Casopis lekaru ceskych最新文献

Biobanks are essential infrastructures for biomedical research and personalized medicine. The exponential growth of heterogeneous data from various sources (genomics, imaging, electronic health records, environmental data) creates opportunities for artificial intelligence (AI) applications to improve data management, biomarker discovery, laboratory automation, and sample accessibility. This article reviews current trends, technical and ethical challenges, GDPR-related considerations, the role of FAIR (findable, accessible, interoperable, reusable) data principles and federated learning, the importance of explainable AI, and implications for the Czech healthcare system. Practical recommendations for safe and sustainable AI integration into biobanks are provided.

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.

The Trauma Plan is a set of measures to mitigate the consequences of injury in emergencies and crisis situations. It was activated at the First Surgical Clinic of the General University Hospital in December 2023, on the day of the tragic shooting in the building of the Faculty of Arts of Charles University in Prague. Thanks to the practice activations, teams, premises and beds were prepared within 20 minutes without complications. An exceptional case was a gunshot wound that occurred at 350 meters (on the other bank of the Vltava River), the origin of which, however, the patient-foreigner was not aware of and was reported as a fracture of the femur after a fall while fleeing.

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.

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.

The still valid method of defining obesity by the current body mass index (BMI) value does not adequately reflect the severity or health risks of individuals and does not meet the requirements of evidence-based medicine. This definition of obesity has, among other things, led in the past to proposals for such problematic categories as metabolically healthy obesity or obesity with normal weight, and it also contributes to the so-called obesity paradox. The definition of clinical obesity according to The Lancet Diabetes & Endocrinology Commission addresses these shortcomings and characterizes obesity as a chronic, systemic disease characterized by changes in the function of tissues, organs, the whole individual, or their combinations due to excessive fat accumulation. Conditions with increased amounts of fat tissue without such changes are referred to as preclinical obesity; the recommendations for the care of individuals with preclinical obesity are somewhat problematic.

Health literacy means the ability to acquire, evaluate and apply health-related information. Health literacy affects motivation, health behavior, but also trust in health systems. For the development and improvement of health literacy in the European context, it is necessary to measure health literacy and compare it internationally.

Self-medication with antibiotics is one of the factors that can influence the process of antibiotic resistance. The results of a sample survey conducted by the Public Opinion Research Centre in the period June-August 2024 on a representative sample of the population of the Czech Republic aged 15 and over map the experience with self-medication with antibiotics and attitudes towards the use of antibiotics without medical consultation. At the same time, they provide an overview of the storage of unused antibiotics from previous treatment, which can be used for future self-medication. In 13.5 % of households in the Czech Republic, there are antibiotics that are not currently used, and these are mostly leftovers from previous treatment. Only 10.6% of respondents reported personal experience with self-medication with antibiotics without consulting a doctor. 18.4 % of respondents agree with the opinion that antibiotics can be administered without medical consultation in some cases. In international comparison, the Czech Republic is one of the countries with a lower proportion of the population storing unused antibiotics. These findings provide important information for public health policy formulation and education about the risks associated with antibiotic self-medication.

Intercultural workers (also intercultural mediators, community interpreters) play a key role in overcoming language and cultural barriers between migrants and the healthcare systems of host countries. Based on international practice, the World Health Organization (WHO) strongly recommends the integration of intercultural mediators into healthcare systems throughout the European region to ensure equity, quality and sustainability of the healthcare system in an intercultural and multicultural environment. This article analyzes the emergence and status of the intercultural worker profession and its role in the process of providing various types of healthcare to refugees and migrants in the Czech Republic, focusing on legal, social and health aspects. It also describes the key challenges of integrating intercultural work into the existing healthcare and social system and suggests practical recommendations for improving cooperation between healthcare institutions and these key actors.