Pediatrics for Practice, 2010, issue 6

Editorial

Vědomosti, odvaha a slušnost...

prof. MUDr. Vladimír Mihál, CSc.

Pediatr. praxi. 2010;11(6):347

Review articles

Immunological principles of safety vaccination in children

MUDr.Vojtěch Thon, Ph.D.

Pediatr. praxi. 2010;11(6):354-357

The requirement of successful vaccination is safety. In past iatrogenic injuries of children after vaccination, incl. deaths were documented in the Czech Republic because of vaccine interactions and insufficient respect to contraindications. Therefore we recommend changing of current practice of BCG vaccination considering new immunization schedule with hexavalent vaccine. We advise to postpone BCG vaccination until the second half of the child’s first year of life which is in accordance with the WHO and leads even to the protection of avian mycobacteriosis. Moreover, implementation of TRECs into the newborn screening from dried blood...

Pertussis - still topical problem not only in children

MUDr.Zuzana Blechová

Pediatr. praxi. 2010;11(6):358-362

Nárůst incidence pertuse navzdory očkování představuje epidemiologický, diagnostický a terapeutický problém. Nejčastěji je infekce hlášena u dětí mezi 10.–14. rokem života. U adolescentů a dospělých s mírným či atypickým průběhem pertuse uniká pozornosti, nebývá diagnostikována, tudíž ani hlášena. Tito mohou být zdrojem infekce pro vnímavé kojence, mnohdy i sami asymptomatičtí. Změna vyhlášky o očkování s posunem první dávky hexavakcíny do 9. týdne života a přeočkování proti pertusi v 10. roce života jsou důležitým, avšak pouze dílčím preventivním opatřením. Přeočkování dospělé populace proti pertusi je rovněž žádoucí minimálně jedenkrát...

Home parenteral nutrition in children

MUDr.Jana Kalousová, MUDr.Blanka Rousková, MUDr.Jitka Stýblová

Pediatr. praxi. 2010;11(6):363-367

Parenteral nutrition delivered at home presents a major improvement in the quality of life of children dependent on long term parenteral nutrition. Indications, technical conditions, logistics, complications, prognosis of home parenteral nutrition as well as some health-care issues to be addressed by pediatric practitioner are summarized.

Rational antibiotic therapy of acute otitis media in children view of clinical microbiologist

MUDr.Václava Adámková

Pediatr. praxi. 2010;11(6):368-372

Otitis media is one of the most common childhood infections. The most frequent causative agents are Streptococcus pneumoniae, Haemophillus influenzae and Moraxella catarrhalis. Viruses play important role in the pathogenesis of otitis media. Treatment with anti biotics is recommended for severe cases of otitis media and for children younger than 2 years. The drug of the first choice is amoxicillin in the Czech Republic due to low prevalence of non-susceptible strains. Polysaccharide pneumococcal vaccine (PVC7) was successful in reducing the incidence of otitis media caused by vaccine serotypes, but is observed the increase of episodes of acute...

Child with significant hearing deficiencies from the viewpoint of a clinical speech and hearing terapist

Mgr.Jitka Holmanová

Pediatr. praxi. 2010;11(6):374-376

The article describes the complex treatment of children with hearing impairment from early detection of the hearing loss through the hearing aid fitting and hearing habilitation till the decision about cochlear implantation. Surgery, programming of the sound processor and post-implant rehabilitation is also described. Assessment of children after cochlear implantation, especially the significant progress in their listenning skills is emphasized.

Breath-holding spells

MUDr.Jan Hálek

Pediatr. praxi. 2010;11(6):378-379

Breath-holding spells are common events in infants and young children. They can be frightening to parents but are benign and do not result in any long-term sequelae. It is important to differentiate them from epileptic seizures.

Nutrigenomics in the concept of children‘s early nutrition

MUDr.Petr Tláskal, CSc.

Pediatr. praxi. 2010;11(6):380-384

The affect of nutrition upon the expression of genes is handled by nutrigenomics. In the context of metabolic programming inadequate nutrition of foetus and postneonatals may significantly influence the health condition of an individual in the adult age. An unsuitable nutrition increases the risk of development of the metabolic syndrome and related disorders in adulthood. The original Barker´s theory is currently verified by number of other studies, and reflected in the practical implementations. For paediatric practice knowledge of nutrigenomics is a further argument to support breast-feeding. In the event of a human milk shortage then to...

