Casopis lekaru ceskych最新文献

Telemedicine video consultations in the Czech Republic have, in recent years, evolved from an improvised tool for improving access to care into an explicitly regulated form of healthcare service delivery. The aim of this paper is to summarize the current legislative, technical and security framework for video consultations and to propose a practical approach to their implementation in outpatient practice. This paper is a review article based on an analysis of the current legal framework, implementing regulations and technical standards applicable to telemedicine healthcare services in the Czech Republic. The analysis demonstrates that the provision of video consultations must be understood comprehensively as a managed digital healthcare service. Key requirements concern the establishment of clinical procedures, legal responsibility, medical documentation, cybersecurity, and the operational organization of the service. Successful implementation of video consultations in outpatient care requires the integration of legislative, technical, security and clinical aspects. Video consultations should therefore not be perceived merely as an isolated technological tool, but as a managed and standardized component of healthcare service delivery.

New-onset sexual dysfunction in men, particularly erectile dysfunction, should not be regarded merely as an isolated sexual complaint. It may represent an early manifestation of endothelial dysfunction, atherosclerotic disease, diabetes mellitus type 2, obesity, arterial hypertension, dyslipidemia, hypogonadism, hyperprolactinemia, thyroid disorders, or adverse drug effects. The aim of this review is to summarize current evidence on the relationship between sexual dysfunction and cardiometabolic risk and to provide a practical outpatient approach for primary care, internal medicine, diabetology, urology, and sexual medicine. This narrative review is based mainly on the current European Association of Urology recommendations, the Princeton IV Consensus, and selected systematic reviews and meta-analyses. Particular attention is paid to focused history taking, physical examination, basic laboratory work-up, risk stratification, and the differential diagnosis of vasculogenic, endocrine, iatrogenic, and psychogenic causes. The review also incorporates the Czech clinical context and proposes a pragmatic referral framework for situations requiring further evaluation or specialist care.

Dr. Ernst Wodak (1891-1962) was one of the most important figures of early European vestibulology. Although he was born in Moravia and received his medical education in Prague, his name is now almost unknown in Czech medical literature. This article provides a comprehensive overview of his life and career - from his studies at the University of Vienna and the German University in Prague, his work at the Otiatric-Rhinological Clinic under professor Otto Piffl, and his scientific achievements and international recognition in interwar Europe, to his emigration from Nazi-occupied Czechoslovakia and his subsequent work in Palestine and later Israel. Wodak made a fundamental contribution to the development of diagnostic methods of the vestibular system, published more than 200 scientific papers, and became a respected member of CORLAS. Despite his worldwide professional reputation, he did not find adequate academic opportunities in Israel, and his later years were marked by severe illness and social isolation. The aim of this article is to highlight his remarkable contributions, place them within their historical and social context, and restore this important figure to his rightful place in the history of otorhinolaryngology in Bohemia.

Therapeutic antibiotic monitoring allows for the assessment of whether the chosen dosage leads to the achievement of the desired pharmacokinetic-pharmacodynamic (PK/PD) indices in a specific patient. The modern concept of therapeutic drug monitoring (TDM) goes beyond merely comparing to the therapeutic range and emphasizes the determination of an individual therapeutic target. Knowledge of PK/PD indices: Cmax/MIC, AUC/MIC, and fT>MIC is crucial for optimizing treatment and minimizing the risk of toxicity. TDM is a tool of personalized pharmacotherapy. TDM represents a process and includes individual steps, the implementation of which into routine practice contributes to the rationalization and safety of antibiotic therapy.

The advance directives institute represents a legally established instrument that allows patients to define their wishes and preferences regarding the provision of health care in advance, for situations in which they lose decision-making capacity. Although advance directives have been part of the Czech legal framework since 2012, their practical use remains limited and systematic data on their implementation are lacking. The aim of this article is to summarize available knowledge regarding the awareness of the Czech public and healthcare professionals about advance directives, identify the main barriers to their use, and place these findings in the context of current debates about end-of-life decision-making.

In 2024, the Chamber of Deputies of the Parliament of the Czech Republic approved a bill amending Act No. 372/2011, on health services and conditions for their provision (the Health Services Act). Its amendment (Act No. 240/2024) was, among other things, supposed to include provisions concerning spiritual care provided by hospital chaplains. However, this did not happen, and hospital chaplaincy received legal support only with the next comprehensive amendment to the Health Services Act in 2025. However, this did not happen, and hospital chaplaincy received legal support only with the next comprehensive amendment to the Health Services Act in 2025 (Act No. 290/2025).

Drug-related complications during acute intercurrent illnesses represent a significant clinical problem particularly in multimorbid patients. The Sick Day Rules concept provides a simple and effective framework for healthcare professionals to safely implement temporary witholding of medications that affect renal haemodynamics and glycaemic control. However, several commonly used high-risk drug classes, specifically statins, anticoagulants, and methotrexate, cannot be included in these simplified recommendations, as their management requires individualised clinical assessment. This article summarizes the pharmacological and clinical rationale for excluding these agents from this concept and proposes an argument-based framework to support clinical decision-making in routine practice, with the aim of minimising risks associatied with both inappropriate continuation and unjustified interruption of therapy.

Administrative and documentation burden is an important factor affecting clinical efficiency, patient-clinician communication and professional well-being. Tools referred to as digital scribes or ambient clinical documentation use the recording or transcription of a clinical conversation to produce a draft structured medical record. This review summarizes current evidence, main benefits and risks, and proposes a practical framework for safe implementation in outpatient and hospital care in the Czech context. Available studies suggest potential reductions in documentation time, lower cognitive workload and improved clinician attention to patients. However, the effect varies by specialty, type of encounter and quality of workflow integration. Key risks include inaccuracies, omissions, excessive note length, medication-related errors and unclear accountability. Safe implementation requires qualified human review, legal and data governance, auditability, staff training and local pilot validation in the specific clinical workflow.

Although Asklepios (Asclepius), the god of medicine, was the main and most famous healing deity of Classical Antiquity, other gods and goddesses also had healing aspects and abilities - especially Eileithyia, the goddess of childbirth and labour pains and the protector of pregnant and birthing women and newborns. Unlike the main ancient deities (including Asklepios/Asclepius), the cult of Eileithyia was practiced in smaller districts, centred around an altar with a statue (sometimes the statue was placed in a small temple) and sometimes located outside the main part of city-states or directly in nature. One such rural sanctuary of the goddess Eileithyia is located on the island of Paros, on the southern slope of Mount Kounados (267 m above sea level), situated about 3.5 km northeast of the centre of Parikia, the capital of the island. The southern, slightly lower peak of this mountain (254 m above sea level) forms a small plateau, along and below the edge of which there is a zone of distinctive rock cliffs, creating smaller overhangs or caves in some places. The sanctuary of Eileithyia is located on a narrow terrace in the zone of these rocky cliffs, about 30 m below the plateau of the lower peak. It is an important site of its kind in the whole of Greece. The centre of worship here was probably a sacred spring (under a rock shelter) and a small cave (or rock overhang). However, offerings and inscriptions were also placed in several niches in the rock face east of the cave (between the cave and the spring). Excavations in the sanctuary have yielded rich finds - inscriptions, votive reliefs and, above all, dozens of (fragments of) terracotta busts and statuettes of women and ceramic sherds. The oldest finds from this site date back to the Geometric period (8th century BC), and the cult persisted here until the Late Roman Empire - probably until the 3rd century AD.