Krize dětské psychiatrieEditorial

MUDr. Jan Uhlíř

Pediatr. praxi. 2023;24(3):147  

Drug-induced liver injury (DILI)Information

MUDr. Pavel Frühauf, CSc.

Pediatr. praxi. 2023;24(3):217-218  

The most common hepatotoxic drugs in children are antibiotics and antiepileptics. DILI is presents mostly with 2 patterns of injury: hepatocellular or cholestatic. Diagnosis can be done with help of the Roussel Uclaf Causality Assessment Method (RUCAM). The mainstay of treatment is prompt withdrawal of the suspect drug.

Intestinal dysmicrobia and allergy in children: the role of probiotics and vitamins in treatment and preventionCompany information

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

Pediatr. praxi. 2023;24(3):209-216  

The article deals with two areas of health problems that often occur in children during the summer. The first part of the article deals with the problem of intestinal discomfort, which often accompanies a disorder of the intestinal microbiota (intestinal dysmicrobia). It deals with the role of intestinal microbiota in the human organism, probiotics and the possibility of their use in children in the treatment of gastrointestinal and other health problems. Combined preparations are advantageous, which, in addition to the probiotic itself, also contain prebiotics and other components such as vitamins, the production of which by the microbiota is impaired...

Infantilní hemangiomy u dětí v klinické praxiHeard at a congress

MUDr. Josef Mališ

Pediatr. praxi. 2023;24(3):205-206  

Support of breastfeeding a premature newbornFor nurses

Mgr. Jana Kučová, Ph.D.

Pediatr. praxi. 2023;24(3):200-204 | DOI: 10.36290/ped.2023.057  

Achieving full breastfeeding of a premature newborn is a challenge for health professionals as well as for mothers who have given birth prematurely. To achieve this goal, it is necessary to maintain the mother's lactation, often for several weeks, before the first attempts at breastfeeding are initiated. Until the baby is able to coordinate sucking, breathing, and swallowing, it is possible to implement many interventions in the care of the premature new-born that can facilitate subsequent breastfeeding. It is mainly the skin-to-skin contact, oral motor interventions, and alternative feeding methods. Support for a woman's emotional stability and support...

Congenital dermal melanocytosis in a vietnamese neonate with lymphangiomaClinicoradiological diagnosis

prof. MUDr. Vladimír Mihál, CSc., MUDr. Veronika Moškořová, MUDr. Markéta Kalivodová

Pediatr. praxi. 2023;24(3):197-199 | DOI: 10.36290/ped.2023.056  

Congenital dermal melanocytosis (Mongolian spots) are congenital birthmarks that most commonly occur in the lumbosacral region. They are grey-blue to blue-green in colour and oval or irregular in shape. They are most commonly found in individuals of Asian or African ethnicity. These lesions resolve within one to two years of age. Although traditionally believed to be harmless in nature, they have been shown to occur in some lysosomal storage diseases. We present a Vietnamese neonate with congenital dermal melanocytosis, which we observed at diagnosis of a cystic mass of the left arm.

CranioFacial Synostosis - Crouzon syndromeCase report

MUDr. Miriam El Husseini

Pediatr. praxi. 2023;24(3):194-196 | DOI: 10.36290/ped.2023.055  

Crouzon syndrome is a rare autosomal dominant disease due to mutation of genes encoding fibroblast growth factor receptor 2 (FGFR2). Premature closure of the cranial sutures causes a number of complications in growing children, such as increased intracranial pressure due to reduced intracranial space and growing brain tissue, epilepsy, hearing impairment, and optic nerve atrophy. The management of patients with Crouzon syndrome requires a multidisciplinary approach at specialized centers. Treatment is mainly surgical (remodulation of the skull) with very good prognosis.

Subglottic cyst as cause of the dyspnea in infantsCase report

MUDr. Monika Debnárová, MUDr. Veronika Mohylová, doc. MUDr. Karol Zeleník, Ph.D., MBA, doc. MUDr. Jan Pavlíček, Ph.D., MUDr. Ondřej Jor, Ph.D., prof. MUDr. Pavel Komínek, Ph.D., MBA

Pediatr. praxi. 2023;24(3):191-193 | DOI: 10.36290/ped.2023.054  

Subglottic cyst is a rare disease of the larynx, which occurs to newborns or infants. The typical symptom is stridor. Diagnosis depends on anamnesis and flexibile endoscopy, in a case of uncertainity the tracheobronchoscopy in general anesthesia is indicated. The main therapeutical modality is surgical excision. Regular check-up sis neccesery, because of often reccurency of the disease. Aim of this case report is to point out this rare disease and to add it to differential diagnosis of stridor in children.

