Casopis Lekaru Ceskych[JOURNAL]
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200 papers
Artificial intelligence in healthcare: the duty to inform patients.
Doležal T, Doležal A
Cas Lek Cesk · 2025 · PMID 41615791
Artificial intelligence (AI) is increasingly used in healthcare, ranging from diagnostic and therapeutic applications to administrative support. Its implementation raises not only medical and ethical, but also legal chal...
Artificial intelligence (AI) is increasingly used in healthcare, ranging from diagnostic and therapeutic applications to administrative support. Its implementation raises not only medical and ethical, but also legal challenges. This review article focuses on the healthcare provider's duty to inform patients about the use of AI systems in clinical practice. It examines the ethical dimension of this duty, particularly the principles of autonomy and the patient's right to information and explanation and analyzes the legal framework arising from the EU Artificial Intelligence Act, GDPR, the Council of Europe Framework Convention, and the Czech Health Services Act. The authors conclude that the patient's right to be informed about the use of AI and to understand its role in clinical decision-making can be derived from the concept of informed consent, even though it is not yet explicitly enshrined in law. The article also offers recommendations for clinical practice regarding the scope and depth of information disclosure.
The last ten years with inosine pranobex - from an "old" therapeutic agent to vaccine research, including anti-cancer vaccines.
Beran J, Slíva J
Cas Lek Cesk · 2025 · PMID 41615790
Inosine pranobex (IP), also known as inosine pranobex dimepranol, is an immunomodulatory drug with a history spanning more than fifty years. It was first introduced in the 1970s and has since been licensed in more than 5...
Inosine pranobex (IP), also known as inosine pranobex dimepranol, is an immunomodulatory drug with a history spanning more than fifty years. It was first introduced in the 1970s and has since been licensed in more than 50 countries around the world. It was originally considered a potential drug for AIDS, which raised high hopes at the time of the discovery of the HIV virus. However, after initial interest, its use in this area declined, and for a long time, IP was no longer discussed significantly in professional literature or clinical practice. Renewed interest came only in the last decade, when IP began to reappear in connection with the treatment of acute respiratory infections, diseases caused by human papillomavirus (HPV), and other viral diseases, including COVID-19. It also began to be used as an adjuvant in the foot-and-mouth disease vaccine, and research began on an IP-based anti-tumor vaccine.
The relationship of B vitamins to diabetes mellitus.
Sotak Š
Cas Lek Cesk · 2025 · PMID 41615789
Vitamins, together with trace elements, belong to the group of essential nutrients called micronutrients, as they are needed by the human body in relatively small quantities. Their deficiency usually develops over a long...
Vitamins, together with trace elements, belong to the group of essential nutrients called micronutrients, as they are needed by the human body in relatively small quantities. Their deficiency usually develops over a longer period, and therefore most often manifests itself in patients with chronic diseases, malnutrition or insufficient supplementation within the framework of long-term artificial nutrition. B vitamins are water-soluble vitamins that are primarily related to hematopoiesis and the nervous system; their deficiency can cause various anemias and neuropathies. However, the relationships of all B vitamins to various types of diabetes mellitus and their complications have also been described. B vitamins are related to glucose metabolism, their reduced serum level can be a risk factor for the onset and development of diabetes mellitus. Supplementation of individual vitamins is relevant for the prevention and/or therapy of diabetes mellitus and its complications.
Doxycycline post-exposure prophylaxis (Doxy-PEP) in Czech clinical practice: a review of efficacy, safety, and implications for antimicrobial resistance.
Broul M, Dlouhý P
Cas Lek Cesk · 2025 · PMID 41615788
Doxycycline post-exposure prophylaxis (Doxy-PEP; a single 200 mg dose of doxycycline within 72 hours after sexual exposure, not exceeding 200 mg per 24 hours) has been shown in randomized trials among men who have sex wi...
Doxycycline post-exposure prophylaxis (Doxy-PEP; a single 200 mg dose of doxycycline within 72 hours after sexual exposure, not exceeding 200 mg per 24 hours) has been shown in randomized trials among men who have sex with men (MSM) and transgender women (TGW) to reduce the incidence of syphilis and Chlamydia trachomatis infection; its effect on Neisseria gonorrhoeae transmission is smaller and varies by locale. In 2024, the U.S. Centers for Disease Control and Prevention (CDC) published the first clinical guidance recommending targeted use of Doxy-PEP for MSM/TGW with a bacterial sexually transmitted infection (STI) in the previous 12 months; European branch of International Union Against Sexually Transmitted Infectuions (IUSTI-Europe) in June 2024 acknowledged individual benefits while urging caution; and in 2025 the World Health Organization initiated development of global guidance. To provide a clinically oriented review of the effectiveness, safety, and risks of Doxy-PEP and to place these findings within the Czech context of epidemiology and antimicrobial resistance, including interpretation of the national position statement of the Society for Infectious Medicine (SIL ČLS JEP). Doxy-PEP is an effective tool for preventing syphilis and Chlamydia trachomatis infection in high-risk MSM/TGW. Given potential adverse effects, the risk of antimicrobial resistance (AMR) development, and the still limited data for other populations, cautious, data-driven use within comprehensive sexual health care is advisable. This approach is consistent with international recommendations and the current SIL ČLS JEP position statement.
