{"id":1358,"date":"2024-12-04T09:42:56","date_gmt":"2024-12-04T07:42:56","guid":{"rendered":"https:\/\/urgentnimedicina.cz\/?p=1358"},"modified":"2024-12-04T09:56:19","modified_gmt":"2024-12-04T07:56:19","slug":"obsah-2-3-2024","status":"publish","type":"post","link":"https:\/\/urgentnimedicina.cz\/?p=1358","title":{"rendered":"Obsah 2-3\/2024"},"content":{"rendered":"<p><b>\u00daVOD<\/b><\/p>\n<ul>\n<li>Obsah<\/li>\n<li>\u00davodn\u00ed slovo \u2013 Jana \u0160eblov\u00e1<\/li>\n<\/ul>\n<p><b>URGENTN\u00cd P\u0158\u00cdJMY<\/b><\/p>\n<ul>\n<li>Urologick\u00e9 urgentn\u00ed p\u0159\u00edpady \u2013 Pavel Navr\u00e1til, David Astapenko<\/li>\n<li>Hemogagocytuj\u00edc\u00ed lymfohistiocyt\u00f3za \u2013 Jitka Horsk\u00e1<\/li>\n<\/ul>\n<p><b>PEDIATRIE V URGENTN\u00cd MEDIC\u00cdN\u011a<\/b><\/p>\n<ul>\n<li>Empirick\u00e1 ambulantn\u00ed antibiotick\u00e1 terapie nej\u010dast\u011bj\u0161\u00edch akutn\u00edch komunitn\u00edch bakteri\u00e1ln\u00edch infekc\u00ed u d\u011bt\u00ed \u2013 Marek \u0160tefan, Jind\u0159ich Havr\u00e1nek, Mark\u00e9ta Petr\u017eelov\u00e1, Jitka Gambacorta, Mark\u00e9ta Kulakowsk\u00e1, \u0160\u00e1rkaNov\u00e1kov\u00e1, Dagmar Dolinsk\u00e1, Ant\u00f3nia Modr\u00e1kov\u00e1, Alena Valko, Otakar Ny\u010d, Jana Tejnick\u00e1, Jakub Zieg, PetraDytrych, Milan Troj\u00e1nek, Jitka M\u00fcllerov\u00e1-Dissou<\/li>\n<\/ul>\n<p><b>VZD\u011aL\u00c1V\u00c1N\u00cd A ATESTA\u010cN\u00cd OT\u00c1ZKY<\/b><\/p>\n<ul>\n<li>Minim\u00e1ln\u00ed standard adapta\u010dn\u00edho procesu zdravotnick\u00fdch z\u00e1chran\u00e1\u0159\u016f na zdravotnick\u00fdch z\u00e1chrann\u00fdch slu\u017eb\u00e1ch \u2013 David Pe\u0159an, Petr Ja\u0161\u0161o, Vladim\u00edr Hus\u00e1rek<\/li>\n<\/ul>\n<p><b>ETIKA, PSYCHOLOGIE, PR\u00c1VO<\/b><\/p>\n<ul>\n<li>Rozhodov\u00e1n\u00ed p\u0159i nedostatku zdroj\u016f ve zdravotnictv\u00ed p\u0159i katastrof\u00e1ch \u2013 Jana \u0160eblov\u00e1<\/li>\n<li>Posledn\u00ed zamy\u0161len\u00ed nad v\u00fdznamem a histori\u00ed poskytov\u00e1n\u00ed prvn\u00ed pomoci \u2013 Ji\u0159\u00ed \u0160t\u011btina, Erika Mat\u011bjkov\u00e1<\/li>\n<\/ul>\n<p><b>DISKUZE, POLEMIKA, N\u00c1ZORY<\/b><\/p>\n<ul>\n<li>Pohled d\u016fchodce: \u201eKdy\u017e si nikdo nest\u011b\u017euje, je n\u011bco \u0161patn\u011b!\u201c \u2013 Pavel Urb\u00e1nek<\/li>\n<li>Pohled d\u016fchodkyn\u011b: \u201eKdy\u017e si nikdo nest\u011b\u017euje, tak je t\u0159eba slu\u017eba kvalitn\u00ed?\u201c \u2013 Jana \u0160eblov\u00e1<\/li>\n<\/ul>\n<p><b>INFORMA\u010cN\u00cd SERVIS<\/b><\/p>\n<ul>\n<li>Zem\u0159ela docentka MUDr. Jarmila Dr\u00e1bkov\u00e1, CSc.<\/li>\n<\/ul>\n<hr>\n<p><b>INTRODUCTION<\/b><\/p>\n<ul>\n<li>Contents<\/li>\n<li>Editorial \u2013 Jana \u0160eblov\u00e1<\/li>\n<\/ul>\n<p><b>EMERGENCY DEPARTMENTS<\/b><\/p>\n<ul>\n<li>Urological Emergencies \u2013 Pavel Navr\u00e1til, David Astapenko<\/li>\n<li>Hemophagotic lymphohistiocytosis \u2013 Jitka Horsk\u00e1\n<\/li>\n<\/ul>\n<p><b>PAEDIATRICS IN EMERGENCY MEDICINE<\/b><\/p>\n<ul>\n<li>Empirical oral antibiotic therapy for the most common acute community-acquired bacterial infections inchildren \u2013 Marek \u0160tefan, Jind\u0159ich Havr\u00e1nek, Mark\u00e9ta Petr\u017eelov\u00e1, Jitka Gambacorta, Mark\u00e9ta