Casopis lekaru ceskych最新文献

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.

In connection with the increasing prevalence of overweight and obesity, the number of these patients in intensive care units is increasing - current statistics indicate 20-30% of patients admitted in the obesity zone and 25% in the overweight zone. Nutritional goals and strategies for patients with obesity are one of the biggest challenges of modern nutritional care. They include a comprehensive diagnosis of malnutrition and the correct determination of energy and protein intake, for which it is possible to use formulas recommended by the European Society for Parenteral and Enteral Nutrition (ESPEN) or the American Society for Parenteral and Enteral Nutrition (ASPEN). The research focuses on the possibilities of immunonutrition and influencing the microbiota.

The current effective antibiotic therapy requires modern approaches focused on optimizing treatment and slowing the growth of antimicrobial resistance. A key tool in hospitals is the concept of antimicrobial stewardship, which relies on collaboration in multidisciplinary teams composed of infectious disease specialists, microbiologists, clinical pharmacists, and epidemiologists. These teams focus on the correct choice of antibiotic and its dosage, monitoring its effectiveness and minimising adverse effects. Expanding possibilities in the field of monitoring and interpretation of plasma concentrations of an increasing number of antibiotics enable effective and safe optimization of dosing and administration methods (prolonged and continuous infusions) adjusted for individual patients, thereby allowing a personalized approach to pharmacotherapy. The optimization of antibiotic dosing is further supported using modern administration tools. In the hospital setting, electronic parametric prescribing, centralized preparation and dispensing of anti-infectives by the hospital pharmacy also leads to improved safety. In outpatient care, possibilities are expanding with the concept of outpatient parenteral antimicrobial therapy, which reduces the risk of nosocomial infections and provides the comfort of a home environment for patients. However, its broader use is hindered mainly by the lack of official stability data for antibiotic preparations, as well as administrative and financial barriers associated with integrating this innovative concept into routine practice.

Artificial intelligence (AI) has been increasingly applied in radiology, where it offers the potential to improve the accuracy and efficiency of diagnosis, particularly in the evaluation of conventional imaging modalities such as chest X-rays. This study analyzes the performance of commercial software using machine learning and, respectively, artificial intelligence approaches (Carebot AI CXR; Carebot s.r.o.) in detecting abnormalities in chest radiographs compared with independent evaluations by 3 radiologists of different levels of experience. The study was conducted in collaboration with Hospital Tabor, which provided a dataset of 207 anonymised radiographs, out of which 196 were assessed as relevant. The sensitivity and specificity of AI were compared with human assessment in 5 categories of abnormalities: atelectasis (ATE), consolidation (CON), cardiac shadow enlargement (CMG), pleural effusion (EFF) and pulmonary lesions (LES). Carebot AI CXR software achieved high sensitivity in all evaluated categories (e.g., ATE: 0.909, CMG: 0.889, EFF: 0.951), and its performance was consistent across all findings. In contrast, AI specificity was lower in some categories (e.g., EFF: 0.792, CON: 0.895), while radiologists achieved performance values approaching 1.000 in most cases (e.g., RAD 1 and RAD 2 EFF: 1.000). AI demonstrated consistently higher sensitivity than less experienced radiologists (e.g., RAD 1 ATE: 0.087, CMG: 0.327) and in some cases than more experienced assessors, but at a modest decrease in specificity. The study also includes case reports, including false-positive and false-negative findings, which contribute to a deeper understanding of AI performance in clinical practice. The results suggest that AI can effectively complement the work of radiologists, especially for less experienced doctors, and improve the sensitivity of diagnosis on chest radiographs.

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.