Nutcracker syndrome diagnosed in a boy with macroscopic hematuria, a frequently neglected diagnosisCase report

MUDr. Patrik Konopásek, MUDr. Shenali Amaratunga, doc. MUDr. Jakub Zieg, Ph.D.

Pediatr. praxi. 2023;24(3):187-190 | DOI: 10.36290/ped.2023.053  

Nutcracker syndrome must be taken into consideration in the differential diagnosis of hematuria and orthostatic proteinuria. When these urine abnormalities are seen, clinicians should never forget about nutcracker syndrome as a possible diagnosis, especially in the case of left flank pain or varicocele. Doppler ultrasound performed by an experienced radiologist is the first line diagnostic approach. Establishing the diagnosis may save patients from invasive procedures like kidney biopsy or cystoscopy. Conservative management is the preferred approach, surgery should be indicated only in severe cases. We present a case of a boy with intermittent macroscopic...

Differential diagnosis of arthralgia and arthritis - how general practitioners might contribute - case reports and summary for clinical practiceCase report

doc. MUDr. Kateřina Bouchalová, Ph.D., MUDr. Hana Flögelová, Ph.D., MUDr. Zuzana Pytelová, MUDr. Lucie Sulovská, Ph.D., prof. MUDr. Jan Mareš, Ph.D., MUDr. Jakub Čivrný

Pediatr. praxi. 2023;24(3):179-185 | DOI: 10.36290/ped.2023.052  

An article is focused on differential diagnosis of arthralgias and arthritides with stress on infectious etiology. We review basic attitudes in diagnostics of pediatric rheumatic diseases and how general practitioners might contribute. Case reports of children with arthritis as a symptom of pediatric rheumatic diseases are described. The arthritis might be the first symptom of juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE), IgA vasculitis and many other rheumatic diseases, or it develops during the disease course. An early diagnosis is a clue to successful therapy.

Prader-Willi syndrome: a case reportCase report

MUDr. Olga Magnová

Pediatr. praxi. 2023;24(3):175-178 | DOI: 10.36290/ped.2023.051  

Prader-Willi syndrome is a dangerous genetic multisystem disorder. It's typical symptoms include facial dysmorphia, muscle weakness, growth and eating disorders (failure-to-thrive followed by polyphagia and obesity). We are presenting three case histories of children with Prader-Willi syndrome. Two of them have been diagnosed after the second year of life, with differing impact on their health. Early diagnosis in the third case history didn't eliminate development of extreme obesity leading to serious morbidity. The aim of the article is to bring attention to importance of early diagnosis and initiation of complex treatment of this condition, including...

Immunodysregulatory aspects of children with Down syndromeReview articles

MUDr. Peter Kunč, PhD., MUDr. Jaroslav Fábry, PhD., MUDr. Peter Ferenc, PhD., MUDr. Tomáš Strachan, PhD., MUDr. Michaela Matiščáková

Pediatr. praxi. 2023;24(3):169-174 | DOI: 10.36290/ped.2023.050  

Unlike other rare genetic disorders, a paediatrician often encounters many cases of children with Down syndrome during clinical practice. This syndrome is characterised by the complexity of characteristic functional and structural manifestations in every organ system. The immune system of children with this syndrome is characterised by various functionally limiting disturbances related to the regulation of immune mechanisms that maintain the integrity of the organism against endogenous and exogenous factors. This results not only in an increased susceptibility to recurrent and severe respiratory infections, but also in a predisposition to selected...

Sun and children´s skinReview articles

doc. MUDr. Karel Ettler, CSc.