Kulakowsk\u00e1,\u0160\u00e1rka Nov\u00e1kov\u00e1, Dagmar Dolinsk\u00e1, Ant\u00f3nia Modr\u00e1kov\u00e1, Alena Valko, Otakar Ny\u010d, Jana Tejnick\u00e1, Jakub Zieg,Petra Dytrych, Milan Troj\u00e1nek, Jitka M\u00fcllerov\u00e1-Dissou<\/li>\n<\/ul>\n<p><b>EDUCATION<\/b><\/p>\n<ul>\n<li>The minimal standard of adaptation process of paramedics at Emergency Medical Services \u2013 David Pe\u0159an,<br \/>\nPetr Ja\u0161\u0161o, Vladim\u00edr Hus\u00e1rek<\/li>\n<\/ul>\n<p><b>ETHICS, PSYCHOLOGY, LAW<\/b><\/p>\n<ul>\n<li>Decision-making in lack of resources in the health care system during catastrophes \u2013 Jana \u0160eblov\u00e1<\/li>\n<li>The last reflection on importance and history of proividing first aid \u2013 Ji\u0159\u00ed \u0160t\u011btina, Erika Mat\u011bjkov\u00e1<\/li>\n<\/ul>\n<p><b>DISCUSSION, OPINION<\/b><\/p>\n<ul>\n<li>The view of a retired man: \u201eThere is something wrong when nobody complaints!\u201c \u2013 Pavel Urb\u00e1nek<\/li>\n<li>Answer of a retired women: \u201eIf nobody complaints\u2026 The service is high-quality then?\u201c \u2013 Jana \u0160eblov\u00e1<\/li>\n<\/ul>\n<p><b>INFORMATION<\/b><\/p>\n<ul>\n<li>Doc. MUDr. Jarmila Dr\u00e1bkov\u00e1, CSc. died<\/li>\n<\/ul>\n<hr>\n<p><span style=\"text-decoration: underline;\"><strong>ABSTRAKTY<\/strong><\/span><\/p>\n<h6><b>UROLOGICK\u00c9 URGENTN\u00cd P\u0158\u00cdPADY<\/b><\/h6>\n<p><b>UROLOGICAL EMERGENCIES<\/b><\/p>\n<p><b>Pavel Navr\u00e1til, David Astapenko<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Urologick\u00e9 urgentn\u00ed p\u0159\u00edpady zahrnuj\u00ed \u0161irokou \u0161k\u00e1lu stav\u016f, jako jsou akutn\u00ed mo\u010dov\u00e1 retence, torze varlete, fraktura penisu, Fournierova gangr\u00e9na a urosepse. Tyto stavy vy\u017eaduj\u00ed rychlou diagnostiku a intervenci, aby se p\u0159ede\u0161lo z\u00e1va\u017en\u00fdm komplikac\u00edm a ohro\u017een\u00ed \u017eivota pacienta. Kl\u00ed\u010dov\u00fdmi n\u00e1stroji p\u0159i diagnostice jsou anamn\u00e9za, fyzik\u00e1ln\u00ed vy\u0161et\u0159en\u00ed a zobrazovac\u00ed metody, jako ultrazvuk a CT. Terapie se pohybuje od konzervativn\u00edch postup\u016f po chirurgick\u00e9 z\u00e1kroky, v z\u00e1vislosti na z\u00e1va\u017enosti stavu. V\u010dasn\u00e1 l\u00e9\u010dba, zejm\u00e9na u stav\u016f, jako je torze varlete nebo Fournierova gangr\u00e9na, je z\u00e1sadn\u00ed pro minimalizaci rizika trval\u00e9ho po\u0161kozen\u00ed a zachov\u00e1n\u00ed funkce posti\u017een\u00fdch org\u00e1n\u016f.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>urologie \u2013 retence mo\u010di \u2013 ren\u00e1ln\u00ed kolika \u2013 urosepse \u2013 fraktura penisu<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>Urological emergencies encompass a wide range of conditions including acute urinary retention, testicular torsion, penile fracture, Fournier\u2018s gangrene, and urosepsis. These conditions require rapid diagnosis and intervention to prevent serious complications and life threatening situations. Key diagnostic tools include patient history, physical examination, and imaging methods such as ultrasound and CT. Treatment ranges from conservative approaches to surgical procedures, depending on the severity of the condition. Prompt treatment, especially for conditions like testicular torsion or Fournier\u2018s gangrene, is crucial for minimizing the risk of permanent damage and preserving the function of affected organs.