Pediatrics for Practice, 2013, issue 6

Editorial

Slovo úvodem

PhDr. Václav Mertin

Pediatr. praxi. 2013;14(6):347

Review articles

New approaches to acne treatment

MUDr.Zuzana Nevoralová, Ph.D.

Pediatr. praxi. 2013;14(6):352-356

Acne vulgaris is the most common skin disease. The acne treatment follows severity of clinical picture, psychological impact on a patient and compliance of a concrete person. Therapy is devided to local, peroral, physical and chemical ones. In local therapy the most important are local retinoids and azelaic acid, besides local antibiotics and benzoylperoxid can be used. Peroral therapy includes first of all antibiotics, combined hormonal contraceptives and isotretinoin. A suitable complementary acne care is necessary. In this article especially latest European treatment recommendations – European Evidence-based (S3) Guidelines for the...

Squinting child in the pediatrician‘s office

MUDr.Jiří Malec

Pediatr. praxi. 2013;14(6):360-362

Strabismus affects about 5–7% of the child population. Squint usually is not only an isolated clinical entity, but is associated with a number of functional disorders, the most serious of them is amblyopia, which occurs in up to 50%. Treatment of strabismus is complex and takes part in her not only child ophthalmologist, ortoptic sister and visual therapist, but also a general practitioner for children and adolescents (PLDD) and a pediatric neurologist. In the paper we present an overview of issues and development of strabismus, diagnostic pitfalls, practical advice and recommendations concerning the care of children with strabismus....

Current trends in the care of full-term newborns

MUDr.Ing.Martin Pánek

Pediatr. praxi. 2013;14(6):363-366

The aim of this article is short summary of actual practices and proposed approaches in the care of full-term newborns. Neonatology is an evolving discipline, not only in the care of premature babies, therefore is still a need to check and modify our procedures in the care of full-term newborns. It must be carried out activity in accordance with the needs of the child, the wishes of the mother, modern knowledge and recommendations.

Primary ciliary dyskinesia

MUDr.Jana Djakow, MUDr.Tamara Svobodová, prof.MUDr.Petr Pohunek, CSc.

Pediatr. praxi. 2013;14(6):368-371

Primary ciliary dyskinesia is a rare and under-diagnosed genetic disorder. Recurrent or chronic upper and lower respiratory tract infections are main clinical symptoms together with fertility disorders. It is challenging to diagnose the disease and the recommended diagnostic procedures changed significantly over the last few years. Improper or absent management of the disease may cause hearing loss, development of bronchiectasis and subsequent irreversible lung parenchyma alterations with the risk of respiratory failure in young adulthood. This reviews aims to present new knowledge in the field of ethiopathogenesis and diagnostics of the disorder....

Wheezing and viruses

prof.MUDr.František Kopřiva, Ph.D.

Pediatr. praxi. 2013;14(6):372-374

Prevalence of reccurent wheeze in infants and toddlers is high. Viral respiratory infections, particularly with respiratory syncytial virus (RSV) and human rhinovirus (HRV), are the most common causes of wheezing. For clinical purposes, reccurent wheeze in children below the age of 5 years is classified as episodic (viral) or multiple-trigger wheeze. Currently, immunoprophylaxis with palivizumab RSV infections is the prevention of wheezing in some patients.

Is genetic testing in children with growth hormone deficiency clinically justified?

prof.MUDr.Jan Lebl, CSc., RNDr.Petra Dušátková, Ph.D., MUDr.Jana Malíková, Ph.D., MUDr.Barbora Obermannová

Pediatr. praxi. 2013;14(6):376-378

Pituitary development is governed by a series of transcriptional factors that firstly orchestrate morphogenesis of brain mid-line structures, optic nerves, eyes and pituitary. Subsequently, five specialized cell lines differentiate to produce growth hormone, TSH, ACTH, FSH/LH and prolactin over the life-span. About 25% of patients with multiple pituitary hormone deficiency have a recognizable genetic cause – predominantly a PROP1 or POU1F1 gene defects that encode transcriptional factors PROP1 and POU1F1. Whereas in most hypopituitary patients genetic testing does not substantially contribute to clinical diagnosis, in a PROP1 defect may...

Staphylococcal toxic shock syndrome

MUDr.Vendula Studničková

Pediatr. praxi. 2013;14(6):379-380

Toxic shock syndrome (TSS) is a potentially fatal, progressive and life-threatening illness. For its rare incidence and easy mismatch with more commonly occuring nosological units, TSS is seldom mentioned in terms of differential diagnostic. But for life support, it is essential to recognize the TSS symptoms early and implement immediate and sufficient treatment. This article summarizes TSS from its pathogenesis to therapy and discusses personal example from practice.

Case report

Swallowing troubles in 13-year old girl

MUDr.Monika Dolejší

Pediatr. praxi. 2013;14(6):381-383

The article discuss a young girl, with whom for lower social status and tendency to truant could have led to misjudge illness, that response well to treatment, for example myasthenia gravis, for somatoform disorder or malingering, though the course of illness was typical.

