Casopis Lekaru Ceskych[JOURNAL]
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200 papers
Recommended diagnostic and therapeutic procedures for psychosomatic care.
Čech P, Kryl M, Stackeová D
Cas Lek Cesk · 2023 · PMID 38981724
Psychosomatic medicine has undergone dynamic development in the Czech Republic in recent years. The Society of Psychosomatic Medicine of the Czech Medical Association of J. E. Purkyně was founded in 2014. It develops bot...
Psychosomatic medicine has undergone dynamic development in the Czech Republic in recent years. The Society of Psychosomatic Medicine of the Czech Medical Association of J. E. Purkyně was founded in 2014. It develops both the professional side of this field and strives for better integration of psychosomatic care into the Czech health care system. After several years of effort, it succeeded in obtaining approval of the medical procedure code in the field of psychosomatics (909) "psychosomatic intervention". The text of Recommended Diagnostic and Therapeutic Procedures for Psychosomatic Care describes the recommended movement of the psychosomatic patient through the health care system, diagnostic categories in psychosomatic medicine and related differential diagnosis, and basic diagnostic units in psychosomatic medicine.
Decriminalisation and smart regulation of psychoactive substances: a modern alternative to prohibition.
Mravčík V
Cas Lek Cesk · 2023 · PMID 38981723
Prohibition has been the globally dominant concept for the regulation and control of psychoactive substances for nearly 70 years. Its effectiveness and legitimacy as a sustainable solution to the problems associated with...
Prohibition has been the globally dominant concept for the regulation and control of psychoactive substances for nearly 70 years. Its effectiveness and legitimacy as a sustainable solution to the problems associated with the existence of psychoactive substances in society has been repeatedly questioned. It is based on the normative assumption that the use of psychoactive substances for other than therapeutic purposes is not allowed, and non-medical supply should be severely punished. This precludes the use of the full range of regulatory, public health, prevention, and harm reduction strategies, reduces well-being, and increases harms for the human-rights, health, and social cohesion. It is time to replace the prohibitionist paradigm with modern regulation that considers the different harms and risks of psychoactive substances, but also the benefits of psychoactive substances for mental health and well-being, lifestyle, and socialisation. This new paradigm (the so-called 'smart regulation') should accept non-medical use of psychoactive substances, apply criminal law as an exceptional tool to regulate human behaviour, regulate the availability of substances according to their harmfulness, regulate the risk profile of the product, strictly regulate marketing and advertising, protect minors and 'others' from the use and supply of psychoactive substances, protect the legal market from the supply of substances from the illegal market, and use economic instruments to regulate demand and to subsidise prevention and treatment.
The challenges of telemedicine in the Czech Republic from an expert perspective.
Těšinová JK, Dobiášová K
Cas Lek Cesk · 2022 · PMID 36543580
Health policy makers are striving to implement new approaches in healthcare with a focus on digital solutions. The COVID-19 pandemic has contributed to an unprecedented acceleration in the spread of information and commu...
Health policy makers are striving to implement new approaches in healthcare with a focus on digital solutions. The COVID-19 pandemic has contributed to an unprecedented acceleration in the spread of information and communication technologies (ICT) in healthcare and has accelerated the use of telemedicine. The aim of the research was to identify problems related to the implementation of telemedicine in practice, to propose possible solutions and to identify the challenges of telemedicine in the Czech Republic in the future. The study is based on the results of a two-phase qualitative expert investigation. Data collection in the first phase took the form of individual semi-structured interviews with experts who have practical experience in the field of telemedicine. The follow-up second phase was conducted in the form of guided group discussions with experts focusing on health, financial and legislative aspects of telecare. It turned out that the introduction and expansion of telemedicine requires changes in the technological infrastructure, in the organization of care and work, and in the adjustment of the legislative environment. It is also necessary to consider the need to overcome several barriers at the level of the healthcare system, healthcare providers, healthcare professionals and patients. On the other hand, a condition for the successful introduction and development of telemedicine is coordinated cooperation between various institutions and stakeholders. The introduction of telemedicine should also be preceded by studies (research) and in-depth analyses. Telemedicine education of healthcare professionals and support for patients in developing their digital competences are also important.
The importance of lung biopsy in a patient with idiopathic pulmonary fibrosis: a case report.
