Simultaneous diagnosis of acute lymphoblastic leukemia and ganglioneuroma of the posterior mediastinum in an 11-year-old girlClinicoradiological diagnosis

prof. MUDr. Vladimír Mihál, CSc., MUDr. Lenka Bakaj-Brožková, Ph.D., MUDr. Kamila Michálková, MUDr. Tomáš Tichý, Ph.D., doc. RNDr. Radek Vrtěl, Ph.D., doc. MUDr. David Krahulík, Ph.D., MBA, MUDr. Zbyněk Novák

Pediatr. praxi. 2024;25(4):253-256 | DOI: 10.36290/ped.2024.049  

Ganglioneuroma is a rare, benign, terminally differentiated and slow-growing tumour of the autonomic nervous system, usually arising from sympathetic ganglion cells. Most are asymptomatic and found incidentally. We report a relatively rare case of a ganglioneuroma of the posterior mediastinum that was diagnosed simultaneously on initial imaging in an 11-year-old girl with acute lymphoblastic leukemia (ALL). Histopathological and histochemical examination of biopsy speci­mens confirmed the diagnosis of ganglioneuroma. Because of an asymptomatic course, without tumor propagation into the spinal canal, a non-operative mana­gement by imaging follow-up...

Paget-Schroetter syndrome - exertional axillo-subclavian thrombosis in an adolescentCase report

MUDr. Veronika Moškořová, MUC. Anna Leharová, MUC. Eva Hrobáriková, doc. MUDr. Jana Volejníková, Ph.D.

Pediatr. praxi. 2024;25(4):246-249 | DOI: 10.36290/ped.2024.048  

A 17-year-old male was admitted due to a deep vein thrombosis in a less common location - in the right subclavian and axillary veins. Further investigation revealed an extensive physical activity leading to a recent weight loss of 20 kgs with a persisting ipsilateral gynecomastia. The diagnosis of Paget-Schroetter syndrome was established. This little-known clinical condition becomes increasingly discussed including social media with relation to sport and bodybuilding. A successful anticoagulant therapy led to resolution of symptoms and recanalization at the site of thrombosis.

Severe pneumonia requiring extracorporeal support in twinsCase report

MUDr. Jakub Jonáš, Ph.D., MUDr. Samuel Mičica, MUDr. Petr Pavlíček

Pediatr. praxi. 2024;25(4):241-245 | DOI: 10.36290/ped.2024.047  

Pneumonia is a common infectious disease in childhood. Its course may be uncomplicated, but it can also lead to respiratory failure requiring hospitalisation in the paediatric intensive care unit. The treatment of respiratory insufficiency includes support or replacement of lung function by oxygen therapy, non-invasive and invasive mechanical ventilation, and procedures such as inhaled nitric oxide or prone positioning. In situations where these methods fail, extracorporeal life support is necessary. In the following case report, we discuss the complicated course of pneumonia in six-year-old twins whose medical condition required connection to extracorporeal...

An unlucky souvenir from the tropics - a case study of fevers occuring after returning from the tropicsCase report

MUDr. Kateřina Velichová, MUDr. et Bc. Karel Medek

Pediatr. praxi. 2024;25(4):236-240 | DOI: 10.36290/ped.2024.046  

In this article we present a case of a fourteen-year-old boy who was transported via ambulance to our Pediatric Ward due to a two-day-lasting fever, dehydration and total exhaustion. Additionally, the patient progressively developed respiratory symptoms, diarrhoea and rash with white dermographism during hospitalization. The medical history revealed that the boy had been visiting a tropical destination two days prior to hospital admission.

