Slovo úvodem

Veronika Burgerová

Pediatr. praxi. 2014;15(4):187  

Mononucleosis - evidence based diagnostics and therapy

MUDr.Jan Pavelka

Pediatr. praxi. 2014;15(4):191-193  

Epstein–Barr virus is the most common ethiology of mononucleosis syndrome. Almost every man is infected during lifetime. More than a half of the cases are asymptomatic. Lifelong carriage ensues with intermittent episodes of reactivation and virus shedding in saliva. Treatment is symptomatic. Causal treatment is not available. Fat restriction in diet is obsolete. Hepatoprotective drugs have similar efficacy to placebo. Patients with normal immunity recover in 2 to 3 weeks. Restriction of a physical exercise for more than 7 weeks in recovered patients is not justified.

Unusual clinical findings on children's hands

MUDr.Vladimír Němec, Ph.D., Bc.Eva Bočkayová

Pediatr. praxi. 2014;15(4):194-196  

The authors deal with less frequent abnormal clinical findings on the hands. Their knowledge can often help to reassure children and their parents who are concerned about the presence of a serious disease. The authors report literature data as well as their own experience in three case reports dealing with less common anomalies: Kirner's deformity, camptodactyly, and pachydermodactyly. In each particular case, the aetiology, clinical and x-ray presentation, and therapeutic approaches are presented.

Influences on immunity development in the prenatal and perinatal period

MUDr.Alice Mocková, Ph.D.

Pediatr. praxi. 2014;15(4):197-200  

The current knowledge about a complex process of the immune system ontogenesis in the fetus and neonate is briefly summarized in the article. Development of the neonatal, especially innate immunity, is affected by endogenous, primarily genetic, factors. Specific (adaptive) immunity is created mainly as a result of external factors including exposure to external pathogens and microorganisms, microbial colonization of the child‘s gut, nutritional factors, and active immunization.

Problems due to nutrition during the first year of life

MUDr.Kateřina Bajerová, Ph.D.

Pediatr. praxi. 2014;15(4):202-204  

The first year of infant’s life is characterised by transition from liquid food, ideally breastfeeding, to solid type of foods. In the early period the infant nutrition is affected by the prenatal period and complications of its course. Important role may play inborn defects and metabolic disorders. Nevertheless there is an important role of parent´s approach to pediatrician´s advice. The most common problems related to nutrition in the early period are vomiting, flatulence, failure to thrive and diarrhea. It is possible to solve these symptoms promoting good clinical examination of the infant after having asked the detailed history and...

Bacterial skin infection in pediatric outpatient department

MUDr.Jiřina Bartoňová

Pediatr. praxi. 2014;15(4):206-208  

Children with bacterial skin infection are significant group of patients which visits pediatric (dermatology) outpatient department. There are superficial or deep pyodermia caused by agresive patogens or secondary bacterial infection of chronic diseases for example: atopic dermatitis, infection of light demaged skin, after insect bites and parasitic skin diseases.

Staphylococcus aureus, cerageniny.

MUDr.Stanislava Polášková

Pediatr. praxi. 2014;15(4):210-211  

Epidermal barrier and its significance in healthy and atopic skin The paper discusses the importance of epidermal barrier (EB) to the function of the skin and to the genesis of atopic dermatitis (AD). It highlights the immaturity of EB in chidren. It is mentioned factors, which involved in the epidermal hydratation and in imunological defense of external influences. It focuses to the role of EB in AD. It is confirmed, that the key point od the damaged EB is the defected filagrin. Defected filagrin in combination with the reduced level of defensins leads to the change of microbioma and to the tendency to bacterial infection. It explains the...

Eating disorders: collaboration of psychiatrist with paediatrician and gynaecologist

MUDr.Jiří Koutek, Ph.D., doc.PhDr.Jana Kocourková

Pediatr. praxi. 2014;15(4):213-215  

Eating disorders are psychosomatic illnesses that significantly affect the patients' somatic condition. Collaboration with a paediatrician particularly involves diagnosing along with ruling out an organic cause as well as realimentation of cachexia that is frequently present. The role of a gynaecologist is then to examine and treat amenorrhoea that is one of the fundamental symptoms of anorexia nervosa and often occurs in bulimia nervosa as well.

Cardiac arrhythmias in children

MUDr.Peter Kubuš

Pediatr. praxi. 2014;15(4):216-221  

The article summarizes essential data concerning the most frequent heart rhythm disorders in children, focusing both on outpatient and hospital management. A major part of the article refers to differential diagnosis and treatment of supraventricular tachycardia, representing the most frequent symptomatic rhythm disorder in children, often requiring relatively urgent therapeutic intervention. The chapter devoted to ventricular tachycardia focuses mainly on hereditary arrhythmia syndromes, especially the long QT syndrome. Finally, in the bradycardia section, complete atrioventricular block is discussed in more details.

