Umělá inteligence v interní medicíně – nová éra klinické praxe

doc. MUDr. Ondřej Volný, Ph.D., FESO

Vnitr Lek 2025, 71(5):271-272  

Artificial intelligence in primary care: From dimensionality reduction to clinical decision­‑making and time efficiency

Michal Mačák

Vnitr Lek 2025, 71(5):284-288  

This review summarizes the principles of applying artificial intelligence (in primary care, focusing on dimensionality reduction and the integration of large language models in clinical decision-making. The article demonstrates how modern algorithms based on latent representations and deep learning contribute to more efficient diagnostics, refined diagnosis, and streamlined administrative processes, all while complementing the clinical expertise of practicing physicians.

Transthyretin cardiac amyloidosis - overview of the issue in 2025

Miloš Kubánek

Vnitr Lek 2025, 71(5):289-294  

Transthyretin cardiomyopathy is associated with a significant mortality and morbidity, which are caused by congestive heart failure, atrial fibrillation and atrioventricular block. In the Czech Republic, we can diagnose mainly wild-type form of the disease. Rarely, a hereditary form may be detected associated with a variable occurrence of sensorimotor polyneuropathy with a significant vegetative component. This review should provide an update of current knowledge regarding aetiology, pathophysiology, clinical presentation, diagnostics, epidemiology and treatment of transthyretin cardiomyopathy.

Osteoporosis - prevention, diagnosis and treatment

Jana Tomasová Studýnková

Vnitr Lek 2025, 71(5):295-304  

Osteoporosis (OP) is the most common systemic skeletal disease with multifactorial etiology, affecting approximately 5-10 % of the population, mainly older people. Osteoporosis is characterized by decreased bone mineral density (BMD) and deterioration of bone tissue with disruption of bone microarchitecture, which leads to enhanced fragility and higher risk of osteoporotic fractures. Osteoporosis is influenced by demographic factors such as age and hormonal changes. The essential tools for asseing osteoporosis are dual energy X-ray absorptiometry (DXA). The intent of this paper is to provide evidence-based information about the evaluation, screening,...

Venous excess ultrasound - what we (don't) know so far

Adam Koudelka, Michaela Habánová, Ondřej Ludka

Vnitr Lek 2025, 71(5):306-311  

Venous excess ultrasound (VExUS) is a novel, non-invasive method for the semiquantitative assessment of venous congestion, using doppler examination of the hepatic, portal and renal veins. It expands the capabilities of bedside ultrasound in evaluating a patient's hemodynamic status. Disorders of fluid balance are a common clinical issue in internal medicine, particularly in patients with cardiac or renal disease, including acute conditions. In such cases, VExUS provides a non-invasive assessment of the venous part of the circulation and enables treatment adjustments based on the findings. This review article outlines the fundamentals of VExUS, its...

Monitoring oxygen concentration using the internet of things during the COVID-19 pandemic

Jan Velička, Martin Pieš, Ján Hrubovčák, Petr Jelínek, Tomáš Mimra, Radovan Hájovský

Vnitr Lek 2025, 71(5):312-319  

During the COVID-19 pandemic, up to twice as many fires and explosions related to the occurrence of dangerous oxygen concentrations in hospitals were recorded compared to non-pandemic times. This was probably due to the lack of preparedness of hospitals for the sharp increase in the use of ventilators during oxygen therapy in seriously ill patients with COVID-19. The pandemic thus showed that it is necessary to consider departments working with medical oxygen as potentially dangerous and to introduce systemic measures that can eliminate these risks threatening human lives. A possible solution to prevent fires related to the occurrence of dangerous...

The role of bronchoscopy in the diagnosis of solitary pulmonary nodules in 2025

Jiří Votruba

Vnitr Lek 2025, 71(5):E6-E12  

Solitary pulmonary nodules (SPN) are an increasingly common clinical challenge and will continue to place a huge burden on healthcare systems for at least another 30 years. They are problematic due to their variable malignant potential and diverse etiology. The number of detected nodules is rapidly increasing and will certainly continue to do so in the future (1). This is due to the widespread use of computed tomography and the introduction of early detection programs for high-risk patients. The shift in the primary detection of bronchogenic carcinoma from the central to the peripheral airways is another reason for the increase in their incidence....