Shaping the future of pediatric healthcare: virtual reality in burn care and rehabilitationReview articles

MUDr. Júlia Bartková, MBA, MUDr. Barbora Karoľová, Ema Knezovičová

Pediatr. praxi. 2024;25(4):230-234 | DOI: 10.36290/ped.2024.045  

Virtual reality (VR) represents a breakthrough in pediatric burn care, providing in- novative solutions not only in acute treatment, but also in rehabilitation. Distractive therapy, a proven psychological phenomenon, underlies the effectiveness of VR. Scientific studies have consistently confirmed that immersive VR experiences can divert a child's attention from painful procedures, thus reducing the perceived intensity of pain. VR also serves as an important non-pharmacological adjunct that is aligned with evidence-based approaches and provides sci- entifically-based alternative and complementary treatment to pharmacological pain management strategies....

Virtual autism. The consequence of overusing digital "screen" technologies at an early ageReview articles

doc. MUDr. Hana Ošlejšková, Ph.D., doc. PhDr. Ilona Bytešníková, Ph.D.

Pediatr. praxi. 2024;25(4):224-229 | DOI: 10.36290/ped.2024.044  

Over the past few decades, we have experienced a digital revolution. Digital media are now part of our lives. The amount of time children spend in front of various "screens" has dramatically increased, including televisions, video games, video portals like YouTube, smartphones, computers, and other gadgets. This has been a societal trend for the past 15-20 years, which has further escalated dramatically due to the COVID pandemic (1, 2). The results of many studies agree that excessive exposure of children to digital screen technologies has significantly negative impacts on both the mental and physical development of children and adolescents. The term...

Interpretation of thyroid hormone resultsReview articles

MUDr. Jarmila Vojtková, PhD., MUDr. Alena Szökeová, MUDr. Terézia Kráľová, PhD., MUDr. Andrej Fiačan, MUDr. Anna Ďurdíková, PhD., prof. MUDr. Peter Bánovčin, CSc.

Pediatr. praxi. 2024;25(4):218-222 | DOI: 10.36290/ped.2024.043  

Dysfunction of thyroid gland is one of the frequent endocrinopathies in childhood, therefore thyroid hormones are investigated as part of the differential diagnosis of various symptoms. Positive autoantibodies indicate autoimmune thyroid disease, and its function is evaluated based on free thyroxin (fT4) and thyroid-stimulating hormone (TSH) results. Subclinical hypothyroidism is a debated finding, since slightly elevated TSH can occur after acute illness or can be related to other associated conditions (obesity, nephrotic syndrome, administration of certain drugs). The concentration of free triiodothyronine (fT3) depends mainly on deiodination by...

Current knowledge about the prevalence of hypertension in children and adolescents and why is it good to know that?Review articles

MUDr. Miroslav Belbl, prof. MUDr. Tomáš Seeman, CSc., MBA

Pediatr. praxi. 2024;25(4):214-216 | DOI: 10.36290/ped.2024.042  

Although the rising prevalence of hypertension among children in the whole world is lately often discussed, recent data from the Czech population are not available to answer seemingly an easy question "How many Czech children are hypertensive?". To determine estimate of the prevalence of hypertension we may base on the many other recent data which include studies performed in the USA, many European countries or the newest meta-analysis. The only published study performed in the Czech Republic until today is based on the data which will be soon twenty years old and thus can quite differ from the reality of today. The role of the general pediatrician...

Empirical oral antibiotic therapy for the most common acute community-acquired bacterial infections in childrenReview articles

MUDr. Marek Štefan, MBA, PharmDr. Jindřich Havránek, PharmDr. Markéta Petrželová, Mgr. Jitka Gambacorta, Mgr. Markéta Kulakowská, PharmDr. Šárka Nováková, PharmDr. Dagmar Dolinská, Mgr. Antónia Modráková, PharmDr. Alena Valko, MUDr. Otakar Nyč, Ph.D., MUDr. Jana Tejnická, MBA, doc. MUDr. Jakub Zieg, Ph.D., MUDr. Petra Dytrych, Ph.D., MUDr. Milan Trojánek, Ph.D., MUDr. Jitka Müllerová-Dissou, MBA

Pediatr. praxi. 2024;25(4):206-212 | DOI: 10.36290/ped.2024.041  

This article addresses the issue of empirical oral antibiotic therapy for the most common acute community-acquired bacterial infections in children, specifically tonsillitis, otitis media, sinusitis, pneumonia, cystitis, pyelonephritis, erysipelas, cellulitis, impetigo, and erythema migrans. In addition to first-choice antibiotics, alternatives are provided in cases of antibiotic shortages or allergies. The recommendations also include magistral (compounded, pharmacist-prepared) formulas for selected antibiotics. The article further focuses on the AWaRe classification of antibiotics, which divides available antibiotics into three groups according to...

