Co předat dětem?

prof. PhDr. Jiřina Šiklová, CSc.

Pediatr. praxi. 2011;12(4):227  

Diagnosis of osteoporosis in children and adolescents

doc.MUDr.Zdeněk Šumník, Ph.D., MUDr.Ondřej Souček

Pediatr. praxi. 2011;12(4):232-234  

Etiopathogenesis of osteoporosis differs substantially between children and adults. The most prevalent cause of childhood osteoporosis is secondary osteoporosis caused by chronic disorder and/or its treatment. Diagnostics of osteoporosis in children is based on DXA and significant clinical history of fractures. Probable course and activity of primary disease should be taken into acount at decision about osteoporosis treatment. The DXA findings should be carefully interpreted with respect to anthropometric parameters, especially height and pubertal stages to avoid overdiagnosis of osteoporosis in short children. This review summarizes the current...

Treatment of community-acquired infections in children

MUDr.Helena Žemličková, Ph.D.

Pediatr. praxi. 2011;12(4):235-237  

The continuing favorable situation in terms of susceptibility to penicillin-like antibiotics in Streptococcus pyogenes and Streptococcus pneumoniae as the most significant etiologic agents of community-acquired bacterial respiratory tract infections confirms the appropriateness of using penicillin and/or amoxicillin to treat respiratory tract infections in the outpatient setting in the Czech Republic. By contrast, the result of irrational use and overprescription of macrolide antibiotics is a growing resistance to these drugs, particularly in strains obtained from adult patients.

Viral gastroenteritis in daily pediatric practice

MUDr.Renata Kračmarová, MUDr.Stanislav Plíšek

Pediatr. praxi. 2011;12(4):238-240  

Diarrheal disease is one of the most common causes of an acute examination and hospitalisation of a child. Portion of a viral etiology of intestinal diseases is increasing in connection with an improvement of social and economical conditions. The most common viral agents are rotaviruses, caliciviruses, adenoviruses and astroviruses, but also other viruses cause an intestinal disease. The most severe clinical course is expected from the rotaviral and noroviral infection. The dehydratation, which could be less or more severe, often complicated the infection. The treatment is symptomatic. The most important role for the prevention of rotavirus...

Clinical use of specific antifungals

PharmDr.Petr Horák

Pediatr. praxi. 2011;12(4):242-246  

The incidence of systemic fungal infections especially has been growing in last decades. It is related to the expansion of HIV/AIDS pandemic and also to the development of therapy of many diseases that affect immunity. It has resulted in the development of new drugs and new therapeutic classes, or changes in the administration and indications of formerly known drugs. Moreover, new therapeutic approaches have also been employed in the therapy of topical mycoses, and this article is devoted to them, too.

Advances in meningococcal vaccination

MUDr.Pavla Křížová, CSc.

Pediatr. praxi. 2011;12(4):247-250  

In September 2010, a tetravalent meningococcal A, C, Y, W135 conjugated vaccine became available in the Czech Republic which had been registered in Europe in April 2010 for use in children aged 11 years and older. In late 2010, the registration of this vaccine was expanded in the United States for use in children aged two years and older and this expansion is expected in Europe in the second half of 2011. Given that, in the Czech Republic, serogroup Y causes invasive meningococcal disease with a high lethality rate particularly in adolescent boys, the inclusion of the Y component in the vaccine is very appropriate for the Czech Republic. The...

Intestinal microflora in early infancy and its role in the course of infectious and allergic diseases

doc.MUDr.Vojtěch Thon, Ph.D.

Pediatr. praxi. 2011;12(4):252-254  

Microbiota represent a complex ecosystem with enormous microbial diversity. The gastrointestinal tract of a new born infant is sterile. Soon after birth it is colonized by numerous types of microorganisms. The gut flora is quantitatively the most important source of microbial stimulations and provides a primary signal for driving the postnatal maturation of the immune system. Over the past years, differences have been documented in the composition of the intestinal microflora between healthy infants in countries with a low and high prevalence of allergy. In developed countries slow colonization of the intestine with enterobacteria may reduce...

Current data about HPV vaccination

MUDr.Jiří Sláma, Ph.D.

Pediatr. praxi. 2011;12(4):258-260  

Prophylactic vaccination against human papillomaviruses is intended for primary prevention of cervical cancers. Currently, there are two approved vaccines – bivalent vaccine Cervarix, which protects against HPV 16, 18 and due to cross-protection against HPV 31, 33, 45 and quadrivalent vaccine Silgard, which protects against HPV 6, 11, 16, 18 and against HPV 31 due to cross-protection. Clinical trials showed high efficacy and safety of both vaccines. Mass vaccination of HPV „naive“ persons could prevent most of the cases of cervical cancers and benign condylomas.

Malignant melanoma in children

MUDr.Jan Čelakovský, prof.MUDr.Karel Pizinger, CSc.

Pediatr. praxi. 2011;12(4):261-264  

The aim of this article is to review distinctive features of malignant melanoma in pediatric population. About 2–3 % of melanomas occur in patients less than 20 years of age. Only 0.3 % of melanomas occur prior to puberty almost always arising in giant congenital melanocytic nevi. In children, the risk factors include in particular giant congenital melanocytic nevi, familial dysplastic nevus syndrome, positive family history, UV exposure, sunburn and immunodeficiency. Prompt pediatric and dermatological examination in every suspicious skin lesion is essential. Authors also discuss some differences in comparison with adult melanoma.