Kaláb J, Lišková E, Dušková J
Cas Lek Cesk · 2022 · PMID 36543579
Idiopathic pulmonary fibrosis (IPF) is a severe progressive fibrotic disease of the lung. Its etiology is not yet completely clear. The affected population is exclusively older than 40 years with maximum incidence in the...
Idiopathic pulmonary fibrosis (IPF) is a severe progressive fibrotic disease of the lung. Its etiology is not yet completely clear. The affected population is exclusively older than 40 years with maximum incidence in the age categories of 60 to 70 years. Its worldwide prevalence varies from 2 to 29/100 000 people (in the Czech Republic 5-6/100 000). Annual incidence is constantly rising, mainly thanks to the ever-improving diagnostic possibilities. Untreated IPF disease causes rapid structural and functional devastation of the lungs with development of respiratory insufficiency and death of the patient within 2 to 3 years after diagnosis, prognosis with IPF is therefore fully (without any exaggeration) comparable to untreated bronchogenic carcinoma. In recent years, the prognosis and quality of life of patients have significantly improved thanks to available specific antifibrotic treatment, which can substantially slow down the disease progression and thus prolong survival. However, a necessary condition for the timely treatment initiation is a quick and accurate diagnosis. The following case report describes a protracted journey to the correct diagnosis in a patient with atypical radiological findings, so that the definitive diagnosis was established only as a result of a surgical lung biopsy.
Current interventional treatment options for severe emphysema.
Šimovič J
Cas Lek Cesk · 2022 · PMID 36543578
Chronic obstructive pulmonary disease (COPD) is one of the three leading causes of death worldwide. If the feature of the disease is dominated by emphysema, we speak of an emphysematic phenotype. Interventional treatment...
Chronic obstructive pulmonary disease (COPD) is one of the three leading causes of death worldwide. If the feature of the disease is dominated by emphysema, we speak of an emphysematic phenotype. Interventional treatment is a standard part of the management of patients with the emphysematic phenotype of COPD. Interventional methods are surgical and endoscopic. An important point in the indication of these methods is the correct selection of profitable patients. In addition to the correct execution of the individual procedure, periprocedural management, anticipation, and optimal handling of complications in the field of severe functional disability have an important effect on the care results.
Chronic cough.
Šestáková Z
Cas Lek Cesk · 2022 · PMID 36543577
Cough is the most common symptom of respiratory diseases, but it is also one of important defense mechanisms of the human body. It is often difficult to determine when this defensive reflex ceases to fulfill its physiolo...
Cough is the most common symptom of respiratory diseases, but it is also one of important defense mechanisms of the human body. It is often difficult to determine when this defensive reflex ceases to fulfill its physiological role and becomes pathological. Cough is not diagnosis; it is the symptom of various diseases and their combination and is the most common symptom of diseases of the respiratory system. Often the definition of chronic cough is confused with the definition of chronic bronchitis, which is defined as a chronic productive cough lasting at least three months in two consecutive years, while other causes of cough are excluded. Chronic cough is associated with poor quality of life and can negatively affect quality of life. Diseases causing chronic cough are most commonly asthma, eosinophilic bronchitis, gastroesophageal reflux, post-nasal drip syndrome, rhinosinusitis, chronic obstructive pulmonary disease, pulmonary fibrosis, and bronchiectasis. Treatment of the underlying etiology of the cough leads to a success rate of up to 90 %. The cause of chronic cough may not be clear and therefore requires a multidisciplinary approach.
Chest pain from pneumologist point of view.
Votruba J
Cas Lek Cesk · 2022 · PMID 36543576
Chest pain is one of the most common symptoms encountered by doctors working in acute, internal, and pulmonary clinics. In the United States in 2006, 10 percent of all visits to the emergency room were caused by diseases...
Chest pain is one of the most common symptoms encountered by doctors working in acute, internal, and pulmonary clinics. In the United States in 2006, 10 percent of all visits to the emergency room were caused by diseases of the respiratory system, and chest pain was the most common symptom. The most common situations that can cause chest pain with an emphasis on their diagnosis and early treatment are chest infections, pneumothorax, pneumomediastinum and tumors affecting the pleural cavity.
Hippocratic Oath and current medical oaths.