Alcohol and drug interactions.
Juřica J, Turjap M
Cas Lek Cesk · 2025 · PMID 41615787
Alcohol use is a serious health problem in the Czech Republic with significant impact on morbidity, mortality and pharmacotherapy. Approximately 15-18% of the population drink risky, and the combination of alcohol and dr...
Alcohol use is a serious health problem in the Czech Republic with significant impact on morbidity, mortality and pharmacotherapy. Approximately 15-18% of the population drink risky, and the combination of alcohol and drugs is common and often overlooked. Ethanol is metabolised predominantly in the liver by the enzymes ADH and CYP2E1. Chronic consumption induces CYP2E1, which might increase the production of toxic metabolites of some drugs. Ethanol acts on the CNS mainly through GABA, NMDA and adenosine receptors and affects ion channels, contributing to its CNS-depressant effects. Alcohol-drug interactions may be pharmacokinetic (e.g., alteration of absorption, induction or inhibition of enzymes) or pharmacodynamic (e.g., potentiation of hepatotoxicity, CNS depression, hypotension, hypoglycemia). A significant risk with several drugs represents so called disulfiram reaction. Alcohol may also increase neurotoxicity and the risk of seizures, especially when abruptly discontinued after chronic use. In the elderly population, an accumulation of risks plays a role: polypharmacy, altered pharmacokinetics and increased susceptibility to adverse effects. The combination of alcohol with immunomodulatory therapy may alter the immune response and increase the risk of infections. Interaction studies are limited by associated liver injury, small sample sizes, and variability in ethanol doses. Polymorbid elderly and patients with liver cirrhosis are at the highest risk.
Alcohol-related liver disease.
Mayerová E
Cas Lek Cesk · 2025 · PMID 41615786
Alcohol-related liver disease (ALD) represents a broad continuum of pathological conditions caused by excessive alcohol consumption - from simple steatosis through steatohepatitis and fibrosis to cirrhosis and its compli...
Alcohol-related liver disease (ALD) represents a broad continuum of pathological conditions caused by excessive alcohol consumption - from simple steatosis through steatohepatitis and fibrosis to cirrhosis and its complications. The article summarizes the current view on this issue.
Alcohol and the cardiovascular system.
Seidlerová JM
Cas Lek Cesk · 2025 · PMID 41615785
Mlíková Seidlerová J. Alcohol and the cardiovascular system The consumption of alcohol leads to a variety of direct and indirect effects on the cardiovascular system, as evidenced by numerous epidemiological studies on t...
Mlíková Seidlerová J. Alcohol and the cardiovascular system The consumption of alcohol leads to a variety of direct and indirect effects on the cardiovascular system, as evidenced by numerous epidemiological studies on this topic. The effect of alcohol on the development of cardiovascular complications is influenced not only by the amount of alcohol consumed but also by the drinking pattern (binge drinking vs. regular consumption of moderate amounts of alcohol). This applies to the relationship between alcohol consumption and the rise in blood pressure or the development of arterial hypertension as well.
Is there a beneficial dose of alcohol?
Souček M
Cas Lek Cesk · 2025 · PMID 41615784
Souček M. Is there a beneficial dose of alcohol? Alcohol consumption has a significant impact on overall health burden and is one of the main causes of morbidity and premature mortality. On average, 10 liters of pure alc...
Souček M. Is there a beneficial dose of alcohol? Alcohol consumption has a significant impact on overall health burden and is one of the main causes of morbidity and premature mortality. On average, 10 liters of pure alcohol per capita are consumed annually in the Czech Republic. Based on recent studies, we are moving away from the concept of a beneficial dose of alcohol, and a minimal dose, ideally none, is recommended. This particularly applies to oncological diseases and liver diseases. From the perspective of cardiovascular diseases, the maximum tolerable dose is reported to be 20-30 g of alcohol for men and 10-15 g for women.
Recommendations for the implementation of European Union regulations on the donation and use of human-derived substances.