<\/p>\n<p><b>Key words: <\/b>urology \u2013 urinary retention \u2013 renal colic \u2013 urosepsis \u2013 penile fracture<\/p>\n<h6><b>HEMOGAGOCYTUJ\u00cdC\u00cd LYMFOHISTIOCYT\u00d3ZA<\/b><\/h6>\n<p><b>HEMOPHAGOTIC LYMPHOHISTIOCYTOSIS<\/b><\/p>\n<p><b>Jitka Horsk\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>Tato kazuistika shrnuje komplikovan\u00fd p\u0159\u00edpad mlad\u00e9ho 32let\u00e9hopacienta s hemofagocytuj\u00edc\u00ed lymfohistiocyt\u00f3zou (HLH). Hemofagocytuj\u00edc\u00ed lymfohistiocyt\u00f3za je vysoce z\u00e1n\u011btliv\u00fd syndrom, kter\u00fd \u010dasto vy\u017eaduje intenzivn\u00ed p\u00e9\u010di a je velmi obt\u00ed\u017en\u011b diagnostikovateln\u00fd. Jedn\u00e1 se o \u017eivot ohro\u017euj\u00edc\u00ed onemocn\u011bn\u00ed s akutn\u00edm pr\u016fb\u011bhem, kter\u00e9 bez rychl\u00e9ho zah\u00e1jen\u00ed adekv\u00e1tn\u00ed terapie vede k multiorg\u00e1nov\u00e9mu selh\u00e1n\u00ed a smrti. V tomto p\u0159\u00edpad\u011b byla ji\u017e v r\u00e1mci diferenci\u00e1ln\u00ed diagnostiky protrahovan\u00fdch febrili\u00ed pojata suspekce na hemofagocytuj\u00edc\u00ed lymfohistiocyt\u00f3zu, nicm\u00e9n\u011b pro jej\u00ed definitivn\u00ed potvrzen\u00ed nebyla spln\u011bna v\u0161echna diagnostick\u00e1 krit\u00e9ria, nebo\u0165 v\u00fdsledky proveden\u00fdch vy\u0161et\u0159en\u00ed nebyly je\u0161t\u011b k dispozici nebo dosud nebyla provedena n\u011bkter\u00e1 speci\u00e1ln\u00ed vy\u0161et\u0159en\u00ed. Vzhledem k tomu, \u017ee se ale klinick\u00fd stav pacienta rapidn\u011b zhor\u0161oval, byla zah\u00e1jena specifick\u00e1 terapie hemofagocytuj\u00edc\u00ed lymfohistiocyt\u00f3zy i bez potvrzen\u00e9 diagn\u00f3zy, co\u017e se ve v\u00fdsledku uk\u00e1zalo jako spr\u00e1vn\u00e9, nebo\u0165 z protrahovan\u00e9 poruchy v\u011bdom\u00ed se septick\u00fdm \u0161okem s multiorg\u00e1nov\u00fdm po\u0161kozen\u00edm(MODS) do\u0161lo k pln\u00e9 \u00faprav\u011b stavu v\u011bdom\u00ed a postupn\u00e9mu zlep\u0161ov\u00e1n\u00ed klinick\u00e9ho stavu pacienta.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>hemofagocytuj\u00edc\u00ed lymfohistiocyt\u00f3za (HLH) \u2013 hore\u010dka nejasn\u00e9 etologie \u2013 sepse \u2013 syndrom multiorg\u00e1nov\u00e9 dysfunkce (MODS)<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>This clinical case presents a young 32 year old male patient with hemophagocytic lymphohistiocytosis (HLH). Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome that often requires critical care support and remains difficult to diagnose. It is a life-threatening disease with acute process which can lead to multiple organ dysfunction syndrome (MODS) and death without rapid adequate treatment. In this case there was an early suspection of this disease at the beginning of the differential diagnosis, but it didn\u2019t meet all the criteria, because not all the results of the tests were known and some of the special tests have not been done yet. Patient\u2019s health condition was still worsening, so the specific therapy of hemofagocytic lymphohistiocytosis was started even the final diagnosis was not established. This decision was shown as right, because there was an immediate improvement of a health conditionby the patient who had a disorder of consciousness and sepsis with multiple organ dysfunction syndrome.