Nefrotický syndrom v proměnách věků

doc. MUDr. Jakub Zieg, Ph.D.

Pediatr. praxi. 2020;21(4):223-224  

Urinary tract infections in children - current approach to the diagnostics and management

doc. MUDr. Jakub Zieg, Ph.D.

Pediatr. praxi. 2020;21(4):228-231 | DOI: 10.36290/ped.2020.047  

Urinary tract infections (UTI) are common in children. The diagnostics may be challenging mainly in infants. Adequate urine collection is important to prevent false positive diagnoses. The cut-off values of significant bacterial count vary between guidelines. Timely antibiotic and supportive therapy is the mainstay of a proper management. Various treatment strategies are used to prevent recurrent UTIs. Although antibiotic prophylaxis proved beneficial in modest reduction of UTI recurrences, it came with aside effect of increased antibiotic resistance. The aim of this review is to present news in diagnostics and management of pediatric UTIs based on...

Myths and pitfalls in management of patient with infantile hemangioma

MUDr. Josef Mališ, MUDr. Adéla Mišove

Pediatr. praxi. 2020;21(4):232-235 | DOI: 10.36290/ped.2020.048  

Infantile hemangioma (IH) occurs in 5 to 10 % of children under one year of age. This benign vascular tumor is characterized by three phases of growth - proliferation, plateau, involution. Superficial hemangiomas reach their maximum size in 6 to 8 months, in deep ones rarely up to 2 years. Modern non-selective β-blocker therapy - propranolol - offers children an effective, safe and non-invasive solution. Starting the therapy in the proliferative phase is crucial for effectiveness.

Extensive hydrolysates and their role in clinical practice

MUDr. Nabil El‑Lababidi

Pediatr. praxi. 2020;21(4):238-242 | DOI: 10.36290/ped.2020.049  

Cow's milk protein allergy (CMPA) is a common health problem encountered by paediatric general practitioners. After establishment of the diagnosis, an elimination diet is indicated. Mothers of fully breast-fed infants should be recommended a strict dairy-free diet. Extensively hydrolysed formulas (eHF) are usually sufficient in the treatment of 90% of formula fed infants. Amino acid formulas (AAF) are indicated less frequently. Results of clinical studies regarding eHF have various and often conflicting results. This seems to be due to different degrees of hydrolysis and residual allergenicity between various eHF. It seems that long-term use of eHF...

Vaccination of pediatric patients with neurological disease - changing the approach from "better not to vaccinate" to "better to vaccinate"

MUDr. Jiří Nečas, MUDr. Tomáš Nečas

Pediatr. praxi. 2020;21(4):243-247 | DOI: 10.36290/ped.2020.050  

In cooperation with pediatric neurologists, vaccinologists and paediatric GPs the recommendation for vaccination of pediatric patients with neurological diseases were developed in 2019. In our paper we would like to present new recommendations and raise awareness of this important topic. Controversial parts of recommendation are discussed too.

Back injures and spinal fractures

MUDr. Radek Štichhauer, Ph.D., MUDr. Miroslav Cihlo, MUDr. Antonín Šafus, MUDr. Karel Zadrobílek, MUDr. Jindřich Preis, Ph.D.

Pediatr. praxi. 2020;21(4):248-252 | DOI: 10.36290/ped.2020.051  

Back and spine injuries are aheterogeneous group of injuries encountered by physicians of pediatric patients almost every day. The article summarizes the approach to examination and treatment of the most common spinal injuries from the perspective of surgical departments of the University Hospital in Hradec Kralove. At the same time, it seeks to propose arational approach to such injured children.

Often ill child

doc. MUDr. Jaromír Bystroň, CSc.

Pediatr. praxi. 2020;21(4):254-258 | DOI: 10.36290/ped.2020.052  

The author considers the term "often ill child" and discusses this topic in relation to the gradually maturing immune system. He points out the specifics of different age periods and tries to prove that the not always higher frequency of diseases (especially the most common ones - respiratory tract infections) must have a cause in the immune system. Above all, it is necessary to distinguish primary-congenital immune disorders, which often require lifelong specialized care, from secondary-acquired disorders, for which it is most important to identify the cause of such a disorder and try to eliminate it. An irreplaceable role in the diagnosis and care...

The role of dermocosmetics in acne treatment

MUDr. Zuzana Nevoralová, Ph.D.

Pediatr. praxi. 2020;21(4):259-263  

The importance of dermocosmetics in acne treatment shows an increasing role. Dermocosmetics can be used for several reasons: for a management of side effects, for a synergystic role with an acne therapy and for a preventive and maintenance therapy. An appropriate chosen camouflage cosmetics and fotoprotection are of a great importance, too. Various types of active compounds can affect different targets: an abnormal sebum production, an abnormal keratinization, a microbioma and an inflammation, alone or in combination. Dermocosmetics can be used in monotherapy, or in combination with drugs. If well choosed, it can help a lot in the treatment of acne....

Vitamins D, C and zinc are essential for function of immune system and enhancement of protective immunity

prof. RNDr. Jan Krejsek, CSc.

Pediatr. praxi. 2020;21(4):270-274 | DOI: 10.36290/ped.2020.055  

The immune system is an integral part of protective inflammatory response with aims to eliminate invasion of pathogenic microorganisms and to eliminate self tissue damage. The potential to participate in protective immune reaction is given to all body cells. The protective strategy is multilevels. The first line is physiological microbiota which is inhabiting all epithelial structures of our body and skin. The second line is formed by epithelial linings which are interacting with both physiological microbiota and components of immunity. The third line of defence is innate immunity including its cellular substrate, namely dendritic cells, macrophages,...

Specific issues of influenza in children in the context of the COVID-19 season

MUDr. Zuzana Blechová, Ph.D.