Pediatr. praxi. 2023;24(3):164-168 | DOI: 10.36290/ped.2023.049  

Sunlight, and especially its ultraviolet part, can damage children's skin with acute burns, and chronically in adults with photoaging and/or skin cancer. The intensity and duration of exposure are important, but also the characteristics (phototype) of the irradiated skin. Natural photoprotection can be strengthened by behavior modification, appropriate clothing and sunscreens. After solar damage, it is necessary to treat the skin and definitely not to continue sunbathing.

Autoimmune liver disease in childhoodReview articles

MUDr. Lucie Gonsorčíková, Ph.D., MUDr. David Bauer, doc. MUDr. Eva Sticová, Ph.D., MUDr. Radim Vyhnánek

Pediatr. praxi. 2023;24(3):158-162 | DOI: 10.36290/ped.2023.048  

Autoimmune liver disease in children can be classified as: autoimmune hepatitis (AIH), autoimmune sclerosing cholangitis (ASC) and de novo AIH after liver transplantation (plasma cell rich rejection). When left untreated, these disorders are progressive in nature and can result in cirrhosis and terminal liver failure. They are characterised by presence of circulating autoantibodies, high levels of IgG class imunoglobulins and inflammatory changes on liver histology. There are two main subtypes of AIH depending on the type of specific autoantibodies detected: type 1 and type 2. AIH has a very wide spectrum of symptoms ranging from being asymptomatic...

Heatstroke and heat exhaustion in childhoodReview articles

MUDr. Sandra Gruberová, MUDr. Beáta Krejčířová, doc. MUDr. Petr Jabandžiev, Ph.D.

Pediatr. praxi. 2023;24(3):155-157 | DOI: 10.36290/ped.2023.047  

Body overheating in children can rapidly lead to a life threatening situation. Children are more susceptible to external temperature changes as their thermoregulation mechanisms are not yet perfectly developed. In extreme cases overheating can lead to a child's death. A lot of these cases are caused by leaving or forgetting a child in a locked car during hot summer days. The temperature inside the car can rise over 70 degrees centigrade and in under an hour the child can go into a severe shock. It is also necessary to make appropriate precautions such as sufficient hydration or sun protection during summer sport activities. In this article we aim to...

Drowning - basic procedures and ways of preventionReview articles

MUDr. Jakub Jonáš, Ph.D.

Pediatr. praxi. 2023;24(3):151-154 | DOI: 10.36290/ped.2023.046  

Drowning is among preventable injuries, having a major impact on morbidity as well as mortality. Fatal drowning results in an individual's death; non-fatal drowning may result in severe neurological impairment. Its degree depends on multiple factors, but is particularly dependent on the oxygen supply to the body. In terms of quality of life, it is thus crucial to initiate properly performed cardiopulmonary resuscitation as early as possible in order to restore adequate oxygen supply.

Jak se vyznat v nových formách nikotinuEditorial

prof. MUDr. Eva Králíková, CSc.

Pediatr. praxi. 2023;24(2):79  

Use of low-FODMAP diet in pediatricsInformation

MUDr. Pavel Frühauf, CSc.

Pediatr. praxi. 2023;24(2):141-142  

Excluding oligo-, di-, monosaccharides and polyols (FODMAP) from the diet is increasingly being used to treat children with gastrointestinal complaints. There is insufficient evidence to routinely recommend the use of the low-FODMAP diet to treat functional gastrointestinal disorders, non-celiac gluten sensitivity, inflammatory bowel diseases or small-intestinal bacterial overgrowth in children.

The possible therapeutic effect of fermented foodsInformation

prof. MUDr. František Kopřiva, Ph.D., MUDr. Denis Dvořák, MUDr. Jitka Pallerová

Pediatr. praxi. 2023;24(2):137-140  

The unhealthy lifestyle of modern man and the negative effects of the environment lead to the disturbance of the balance of the intestinal microbiota and an increase in chronic non-infectious (non-communicable) diseases and increased activity of chronic inflammation in the body and an increased risk of metabolic syndrome, diabetes, obesity, tumors, autoimmune diseases, etc. One of the possibilities to support the variability and growth of the microbiota is to increased proportion of fermented foods in diet, which restore the "healthy" balance of bacteria in the intestine and reduce the activity of the inflammatory response.

Monitoring of nursing care for peripheral intravenous access in hospitalized childrenFor nurses

Mgr. Gabriela Světnická, prof. PhDr. Darja Jarošová, Ph.D.