<\/p>\n<p><b>Key words: <\/b>hemophagocytic lymphohistiocytosis (HLH) \u2013 fever of unknown origin \u2013 sepsis \u2013 multiple organ dysfunction syndrome (MODS)<\/p>\n<h6><b>EMPIRICK\u00c1 AMBULANTN\u00cd ANTIBIOTICK\u00c1 TERAPIE NEJ\u010cAST\u011aJ\u0160\u00cdCH AKUTN\u00cdCH KOMUNITN\u00cdCH BAKTERI\u00c1LN\u00cdCH INFEKC\u00cd U D\u011aT\u00cd<\/b><\/h6>\n<p><b>EMPIRICAL ORAL ANTIBIOTIC THERAPY FOR THE MOST COMMON ACUTE COMMUNITY-ACQUIRED BACTERIAL INFECTIONS IN CHILDREN<\/b><\/p>\n<p><b>Marek \u0160tefan, Jind\u0159ich Havr\u00e1nek, Mark\u00e9ta Petr\u017eelov\u00e1, Jitka Gambacorta, Mark\u00e9ta Kulakowsk\u00e1, \u0160\u00e1rka<br \/>\nNov\u00e1kov\u00e1, Dagmar Dolinsk\u00e1, Ant\u00f3nia Modr\u00e1kov\u00e1, Alena Valko, Otakar Ny\u010d, Jana Tejnick\u00e1, Jakub Zieg, Petra<br \/>\nDytrych, Milan Troj\u00e1nek, Jitka M\u00fcllerov\u00e1-Dissou<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>V \u010dl\u00e1nku je zpracov\u00e1na problematika empirick\u00e9 peror\u00e1ln\u00ed antibiotick\u00e9 terapie nej\u010dast\u011bj\u0161\u00edch akutn\u00edch komunitn\u00edch bakteri\u00e1ln\u00ed infekc\u00ed u d\u011bt\u00ed, a sice tonzilitidy, otitis media, sinusitidy, pneumonie, cystitidy, pyelonefritidy, erysipelu, flegm\u00f3ny, impetiga a erythemamigrans. Krom\u011b antibiotik prvn\u00ed volby jsou uvedeny i alternativy p\u0159i v\u00fdpadku antibiotik nebo p\u0159i alergii. Sou\u010d\u00e1st\u00ed doporu\u010den\u00ed jsou tak\u00e9 magistraliter receptury vybran\u00fdch antibiotik. V \u010dl\u00e1nku je d\u00e1le v\u011bnov\u00e1na pozornost klasifikaci antibiotik AWaRe, kter\u00e1 rozd\u011bluje dostupn\u00e1 antibiotika do t\u0159\u00ed skupin podle rizika indukce rezistence bakteri\u00ed.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>antibiotika \u2013 bakteri\u00e1ln\u00ed infekce \u2013 selek\u010dn\u00ed tlak \u2013 alergie \u2013 AwaRe klasifikace<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>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 providedin cases of antibiotic shortages or allergies. The recommendations also include magistral (compounded, pharmacist-prepared) for mulasfor selected antibiotics. The article further focuses on the AWaReclassification of antibiotics, which divides available antibiotics into three groups according to the risk of inducing bacterial resistance.<br \/>\n<b>Key words: <\/b>antibiotics \u2013 bacterial infections \u2013 selection pressure \u2013 allergy \u2013 AwaRe classification<\/p>\n<h6><b>ROZHODOV\u00c1N\u00cd P\u0158I NEDOSTATKU ZDROJ\u016e VE ZDRAVOTNICTV\u00cd P\u0158I KATASTROF\u00c1CH<\/b><\/h6>\n<p><b>DECISION-MAKING IN LACK OF RESOURCES IN THE HEALTH CARE SYSTEM DURING CATASTROPHES<\/b><\/p>\n<p><b>Jana \u0160eblov\u00e1<\/b><\/p>\n<p><b>Abstrakt <\/b><\/p>\n<p>\u010cl\u00e1nek shrnuje z\u00e1kladn\u00ed etick\u00e9 principy, kter\u00fdmi se \u0159\u00edd\u00ed