Pediatr. praxi. 2020;21(4):275-280 | DOI: 10.36290/ped.2020.056  

The paediatric population is a typical source for the spread of influenza as well as other respiratory viruses in the population, including coronavirus, particularly in the case of mild or asymptomatic course. In predisposed at-risk individuals or in those aged two to five years old, however, it may become a life-threatening infection due to respiratory or neurological complications. Annual influenza vaccination is essential primary prophylaxis affecting the morbidity, complications, and mortality of this infection; still, it has been neglected in our country.

Middle ear inflammations in pediatric patients

MUDr. Viktorie Herejková, MUDr. Tomáš Kostlivý, MUDr. Filip Ruml, MUDr. David Slouka, Ph.D., MBA

Pediatr. praxi. 2020;21(4):281-286 | DOI: 10.36290/ped.2020.057  

One attack of acute middle ear inflammation undergoes 1/2-3/4 of the pre-school child population. This incidence makes acute otitis one of the most common pediatric disorders. Despite the high standard of medical care in the Czech Republic, some of the acute inflammations may go into the stage of protracted or chronic otitis media. Conductive hearing loss accompanying otitis media may have an impact on the psychomotor development of pediatric patients or may limit their well-being at school or the involvement of common life activities. The authors summarize the field of middle ear inflammations in pediatric patients, including possible related complications...

Otogenic cranial sinus thrombosis and epidural abscess

MUDr. Tomáš Kostlivý, MUDr. Viktorie Herejková, MUDr. Filip Ruml, MUDr. David Slouka, Ph.D., MBA

Pediatr. praxi. 2020;21(4):287-289 | DOI: 10.36290/ped.2020.058  

Otitis media complications are among rare but serious and life-threatening conditions. Despite dramatic decrease of their incidence due to widespread antibiotic therapy we can come across them in everyday practice, in case of both acute and chronic middle ear inflammations. We present the case history of an eleven year old boy who was treated for acute otitis media and presented with headache after the treatment was finished. After several check-ups imaging techniques were indicated after three weeks and revealed aserious intracranial complication - otogenic cranial sinus thrombosis and epidural abscess. He was treated with antibiotics, low-molecular-weight...

Severe hypernatremia in an infant with a central nervous system developmental disorder

MUDr. Petr Jabandžiev, Ph.D., MUDr. Jakub Pecl, MUDr. Martin Jouza, MUDr. Jiří Štarha, Ph.D., MUDr. Jan Papež, MUDr. Milan Urík, Ph.D., MUDr. Anna Seehofnerová, MUDr. Ondřej Horák

Pediatr. praxi. 2020;21(4):290-294 | DOI: 10.36290/ped.2020.059  

We present acase report of an infant with septooptic dysplasia variant (holoprosencephaly spectrum) with accidentally found severe hypernatremia. The case report points to the possibility of coincidence of hypopituitarism in patients with this form of forebrain malformation. Combined primary endocrine deficits in neonates and infants may result in derangement of body internal environment. Severe hypernatremia due to central diabetes insipidus is one of the potentially fatal complications requiring avery gradual, strictly controlled correction of the internal environment parameters. This is the only way to prevent serious neurological complications...

Plant based diets: from toddler to adolescence

MUDr. Martin Světnička, MUDr. Eliška Selinger, MUDr. Jan Gojda, Ph.D., MUDr. Eva El‑Lababidi, Ph.D.

Pediatr. praxi. 2020;21(4):264-269 | DOI: 10.36290/ped.2020.054  

An increasing popularity of alternative nutritional styles, including vegetarianism and veganism, is now significantly affecting the child population. If the adequate composition of the diet is not meet, the exclusion of all animal components can lead to nutritional deficiencies. The main risks include alack of vitamin B12, vitamin D, calories, protein, calcium, iron, fatty acids, but also iodine. All the above-mentioned deficits can be early diagnosed by appropriately chosen laboratory diagnostics and can be prevented by the right composition of the plant-based diet.

Parents' and nurses' health literacy in primary healthcare regarding children vaccination

prof. MUDr. Miloš Velemínský, CSc., dr. h. c., Adéla Lepšová

Pediatr. praxi. 2020;21(4):300-301 | DOI: 10.36290/ped.2020.062  

The authors evaluated the health literacy in nurses and parents in the field of the children vaccination. In nurses, active in the primary health care at facilities for children and adolescents, they found a high level of the health literacy - 93%. There was, however, a poor health literacy in parents - only 52% exerted appropriate knowledge concerning the vaccination. Aproportion of 18% of them fall into a group of "vaccination opponents". It is thus necessary to enhance the quality as well as quantity of education actions focused on parents. The results suggest that there is an important role of physicians and children'snurses in supporting the individual...

Surgical correction of pectus excavatum in an adolescent boy

prof. MUDr. Vladimír Mihál, CSc., MUDr. Tomáš Malý, Ph.D., MUDr. Eva Klásková, Ph.D., MUDr. Kamila Michálková

Pediatr. praxi. 2020;21(4):296-299 | DOI: 10.36290/ped.2020.061  

Pectus excavatum (PEx) is a developmental deformity of the anterior chest wall that affects one in 400 live births. The depression of the sternum can displace the heart and reduce the lung volume, and may cause pulmonary and cardiovascular impairments. We present a case report of a severe form of PEx in an adolescent boy with a characteristic finding on imaging. According to Ravitch method, the open plastic surgery of the anterior chest wall led to aesthetic and symptomatic improvement.

Molloscum contagiosum

doc. MUDr. Karel Ettler, CSc.

Pediatr. praxi. 2020;21(4):295 | DOI: 10.36290/ped.2020.060  

Mollusca are fair viral papules usually occuring on the atopic skin in kids after attendace of swimming pools. The most credible therapy is removing by sharp spoon.