Fischerová S, Pohl M
Cas Lek Cesk · 2022 · PMID 36443102
The so-called Hippocratic Oath is based on a standardized form of oath in the ancient world and is undoubtedly the most famous, most discussed and most commented part of the Corpus Hippocraticum, collection of medical wr...
The so-called Hippocratic Oath is based on a standardized form of oath in the ancient world and is undoubtedly the most famous, most discussed and most commented part of the Corpus Hippocraticum, collection of medical writings whose authorship is traditionally attributed to the legendary physician Hippocrates. The study will first introduce the nature of this brief text and the various theories about the origins of the Oath, as well as the evidence for its earliest use. The second part of the study focuses on the history of medical oaths in Czechoslovakia since 1918, especially on the changes in the text of the oaths after 1948 (mainly on the basis of so far unpublished documents from the archives), and presents the form of current medical oaths in the Czech Republic, with reference to the formulations of the Hippocratic Oath itself; an overview table lists both the Czech and Latin versions of the current medical oaths.
The importance of molecular autopsy in forensic medicine.
Orlíčková J, Zeman M, Vojtíšek T … +1 more , Slabý O
Cas Lek Cesk · 2022 · PMID 36443101
Standard autopsy does not always detect a cause of individuals death. It occurs often in cases of sudden death. The reason for decease, at least in a part of unsolved cases, can be revealed using methods of molecular bio...
Standard autopsy does not always detect a cause of individuals death. It occurs often in cases of sudden death. The reason for decease, at least in a part of unsolved cases, can be revealed using methods of molecular biology and genetics. This approach is called molecular autopsy. First application dates to the end of 20th century when cause of sudden unexplained death of a young woman was provided only after execution of molecular autopsy. Molecular autopsy (also known as post-mortem genetic testing) finds its application particularly in cases of sudden death of young people or infants as their decease is more frequently associated with hereditary diseases linked for example to heart or metabolic conditions. In terms of methodical development, the form of molecular testing has been improved until now. Originally, targeted analysis of small number of genes was used. Nowadays, whole-exome and whole-genome sequencing slowly becomes a new standard for molecular autopsy. Although molecular autopsy has a potential to be integrated into an autopsy as a standard part of it, for now it has not become a standardised routine part of forensic autopsy.
Management of Graves ophthalmopathy - 2022 update.
Jiskra J
Cas Lek Cesk · 2022 · PMID 36443100
Graves ophthalmopathy (GO) occurs in 25-50% cases of Graves disease. Most cases are just mild, only 5% represents eye threatening diseases. About 5-10% of cases could be euthyroid and 10% hypothyroid, respectively. All p...
Graves ophthalmopathy (GO) occurs in 25-50% cases of Graves disease. Most cases are just mild, only 5% represents eye threatening diseases. About 5-10% of cases could be euthyroid and 10% hypothyroid, respectively. All patients with GO should be assessed for activity (clinical activity score - CAS) and severity of the disease. Essential conditions of the successful treatment are well controlled thyroid dysfunction, smoking cessation and to refer patients with moderate to severe and sight threatening GO to specialized thyroid eye centers as soon as possible. Local therapy to maintain wet eye (lubricants) and supplementation of selenium deficiency is adequate in mild cases of GO. In cases of moderate to severe and sight threatening GO, administration of intravenous glucocorticoids in thyroid eye centers is first line treatment and a combination with mycophenolate or radiotherapy could be considered. When the first-line treatment fails or a contraindication/intolerance to them is present, non-steroid immunosuppressive drugs (mycophenolate, ciclosporin), rituximab, or radiotherapy could be considered. In rare cases of sight threatening GO urge surgical orbital decompression or tarsorrhaphy is warranted.
Obesity and thyroid gland.
Sucharda P
Cas Lek Cesk · 2022 · PMID 36443099
Decreased thyroid function (both overt and subclinical) is more frequent in overweight and obese people but hypothyroidism as cause of obesity is rare. Borderline or slightly elevated values of thyrotropin without other...
Decreased thyroid function (both overt and subclinical) is more frequent in overweight and obese people but hypothyroidism as cause of obesity is rare. Borderline or slightly elevated values of thyrotropin without other signs of autoimmune inflammation (elevated antibodies, changes at ultrasonography) are mostly consequence of hormonal/cytokine reactions to obesity, especially to hyperleptinemia. However, they simultaneously represent metabolic and cardiovascular risk factor.
