Pediatrics for Practice, 2011, issue 5

Editorial

Jak se bude jmenovat?

MUDr. Gita Fritscherová

Pediatr. praxi. 2011;12(5):295

Review articles

Urinary tract infection - what is and what is not new

prof.MUDr.Zdeněk Doležel, CSc., MUDr.Dana Dostálková, MUDr.Jiří Štarha, Ph.D.

Pediatr. praxi. 2011;12(5):300-303

In recent years, added some new evidence relating to the issue of urinary tract infections (UTI). Critically, it is clear that so far only a part of this new knowledge found its use in routine clinical practice. Many problems are solved by the UTI in a number of ongoing studies and they can expect in the coming years will be to review some best practices. Constant attention is especially important to pediatricians acute pyelonephritis (AP), which are often the lowest in children aged nonspecific clinical symptoms and can sometimes be diagnosed late. Especially after repeated episodes of AP in the kidneys, then the scar tissue can cause chronic...

Acute orbital cellulitis - diagnostics and treatment

MUDr.Ondřej Vláčil, MUDr.Jiří Kincl

Pediatr. praxi. 2011;12(5):304-305

Acute orbital cellulitis is the most common disease in childhood. In 85 % of cases arising from infection of the paranasal sinuses, the transfer from surrounding skin inflammation, after penetrating injury of the orbit or the hematogenous transfer is possible. The patient is threatened mainly temporary or permanent loss of visual acuity, intracranial spread of infection, usually by the cavernous sinus and the consequent risk of sepsis with an overall alteration of the state. The therapy is the overall administration of broad spectrum antibiotics. Although the results of early treatment are very good, preservation of visual acuity is not always...

Current approach to antiasthmatic therapy in very small children

MUDr.Katarína Beránková

Pediatr. praxi. 2011;12(5):306-308

Bronchial asthma belongs to the most common chronic diseases that every paediatrician sees almost daily. As the symptomatology and long-term course of this disease in different periods of childhood is very variable, the decisions about therapeutic strategies are quite complicated. Until recently we did not have specific guidelines for the treatment of paediatric asthma, so the therapy was usually guided by the guidelines for adult asthmatics and was individually adjusted for particular patient. Two years after the Practall initiative document was published (2007) the Global initiative for asthma issued the guidelines for the treatment of asthma...

Acne and atopic dermatitis in a paediatrician’s surgery

MUDr.Lucie Růžičková Jarešová

Pediatr. praxi. 2011;12(5):309-312

Acne is a chronic, noninfectious, inflammatory skin disease of the sebaceous glands and hair follicles. It affects both sexes regardless of age; however, it is most common between 11 and 25 years of age. In about 10–15 % of patients, manifestations may occur at older age. Atopic eczema is an intensely itchy, chronic inflammatory skin condition. The incidence of the disease has a progressive trend. In the Czech Republic, the prevalence is approximately 5–10 %. A positive family history increases the likelihood of development of the disease in children.

Clinical manifestations of inherited metabolic disorders in childhood

doc.MUDr.Tomáš Honzík, Ph.D.

Pediatr. praxi. 2011;12(5):314-319

Inherited metabolic disorders represent a heterogeneous group of diseases, whose common feature is the presence of biochemical or enzymatic abnormalities detectable only by a special laboratory tests. Clinical findings are dependent mainly on exact molecular defect and on level of residual enzymatic activity. In majority of cases the first clinical signs of the disease developed during early childhood, however, some metabolic diseases have their onset later or even during adulthood. The early diagnosis is essential for treatment commencement and for genetic counseling or prenatal diagnostic in affected families. Expanded newborn screening speeds...

Oral hygiene in children

doc.MUDr.Vlasta Merglová, CSc.

Pediatr. praxi. 2011;12(5):320-324

In this article, the author introduce various instruments of oral hygiene in children and presents different toothbrushing techniques recommended in each age category. Toothbrushes, interdental hygiene tools, toothpastes and mouthwashes are described in details. Parents have a highly important role in oral hygiene of their children, since not only could be a good example to their own children but also because they teach their children to clean properly their teeth, they assist during toothbrushing, they supervise the implementation of oral hygiene and they provide with motivation their children for keeping their oral hygiene in good standards.

