Jaká pediatrie je nejlepší a co očekává mladý lékař?

Martin Gregora

Pediatr. praxi. 2024;25(5):271

Up-to-date view of the fluids therapy in children

MUDr. Tereza Pomahačová, prof. MUDr. Josef Sýkora, Ph.D., MUDr. Jiří Fremuth, Ph.D.

Pediatr. praxi. 2024;25(5):276-281 | DOI: 10.36290/ped.2024.053

Although the administration of crystalloid fluids is one of the most frequently used treatment procedures, we often forget that the administration of fluids should be governed by the same rules that apply to the administration of any medicinal product. Fluid administration has its indications and contraindications, the exact dose should be defined and both therapeutic effects and goals, as well as possible adverse effects accompanying fluid administration, should be monitored. Each time a crystalloid fluid is administered, we must think about its composition in the context of the patient's clinical condition, and from this point of view, we should...

Convulsions - diagnosis and treatment

MUDr. Jitka Müllerová Dissou, MBA

Pediatr. praxi. 2024;25(5):282-285 | DOI: 10.36290/ped.2024.054

Seizures are among the acute conditions that we encounter quite often in children. This is a symptom that can have a very diverse etiology. From different points of view, seizures can be divided into epileptic and non-epileptic, into convulsions with temperature and without temperature, into focal and generalized convulsions. A thorough anamnesis, physical examination of the patient, auxiliary examination methods will help us to make the distinction. In pre-hospital and early hospital care, the basic differential diagnosis of a convulsing child should be performed quickly, and adequate symptomatic and supportive treatment should be started in time....

Troponin elevation in children

MUDr. Hana Pudichová, doc. MUDr. Jan Pavlíček Ph.D., MHA, MUDr. Bořek Trávníček, MBA, MUDr. Markéta Nowaková, MBA, MUDr. Miroslava Burešová, MUDr. Jiří Pudich

Pediatr. praxi. 2024;25(5):286-293 | DOI: 10.36290/ped.2024.055

Troponins T and I are important biomarkers of cardiac damage, the levels of which are currently determined by highly sensitive diagnostic kits. In the adult population, troponin is of central importance in the diagnosis of acute coronary syndrome. In pediatrics, the reasons for troponin testing are different, with acute myocarditis of infectious or non-infectious aetiology being the most common indication. Troponin levels can rule out or to a great degree confirm this disease and correlate with its severity; the levels, however, can not reliably predict late myocardial dysfunction. Still, troponin, along with natriuretic peptides, can be used in the...

Kratom - risk for teens

RNDr. Tomáš Gucký, Ph.D.

Pediatr. praxi. 2024;25(5):295-298 | DOI: 10.36290/ped.2024.056

The abuse of herbal drug kratom has widely spread during past few years among the population of young adults. Kratom has a unique pharmacological profile and its alkaloids act predominantly as opioid and α-2 adrenergic agonists. While the risks of acute kratom intoxication are relatively low, the risks of chronic use and drug dependence development are underestimated. The article summarizes basic toxicological and epidemiological data on kratom.

Probiotics and infant nutrition - part one

prof. MUDr. Josef Sýkora, Ph.D., MUDr. Marek Vébr, MUDr. Jiří Bufka, MUDr. Jan Schwarz, Ph.D.

Pediatr. praxi. 2024;25(5):299-302 | DOI: 10.36290/ped.2024.057

The purpose of this paper is to provide an overview of the effectivness of specific probiotics including those added to commercially available baby-milk formula feeding featuring well-designed and carefully conducted randomised controlled clinical trials. They show that probiotics are generally considered safe and affect a wide range of metabolic and immune processes.

Childhood apraxia of speech

Mgr. Barbora Červenková, Ph.D.

Pediatr. praxi. 2024;25(5):304-310 | DOI: 10.36290/ped.2024.058

This review article on verbal dyspraxia in children presents the current knowledge on the prevalence, classification, symptomatology and comorbidities of this neurodevelopmental disorder. It provides basic information on assessment and treatment. It also highlights the key role of the paediatrician in identifying early symptoms. Based on knowledge of these symptoms, it is then possible to ensure early diagnosis and referral to early therapeutic intervention by a clinical speech and language therapist.

Non-pharmacological therapy of hypertension in childhood

doc. MUDr. Mgr. Terezie Šuláková, Ph.D., MUDr. Miroslava Burešová, MUDr. Michael Řepišťák, MUDr. Kristýna Láner, prof. MUDr. Tomáš Seeman, CSc.

Pediatr. praxi. 2024;25(5):311-314 | DOI: 10.36290/ped.2024.059

Arterial hypertension is the most important modifiable risk factor for cardiovascular morbidity and mortality. Appropriate therapy of the disease should be initiated in children and adolescents as early as possible; mostly at the time of the diagnosis confirmation and the evaluation of the risk factors for hypertension-mediated organ damage (HMOD). Therapy includes non-pharmacological and pharmacological interventions. Nonpharmacological therapy consists from combined lifestyle interventions (diet, physical activity, body weight changes and behavioral therapy components). The complex of lifestyle interventions can lead to effective reduction in blood...