Konečná H
Cas Lek Cesk · 2025 · PMID 41582914
In July 2024, a European Union regulation on substances of human origin came into effect, which is to be implemented into the legislation of member states by August 2027. The fundamental ethical principle remains volunta...
In July 2024, a European Union regulation on substances of human origin came into effect, which is to be implemented into the legislation of member states by August 2027. The fundamental ethical principle remains voluntary and unpaid donation, but the responsibility for addressing related ethical issues is left to the member states. Ethical topics that should be considered during implementation, such as methods of obtaining and compensating donors of substances of human origin, donor anonymity, and the content of informed consents, were addressed in our research project "Quality and Sustainability of Body Part Donation Programs in the Czech Republic - TA ČR No. TL05000144", which took place between 2021 and 2023.
A pilot project of retrospective analysis of the use of is-CGM aimed at evaluating the quality of therapy for geriatric patients with type 2 diabetes treated with insulin hospitalized in internal or long-term care beds (PRAVis-CGM: Project of Retrospecti….
Kvapil M
Cas Lek Cesk · 2025 · PMID 41582913
New glucose monitoring technologies improve diabetes compensation and reduce the risk of hypoglycemia. The aim of the multicenter pilot project of retrospective analysis of the use of is-CGM (PRAVis-CGM: Retrospective An...
New glucose monitoring technologies improve diabetes compensation and reduce the risk of hypoglycemia. The aim of the multicenter pilot project of retrospective analysis of the use of is-CGM (PRAVis-CGM: Retrospective Analysis of is-CGM Project) is to evaluate the benefit of intermittently scanned continuous glucose monitoring for improving the quality of therapy of geriatric patients with type 2 diabetes treated with insulin hospitalized in inpatient or long-term care beds. The main goals are the quantification of hypoglycemic events using the time spent in lower values of glycemia concentration and providing data for the implementation of is-CGM into the routine operation of the inpatient facility. We assume that the selected parameters can subsequently be defined as indicators of the quality of care for seniors treated with insulin during hospitalization.
Classification of diabetic foot disease cases using Czech DRG system.
Fejfarová V, Piťhová P, Koliba M … +6 more , Jirkovská A, Jirkovská J, Kůsová H, Drienko M, Molinari I, Zvolský M
Cas Lek Cesk · 2025 · PMID 41582912
The implementation of the DRG system into real podiatric practice presupposes the application and adherence to the rules for reporting hospitalizations related to diabetic foot syndrome. The reason is both the cultivatio...
The implementation of the DRG system into real podiatric practice presupposes the application and adherence to the rules for reporting hospitalizations related to diabetic foot syndrome. The reason is both the cultivation of reimbursements for relatively economically demanding hospitalizations of patients with this late complication and the availability of data providing a national overview of the development and prognosis of patients with diabetic foot syndrome in real-time.
Late-onset hypogonadism in men over 40 - how to use the updated EAU 2025 guidelines and new findings on the cardiovascular safety of testosterone therapy.
Broul M, Hujová A
Cas Lek Cesk · 2025 · PMID 41582911
Late-onset hypogonadism is a clinical syndrome defined by androgen-deficiency symptoms and persistently low testosterone; it affects roughly two to eight percent of European men aged 40-79 years and becomes more prevalen...
Late-onset hypogonadism is a clinical syndrome defined by androgen-deficiency symptoms and persistently low testosterone; it affects roughly two to eight percent of European men aged 40-79 years and becomes more prevalent with advancing age, obesity and cardiometabolic comorbidities. The 2025 update of the European Association of Urology (EAU) guidelines sets a unified biochemical threshold of total testosterone below 12 nmol/L confirmed by two morning samples and emphasises baseline assessment of luteinizing hormone (LH), follicle-stimulating hormone (FSH), blood pressure and haematocrit before therapy. The large multicentre TRAVERSE trial showed that transdermal testosterone replacement does not increase major adverse cardiovascular events, yet revealed a mild rise in systolic blood pressure, a finding reflected in the latest US Food and Drug Administration (FDA) labelling changes. Building on this evidence, we propose a four-step algorithm encompassing precise diagnosis, judicious initiation of treatment, integrated management of cardiometabolic risk factors and personalised fertility preservation. Such an approach permits effective and safe management of symptomatic late-onset hypogonadism while mitigating long-term risks.
Prevalence of haemostatic genes' polymorphisms in men and women with venous thromboembolism in the Czech Republic - a population-based study of cases and controls.