Preoperative anxiety and its preventionReview articles

MUDr. Michal Frelich, Ph.D., MBA, MUDr. Filip Burša, Ph.D., MUDr. Ondřej Jor, Ph.D., MUDr. Peter Sklienka, Ph.D., MUDr. Bořek Trávníček, MBA, MUDr. Markéta Nowaková, MBA, doc. MUDr. Jan Pavlíček, Ph.D., MHA

Pediatr. praxi. 2024;25(4):200-204 | DOI: 10.36290/ped.2024.040  

Up to 70 % of children undergoing surgery experience pre-operative anxiety. This unpleasant experience continues for many children after the operation and even after discharge from hospital. Severe preoperative anxiety has a number of negative clinical and behavioural consequences. The aim of preoperative anxiety management is to identify patients at risk and to initiate preventive measures that include non-pharmacological interventions, supplemented by the administration of sedative premedication, when indicated

Vzpomínka na MUDr. Pavla Frühaufa, CSc.Necrology

Nabil El-Lababidi

Pediatr. praxi. 2024;25(3):190  

Pediatrie, demografie, pravidelná a nepravidelná péčeEditorial

doc. MUDr. Jan Pavlíček, Ph.D., MHA

Pediatr. praxi. 2024;25(3):131  

Bonding - a relationship supporting to breastfeedingFor nurses

PhDr. Ľubomíra Karoľová, prof. PhDr. Mária Kilíková, PhD., MPH

Pediatr. praxi. 2024;25(3):187-189 | DOI: 10.36290/ped.2024.039  

Bonding is characterized as a relationship that strengthens the emotional bond between mother and newborn, promotes adaptation, thermoregulation and immunity of the newborn. The aim of the study was to conduct a systematic collection and quantitative analysis of bonding data. To determine whether there is a statistically significant relationship between bonding and full breastfeeding of newborns at discharge to home care. We used document content analysis method (n = 1 650) and correlation analysis method to collect data. In the set of newborns born in 2023, we identified the implementation of bonding in 1 282 newborns (77,7 %). At discharge to home...

Pyogenic granuloma (lobular capillary hemangioma) in a 4-year-old girl after treatment of acute lymphoblastic leukemiaCase report

prof. MUDr. Vladimír Mihál, CSc., MUDr. Bohumil Zálešák, Ph.D., MUDr. Daniel Stehlík, MUDr. Patrik Flodr, Ph.D.

Pediatr. praxi. 2024;25(3):183-186 | DOI: 10.36290/ped.2024.038  

Pyogenic granuloma (lobular capillary hemangioma) is characterized by a rapidly growing mulberry-like lesion that may be sessile or pedunculated. Bleeding even with light touch (trauma) is usually its first clinical manifestation. Unlike infantile haemangioma, it can occur at any age, including adulthood. We present a case report of a 4-year-old girl with pyogenic granuloma (PG) of the left cheek, observed by her mother 3 months after treatment for acute lymphoblastic leukemia (ALL). Under general anesthesia, extirpation of the partially pedunculated PG was performed simultaneously with excision of its base. Histological findings showed a focally hemorrhaged...

Why Vašek couldn't smile: a case study - facial nerve palsy as the initial symptom of hematologic malignancy in a pediatric patientCase report

MUDr. Silvie Šurková

Pediatr. praxi. 2024;25(3):180-182 | DOI: 10.36290/ped.2024.037  

We present a case of a patient investigated for facial nerve palsy of unknown etiology. After a series of examinations ruling out infections, the diagnosis eventually led to acute lymphoid leukemia. Before this diagnosis was established, the patient had initiated corticosteroid treatment, which could have been potentially very dangerous and even fatal without proper monitoring in the context of large tumor mass. The aim of the case report is to highlight that although oncological diseases in children are rare, they may initially mimic other diagnoses, emphasizing the importance of considering their occurrence.

