Slovo úvodem

Viktorija Ragénaité-Mrnka, MD.

Med. praxi. 2026;23(2):75

Travel medicine in general practice

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...

The role of cytisinicline in the treatment of nicotine dependence

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‑20^th 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,...

Early detection of lung cancer in the Czech Republic -new hope for potential patients

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.

Why vitamin D remains a clinically relevant topic

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...

Primary prevention of frailty syndrome

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.

Management of gastroesophageal reflux disease - up to date

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...

Current indications for testing for inherited

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.

Biological therapy for migraine

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...

Na cestě za ideálním tlakem

MUDr. Zuzana Zafarová

Med. praxi. 2026;23(2):106-111

Hemorrhoidal disease - an overview for clinical practice

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,...

Spironolactone as the first-line treatment for HFrEF

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.

Shared medication record in general practice - a tool for improving pharmacotherapy safety

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...

A practical guide to depression screening in clinical practice

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.