Casopis lekaru ceskych最新文献

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.

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.

The MEDEVAC Permanent Medical Humanitarian Program of the Czech Republic focuses on providing medical care to vulnerable groups of the population in regions affected by migration, burdened by many refugees or in places where specialized medical care is not available. Treatment is provided free of charge and exclusively to civilians who are in a serious health condition or whose health condition does not allow them to lead a dignified life. The program started in 1993 in Bosnia and Herzegovina, continued in Kosovo and has gradually been extended to several other countries. At present, MEDEVAC is a program of the Government of the Czech Republic coordinated by the Department of Asylum and Migration Policy of the Ministry of the Interior of the Czech Republic in cooperation with the Ministry of Foreign Affairs, the Ministry of Health, the Ministry of Defense and the Army of the Czech Republic. The MEDEVAC program is of fundamental educational importance. Participants expand their practical experience with situations typical of conflict and natural disaster areas and become acquainted with the organizational specifics of care in crisis areas. The experience gained in crisis areas is a significant contribution to the preparedness of our health care system, especially traumatology and related fields. The General University Hospital in Prague has been involved in several of its departments since 2011, in addition to the First Surgical Clinic, the Department of Ophthalmology, the Department of Rehabilitation Medicine and the Department of Gynaecology, Obstetrics and Neonatology.

The article presents selected findings from the research project KULTIMED - Cultivation of Medicine (relationships, environment, and conditions). It is a multidisciplinary project supported by the Technology Agency of the Czech Republic (TA CR) within the Sigma program, carried out by the Institute of Sociology of the Czech Academy of Sciences (IS CAS) in cooperation primarily with the First and Second Faculties of Medicine of Charles University. The article introduces the most important findings from a survey conducted at the beginning of 2025 at almost all medical faculties in the Czech Republic. The aim of the survey was to map the environment of medical faculties, study conditions, and the most pressing problems currently faced by medical students in the Czech context. Three key problems include 1) organizational shortcomings of studies, 2) students' psychological distress, 3) a very high prevalence of inappropriate behavior by teachers and other persons in the educational process toward students. KULTIMED pursues awareness-raising, cultivation, and educational goals, which are also briefly introduced in the article. In conclusion, the article offers an overview of recommendations for each of the three identified problem areas.

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.

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.

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.