Surprising diagnosis of a rare endocrine disease when examining a child for short stature

MUDr.Renata Pomahačová, Ph.D., MUDr.Petra Paterová, MUDr.Ivan Šubrt, Ph.D., MUDr.Radka Jaklová, RNDr.Petra Vohradská, MUDr.Eliška Hrdonková

Pediatr. praxi. 2014;15(4):222-224  

We describe a case of a 9-year-old girl examined for short stature with growth below the 3rd percentile. As part of comprehensive examination with regard to the family history of the incidence of complete androgen insensitivity syndrome (AIS – androgen insensitivity syndrome) in a 33-year-old aunt, we indicated for our patient the cytogenetic examination, which revealed a chromosomally male. We confirmed the complete androgen insensitivity syndrome with mutation in the gene for the androgen receptor locus on chromosome X. The same mutation is presented in her 33-year-old aunt with AIS, and the mother and the grandmother of our patient...

Infant with obstructive jaundice or what is the cause of ALP elevation?

MUDr.Beata Sikorová, MUDr.Štěpán Rucki, CSc.

Pediatr. praxi. 2014;15(4):225-227  

We present a case of an infant born in the twenty-eighth week of pregnancy with elevated alkaline phosphatase (ALP). In addition to the regular daily supplementation of vitamin D, calcium and phosphate an intramuscular injection of cholecalciferol was administered in the age of three month because of persistent elevation of ALP. At the subsequent examination carried out because of failure to thrive mild hypercalcemia, significant hypercalciuria and raised level of 25-OH-vitamin D3 were detected. During the further follow-up clinical and laboratory signs of cholestasis appeared. The obstruction of the efferent bile ducts due to multiple cholelithiasis...

Trigeminal neuralgia - was it primary infection of Herpes simplex virus?

MUDr.Vladimír Mišuth, MUDr.Marta Neklanová, MUDr.Eva Bazgerová

Pediatr. praxi. 2014;15(4):228-229  

Trigeminal neuralgia aren´t so rare in the adult population. But in the population of children we can meet trigeminal neuralgia rather occasionally. On the contrary, Herpes simplex infection with typical clinical signs of primary infection, we often knows from our own practise, just in a population of pediatric patients. The case report presents the case with untypical start of trigeminal neuralgia and at the same time describes possible etiological relationship with primary infection of Herpes simplex virus.

A rare cause of abdominal pain at a fifteen years old girl

MUDr.Jaroslav Zikmund, CSc.

Pediatr. praxi. 2014;15(4):230-232  

The girl, 15 years old, was sent to renal ultrasound for abdominal pain, back pain, pollakisuria and proteinuria. Difficulties lasted for four days. ATB treatment was without effect. Sonographic findings in the kidney were completely physiological. During examination of the urinary bladder there were displayed 2 spherical hypoechoic structures with communication between them. After finding out that the girl has amenorrhea, there was suspicion of hematocolpos, which was confirmed during a gynecological examination.

Risks in intra-operational nursing care

Bc.Dagmar Kudrličková, Mgr.Jana Somrová, Ing.Iva Brabcová, Ph.D.

Pediatr. praxi. 2014;15(4):235-237  

Time spend in the operating room is the most risk-filled period of whole hospital stay, and children are patients running highest risks. The mail aim of this study was to identify the risks that could threaten the patients during operation. According to the results risks are mainly connected to anesthesia (complications with intubation, laryngospasmus, or teeth damage), operation procedure (risk of burns, falls and patient swap) and the stay in the operational room itself (for example hypothermia caused by air-condition). Preventive measures in intra-operational care are: check of anesthesiology equipment, medication and tools, following verification...

Biphasic stridor as a cause of esophageal duplication cyst

prof.MUDr.Vladimír Mihál, CSc., MUDr.Martin Zápalka, Ph.D., MUDr.Kamila Michálková, Barbora Remeníková, MUDr.Jiří Tůma, CSc.

Pediatr. praxi. 2014;15(4):233-234  

Esophageal duplication cysts are congenital rare cystic anomalies that may induce various symptoms. In a 7-year-old boy we present a case of a esophageal duplication located at the lower third esophagus that was clinically presented as permanent soft biphasic stridor and dyspnea after physical exertion. Definitive treatment was surgical removal followed with complete resolution of clinical symptoms.

Where is focused ATB therapy in paediatric medicine?

MUDr.Václava Adámková

Pediatr. praxi. 2014;15(4):240-242  

It is impossible to predict bacterial susceptibility according to patient symptoms, in era of increasing bacterial resistance. The rate of multidrug resistant bacteria is steadily increasing in paediatric patients. Empirical antibiotic treatment must respect basic principles to prevent selection of resistant bacteria.