Celiakie, co o ní víme v roce 2020?

prof. MUDr. Jiří Nevoral, CSc.

Pediatr. praxi. 2020;21(3):143  

Picky Eaters, or children who are too fussy in their food

MUDr. Nabil El‑Lababidi

Pediatr. praxi. 2020;21(3):147-151 | DOI: 10.36290/ped.2020.029  

Picky eating in children is a common problem encountered by paediatric general practitioners. Depending on the reference source, picky eating has an incidence between 14-50% in preschool children. Most of these children are thriving, and their food fussiness is reflective of their age. The aetiology of picky eating is not fully understood. Environmental and genetic factors play a clear role. Targeted search for red flags in the child's history and in his physical examination can reveal suspicion of an underlaying organic cause. Adequate evaluation of the child's quantitative and qualitative dietary intake is vital. In some cases, administration of...

Simple eye examination in a child patient

doc. Mgr. Pavel Beneš, Ph.D., Mgr. Martin Vrubel, Ph.D., Mgr. Šárka Hlubocká, Bc. et Bc. Kateřina Malá

Pediatr. praxi. 2020;21(3):152-155 | DOI: 10.36290/ped.2020.030  

One of the preventive examinations in pediatry is an orientation eyes checking. Nowadays, the focus is on performing tasks carefully, non-invasively and effectively. For this we can use various simple aids and devices that make the whole examination easier and more attractive. As helpers we can include the Spot Vision Screener or Plusoptix Vision Screener which in a few seconds perform a series of measurements during the screening of visual functions in a child patient. The article focuses on an overview of adequate screening procesdures and comparison of Spot Vision Screener and Plusoptix Vision Screener screening devices applicable in pediatric practice.

Dermatitis perioralis with children

MUDr. Zuzana Nevoralová, Ph.D.

Pediatr. praxi. 2020;21(3):156-159 | DOI: 10.36290/ped.2020.031  

Perioral dermatitis is a chronic facial dermatosis characterized by small papules and pustules on a red, sometimes scaled skin typically affected area of nasobuccal sulci and a of a chin, with sparing a narrow area round lips. It can be manifested also perinasal and at lateral parts of both eyes. Subjective symptoms include tingling and burning, pruritus is rare. Causative agents at children are most often overusage of tooth-pastes with fluor, various emmolients and local corticoids. For healing an elimination of causative agents and local treatments are necessary. Peroral treatment with children is used only exceptionally. Less severe forms of perioral...

Non traumatic skull lesions in children

MUDr. Helena Homolková, Ph.D.

Pediatr. praxi. 2020;21(3):160-163 | DOI: 10.36290/ped.2020.032  

Non-traumatic skull defects in children are an etiologically heterogenous group. They usually occur as a result of a congenital developmental defect in the cranial closure or are caused by a pathological process. They may be palpable as a pulsating bulging of the skull, or may be an accidental finding on X-ray scan. Their severity depends on whether the defect is only in the bone or is an open cleft defect, and in the case of bone defects it is further dependent on the etiology of the process. In this article we will focus only on non-traumatic bone defects of the skull in children.

Diagnosis of celiac disease in children, when a biopsy is needed and when it can be omitted

prof. MUDr. Jiří Nevoral, CSc.

Pediatr. praxi. 2020;21(3):164-167 | DOI: 10.36290/ped.2020.033  

For high prevalence celiac disease (CD) is one of the most important diseases of the digestive tract. Patients are approximately 1% in the population and therefore a search for this disease is necessary. The first step in the diagnosis of CD is to test antibodies to tissue transglutaminase in class A immunoglobulins (anti-TG-IgA) and to eliminate IgA deficiency by determining its total value. This combination of total IgA and anti-TG- IgA is the most accurate and cost-effective initial testing. At this time, there is no need to test antibodies to endomysium in class IgA (EMA-IgA) and antibodies to deamided gliadin in class G immunoglobulins (anti-DGP-IgG)....

New "UTD classification" of hydronephrosis and comparison with SFU classification

MUDr. Hana Flögelová, Ph.D., MUDr. Lenka Bakaj-Zbrožková, Ph.D., MUDr. Zuzana Seifriedová

Pediatr. praxi. 2020;21(3):168-172 | DOI: 10.36290/ped.2020.034  

Prenatal and postnatal ultrasound (US) screening has improved the early detection of renal and urinary disorders. The most commonly identified organ abnormality is pelvicalyceal dilatation (PCD) - hydronephrosis. Apart from pediatric nephrologists and urologists, virtually all general pediatricians care for children with PCD. To determine the severity of PCD, various scales are used; in the Czech Republic, the SFU grading system has been most commonly used for postnatal PCD. The paper introduces the UTD classification of urinary tract dilatation, a novel international system including both prenatal and postnatal US findings. It explains the advantages...