Nitrate food poisoning in infant

MUDr. Jana Micherová

Pediatr. praxi. 2024;25(5):318-320 | DOI: 10.36290/ped.2024.061

We present a case report of severe methemoglobinemia in infant caused by poisoning of nitrates from the beetroot cooked in water from private well. It was manifestated by unconsciousness, tachycardia, grey-bluish discoloration of the skin and mucous membranes. The arteficial ventilation was needed. There was metabolic lactate acidosis, normal counted oxygen saturation in blood gases analysis, but low measured oxygen saturation by pulse oxymeter. Diagnosis of methemoglobinemia was clear after confirmation of hight level of methemoglobin in blood (67 %). The child was treated by methylen blue, which had very prompt effect on clinical condition, the level...

Retropharyngeal abscess in a 6-year-old boy with nephrogenic diabetes insipidus

doc. MUDr. Miroslava Brndiarová, PhD., MUDr. Vladimír Zoľák, PhD., MUDr. Nikola Halačová, prof. MUDr. Peter Bánovčin, CSc.

Pediatr. praxi. 2024;25(5):322-324 | DOI: 10.36290/ped.2024.062

Autori v článku prezentujú kazuistiku 6-ročného chlapca s nefrogénnym diabetes insipidus a retrofaryngovým abscesom. Perioperačné obdobie bolo komplikované neadekvátnym perorálnym príjmom a poruchou minerálovej a tekutinovej rovnováhy. Nephrogenic diabetes insipidus is a rare disorder characterized by impaired concentration ability of the kidneys. For these patients, not only the adequate fluid intake is crucial, but also their composition itself. The adequate hydration is especially important in situations with limited oral intake, such as in the case of an operation and preoperative period. In this article, the authors present a case report of a...

Surgical management of familial unilateral gynecomastia in a paediatric patient

MUDr. Júlia Bartková, MBA, MPH, MUDr. Diana Ng, MUDr. Naveen Cavale BSc, MBBS, MSc, FRCSEd

Pediatr. praxi. 2024;25(5):326-328 | DOI: 10.36290/ped.2024.063

Familial unilateral breast enlargement in prepubertal boys, in the absence of other signs of puberty, rapid growth, or endocrine disorders, is an uncommon condition. Unilateral gynecomastia can also be indicative of an underlying disease. Comprehensive diagnostic evaluation is essential to rule out all potential pathologies. To ensure optimal care for pediatric patients with unilateral gynecomastia, a multidisciplinary approach is recommended. Collaboration among pediatric endocrinologists and plastic surgeons is crucial for accurate diagnosis and appropriate treatment planning. We present the case of an eight-year-old male, with familial unilateral...

Objective assessment of diaper dermatitis

PhDr. Kristina Janoušková, Ph.D., prof. MUDr. Vladimir Resl, CSc., Mgr. Kateřina Ratislavová, Ph.D.

Pediatr. praxi. 2024;25(5):333-336 | DOI: 10.36290/ped.2024.065

Objective: The aim of the study was to verify the reliability of the Scoring System for Diaper Dermatitis scale. Methodology: A quantitative research method using a cross-sectional study was used. The reliability of the evaluation tool Scoring System for Diaper Dermatitis scale was verified by three evaluators. 31 infants and three evaluators participated in the research. Results: The Scoring System for Diaper Dermatitis scale is a simple and quick tool. The agreement of the raters was significant (α = 0.9540). Conclusion: The assessment tool is reliable. However, it is necessary to carry out further investigations and validate the Scoring System...

Acute pericarditis associated with parvovirus infection in a girl with acute lymphoblastic leukemia

prof. MUDr. Vladimír Mihál, CSc., MUDr. Alžběta Palátová, MUDr. Veronika Stará, MUDr. Olena Jurchenko, MUDr. Lenka Bakaj-Brožková, Ph.D.

Pediatr. praxi. 2024;25(5):329-332 | DOI: 10.36290/ped.2024.064

One week after the end of maintenance treatment, acute parvovirus B19 infection was confirmed by DNA in the blood of an 11-year-old girl with acute lymphoblastic leukaemia Clinical manifestations were two weeks of fever, moist cough, and intermittent chest pain on inspiration. Elevated serum CRP, N-terminal natriuretic peptide, but slightly elevated troponin values were detected. The ECG recording showed strikingly low P-wave, QRS complex and T-wave voltages. Echocardiographic examination confirmed acute myopericarditis with extensive pericardial effusion. The patient's recovery, supported by diuretic therapy and corticosteroids was prompt, with complete...

Newborn screening of sborn errors of immunity - SCID screening

MUDr. Markéta Bloomfield, Ph.D., MUDr. Adam Klocperk, Ph.D., prof. MUDr. Anna Šedivá, DSc.

Pediatr. praxi. 2024;25(5):315-316 | DOI: 10.36290/ped.2024.060

In the Czech Republic, a pilot programme for newborn screening of severe iborn errors of immunity, collectively known as SCID screening, took place in 2022-2023. The pilot data demonstrated a high efficiency of the entire methodological and clinical apparatus.

Vitamin C as a neuroprotective factor and the consequences of its deficiency

MUDr. Pavel Kostiuk, CSc., PharmDr. Lucie Kotlářová, PharmDr. Zdeněk Procházka

Pediatr. praxi. 2024;25(5):337-342

Vitamin C plays a number of roles in the development and function of the central nervous system. It affects the development of the brain through the epigenetic effect, ensures antioxidant protection of neurons, and its role in the synthesis of collagen is indispen­sable for the formation of myelin sheaths and brain vessels. It is needed for the synthesis of neuromodulators, transmission of signals in the central nervous system. Long-term vitamin C deficiency can lead to structural changes and functional disorders in the brain. Vitamin C deficiency also plays a significant role in the pathogenesis of neuropsychiatric diseases, especially depression....