Kvasnička J, Zenáhlíková Z, Cífková R … +10 more , Šťastná S, Kudrnová ZK, Brzežková R, Hájková J, Bobčíková P, Syrůčková A, Linhartová P, Ševčík M, Dušková D, Kvasnička T
Cas Lek Cesk · 2025 · PMID 41582910
Our study aimed to determine the prevalence of five polymorphisms of haemostatic genes rs6025 (F5, Leiden), rs1799963 (F2, prothrombin), rs2066865 (FGG), rs2289252 (F11), and rs8176719 (ABO), in 2 cohorts of 924 men and...
Our study aimed to determine the prevalence of five polymorphisms of haemostatic genes rs6025 (F5, Leiden), rs1799963 (F2, prothrombin), rs2066865 (FGG), rs2289252 (F11), and rs8176719 (ABO), in 2 cohorts of 924 men and 1,706 women who had venous thromboembolism (VTE), and to compare their occurrence with that in two control groups of healthy individuals (1,516 men and 1,121 women) with no history of VTE in the Czech Republic. Statistically significant increases in the prevalence of rs6025 (F5), rs1799963 (F2), rs2066865 (FGG), rs2289252 (F11) and rs8176719 (ABO) were found in both groups of men and women compared to controls (all p ˂ 0.0001). Both F5 Leiden variants increase the risk of VTE. In male homozygotes 70.56-fold, in male heterozygotes 5.45-fold; in female homozygotes 18.8-fold and in female heterozygotes 5.58-fold. For rs1799963 (F2), the risk of VTE was statistically significantly increased only in the heterozygous variant (3.86-fold in males and 3.95-fold in females). Mutated homozygotes could not be evaluated due to their rare occurrence in the sample. An increase in the risk of VTE of the rs2066865 (FGG) variants was again observed in males (1.8-fold in homozygotes, 1.17-fold in heterozygotes) and females (1.88-fold in homozygotes, 1.32-fold in heterozygotes). Derived variants of rs2289252 (F11) also increased the risk of VTE (1.8-fold in male homozygotes and 1.5-fold in male heterozygotes;1.73-fold in female homozygotes and 1.35-fold in female heterozygotes). Again, we found a higher risk of VTE in individuals with VTE when mutant variants of rs8176719 (ABO) were present. In male homozygotes, it was 4.03-fold and in heterozygotes 2.38-fold. In homozygous women, it was 3.16-fold and in heterozygotes 2.11-fold. Conclusions: Our study confirms that in the Czech Republic, in addition to the known thrombophilic mutations rs6025 (F5) and rs1799963 (F2), there is also a higher prevalence of polymorphisms of the haemostatic gene rs2066865 (FGG), rs2289252 (F11) and rs8176719 (ABO) in both sexes, which can therefore be identified as additional independent heritable risk factors for the VTE.
Oldřich Ferdinand, MD - a notable figure of moravian phoniatrics. A remembrance on the 115th anniversary of his birth.
Kalivoda I
Cas Lek Cesk · 2025 · PMID 41417594
Oldřich Ferdinand, MD (1910-1997) was a prominent figure in Czechoslovak phoniatrics and the founder of modern phoniatric care in northern Moravia. After graduating from the Faculty of Medicine at Masaryk University in B...
Oldřich Ferdinand, MD (1910-1997) was a prominent figure in Czechoslovak phoniatrics and the founder of modern phoniatric care in northern Moravia. After graduating from the Faculty of Medicine at Masaryk University in Brno in 1934, he served in various medical positions, including military service and work at the otolaryngology clinic under professor František Ninger. In 1940, he completed a study stay with professor Miloslav Seemann, a leading global expert in phoniatrics, which influenced his lifelong dedication to caring for individuals with hearing and speech disorders. In 1945, he became the head physician of the otorhinolaryngology department at the hospital in Hranice, where he established a modern phoniatric clinic. He was instrumental in founding phoniatric departments in Ostrava (1949) and Olomouc (1951), as well as an inpatient phoniatric department in Hranice (1966). His organizational skills led to the development of speech therapy services in the North Moravian region. Alongside his medical practice, he was an active educator, leading courses for speech therapists and serving as an external lecturer at several faculties. His scientific work includes over 50 publications, including studies on Jan Evangelista Purkyně and Gregor Mendel. In recognition of his contributions, he was awarded the J. E. Purkyně Medal and other honours. Ferdinand's dedication and contributions to the development of phoniatrics and speech therapy influenced thousands of patients and colleagues. His life and work remain an inspiration for future generations of physicians and have significantly contributed to the advancement of healthcare in Czechoslovakia.
Newly discovered documents about J. E. Purkyně at the Anatomical Institute of the 1st Faculty of Medicine, Charles University.