Burn and mechanical injury of hand in case of three year old girl

MUDr.Iva Hufová, MUDr.Ivan Suchánek, MUDr.Alica Hokynková, MUDr.Břetislav Lipový, MUDr.Nora Gregorová, MUDr.Jitka Vokurková, Ph.D., prof.MUDr.Pavel Brychta, CSc.

Pediatr. praxi. 2013;14(6):384-385

There are about 170 children treated for burns at Department of burns and reconstructive surgery in University hospital Brno every year. Burn injury associated with the mechanical injury is very severeas this type of injury carries high risk of the compartment syndrome. It is the case in which theperfusion pressure falls below the tissue pressure in a closed anatomic space.

Thanatophoric dysplasia

MUDr.Martina Pokrývková, MUDr.Renáta Poláčková

Pediatr. praxi. 2013;14(6):386-388

Thanatophoric dysplasia is the most severe form of dwarfism. The disease incidence is between 1/20 000–50 000 newborns. Despite the low incidence, this is the most common lethal form of dwarfism. Children affected by TD have the typical phenotype: short, deformed limbs, narrow asphyxial chest, relative macrocephaly and deformity of the spine (platyspondyly), the skin is roughened and stacked in the folds. Children are born dead or die shortly after birth. The cause of the lethality of disease is respiratory failure.

For nurses

Parent´s awareness of the rights of hospitalized children

Bc.Radka Vyoral Krakovská, DiS.

Pediatr. praxi. 2013;14(6):392-394

Objectives: The point of the research was to find out, how well are the parents or the legal guardians of child patient informed about the rights arising from The Charter for Children in Czech hospital. Metodology: To realization of investigation was used an self made anonymous questionnaire. It was divided into two parts, the first part was common to all the parents, the second part was only for parents who have had experience with hospitalization of the child in the hospital. The sample group contained 403 parents or legal guardians. From the total number, 205 had already personal experience with their children hospitalization. Results:...

Clinicoradiological diagnosis

Repeated bronchoscopy for peanut aspiration with life-threatening complications

prof.MUDr.Vladimír Mihál, CSc., MUDr.Jan Saitz, MUDr.Kamila Michálková

Pediatr. praxi. 2013;14(6):390-391

Foreign body aspiration is potentially life-threatening condition. Delayed extraction using rigid bronchoscopy can lead to serious morbidity. Authors present a rare case of repeated and complicated bronchoscopic extraction peanut in a 2-year old boy who presented with acute respiratory distress after a history of their aspiration 14 hours earlier. Bronchial foreign bodies were finally removed during the second bronchoscopy, prolonged removal foreign bodies during initial bronchoscopy was complicated with severe laryngeal edema, arterial desaturation and respiratory insufficiency.

At a glance

Pediatric hyperkalemia

MUDr.Jakub Zieg

Pediatr. praxi. 2013;14(6):397-398

Elevated potassium is a common problem seen in hospitalized children and can be potentially life-threatening. Emergency management is warranted especially in cases with rapidly rising potassium values, ECG changes, decreased renal functions and presence of significant acidosis. The goal of the therapy is a prevention of severe arrhytmias development. Renal replacement therapy is used when conservative methods fail.

Nasal sprays/drops

MUDr.Klára Bartoňková, Ph.D.

Pediatr. praxi. 2013;14(6):399-402

Nasal sprays/drops are widely used systems intended for both local and systemic administration of medications. They have been used for several decades in the treatment of nasal disease, particularly rhinitis, rhinosinusitis, and nasal polyps. An adult person suffers from two to four colds a year on average, children from six to ten.

Ethics in pediatrics

Racial and ethnic aspects in pediatrics

MUDr.Josef Grym

Pediatr. praxi. 2013;14(6):395-396

In general terms, the article highlights the fact that racial and ethnic origin can be linked to genetically determined health risks (or benefits). Contemporary genetics can identify a number of these predispositions and thus contribute to timely diagnosis, treatment, and better prognosis of some conditions. The children’s health status can also be affected by ethnically bound traditions and customs in treating and bringing up children in families; these are studied and utilized by ethnopediatrics. Moreover, pediatricians should be prepared for the situation when children of certain ethnic backgrounds can present with conditions not common...

Comments

Jak je to s kojením a kojeneckou obezitou? Komentář ke článku Marinov Z., Pediatr. praxi 2013; 14(2): 89-92

Pediatr. praxi. 2013;14(6):403

Information

Caesarean section and its possible negative for newborns

MUDr.Martin Gregora

Pediatr. praxi. 2013;14(6):404-406

More studies confirm that Caesarean delivery influences negatively the gut microbiota development, and that the use of antibiotics, in combination with Caesarean delivery impacts early infantile gut microbiota development. There is now solid evidence, through large- -scale meta-analyses, that Caesarean delivery increases the risk for allergic diseases. There is new evidence that Caesarean delivery increases the risk for auto-immune and chronic metabolic diseases such as celiac disease, type 1 diabetes mellitus and even obesity.