t\u0159\u00edd\u011bn\u00ed v p\u0159\u00edpad\u011b extr\u00e9mn\u00edho nedostatku materi\u00e1ln\u00edch i person\u00e1ln\u00edch zdroj\u016f p\u0159i katastrof\u00e1ch. Jako referen\u010dn\u00ed ud\u00e1lost je zvolena pandemie nemociCOVID-19 z let 2020\u20132023. Nutnost prioritizace pacient\u016f v n\u011bkter\u00fdch obdob\u00edch pandemie byla jedn\u00edm ze stresor\u016f a souvisela s negativn\u00edmi dopady na psychiku zdravotn\u00edk\u016f, v\u010detn\u011b projev\u016f mor\u00e1ln\u00edho traumatu, syndromu vyho\u0159en\u00ed a \u00fanavy ze soucitu. Dokumenty pro t\u0159\u00edd\u011bn\u00ed dostupn\u00e9 v \u010cesk\u00e9 republice v kritick\u00e9 f\u00e1zi pandemie jsou analyzov\u00e1ny z hlediska podpory zdravotn\u00edk\u016f v rozhodovac\u00edm procesu alokace zdroj\u016f.<\/p>\n<p><b>Kl\u00ed\u010dov\u00e1 slova: <\/b>mimo\u0159\u00e1dn\u00e9 ud\u00e1losti \u2013 katastrofy \u2013 pandemie \u2013 t\u0159\u00edd\u011bn\u00ed \u2013 etika \u2013 nedostatek zdroj\u016f<\/p>\n<p><b>Abstract <\/b><\/p>\n<p>The paper summarizes basic ethical principles used for triage inextreme lack of material and personnel resources during catastrophes. COVID-19 pandemics 2020\u20132023 was chosen as a reference event. The necessity to prioritize patients during some pandemic periods was one of the stressors and it was associated with negative impact on mental health of healthcare workers including moral injury, burnout syndrom and compassion fatique. Documents on triage available in the Czech Republic during critical phase of pandemicare analysed from the point of view of helathcare workers\u00b4 supportin decision-making.<br \/>\n<b>Key words: <\/b>multiple victim incidents \u2013 catastrophes \u2013 pandemic \u2013 triage \u2013 ethics \u2013 lack of resources<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00daVOD Obsah \u00davodn\u00ed slovo \u2013 Jana \u0160eblov\u00e1 URGENTN\u00cd P\u0158\u00cdJMY Urologick\u00e9 urgentn\u00ed p\u0159\u00edpady \u2013 Pavel Navr\u00e1til, David Astapenko Hemogagocytuj\u00edc\u00ed lymfohistiocyt\u00f3za \u2013 Jitka Horsk\u00e1 PEDIATRIE V URGENTN\u00cd MEDIC\u00cdN\u011a Empirick\u00e1 ambulantn\u00ed antibiotick\u00e1 terapie nej\u010dast\u011bj\u0161\u00edch akutn\u00edch komunitn\u00edch bakteri\u00e1ln\u00edch infekc\u00ed u d\u011bt\u00ed \u2013 Marek \u0160tefan,<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[38],"tags":[],"class_list":["post-1358","post","type-post","status-publish","format-standard","hentry","category-rocnik-2024"],"_links":{"self":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1358","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1358"}],"version-history":[{"count":3,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1358\/revisions"}],"predecessor-version":[{"id":1364,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=\/wp\/v2\/posts\/1358\/revisions\/1364"}],"wp:attachment":[{"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1358"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1358"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/urgentnimedicina.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1358"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}