Ivánková M
Cas Lek Cesk · 2025 · PMID 41417593
Abstract loading — click title to view on PubMed.
Little-known first autopsies in the Czech lands.
Krá D
Cas Lek Cesk · 2025 · PMID 41417592
The autopsy performed by Ján Jesenský in 1600 is often perceived as the first autopsy in the history of Czech medicine. However, when examining historical sources and previously published articles, it turns out that seve...
The autopsy performed by Ján Jesenský in 1600 is often perceived as the first autopsy in the history of Czech medicine. However, when examining historical sources and previously published articles, it turns out that several autopsies had been performed in our territory earlier. The article presents these events chronologically and with available details.
What to consider when sharing health information on-line?
Dubanská B
Cas Lek Cesk · 2025 · PMID 41417590
Abstract loading — click title to view on PubMed.
Modern possibilities of diagnosis and treatment of Peyronie's disease in the Czech context.
Broul M, Hujová A, Zámečník L
Cas Lek Cesk · 2025 · PMID 41417589
Peyronie's disease is an acquired fibrotic disorder of the tunica albuginea, leading to penile deformity, painful erections, and often erectile dysfunction; its prevalence in Europe reaches up to 9% in middle-aged men. T...
Peyronie's disease is an acquired fibrotic disorder of the tunica albuginea, leading to penile deformity, painful erections, and often erectile dysfunction; its prevalence in Europe reaches up to 9% in middle-aged men. This review summarizes the results of studies from 2019-2025 concerning diagnostic methods and therapeutic options. Based on the analysis of 142 original studies, 23 meta-analyses, and current European Association of Urology (EAU) a American Urological Association (AUA) recommendations, we confirm that intralesional verapamil reduces curvature in the active phase by an average of 9-17° and low-intensity shockwave therapy (LiSWT) improves pain and reduces curvature by approximately 10°, particularly for plaques larger than 2 cm. Surgical methods - plication, incision/grafting, and penile prosthesis implantation - achieve initial straightening in more than 90% of cases but differ in impact on penile length and the risk of de novo erectile dysfunction. Regenerative therapies like platelet-rich plasma (PRP) or mesenchymal stem cells (MSC) offer promising, yet currently experimental results. Optimal care is based on early diagnosis, individualization of conservative treatment, and precise surgical correction; in the Czech Republic, standard approaches include verapamil, LiSWT, and surgery, while biological approaches require further research.
Probiotics in antibiotic treatment - an overview of effectiveness, risks, and recommended practices.
Fenclová K, Murínová I
Cas Lek Cesk · 2025 · PMID 41417588
The administration of antibiotics is associated with the risk of diarrhea due to disruption of the natural gut microbiome, a condition that may persist for several months after the completion of treatment. Probiotics are...
The administration of antibiotics is associated with the risk of diarrhea due to disruption of the natural gut microbiome, a condition that may persist for several months after the completion of treatment. Probiotics are often used to prevent antibiotic-associated diarrhea; however, their effectiveness in this indication remains a subject of discussion. Meta-analyses confirming the benefits of probiotics are critically assessed by the professional community, and for a long time, their administration was not included in the recommended practices of professional societies. The situation changed in 2023 when probiotics were included in the recommended practices of the World Gastroenterology Organization. This article focuses on the possibilities of administering probiotics in the Czech context, emphasizing currently available medicinal products, their composition, benefits, and potential risks.
Survey of experiences of chronically ill patients with care provided by general practitioners and evaluation of the outcomes of this care.
Seifert B, Král N, Chloupková R … +1 more , Vostalová L
Cas Lek Cesk · 2025 · PMID 41417587
The aging population and the increase in chronic multimorbidity are challenges for health systems. The PaRIS international survey assesses the experiences of chronically ill patients with primary healthcare provision and...
The aging population and the increase in chronic multimorbidity are challenges for health systems. The PaRIS international survey assesses the experiences of chronically ill patients with primary healthcare provision and the outcomes of this care. Questionnaires were collected from 1,816 primary care providers and 107,011 patients from 19 OECD countries participating in the project. The Czech Republic contributed 110 questionnaires from primary care providers and 4,136 questionnaires from patients. In the Czech Republic, people with chronic diseases have better experiences with the quality of primary care and care coordination compared to the OECD PaRIS average. More chronically ill people in Czechia rate the fulfillment of social functions positively, while other care outcomes are around OECD PARIS average. This assessment is based on 10 key indicators, assessing patient-reported outcomes of care (PROMs) and evaluating patient-reported experiences (PREMs). The project provides valuable information for health policy and ongoing reforms.
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