Options for artificial nutrition in a home setting

Michal Šenkyřík, Petr Wohl, Pracovní skupina pro domácí parenterální výživu při Společnosti klinické výživy metabolické péče

Vnitr Lek 2025, 71(5):E13-E18  

Home artificial nutrition allows the administration of specialized nutritional products for the purpose of treatment and/or nutrition in the home environment. Home enteral nutrition is a widely available modality, involving sipping and administration of enteral formulas into a tube or through a specially acesses into the gastrointestinal tract. Home parenteral nutrition is a method performed in specialized centers, mainly in patients with chronic intestinal failure. It allows the administration of parenteral nutrition or hydromineral substitution through long-term vascular access. The administration of nutritional support in the home environment reduces...

The role of insuline glargine in the context of current pharmacotherapy of type 2 diabetes - real life data

Denisa Janíčková Žďárská, Praveen Raj, Rahul Kapur, Zbynek Schroner, Robert Bém

Vnitr Lek 2025, 71(5):275-282  

Basal insulin analogues still play an irreplaceable role in the treatment of type 2 diabetes mellitus (T2DM) and are indicated when patients are poorly controlled with oral antidiabetic drugs. In the multicentre prospective observational BIGGER (Biosimilar Insulin GlarGin czEch Real-life non-interventional study) trial, the efficacy of biosimilar insulin glargine (Semglee) and its good safety profile were confirmed. Aim: To determine the efficacy and safety of biosimilar insulin glargine (Semglee) in adult patients with T2DM in real clinical practice and to evaluate the effect of previous therapy on the course of treatment. Patient population (material)...

Myostatin and irisin in predicting the outcomes of patients with systemic inflammation

Otakar Pšenička, Zuzana Kršáková, Jarmila Křížová

Vnitr Lek 2025, 71(5):E1-E5  

Background: Systemic inflammatory response syndrome (SIRS) is associated with rapid development of myopathy. Skeletal muscles produce myokines, which may contribute to muscle weakness. The aim of this study is to determine the potential effect of selected myokines in SIRS on the length of the hospitalization of probands. Methodology: Levels of myostatin and irisin, selected, laboratory and muscle parameters were recorded upon admission and at the day 10 of hospital stay. Control group consists of healthy individuals with BMI 18,5-29,9. Results: Myostatin levels were higher in probands than in controls and there was a significant correlation between...

Complete atrioventricular block as a manifestation of Lyme carditis

Ivana Čapková

Vnitr Lek 2025, 71(5):321-325  

Lyme disease is a common infection with multi-systemic manifestations. In some patients, it may be asymptomatic, but in symptomatic cases, the most frequent manifestation is a skin lesion known as erythema migrans. In a small percentage of cases, the infection presents as Lyme carditis. The symptoms of Lyme carditis include fatigue, syncope, palpitations, and dyspnea. These symptoms are most often caused by cardiac conduction system disorders. The main risk of Lyme carditis is rapid progression of conduction abnormalities, the development of malignant arrhythmias, and sudden cardiac death. Suspicion of Lyme-associated carditis should prompt immediate...

Hypomagnezemie jako nejčastější nediagnostikovaná iontová nerovnováha v klinické praxi a jak ji řešit

MUDr. Jiří Havel, MSc.

Vnitr Lek 2025, 71(5):330-334  

How to properly interpret lipid profile results

Vladimír Soška

Vnitr Lek 2025, 71(5):326-328  

The lipid profile usually includes total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol and calculation of non-HDL-cholesterol. It is optimal to evaluate the results in their mutual context, not in isolation as a single parameter. The concentration of triglycerides and total cholesterol is important for assessing whether atherogenic dyslipidemia is present, whether the LDL-cholesterol result can be relied on, and whether non-HDL-cholesterol can be used to estimate risk according to the SCORE2 tables. Lipoprotein(a) and apolipoprotein B can be used to specify the risk. It is also appropriate to take into account the reliability of blood...

42. dny mladých internistů v Olomouci

MUDr. Jiří Vymětal, Ph.D.

Vnitr Lek 2025, 71(5):E29-E30  

Upadacitinib: JAK inhibitor for the treatment of rheumatoid arthritis

Daniel Zuzčák, Petra Matalová

Vnitr Lek 2025, 71(5):E19-E28  

Upadacitinib (UPA), a JAK inhibitor, is classified as a tsDMARD, a targeted synthetic disease-modifying antirheumatic drug. It was first approved by the FDA in August 2019 and by the European Commission in December of the same year. Unlike monoclonal antibodies, UPA is a very small molecule with a molecular weight of 380 Da (daltons), which makes it preferable for oral administration. It is currently one of the leading drugs in the treatment of rheumatoid arthritis.