Neck tumours in children

doc.MUDr.Ludmila Vyhnánková, CSc.

Pediatr. praxi. 2010;11(6):385-388

There are less tumours in children than in adults, the incidence of malignities is the ratio 1:600. Teratoma, haemangioma, lymphangioma belong to benign tumours of neck. Even a benign tumour can threaten child’s life by airway oppression or bleeding. Malign lymphomas – Hodgkin’s disease and non-Hodgkin’s lymphomas – are the most frequent malignities of neck. We can encounter also neuroblastoma, metastases into lymphnodes, carcinomas of thyroidea and rhabdomyosarcoma in this region. Differential diagnosis of neck resistances includes mainly lymphadenitis of viral or bacterial etiology, specific infections are rare;...

Case report

Tourniquet syndrome

MUDr.Josef Grym, MUDr.Petr Mylek

Pediatr. praxi. 2010;11(6):389-391

The authors describe a 4.5-month-old infant with necrosis of the second left toe developing for five days with subsequent secondary inflammatory changes. The general condition of the infant was good. It was only the presence of a strangulation line that led to a thorough search for the cause of the changes. The hidden cause of the strangulation was a hair wound around; it was loosened first and then removed completely. Due to the extent of local changes, there was a risk of amputation of the distal portion of the toe. After the hair had been removed, gradual healing occurred which, however, was prolonged and with residual changes.

Neonatal chylothorax

MUDr.Tomáš Jimramovský, MUDr.Dan Wechsler

Pediatr. praxi. 2010;11(6):392-393

Chylothorax is the most common cause of pleural effusion in the newborn. We distinguish primary and secondary form. In our report we discuss pathofysiology, etiology, diagnostics and new perspectives in treatment of the chylothorax and we add a story of one of our children from NICU.

Septic condition with multiple organ failure as initial manifestation of refractory anaemia with excess blasts

MUDr.Hana Ptoszková, MUDr.Bohumír Blažek, MUDr.Tomáš Kuhn, MUDr.Iveta Láryšová, MUDr.Tomáš Zaoral, prof.MUDr.Jan Starý, DrSc., MUDr.Vít Campr

Pediatr. praxi. 2010;11(6):394-396

in transformation The authors describe the course of a seemingly trivial infection complicated by hypersensitivity to lamotrigine in a patient with a previously clinically silent bone marrow disorder, myelodysplastic syndrome.

For nurses

The role of paediatric nurse in laboratory screening of newborns

Mgr.Alena Machová, Ing.Iva Brabcová

Pediatr. praxi. 2010;11(6):398-399

Currently, all newborns born in the Czech Republic are subjected to laboratory screening for 13 congenital or hereditary illnesses by a so called dry blood drop method. Among these illnesses belong congenital malfunctions of the thyroid gland (hypothyroidism) and the adrenal gland (adrenal hyperplasia), metabolism disorders (phenylketonuria and nine other hereditary metabolism disorders) and cystic fibrosis. The aim of this screening is early diagnostics and treatment of newborns with these illnesses. A paediatric nurse is most often responsible for the quality of the sampling and The methodical manual for full-area newborn screening and subsequent...

Clinicoradiological diagnosis

The importance of sonography in the diagnostic workup in two female infants with inguinal ovarian hernia

prof.MUDr.Vladimír Mihál, CSc., MUDr.Kamila Michálková, MUDr.Tomáš Malý, Ph.D., MUDr.Martin Zápalka, Ph.D.

Pediatr. praxi. 2010;11(6):400-401

The authors describe two female infants with atypical ingiunal hernia. The hernial sac contained ovary. The diagnosis was made by physical and sonographic examination amd was confirmed during surgical correction. The authors suggest sonography in the diagnostic workup in (premature) female infants with atypical inguinal hernia. radiology.

At a glance

Percutaneous endoscopic gastrostomy in paediatric patients

MUDr.Peter Szitányi, Ph.D., MUDr.Radim Vyhnánek, MUDr.Pavel Frühauf, CSc.

Pediatr. praxi. 2010;11(6):403-405

Long-term enteral nutrition support should be provided preferentially using Percutaneous Endoscopic Gastrostomy (PEG). Indication and placement of PEG in paediatric patients should be realized in centers designed for pediatric gastroenterology with experienced team and appropriate equipment.