Professor Josef Charvát and Informatics.
Svačina Š
Cas Lek Cesk · 2022 · PMID 36443098
Professor Josef Charvát, a prominent internist and endocrinologist, has been following the issues of cybernetics and computers from the very beginning. In the difficult times of the 1950s, he was heavily involved in the...
Professor Josef Charvát, a prominent internist and endocrinologist, has been following the issues of cybernetics and computers from the very beginning. In the difficult times of the 1950s, he was heavily involved in the organization of seminars and meetings of workers in technical and medical fields interested in cybernetics. Later, in his books for the general public, he foresaw a significant application of computers in medicine. His predictions are quite accurate even 50 years after the publication of these ideas.
Jakub Hron Metánovský and his traces in Czech medicine.
Musil V
Cas Lek Cesk · 2022 · PMID 36100460
Among other serious scientific efforts of revivalists, somewhat distinctive personalities also appeared at the time of the National Revival. Among them was the secondary school teacher, physicist and inventor Jakub Hron...
Among other serious scientific efforts of revivalists, somewhat distinctive personalities also appeared at the time of the National Revival. Among them was the secondary school teacher, physicist and inventor Jakub Hron Metánovský, whose 100th anniversary of death passed last year. Although he did not complete his studies at the Faculty of Medicine in Prague, which he began at the age of 51, a medical trace can be found in his works, not only in his inventions, but also in professional Czech medical and anatomical terms. Although he has never become a doctor of medicine, it is certainly worth remembering this peculiar figure in our history.
Czech public health - past and present.
Hnilicová H
Cas Lek Cesk · 2022 · PMID 36100459
The article deals with the concept, development, and current state of public health in the Czech lands as a theoretical and practical scientific discipline, as it has been formed and profiled during more than two hundred...
The article deals with the concept, development, and current state of public health in the Czech lands as a theoretical and practical scientific discipline, as it has been formed and profiled during more than two hundred years of history. It identifies five developmental stages, which briefly characterizes and introduces important representatives of the field at the time. It describes the transformation of public health care after 1989 and points out some of the consequences of institutional reduction associated with the weakening of the field, which became fully apparent during the COVID-19 pandemic.
Horizon Europe, research and innovation programme until 2027 - what is new comparing with Horizon 2020?
Kinkorová J
Cas Lek Cesk · 2022 · PMID 36100458
Horizon Europe is the 9th framework programme of European Union (EU) funding research and innovation with the biggest budget ever of €95.5 billion. The main aims of the programme are to boost competitiveness and gr...
Horizon Europe is the 9th framework programme of European Union (EU) funding research and innovation with the biggest budget ever of €95.5 billion. The main aims of the programme are to boost competitiveness and growth of European Union, to achieve EU sustainable development and to tackle climate change. The programme facilitates collaboration between member states and strengthens the impact of research and innovations. The structure of HEU is similar as in Horizon 2020 based on three pillars: Excellent Science, Global Challenges and European Industrial Competitiveness, and Innovative Europe. Horizon Europe brings several novelties as missions, European partnerships, open science, and gender issues. There are five mission areas and the first one of them is Cancer Mission. European partnership is a new form of objective-driven collaborations bringing together private and/or public partners together to address some of Europe´s most important challenges through concerted research and innovation initiatives. Open science policy is mandatory and refers to the open access to publications and open science principles. In the frame of gender equality strategy, the EU has established a well-established regulatory framework on gender equality, including binding directives, which apply widely across the labour market including the research sector.
Islamic Republic of Iran - a surprisingly progressive centre of medical tourism.
Sobotková V
Cas Lek Cesk · 2022 · PMID 36100457
The Islamic Republic of Iran is a very progressive state in the field of medical research and its application. Although the country is fully subject to Islamic law (shari'a) and the influence of Shi'ite clerics,...
