospitalization, even though non-specific symptoms often manifest up to five years prior to the diagnosis. The key tool for early detection is the determination of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. This article provides a comprehensive and practical guide to interpreting NT-proBNP values based on the latest guidelines of the European Society of Cardiology (ESC). Attention is also paid to the update...
Male hypogonadism in general practice: from risk factors to testosterone therapyInterdisciplinary overviews
MUDr. Marcela Fontana, Ph.D., MUDr. Marek Broul, Ph.D.
Med. praxi. 2026;23(4):269-273 | DOI: 10.36290/med.2026.034
Male hypogonadism is a clinical syndrome whose diagnosis requires both compatible symptoms and repeatedly confirmed low testosterone concentrations. In adult men, particularly at older age, hypogonadism is often functional and is mainly associated with obesity, metabolic and other chronic diseases, or medication. General practitioners have a key role in recognizing sexual symptoms, arranging standardized laboratory testing, identifying reversible causes, and referring patients to a specialist when indicated. Testosterone therapy is reserved for men with confirmed symptomatic hypogonadism. It may improve libido and mild erectile dysfunction, but it...
Lipedema in primary care: the role of nutritional therapy and lifestyle measuresInterdisciplinary overviews
Mgr. Monika Kunzová, Ph.D.
Med. praxi. 2026;23(4):263-267 | DOI: 10.36290/med.2026.028
Lipedema is a chronic disorder of adipose tissue characterized by symmetrical, disproportionate enlargement of subcutaneous adipose tissue, most commonly affecting the lower extremities, and accompanied by pain, heaviness, and easy bruising. Its pathophysiology involves alterations in adipocytes, microcirculation, extracellular matrix, inflammatory activity, and, in some patients, fluid retention or lymphatic insufficiency. Weight reduction may be beneficial, particularly in patients with concomitant overweight or obesity, but it does not provide causal treatment and its effects are variable. Nutritional therapy is a supportive component of comprehensive...
Influenza versus common cold - what to do?Review articles
MUDr. Marianna Augustínová
Med. praxi. 2026;23(4):255-258 | DOI: 10.36290/med.2026.031
The article addresses the issue of the common cold and influenza as the most frequent viral diseases of the respiratory tract, focusing on their epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prevention. The common cold comprises a set of mild to moderately severe respiratory symptoms, most commonly caused by rhinoviruses. The disease is highly prevalent, and its manifestations are generally mild to moderate in severity. Treatment is symptomatic; antibiotics are used only in cases of bacterial superinfection. Prevention is based primarily on adherence to hygienic measures. Influenza is a highly contagious disease, typically...
Acute coronary syndromes in the general practitioner's office: diagnosis, first steps, and follow-up careReview articles
MUDr. Radomír Nykl, Ph.D., MUDr. Petr Zdráhal, prof. MUDr. Mgr. Alan Bulava, Ph.D., FESC
Med. praxi. 2026;23(4):250-254 | DOI: 10.36290/med.2026.030
Acute coronary syndromes (ACS) represent one of the most critical cardiovascular situations that a general practitioner (GP) can encounter in daily clinical practice. Given the high risk of mortality and the development of severe complications, such as cardiogenic shock or malignant arrhythmias, the GP plays an indispensable role in the initial detection, urgent triage, and immediate management of the patient. This article provides a comprehensive overview of ACS management in primary care, reflecting the current European Society of Cardiology (ESC) guidelines and the specific conditions of the healthcare system in the Czech Republic. Special emphasis...
Patient with atopic dermatitis in general practiceReview articles
MUDr. Jana Nováková
Med. praxi. 2026;23(4):244-249 | DOI: 10.36290/med.2026.033
Atopic dermatitis is a chronic, relapsing, non-infectious inflammatory skin disorder characterized by persistent pruritus and xerosis, associated with an atopic predisposition. It may occur as part of the atopic syndrome together with bronchial asthma, allergic conjuctivitis, allergic rhinitis, mucous colitis and migrena, or as a component of the dermorespiratory syndrome in association with asthma. The clinical presentation of atopic dermatitis is highly variable and is characterized byl alternating periods of remmision and exacerbation. Its ethiopathogenesis involves a complex interplay of genetic predisposition, impared skin barrier function, enviromental...
Patient with dyspepsia in general practiceReview articles
MUDr. Jan Šťovíček, Ph.D.
Med. praxi. 2026;23(4):235-242 | DOI: 10.36290/med.2026.035
Dyspepsia is a common clinical problem in primary care. The key task is to distinguish low-risk patients suitable for an empirical management strategy from those with alarm features or an increased risk of organic disease, in whom prompt diagnostic evaluation is indicated. Functional dyspepsia most commonly presents with postprandial fullness, early satiety, epigastric pain, or epigastric burning and may have a substantial impact on quality of life. The diagnostic approach is based on a careful medical history, physical examination, medication review, and appropriately targeted laboratory, imaging, and endoscopic investigations. In low-risk patients,...
Pacient s revmatickým onemocněním v primární péčiReview articles
MUDr. Jana Tomasová Studýnková, Ph.D.
Med. praxi. 2026;23(4):228-234 | DOI: 10.36290/med.2026.032 
Muskuloskeletální symptomy patří mezi nejčastější problémy, se kterými se setkáváme ve všeobecné praxi. Ačkoli většina případů je mechanického původu, významná část pacientů má zánětlivá revmatická nebo systémová autoimunitní onemocnění, u kterých má včasná diagnóza zásadní vliv na prognózu. Úlohou praktického lékaře je rozpoznat znaky naznačující zánětlivou etiologii a zahájit vhodné diagnostické vyšetření. Základem diferenciální diagnózy je rozlišení mezi mechanickými a zánětlivými příčinami symptomů na základě anamnézy, fyzikálního vyšetření a vhodně indikovaných laboratorních a zobrazovacích vyšetření. Včasné rozpoznání revmatického onemocnění...
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...