Psychological reactions of child victims of sexual abuse and rape

MUDr.František Čihák

Pediatr. praxi. 2011;12(5):325-327

Sexual abuse and rape are very serious disturbances of a child’s life with both immediate and delayed psychological effects similar to those following other traumas, but not uncommonly with a more severe course and a specific development disorder. Nonspecific reactions include acute reaction to stress, post-traumatic stress disorder (PTSD) and persistent personality change. Specific effects are sexualization, impaired sexual life and ability to establish and maintain partner relationships, and suicidal behaviour. Treatment is possible, but victims often refuse it. Accusation of sexual abuse is false in only 5–10%; however, children...

Varicella: neverending story

MUDr.Renata Kračmarová

Pediatr. praxi. 2011;12(5):328-331

Varicella (chickenpox) is a frequent infectious disease of children. There were reported more than 48000 cases in 2010 in Czech Republic. It usually has a benign course. We can expect complications during the infection of immunocompromised patients, infants, adults and in connection with pregnancy. Varicella is one of preventable diseases, vaccination in Czech Republic is individual.

Sudden and unexpected life-threatening events in paediatric neurology

MUDr.Josef Kraus, CSc.

Pediatr. praxi. 2011;12(5):332-335

This article reviews the common causes of life-threatening events in child neurology. They affect ventilation, circulation or may increase an intracranial pressure. In infants ALTE or SIDS are diagnosed. In childhood and adolescence radiculopathies, peripheral nerve and muscle lesions, disturbances of the neuromuscular transmission, and SUDEP in patients with epilepsy, are main causes. The events may also be caused by spinal cord or brain lesions. Management of the immediate events can be done just by the prepared integrated system. periodic paralysis, epilepsy, dystonia, unconsciousness.

Case report

Ventricular fibrillation as an initial clinical manifestation of myotonic dystrophy

MUDr.Marie Ryzí, MUDr.Pavel Vít, MUDr.Miroslava Burešová, MUDr.Michal Ryzí

Pediatr. praxi. 2011;12(5):336-338

Myotonic dystrophy type 1 (MD1) is an autosomal dominant disease affecting both striated and smooth muscle. Clinical symptomatology of the disease includes not only muscular manifestations but also other symptoms resulting, in particular, from the involvement of the heart, eyes, central nervous system or some endocrine glands. A case report is presented of a boy who was diagnosed with asymptomatic MD1 at the age of ten years old. In the subsequent period, he had not been under neurological observation and had never undergone cardiological evaluation. At the age of 17, he had collapsed during sports and was found to have severe ventricular...

Boy with a short stature

MUDr.Darina Aleksijević, doc.MUDr.Jiřina Zapletalová, CSc., MUDr.Vratislav Smolka, MUDr.Eva Klásková, MUDr.Jaroslav Wiedermann, CSc., MUDr.Petra Venháčová, MUDr.David Krahulík, MUDr.Kamila Michálková, prof.MUDr.Vladimír Mihál, CSc.

Pediatr. praxi. 2011;12(5):339-342

Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality in children. The incidence ranges from 185–250 per 100 000 children under the age of 15 per year, of which about 6 % die. Effects of patients who survive are very diverse: from the disability of varying degrees to the long-term cognitive, psychological and social problems. Hormonal disorders are frequently the result of brain injuries. They are especially found in the acute phase of the trauma leading to fatal consequences in some patients. An important disorder to look out for is so-called post-traumatic hypopituitarism (PTHP), which includes disorders...

Postantibiotics pseudomembranous colitis caused by the Clostridium difficile bacteria

MUDr.Irena Baroňová, MUDr.Eva Šipková, MUDr.Lenka Krystová

Pediatr. praxi. 2011;12(5):344-346

In the context of antibiotics usage various complications can affect patients. Among the most common there is diarrhea. It is often brought about by various forms of intestine dysmicrobia. The following article deals with one of possible causes of postantibiotic diarrhea – intestine infection caused by the Clostridium difficile (CD) bacteria. This illness can range from simple diarrhea to life-threatening conditions.