The Islamic Republic of Iran is a very progressive state in the field of medical research and its application. Although the country is fully subject to Islamic law (shari'a) and the influence of Shi'ite clerics, the development of medical science is not limited at all; Shi'ite medical ethics (unlike Sunnite) allows most of the modern medical techniques. Due to this attitude, Iran specializes today in many techniques that are prohibited in other countries for religious or ethical reasons. For example, Iranian research on cloning, cell and gene therapy reaches the world level, patients can use a third-party donor program and surrogacy for infertility treatment, the sale of kidney for transplantation was legalized, gender reassignment surgery is performed, and the country is a centre of cosmetic surgery. All of these services (excluding transplantation) are also offered to foreign patients. Thanks to these unlimited possibilities, high quality and low price, Iran has been currently gaining a strong position in the medical tourism market, not only in the Middle East region, but also worldwide.
Current issues of body donation for teaching and research purposes and their use in the Czech Republic.
Frišhons J, Joukal M, Vojtíšek T … +6 more , Hájek P, Miklošová M, Ferda J, Naňka O, Mrzílková J, Kachlík D
Cas Lek Cesk · 2022 · PMID 36100456
Since time immemorial, bodies of deceased have been an integral part of teaching anatomy, and therefore the study of medicine. Without them, the teaching of anatomy, clinical anatomy and many research projects could not...
Since time immemorial, bodies of deceased have been an integral part of teaching anatomy, and therefore the study of medicine. Without them, the teaching of anatomy, clinical anatomy and many research projects could not be realized. Nowadays, the European countries allow to use exclusively bodies of the deceased donors. Recently, we have registered a growing trend in the needs of the bodies not only for the purposes of medical education, but also for those of clinical anatomy. The question also arose of the suitability of using COVID-19 positive donors or the legislative possibility of obtaining bodies in the absence of donors in the donor program. Our communication addresses current issues of body donation for teaching and research purposes and their use in the Czech Republic.
Use of unmanned aerial systems in the health care.
Bohoněk M
Cas Lek Cesk · 2022 · PMID 36100455
The use of unmanned aerial systems (drones) in the medical care, especially for the distribution of blood, laboratory samples, drugs and medical supplies is the subject of several research and practical pilot projects ar...
The use of unmanned aerial systems (drones) in the medical care, especially for the distribution of blood, laboratory samples, drugs and medical supplies is the subject of several research and practical pilot projects around the world with a wide perspective of use in civilian and military settings. For the purposes of medical service of troops, this is a suitable and promising solution for strengthening of pre-hospital care in advanced lines and in small combat task forces, which often operate in the rear of the enemy, in conditions of irregular warfare and difficult to access medevac. Deploying drones can effectively enhance the capabilities of mobile medical teams and at the same time life-saving prehospital healthcare concepts such as "remote damage control resuscitation" and "blood far forward". The paper presents a brief overview of the development and use of drones in medical applications for civil and military use.
Thoracoscopic approach in the treatment of thoracic duct injuries - case reports and review of the literature.
Tulinský L, Mitták M, Ihnát P
Cas Lek Cesk · 2022 · PMID 36100454
Thoracic duct injuries are very rare due to its protected location. Duct is most often injured in polytraumas and during operations in his vicinity. Treatment is primarily conservative, based on a low-fat diet or parente...
Thoracic duct injuries are very rare due to its protected location. Duct is most often injured in polytraumas and during operations in his vicinity. Treatment is primarily conservative, based on a low-fat diet or parenteral nutrition and adequate chest drainage. If the conservative management fails, a surgical duct ligation via thoracotomy, or more conveniently thoracoscopic approach, is necessary. The presented case reports describe the surgical treatment of isolated injury of the thoracic duct via thoracoscopic approach.
Anaesthesia for non-cardiac surgical procedures in patients after heart transplantation.
Šoltés J, Říha H, Bruthans J … +2 more , Kramář P, Ročeň M
Cas Lek Cesk · 2022 · PMID 36100453
Over the last 5 years, around 75 heart transplantations a year have been performed in the Czech Republic. According to these data and longer survival of these patients, it is obvious that non-cardiac surgical procedures...
Over the last 5 years, around 75 heart transplantations a year have been performed in the Czech Republic. According to these data and longer survival of these patients, it is obvious that non-cardiac surgical procedures in this particular group of patients are not rare. In the patients after heart transplantation, there is a significantly higher risk of undergoing elective and emergency surgical procedures due to various reasons. Appropriate anaesthesia and perioperative care are fundamentally affected by the knowledge of pathophysiological and pharmacological differences of transplanted heart. An equally important aspect is a lifetime immunosuppressive therapy in these patients.
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