Incidentally detected abdominal mass - atypical origin, atypical diagnosisCase report

MUDr. Terézia Tureková, MUDr. Jan Máchal, Ph.D., MUDr. Pavel Mazánek

Pediatr. praxi. 2024;25(3):176-179 | DOI: 10.36290/ped.2024.036  

The differential diagnosis of a pathological abdominal mass is broad. Usually, the first thing the attending physician is concerned of is a malignant disease. Neuroblastomas, hepatoblastomas, lymphomas, sarcomas, Wilms' or ovarian tumors can be palpated in the abdominal cavity. As part of the proper differential diagnostic process, it is also nece­ssary to keep in mind non-malignant causes that may point to other serious diseases. This case report presents the patient with accidentally palpated abdominal resistance, who was in diagnostic process for suspected malignancy. In this patient, the mass did not have a malignant origin, it was a large hematoma,...

That knee hurts terribly at nightCase report

MUDr. Tomáš Vereš, MUDr. Jiří David, MUDr. Jiří Palíšek, MUDr. Jan Šenkyřík, doc. MUDr. Jarmila Skotáková, CSc.

Pediatr. praxi. 2024;25(3):173-175 | DOI: 10.36290/ped.2024.035  

The case report discusses diagnostic approach and course of the disease of a 13-year-old female with osteosarcoma of the knee, which has presented as unilateral, escalating night pain in knee. Then briefly summarizes essential parts of patient's history used in the differential diagnosis of musculoskeletal pain in children and adolescents and the use of basic imaging methods when malignant disease is suspected.

Therapeutic options for arterial hypertension in childrenReview articles

MUC. Jiří Kodeš, MUDr. Petra Matalová, Ph.D.

Pediatr. praxi. 2024;25(3):166-169 | DOI: 10.36290/ped.2024.034  

Arterial hypertension is a chronic disease with constantly increasing prevalence in both adult and paediatric patients. The goal of treatment is to normalise the blood pressure values and to prevent or regress organ damage. In primary hypertension treatment, regime measures are the first-line approach. These include increased physical activity, dietary adjustments and weight reduction. In cases of insufficient efficacy, pharmacotherapy is introduced after 6-12 months, initially as monotherapy, eventually in combinations later. Five groups of antihypertensive drugs can be administered in children - angiotensin-converting enzyme inhibitors, AT₁...

Current treatment options of diabetes mellitus type 1 in pediatric populationReview articles

MUDr. Petr Polák, doc. MUDr. Renata Pomahačová, Ph.D., MUDr. Karel Fiklík, MUDr. Petra Paterová, prof. MUDr. Josef Sýkora, Ph.D.

Pediatr. praxi. 2024;25(3):161-164 | DOI: 10.36290/ped.2024.033  

The world-wide increasing incidence of this autoimunne disease, new types of short-acting insulin analogues and the improvement of the use of modern technologies, such as continuous glucose monitoring and the closed-loop hybrid insulin pump algorithm, lead to an improvement in the overal care of diabetics and a better long-term compensation of the underlying disease. The review article tries to summarize the current trends in the treatment of diabetes mellitus type I in the pediatric population and point out its possible complications. Key words: diabetes mellitus type 1, insulin, continuous glucose monitoring, insulin pumps.

Children's photoprotection and monitoring of birthmarks in childrenReview articles

MUDr. et Bc. Lucie Jarešová, MUDr. Jakub Brigant

Pediatr. praxi. 2024;25(3):157-160 | DOI: 10.36290/ped.2024.032  

Children are one of the most important population groups in which the photo-protection must be maximised due to spending a lot of time outdoors. It should be remembered that children's skin is particularly sensitive to the harmful effects of UV radiation, which increases the risk of burns and adverse effects on the skin, including the risk of skin cancer. Therefore, it is essential that we actively participate in the protection of children's skin and eliminate chronic exposure to UV radiation on children's skin.