Pediatr. praxi. 2023;24(2):132-134 | DOI: 10.36290/ped.2023.038  

Objective: The objective of the study was to determine how nursing care for peripheral intravenous access is performed in hospitalized children. Methodology: As part of an observational study, nursing care for inserted peripheral venous catheters (PVC) was monitored using the PIVC-mini Q evaluation tool in 209 children aged 6 to 11 years. The research was carried out in seven hospitals of the Moravian-Silesian Region from July 2021 to March 2022. The evaluation was performed by trained nurses in the respective departments. Results: It was found that nursing care for children's intravenous access is performed by nurses based on their personal experience....

Open depressed skull fracture after stone-throwing accidentClinicoradiological diagnosis

prof. MUDr. Vladimír Mihál, CSc., MUDr. Vlastimil Novák, Ph.D., MUDr. Petra Crhonková, MUDr. Kamila Michálková

Pediatr. praxi. 2023;24(2):127-131 | DOI: 10.36290/ped.2023.037  

The most common causes of traumatic brain injury in children are falls, traffic or sports accidents, and aggressive attacks to the head. Impression fracture of the skull is common in pediatric patients with traumatic brain injury and accounts for up to 23% of all skull fractures.The main goal of surgical management of depressed fractures is to correct the cosmetic deformity and prevent infection. For the diagnosis of skull fractures and traumatic brain injury (TBI), CT is the reference standard. We present the case of a 10-year-old boy who suffered an open depressed fracture of the frontal bone by a thrown stone during a sibling fight. Emergency neurosurgery...

What a travel first-aid kit should includeAt a glance

PharmDr. MVDr. Vilma Vranová, Ph.D.

Pediatr. praxi. 2023;24(2):124-126 | DOI: 10.36290/ped.2023.036  

A travel first aid-kit does not differ significantly from a household one. What items should be included depends on the length of stay away from home, the particular destination as well as the activities planned. The following text can serve as a guide as to which medications and medical devices should be contained in a travel first-aid kit, depending on the traveller's requirements.

Communication with a child with autism spectrum disorder in a hospital settingCase report

Mgr. Veronika Dobešová, Bc. Veronika Glosová, doc. PhDr. Andrea Botíková, PhD., MPH, Mgr. Daniela Bartoníčková

Pediatr. praxi. 2023;24(2):120-123 | DOI: 10.36290/ped.2023.035  

Communication impairment, which belongs to the basic triad of symptoms of autism spectrum disorder (ASD), can be a complication in providing comprehensive nursing care for children with this disorder. Nurses lack knowledge about the manifestations and issues of communication with children with ASD and often do not know how to establish effective communication. A short and clear form of communication is very important and sufficient time is needed. Short case studies revealed shortcomings in communicating with children with ASD in a hospital setting; communication with a child with ASD in a residential care facility could be an inspiration. From the...

Hypertension not treatable with enalapril in a boy with recurrent acute myocarditisCase report

MUDr. Simona Ulrich, MUDr. Eva Drahokoupilová, MUDr. David Sumerauer, Ph.D., MUDr. Patrik Konopásek, MUDr. Lucie Slámová, Ph.D., doc. MUDr. Lucie Šrámková, Ph.D.

Pediatr. praxi. 2023;24(2):116-119 | DOI: 10.36290/ped.2023.034  

Secondary hypertension in the paediatric preadolescent population prevails over primary hypertension. Although in most children, the cause is renal or cardiac, it is also necessary to consider endocrine and other factors. Here we present the case report of an 11-year-old boy, who presented predominantly with signs of acute myocarditis, and the cause of hypertension was clarified only at the second attack of these problems. A tumour was found in the retroperitoneum by ultrasound, later histologically determined to be a paraganglioma. Endogenous overproduction of catecholamines based on the presence of paraganglioma represents a very rare cause of hypertension...