Death from rotavirus gastroenteritis

MUDr.Radka Boháčová, MUDr.Helena Uhrová, MUDr.Renata Vaverková

Pediatr. praxi. 2011;12(4):265-266  

In a case report is presented death of a two-and-half-year-old boy from a family where occured at the same time two infections – rotavirus gastroenteritis and B influenza. The boy died of extreme dehydratation as a result of severe diarrhoea and vomiting. Rotavirus was comfirmed as the causative agent. Epidemiological informations and data of rotavirus gastroenteritis are included.

Acute methemoglobinemia - serious alimentary intoxication caused by vegetable

MUDr.Kateřina Pizingerová, Ph.D., MUDr.Jiří Fremuth, MUDr.Lumír Šašek, prof.MUDr.Josef Sýkora, Ph.D., MUDr.Zdeňka Černá, MUDr.Alice Hrušková, MUDr.Renata Pomahačová, Ph.D., MUDr.Zdeňka Baliharová, RNDr.Svatopluk Krýsl, CSc., MUDr.Vlasta Petříková, doc.MUDr.Jiří Kobr, Ph.D.

Pediatr. praxi. 2011;12(4):267-269  

Authors present a case report of a 2-year-old male who developed acute intoxication caused by nitrates following a large amount of ingested uncooked pumpkin. Clinical signs included partial loss of consciousness, vomiting and cyanosis. The level of methemoglobin reached > 0,3 (> 30 %). This condition required urgent tracheal intubation, artificial lung ventilation using 100 % oxygen and administration of antidote. Complete treatment was effective and led to the full-recovery of the patient. The definitive evidence of the cause of the condition was difficult, nevertheless convincing. The authors inform the medical community about dangerous alimentary...

Choledochal cyst - less frequent cause of abdominal pain

MUDr.Eva Stránská, MUDr.Alena Holubová, prof.MUDr.Zdeněk Doležel, CSc.

Pediatr. praxi. 2011;12(4):270-272  

The authors present a case of 4.5-year-old boy with abdominal spastic pain, elevated liver transaminases and pancreatic amylase in serum and urine. Ultrasound examination of the liver showed multiple cysts in the parenchyma, a finding with scintigraphy with HIDA 99Tm corresponded mainly extrahepatic obstruction of bile ducts. Given the progression of cystic dilatation of the biliary system was in control liver ultrasound shows choledochal cyst, which was extirpated. In the period after the surgery the boy had no more abdominal pain and thrived normally. Choledochal cyst is a rare cause of abdominal pain and can cause serious complications.

Specifisity of adolescent nutrition

Bc.Jitka Rusková, DiS.

Pediatr. praxi. 2011;12(4):277-280  

The nutrition of adolescents should be more like the nutrition of adults. Even so there are some differences in recommandation following the puberty. That includes namely the higher intake of energy, protein and carbohydrate and some mineral substances. Regardless many adolescents make mistakes, influenced by their schoolmades, fashion and commercials. They prefer hight caloric food, rich in sugar, and no physical activity. On the other hand especially girls favour skinny body shapes and abide by extreme weight reducing diets. It faces to health insults due to obesity or eating disordes. Though healthy nutrition for adoslescents is not as complicated...

Retrobulbar optic neuritis and development of multiple sclerosis in adolescent

prof.MUDr.Vladimír Mihál, CSc., MUDr.Kamila Michálková, MUDr.David Horák, MUDr.Marta Neklanová, MUDr.Barbora Babáková

Pediatr. praxi. 2011;12(4):273-275  

Association of recurrent optic neuritis and subsequent development of multiple sclerosis in children are common and well known, close collaboration among ophtalmologists and neurologists is needful. We report on recurrent retrobulbar optic neuritis and subsequent multiple sclerosis in a 14-years old girl.

Inhaled corticosteroids in childhood

MUDr.Jiří Novák

Pediatr. praxi. 2011;12(4):281-285  

The beneficial effect of inhaled corticosteroids (ICS) on asthmatic child is conditioned by correct indications and an adequate dosage. Based on the current state of knowledge, the individual ICS can be ranged according to the generally expressed therapeutic index from the most to the least favourable in the following order: ciclesonide, budesonide, beclometasone dipropionate, fluticasone propionate. In the Czech Republic, however, there is not complying with this order often. With children in the Czech Republic, ICS indications are often little substantiated while the dosage is excessive. As a result the overall ICS consumption, here may reach...

Efective and safe immunomodulator for paediatric praxis - imunoglukan

MUDr.Miloš Jeseňák, PhD., MBA, MUDr.Pavel Kostiuk, CSc.

Pediatr. praxi. 2011;12(4):286-288  

Recurrent respiratory infections present one of the most frequent health problems in paediatrics. The basic preventive approach in these children is immunomodulation, eventually immunostimulation. Recently, there is besides bacterial lysates an increasing evidence for the efficacy also of other naturally based immunomodulators. Important position in this group have beta-glucans – polysaccharides isolated from fungi. Imunoglukan is one of the most important beta-glucans and its efficacy and safety is docummented and confirmed in several clinical studies.

Komplikovaná pansinusitida

prof.MUDr.Zdeněk Doležel, CSc., MUDr.Dana Dostálková, MUDr.Zdeňka Ráčilová, MUDr.Katarína Pramuková, MUDr.Jiří Štarha, Ph.D.

Pediatr. praxi. 2011;12(4):276  

Autodidaktický test 4/2011

Pediatr. praxi. 2011;12(4):289-290