Parenteral nutrition in neonatology III - critically ill newbornReview articles

MUDr. Peter Korček, Ph.D., MUDr. Zuzana Korčeková

Pediatr. praxi. 2024;25(3):152-156 | DOI: 10.36290/ped.2024.031  

The strategy for parenteral nutrition in critically ill neonates fundamentally differs from that in stable patients. The optimal intake of macronutrients and energy depends on the individual phases of the disease, which can be distinguished by the dynamics of changes in biomarkers and the level of cardiopulmonary support provided. In the acute phase, endogenous lipolysis and proteolysis occur, which is relatively independent of the exogenous nutrient supply. Catabolism of fat and muscle tissue (substrate formation for gluconeogenesis) along with glycogenolysis causes hyperglycemia, to which insulin resistance and parenteral nutrition also contribute....

Chronic diarrhoea of infants and toddlersReview articles

MUDr. Nabil El-Lababidi

Pediatr. praxi. 2024;25(3):146-150 | DOI: 10.36290/ped.2024.030  

Diarrhoea is a frequent health problem in children, mainly in those younger than 2 years of age, and is responsible for up to 13,2% of international child mortality. Majority of diarrhoea is acute and 3-20% are chronic, lasting for more than 2 (to 4) weeks. In most cases, infectious causes are responsible for chronic diarrhoea. In developed countries and with the decreasing age of the child, mainly in newborns and infants, the risk of congenital and genetic causes is increasing. In older children, allergies and immune mediated aetiologies should be considered. History and a detailed physical examination are key in evaluating a child with chronic diarrhoea....

Gynecomastia in puberty and adolescenceReview articles

MUDr. Stanislava Koloušková, CSc., MUDr. David Mikulík, MUDr. MgA. Pavla Tichá, Ph.D., MUDr. Eva Dřevínková

Pediatr. praxi. 2024;25(3):140-144 | DOI: 10.36290/ped.2024.029  

Gynecomastia is defined as benign proliferation of the breast tissu; it can occur in up to 40-65% of men during their lifetime. In most cases, pubertal gynecomastia is the result of hormonal imbalance, it usually occurs in Tanner stage 3-4, when the testicular volume reaches 8-10 ml, at an average age of 14 years. Later it disappears spontaneously, so it does not require therapeutic intervention. In the remaining cases, it is necessary to exclude a pathological cause. The method of first choice is conservative therapy, in case of unsatisfactory results, very rare an operative solution is indicated. The case report describes the case of an adolescent...

Oral hygiene in childrenReview articles

prof. MUDr. Romana Koberová Ivančaková, CSc., prof. MUDr. Vlasta Merglová, CSc.

Pediatr. praxi. 2024;25(3):136-139 | DOI: 10.36290/ped.2024.028  

Oral hygiene together with daily topical application of fluorides and reduction of sugar consumption from diet represent the main three pillars of caries prevention in paediatric population. Methods and time of tooth brushing depend on age and manual skills of the child. Parents are responsible of oral hygiene in early childhood, later they help and check the effectiveness of tooth brushing. The tooth brush, its modifications and dental floss are the main tools for plaque removal. The adequate amount of fluoride tooth paste applied on the tooth brush is essential. The aim of this paper is to bring the current information of oral hygiene in children.

The psychological impact of enuresis on the child and parentsFor nurses

Mgr. Jana Chromá, Ph.D., Bc. Eliška Chlumecká, PhDr. Bohdana Dušová, Ph.D.