Indication of the examination of the thorax in children

MUDr. Ivana Červinková, MUDr. Lucie Dohnalová, doc. MUDr. Jarmila Skotáková, CSc.

Pediatr. praxi. 2020;21(3):173-175 | DOI: 10.36290/ped.2020.035  

Correct indication of the examination of the thorax in pediatric patients is often discussed issue. Most frequently it is an X-ray, other radiological methods are usually superstructure. The starting point for indicating the physician should be the Ministry of Health Bulletin, No. 11, 2003 "The indications for imaging".

Travelling with Children

doc. MUDr. Dalibor Sedláček, CSc., MUDr. Alena Koubová, MUDr. Jana Váchalová, MUDr. Sam Hofman, MUDr. Ing. Robin Šín, MBA

Pediatr. praxi. 2020;21(3):176-179 | DOI: 10.36290/ped.2020.036  

With a growing economy and thus purchasing power, more and more inhabitants of the Czech Republic travel to remote areas. They often travel with their children, sometimes very young. Travelling and staying in remote destinations requires careful prior preparation, focused on a specific area. Before the planned departure, a visit to the nearest travel medicine centre well in advance is recommended, where parents will become acquainted with the most important preventive measures such as vaccinations, exposure prophylaxis of infectious diseases, food treatment and protection against poisonous animals and insects carrying infectious agents. The risks lie...

Atopic dermatitis, part II - course of disease, therapy

doc. MUDr. Jarmila Čelakovská, Ph.D.

Pediatr. praxi. 2020;21(3):180-185 | DOI: 10.36290/ped.2020.037  

Atopic dermatitis together with bronchial asthma and allergic rhinitis belong to the so-called atopic diseases. Atopic dermatitis is a chronic, itchy, inflammatory skin disease. Genetic predisposition, abnormal immune response and skin barrier defect are implicated in the etiopathogenesis of this disease. The course of the disease is influenced by environmental factors (food and inhalation allergens, infectious agents, mechanical and chemical stimuli), internal influences (hormonal influences, stress). Interest in this disease is steadily increasing, due to its increasing prevalence and adversely affecting the quality of life. The article summarizes...

Unusual intestinal pathogen in newborns

MUDr. Pavla Zárubová, MUDr. Hana Wiedermannová, MUDr. Jan Pavlíček, Ph.D.

Pediatr. praxi. 2020;21(3):188-191 | DOI: 10.36290/ped.2020.038  

The presence of stool blood in neonatal age may be an insignificant symptom or may indicate a serious condition that requires rapid diagnosis and treatment. Severe conditions with this symptom include neonatal colitis due to various infectious agents. The authors present two cases of Campylobacter jejuni infection in newborns. The bacteriological examination is crucial. Even in neonatal age macrolides can be used, the duration of treatment is usually 7-10 days. With early diagnosis and treatment, the campylobacter infection of the newborn may proceed uncomplicated and without a general alteration of the condition.

Postnatal antibiotic chemoprophylaxis does not have to prevent a devastating GBS neuroinfection in the newborn

MUDr. Kristýna Boráková, prof. MUDr. Zbyněk Straňák, CSc., MBA

Pediatr. praxi. 2020;21(3):192-195 | DOI: 10.36290/ped.2020.039  

The case study demonstrates the complexity and severity of the perinatal infection caused by Streptococcus agalactiae (GBS). The vertical transmission of GBS to a newborn occurred in a GBS negative mother. The neonate with muco-cutaneous GBS colonization and without signs of GBS sepsis was treated prophylactically using antibiotics. However chemoprophylaxis did not prevent developing severe and devastating neuroinfection (late onset GBS infection). Current preventive measures (screening of GBS in pregnancy, antibiotic chemoprophylaxis in GBS positive mothers, stratified infection monitoring in newborns, prophylactic treatment in high-risk newborns)...

Bilateral schizencephaly in a preterm newborn

MUDr. Klára Berková, MUDr. Blanka Prosová, prof. MUDr. Zbyněk Straňák, CSc., MBA

Pediatr. praxi. 2020;21(3):196-199 | DOI: 10.36290/ped.2020.040  

Schizencephaly is a rare congenital developmental defect of the central nervous system. It is manifested by a combination of motor deficit, mental retardation and epilepsy. The resulting clinical picture is extremely variable and difficult to predict despite highly accurate neoroimaging. Significant discrepancy between severe morphological disability and absence of expected symptoms is also described in the case report of our patient. Bilateral schizencephaly was diagnosed in a extremely premature newborn in the intensive care unit. It describes the subsequent development of the defect, associated anomalies (septo-optic dysplasia) and the clinical...

