Medicine for Practice - Latest articles
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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, FFTM RCPS (Glasg.)
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
Medication and baveragesPharmacological profile
PharmDr. Josef Suchopár, MUDr. Štěpán Suchopár
Med. praxi. 2026;23(1):57-63 | DOI: 10.36290/med.2025.079
Proper co-ingestion of oral medications with an appropriate beverage is crucial to ensure their efficacy and safety. However, studies have shown that most patients do not take their medications with water as recommended, but instead use other drinks such as tea, fruit juices, or alcohol. This practice can lead to clinically significant drug interactions. These interactions most commonly arise from the inhibition of transporters such as OATP1A2 and OATP2B1, or the CYP3A4 enzyme, resulting in decreased or increased bioavailability of medications. For example, green tea, grapefruit juice, or orange juice may reduce the absorption of fexofenadine, lisinopril,...
Kardiovaskulární prevence v linii s národním kardiovaskulárním plánemHeard at a congress
MUDr. Zuzana Zafarová
Med. praxi. 2026;23(1):52-56
Dermatoscopy in general practiceInterdisciplinary overviews
MUDr. Lubomír Drlík
Med. praxi. 2026;23(1):47-51 | DOI: 10.36290/med.2025.061
Dermocopy is a higly useful method enhancing accuracy in diagnosis of skin diseases. It is based between clinical and histologic examination. The method has developed in the last 30 years. Beside crucial role in pigmented lesions and malignant melanoma diagnosis, dermoscopy encompasses a broad field of indications.
Macular diseasesInterdisciplinary overviews
doc. MUDr. Tomáš Sosna, Ph.D., MUDr. Bc. Tomáš Novotný, FEBO, MUDr. Kateřina Myslík Manethová, Ph.D., FEBO
Med. praxi. 2026;23(1):38-46 | DOI: 10.36290/med.2025.076
Maculopathies are a diverse group of diseases that affect the central area of the retina, the yellow spot - macula lutea, which is responsible for central vision. If this part of the retina is damaged by any disease, visual acuity often deteriorates to the point of practical blindness. The macula is a very specific part of the retina from a histoanatomical point of view. In the article, we deal with the most common diseases of the macula, age-related macular degeneration, diabetic macular edema and central serous chorioretinopathy. We also mention other causes of maculopathies such as genetic, vascular, hematological diseases, paraneoplastic syndromes...
Diseases of the scalp: an overview for general practitionersInterdisciplinary overviews
MUDr. Kristýna Papajíková, MUDr. Renata Kučerová, Ph.D.
Med. praxi. 2026;23(1):33-37 | DOI: 10.36290/med.2025.078
Diseases of the scalp are a common reason for visits not only to specialized dermatology clinics but also to general practitioners. This review article provides general practitioners with comprehensive information on the most common scalp conditions - dandruff, seborrheic dermatitis, psoriasis, and tinea capitis. It discusses their etiology, pathogenesis, clinical presentation, differential diagnosis, diagnostic options, and current therapeutic approaches. Emphasis is placed on distinguishing between individual conditions and on the personalization of treatment, including relapse prevention. The article also reflects current insights into the role...
Adrenal incidentalomas: management approachInterdisciplinary overviews
doc. MUDr. Ondřej Petrák Ph.D., prof. MUDr. Tomáš Zelinka, CSc.
Med. praxi. 2026;23(1):28-32 | DOI: 10.36290/med.2025.072
Incidentalomas are adrenal masses detected on imaging performer for reasons other than suspected adrenal disease. They include a wide spectrum of diagnoses from completely benign and insignificant findings to hormonally active tumors, to possible rare adrenal cortex carcinoma or metastatic disease. The following article contains a basic diagnostic and therapeutic approach considering currently valid European guidelines on management of adrenal incidentalomas. It includes several basic considerations, namely when to think about malignancy and hormonally active form, when to operate and how follow up the patient.
Beta-blokátory/blokátory kalciových kanálů již nejsou jedinou léčebnou možností u pacientů s obstrukční hypertrofickou kardiomyopatiíHeard at a congress
MUDr. Zuzana Zafarová
Med. praxi. 2026;23(1):23-27
Vegetarianism and veganism - what's the right attitude?Review articles
Mgr. Martin Krobot, Ph.D., Mgr. Marina Jeřábková, MUDr. Eliška Selinger, MSc
Med. praxi. 2026;23(1):17-21 | DOI: 10.36290/med.2026.003
Plant-based diets are gaining popularity due to health, environmental and ethical factors, and an increasingly broad segment of the Czech population is adopting them. Evidence shows that a well-planned plant-based diet can offer substantial health benefits, especially in preventing non-communicable diseases, and can be appropriate across all life stages with adequate supplementation. Poorly planned plant-based diets, however, may pose nutritional risks, particularly for vulnerable groups such as children and pregnant women. Recent position statements increasingly recognise plant-based diets as suitable, while emphasising the need for supervision in...
New from the new year: NT-proBNP in preventive health check-upsReview articles
MUDr. Helena Kostková, Mgr. Tereza Kubecová
Med. praxi. 2026;23(1):12-16 | DOI: 10.36290/med.2025.081
Heart failure is a common and prognostically serious syndrome, where early detection in primary care significantly impacts mortality, morbidity, and patients' quality of life. Natriuretic peptides, particularly NT-proBNP, have become a standard component in the diagnosis of heart failure. An amendment to the preventive check-up regulation, effective from January 1, 2026, introduces NT-proBNP testing into preventive examinations for selected risk groups. This broadens the opportunities for general practitioners to actively identify early stages of heart failure. The article outlines the key principles of NT-proBNP interpretation and highlights the main...
Breast cancer - when to genetically test first-degree relatives of patients with hereditary predispositionReview articles
doc. MUDr. Ing. Jakub Cvek, Ph.D., MUDr. Zlatuše Bravencová
Med. praxi. 2026;23(1):8-11 | DOI: 10.36290/med.2025.074
The familial form of breast cancer constitutes a clinically significant subgroup of the disease, associated with germline mutations in BRCA1, BRCA2, and other susceptibility genes. This article reviews current recommendations for genetic testing in relatives of patients with confirmed or suspected hereditary breast cancer, including testing indications, genetic counseling procedures, and risk stratification strategies. It further discusses surveillance and individualized screening protocols aimed at early cancer detection and reduction of mortality in high-risk populations. The importance of interdisciplinary collaboration and the integration of genetic...
Abstrakta: 4. kongres Medicíny pro praxi v Českých Budějovicích, 28. 2. – 1. 3. 2025, Clarion Congress Hotel České BudějoviceSupplementum
Společnost SOLEN, s. r. o., ve spolupráci s Gastroenterologickým oddělením Nemocnice České Budějovice, a. s.
Med. praxi. 2025;22(Suppl.B) 
Abstrakta: 11. kongres Medicíny pro praxi v Ostravě, 14.–15. února 2025, Clarion Congress Hotel OstravaSupplementum
SOLEN, s. r. o., ve spolupráci s Klinikou anesteziologie, resuscitace a intenzivní medicíny FN Ostrava a LF OU
Med. praxi. 2025;22(Suppl.A)
Infekční respirační onemocnění Editorial
prof. MUDr. Petr Pazdiora, CSc.
Med. praxi. 2025;22(5):311