Pediatr. praxi. 2024;25(2):122-126 | DOI: 10.36290/ped.2024.023  

Nocturnal enuresis is referred to in the literature as uncontrolled leakage of urine without the participation of will and attention during sleep in a child older than 5 years. It is a relatively common pediatric problem. Aim: The aim of the review was to summarize and analyze relevant studies related to the perception of enuresis from the perspectives of children and their parents. Methods: Design: literature review. Results: Children diagnosed with enuresis have more psychological and behavioural problems, lower self-esteem, lower quality of life and a greater tendency to social anxiety and depression compared to children without enuresis. Conclusion:...

Early feeding practices and the risk of coeliac diseaseInformation

MUDr. Pavel Frühauf, CSc.

Pediatr. praxi. 2024;25(2):120-121  

In the population at genetic risk of developing CD (HLA DQ2/DQ8-positive), exclu­sive or any breastfeeding and longer breastfeeding duration did not reduce the risk of developing CD/CDA during childhood. Age at gluten introduction was not associated with cumulative CD/CDA risk. Evidence from six observational stu­dies suggests that consumption of a higher amount of gluten at weaning and/or thereafter may increase CD risk. There is insufficient evidence to determine the amount of gluten associated with an increased CD/CDA risk. Regarding whether infant feeding practices modulate the risk conferred by different HLA genotypes results were inconsistent.

Look at erdosteine in the decade since Erica's studyInformation

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

Pediatr. praxi. 2024;25(2):115-119  

In 2013-2015, in cooperation with general practitioners for children and adolescents, the ERICA study was conducted in children with recurrent respiratory tract infections. We hypothesized that when erdosteine is administered in the first days of an incipient infection, the rate of inflammatory response in the respiratory tract will decrease and thus the severity of clinical symptoms and the need for antibiotic treatment. Within ten years, the new properties of erdostein were confirmed in patients with chronic obstructive pulmonary disease and during the SARS-Covid-2 epidemic. Thus, erdostein is not only a mucolytic substance, but has significant antioxidant...

Probiotic, prebiotic, synbiotic, postbiotic, paraprobiotic…Information

doc. MUDr. Milan Kuchta, CSc.

Pediatr. praxi. 2024;25(2):109-114  

Introduction: Improving human health through the modulation of microbial interaction during all stages of life is an evolving concept that is increasingly important to consumers, food manufacturers, healthcare professionals and regulators. With the development of the aforementioned knowledge, scientific evidence, theories and hypotheses, „new“ designations and definitions of basic terms were also developed, which are important for a systemic view and understanding of the meaning and current state of knowledge in this area. Context: We present recent definitions of basic terms, partly with their explanation, to help pediatricians better...

Exocrine pancreatic insufficiency as a first sign in toddler with cystic fibrosis with negative newborn screening - a case studyCase report

MUDr. Zuzana Michnová, PhD., MBA, doc. MUDr. Zuzana Havlíčeková, PhD., MUDr. Marek Pršo, PhD., MUDr. Michaela Matiščáková, MUDr. Jaroslav Fábry, PhD., prof. MUDr. Peter Bánovčin, CSc.

Pediatr. praxi. 2024;25(2):105-108 | DOI: 10.36290/ped.2024.022  

The cause of exocrine pancreatic insufficiency is inadequate secretion of pancreatic enzymes or premature inactivation or inadequate activation in the bowel. The main cause is chronic pancreatitis and cystitic fibrosis. Clinical manifestations of pancreatic malabsorption are weight loss, steatorrhea with diarrehea, azotorhhea, loss of serum albumin and proteins. Cystic fibrosis is the most common autosomal recessive disease of the Caucasian population characterised by chronic multi-organ impairment. Early diagnosis and multi-professional centre care is necessery for optimal management and improved quality of life and survival of patients. The authors...

Wheat-dependent exercise-induced anaphylaxisCase report

MUDr. Barbara Mílková

Pediatr. praxi. 2024;25(2):102-104 | DOI: 10.36290/ped.2024.021  

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare but potentially serious food allergy in which anaphylaxis develops if food containing wheat is consumed within 4 hours before or shortly after physical activity. While its consumption is tolerated by the patient under other circumstances. In addition to physical exertion, some other cofactors can contribute to its development.