Mild encephalopathy with reversible splenial lesion of the corpus callosum - case report

MUDr. Ivana Červinková, MUDr. Denisa Pavlovská, MUDr. Jan Šenkyřík, doc. MUDr. Jarmila Skotáková, CSc.

Pediatr. praxi. 2020;21(3):200-202 | DOI: 10.36290/ped.2020.041  

MERS - Mild encephalopathy with reversible splenial lesion of the corpus callosum is a clinical-radiological syndrome characterized by acute mild encephalopathy and reversible SCC changes in diffusion-weighted MRI (DWI) of the brain. It is described in connection with infection, especially viral. The prognosis is generally favourable. Most patients have complete resolution of symptoms within one month without long-term neurological sequelae. We present a case of a ten-year-old boy with sudden dysarthria and a clinical-radiological image which is consistent with this syndrome.

Psyche of parents of premature babies

Bc. Jana Nováková, PhDr. Kristina Janoušková

Pediatr. praxi. 2020;21(3):210-212 | DOI: 10.36290/ped.2020.044  

The article deals with the mental state of mothers of premature babies. The topic of premature births is still very topical. All levels of the mother's everyday life, and therefore the whole family, are affected and affected. Therefore, it is important to pay attention and provide top care not only to premature babies, but also to their mothers, especially to focus on their mental state. The article contains an introduction to the issue, the results of the investigation, discussion and conclusion. The aim of the survey was to analyze the psyche of two mothers who gave birth to their children prematurely. The survey was conducted in the form of a semi-structured...

Adapted clinical practice guideline: Pain management in neonates and Infants

Mgr. Jaroslava Fendrychová, Ph.D.

Pediatr. praxi. 2020;21(3):206-209 | DOI: 10.36290/ped.2020.043  

The article presents another adapted clinical practice guideline (CPG) which is focused on assessment and management of pain in neonates and infants. The process of adaptation of foreign clinical recommendations was again realized according to the ADAPTE Collaboration, Version 2.0 just as in the case of the previous practice guidelines published in Pediatrie pro praxi (No. 4/2015, No. 1/2016, No. 4/2017, No. 2/2018, No. 5/2018, No. 2/2019 and No. 5/2019). On the basis of a literature search the existing clinical practice guidelines and other recommendations were identified and analysed methodologically and then a draft of a new, adapted clinical practice...

Benign enlargement of subarachnoid spaces in infancy

prof. MUDr. Vladimír Mihál, CSc., MUDr. Jan Hálek, Ph.D., MUDr. Iva Šebestová, doc. MUDr. David Krahulík, Ph.D., MUDr. Kamila Michálková

Pediatr. praxi. 2020;21(3):203-205 | DOI: 10.36290/ped.2020.042  

Benign enlargement of subarachnoid spaces (BESS) is one of the most frequent cause of macrocephaly and reasons for referral to a pediatric neurologist. We report a case of an infant aged 7 months who was referred for magnetic resonance imaging of the brain as the head circumference of the infant had increased rapidly to the 97^th percentile. A possibility of BESS was suspected since the child was mild neurodevelopmentally delay. Ultrasound and MRI of the cranium revealed enlargement anterior subarachnoid spaces with normal ventricules.

Milk fat in infant formulas - new findings

MUDr. Radim Vyhnánek

Pediatr. praxi. 2020;21(3):216-218 | DOI: 10.36290/ped.2020.046  

Breast milk is the best nutrition choice for infants. Some infants, however, cannot be breastfed. For those infants, we recommend formulas, that have a composition defined by the legislature. Still, infant formulas vary in several aspects. New findings suggest that natural mammalian milk components such as beta-palmitate or milk fat globule membrane (MFGM) might play a positive role in cognitive development and health of infants.

It is possible to replace milk by plant beverages?

prof. Ing. Jana Dostálová, CSc.

Pediatr. praxi. 2020;21(3):213-215 | DOI: 10.36290/ped.2020.045  

Milk has been consumed for several thousand years. Together with dairy products, it is an integral part of the western civilization diet due to its pleasant sensory properties, but above all as a source of many important nutrients. At present the popularity of plant beverages as a milk substitute is constantly increasing in the Czech Republic. The importance of milk from the nutrition point of view is presented. The nutritional and sensory evaluation of 12 plant beverages is presented on the base of test of the Federation of the Food and Drink Industries of the Czech Republic. The results of analysis of fatty acids composition of dry soya beverages...