Lethal syndromes in pediatrics - three cases of trisomy 18Case report

MUDr. Michaela Ducháčová, doc. MUDr. Jan Pavlíček, Ph.D., MUDr. Eva Pavlíčková, MUDr. Markéta Nowaková, MBA, MUDr. Bořek Trávníček, MBA, Mgr. Iva Kuzníková, Ph.D., Bc. Tereza Broďáková

Pediatr. praxi. 2023;24(2):111-115 | DOI: 10.36290/ped.2023.033  

Edwards syndrome is a significant genetic abnormality with an unfavorable prognosis. It has a high rate of prenatal detection, which significantly affects its occurrence in the pediatric population. Postnatally, the dominant organ pathology is heart defects, clinically these patients always present with psychomotor impairment and failure to thrive. Despite the high percentage of early lethality, some patients may live longer than one year, and it is, therefore, to set up complex care for them. This care is available, including the management of organ pathologies. Complex or palliative care concepts are of considerable benefit in these children.

Erythema ab IgneCase report

MUDr. Zuzana Nevoralová, Ph.D.

Pediatr. praxi. 2023;24(2):107-110 | DOI: 10.36290/ped.2023.032  

Erythema ab igne is a rash characterized by a reticulated pattern of erythema and hyperpigmentation. It is caused by repeated exposure to direct heat or infrared radiation. While the rash is most often benign, its presence can indicate chronic inflammation or, less commonly, systemic illness. Furthermore, a careful inspection of the rash is necessary. Evidence of pre-malignant or malignant trasformation is possible. A case of a 12-year old girl with a typical signs of erythema ab igne is presented. In an article, clinical sign, possible causes, pathogenesis, epidemiology, diagnosis, differential diagnosis and treatment of this clinical unit is given.

Treatment of nicotine pouches addiction in children and adolescents - two case reportsCase report

MUDr. Lenka Štěpánková, Ph.D.

Pediatr. praxi. 2023;24(2):105-106 | DOI: 10.36290/ped.2023.031  

The use of nicotine pouches among children and adolescents has unfortunately become a very common phenomenon in the last few years. Until now, children and teenagers could even purchase nicotine pouches themselves without legal restrictions. Their use is very inconspicuous and difficult for parents, teachers and doctors to identify, which further contributed to their spread. Below I want to demonstrate two different case studies that show opposite sides of the spectrum: Most cases do not proceed as dramatically as the first case study describes, nor as smoothly as in the second case study.

Sexual risky behaviour - children and youth as victims and participantsReview articles

prof. PhDr. Ingrid Emmerová, PhD.

Pediatr. praxi. 2023;24(2):102-104 | DOI: 10.36290/ped.2023.030  

The article deals with the problem of sexual risky behaviour of children and youth. They can be victims, but they can also engage in sexual risky behaviour (of varying severity and dangerousness). The current situation convinces us of the need for effective prevention in primary and secondary schools. The author pays special attention to the possibilities of paediatricians in this area.

Roma population and selected aspects of health careReview articles

prof. MUDr. Tatjana Dostálová, DrSc., MBA, RNDr. Hana Eliášová, Ph.D., MDDr. Eliška Šedivá, doc. MUDr. Vlasta Merglová, CSc., prof. MUDr. Milan Macek, DrSc., MHA

Pediatr. praxi. 2023;24(2):98-101 | DOI: 10.36290/ped.2023.029  

Generally, the Roma population has problems with treatment options and often experiences discrimination due to structural barriers when accessing health services and for that reason may mistrust those services. The aim of our study is to evaluate the most efficient systems for the engagement of the Roma community aimed at enhancing trust in health services, mainly in the field of dentistry. Since the overall state of dentition significantly affects the quality of life, it is not possible to neglect dental care in excluded localities. A combined social and healthcare approach that represents the basic pillars of prevention (comprising dental hygiene,...

ESPGHAN recommendations for paediatric coeliac disease follow-upReview articles

MUDr. Nabil El-Lababidi

Pediatr. praxi. 2023;24(2):95-97 | DOI: 10.36290/ped.2023.028  

Thanks to the ESPGHAN (European Society for Paediatric Gastroenterology, Hepatology and Nutrition) guidelines, the ideal approach to establishing the diagnosis of coeliac disease (CD) in children is clear. However, uncertainty in further follow-up of these children was present. In 2022, ESPGHAN published a position paper regarding further clinical and laboratory follow-up of children with CD. This position paper expresses its opinion regarding even controversial topics such as refractory and potential CD. Implementation of these published recommendations into clinical practice should lead to improvement in the care of paediatric CD patients.