Tiché setkání s kolegou z roku 1943

Mgr. Olga Klepáčková

Med. praxi. 2026;23(4):219

Patient with rheumatic disease in primary care

MUDr. Jana Tomasová Studýnková, Ph.D.

Med. praxi. 2026;23(4):228-234 | DOI: 10.36290/med.2026.032

Musculoskeletal symptoms are among the most common problems encountered in general practice. Although most cases are of mechanical origin, a significant proportion of patients have inflammatory rheumatic or systemic autoimmune diseases, in which early diagnosis has a major impact on prognosis. The role of the general practitioner is to recognize features suggestive of an inflammatory etiology and to initiate an appropriate diagnostic work-up. The cornerstone of differential diagnosis is the distinction between mechanical and inflammatory causes of symptoms based on medical history, physical examination, and appropriately indicated laboratory and imaging...

Patient with dyspepsia in general practice

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,...

Patient with atopic dermatitis in general practice

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...

Acute coronary syndromes in the general practitioner's office: diagnosis, first steps, and follow-up care

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...

Influenza versus common cold - what to do?

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...

Mild cognitive impairment in the era of biological therapy: the importance of early intervention

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.

Lipedema in primary care: the role of nutritional therapy and lifestyle measures

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...

Male hypogonadism in general practice: from risk factors to testosterone therapy

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...

On-line romance scam

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 screening

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...

Chronické žilní onemocnění jako modifikátor kardiovaskulárního rizika

MUDr. Zuzana Zafarová

Med. praxi. 2026;23(4):275-280