Clinicoradiological diagnosis

Haemorrhage in a chest wall lymphangioma and left axilla as a cause of his progressive enlargement

prof.MUDr.Vladimír Mihál, CSc., MUDr.Kamila Michálková, MUDr.Vojtěch Prášil, MUDr.Tomáš Malý, Ph.D., MUDr.Zbyněk Novák, MUDr.Daniela Kurfürstová, Marie Geierová

Pediatr. praxi. 2011;12(5):348-350

We report here a three-year-old girl with a cystic lymphangioma of a chest wall and left axilla presenting as progressive enlargement due to haemorrhage. The diagnosis was confirmed on ultrasonography and managed successfully by surgical excision. Cystic lymphangioma of a chest wall complicated by hemorrhage is rare; two cases were being reported with a review of literature.

Information

Infant nutrition - recommendation 2011

MUDr.Pavel Frühauf, CSc.

Pediatr. praxi. 2011;12(5):352-356

Introducing solids (rather than formula) before six months may not significantly affect risk of infection. By contrast, exclusive breast feeding to six months raises concerns about higner risk of food allergies, iron deficienty anemia and coeliac disease.

Vaccination of children against influenza: considerations before the upcoming epidemic season

MUDr.Martina Havlíčková, MUDr.Jan Kynčl, MUDr.Helena Jiřincová

Pediatr. praxi. 2011;12(5):357-358

Influenza infection in children involves certain specific features. In children up to two or three years of age, influenza often results in hospitalization with a clinical presentation dominated by febrile convulsions, bronchiolitis, croup or otitis media. The approaches to vaccination of children vary from country to country. In the Czech Republic, vaccination of children against influenza is, in accordance with the current legislation, restricted to risk groups only. It can be considered a reasonable compromise to maximally support vaccination of all school-age children since the great importance of vaccination of this very segment of the...

The role of prebiotics in prevention of allergy in children

MUDr.Jiří Bronský, Ph.D.

Pediatr. praxi. 2011;12(5):359-360

Prebiotics are indigestible components of food that are not fermented in upper GI tract, but are fermented by colonic bacteria. Due to this fact, they are able to support selectively growth of some profitable bacterial species (especially bifidobactaeria and lactobacilli) and therefore positively influence health status of the organism. From artificially-produced prebiotics, the scGOS/lcFOS (9 : 1) combination has been shown as the most effective. Current scientific data show that infant formulae supplemented with this prebiotic mixture might possibly have positive effect on incidence of atopic dermatitis and other allergic diseases in infants...

Bacillus clausii - a probiotic resistant to antibiotics

MUDr.Pavel Frühauf, CSc., MUDr.Jiří Slíva, Ph.D., MUDr.Helena Ambrožová, Ph.D., Mgr.Lucie Kotlářová

Pediatr. praxi. 2011;12(5):361-362

Intestinal dysmicrobia (which could manifest itself as diarrhea) represents a frequent undesirable effect of antibiotic therapy. In the management of complications associated with antibiotic treatment application of probiotics is recommended. Resistance to antibiotics represents a significant precondition of effectiveness of a probiotic. Ofcourse, mere documentation of resistance to antibiotics is not sufficient in terms of safety profile of a probiotic strain. It should also prove that the resistance is not tranferable to other microorganisms. Spore-forming Bacillus clausii show high resistance to antibiotics that is not tranferable to other...

Summary of sanitary and cosmetic products for children

Mgr.Pavel Koktavý

Pediatr. praxi. 2011;12(5):364-368

The skin of child is different than skin of adults in it‘s morphology and also in it‘s function. As a results of this differences the child skin demands increasing and delicate care. In choosing of sanitary and cosmetic products for children is important to preserve moisture and impalpability of skin, make possible breathing of skin, ensure anti-inflammatory effect and make safe that doesn‘t allergic contens.