Cestování je fenomén doby. I praktický lékař by měl být schopen podat svému pacientovi základní rady a informace a nasměrovat jej do specializovaného centra pro cestovní medicínu. Článek je velmi stručným shrnutím a úvodem do problematiky. Text může být osnovou pro předcestovní přípravu od anamnézy přes rutinní, povinná a doporučená očkování po preskripci antimalarické profylaxe, léků pro cestovní lékárničku a doporučení prostředků k ochraně před poštípáním hmyzem. Obsahuje rovněž odkazy na souhrnné literární a internetové zdroje, které jsou pro poskytnutí smysluplného předcestovního poradenství nezbytné.
Traveling is a phenomenon of the times. The general practitioner should be able to give his patient basic advice, and information and direct him to a specialized center for travel medicine. The article is a summary and introduction to the issue. The text can be an outline for pre-travel preparation from anamnesis to routine, mandatory, and recommended vaccinations to the prescription of antimalarial prophylaxis, drugs for the travel first aid kit, and recommendations for protection against insect bites. It also contains links to comprehensive literature and internet resources that are necessary to provide meaningful pre-travel advice.
Očkovací látky a princip očkování jsou jedním z největších objevů na poli medicíny. I když má očkování dlouhou historii, stále se vyvíjí a rychlost vývoje, včetně nástupu nových typů vakcín a jejich využití, se zrychluje. Článek je metodickým úvodem do problematiky očkování se zaměřením na dospělé. Popisuje základní směry vývoje vakcín, jejich typologické rozdělení a základní principy jejich účinku. V závěru jsou formulována základní doporučení pro očkování dospělých: dodržovat předepsaná pravidelná očkování, doporučovat sezónně důležitá očkování, očkovat těhotné, zaměřit se na chronicky nemocné a seniory a neodrazovat od očkování, pokud o něj sám pacient projeví zájem.
The development of vaccines, types, effects, new recommendations. Vaccination is one of the greatest discoveries in the field of medicine. Although vaccination has a long history, it is still evolving, and the development is accelerating. The article is a methodical introduction to the issue of vaccination with a focus on adults. It describes the basic directions of vaccine development, types of vaccines, and the basic principles of their effect. In the conclusion, basic recommendations for vaccination of adults are formulated: comply with prescribed regular vaccinations, recommend seasonally important vaccinations, vaccinate pregnant women, focus on the chronically ill and the elderly, and do not discourage vaccination.
- MeSH
- dospělí MeSH
- imunomodulace MeSH
- lidé MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- vakcinace MeSH
- vakcíny * imunologie terapeutické užití MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
Očkovací látky a princip očkování jsou jedním z největších objevů na poli medicíny. I když má očkování dlouhou historii, stále se vyvíjí a rychlost vývoje, včetně nástupu nových typů vakcín a jejich využití, se zrychluje. Článek je metodickým úvodem do problematiky očkování se zaměřením na dospělé. Popisuje základní směry vývoje vakcín, jejich typologické rozdělení a základní principy jejich účinku. V závěru jsou formulována základní doporučení pro očkování dospělých: dodržovat předepsaná pravidelná očkování, doporučovat sezónně důležitá očkování, očkovat těhotné, zaměřit se na chronicky nemocné a seniory a neodrazovat od očkování, pokud o něj sám pacient projeví zájem.
The development of vaccines, types, effects, new recommendations. Vaccination is one of the greatest discoveries in the field of medicine. Although vaccination has a long history, it is still evolving, and the development is accelerating. The article is a methodical introduction to the issue of vaccination with a focus on adults. It describes the basic directions of vaccine development, types of vaccines, and the basic principles of their effect. In the conclusion, basic recommendations for vaccination of adults are formulated: comply with prescribed regular vaccinations, recommend seasonally important vaccinations, vaccinate pregnant women, focus on the chronically ill and the elderly, and do not discourage vaccination.
- MeSH
- dospělí MeSH
- imunomodulace MeSH
- lidé MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- vakcinace MeSH
- vakcíny * imunologie terapeutické užití MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
BackgroundTimely treatment with neuraminidase inhibitors (NAI) can reduce severe outcomes in influenza patients.AimWe assessed the impact of antiviral treatment on in-hospital deaths of laboratory-confirmed influenza patients in 11 European Union countries from 2010/11 to 2019/20.MethodsCase-based surveillance data from hospitalised patients with known age, sex, outcome, ward, vaccination status, timing of antiviral treatment, and hospitalisation were obtained. A mixed effect logistic regression model using country as random intercept was applied to estimate the adjusted odds ratio (aOR) for in-hospital death in patients treated with NAIs vs not treated.ResultsOf 19,937 patients, 31% received NAIs within 48 hours of hospital admission. Older age (60-79 years aOR 3.0, 95% CI: 2.4-3.8; 80 years 8.3 (6.6-10.5)) and intensive care unit admission (3.8, 95% CI: 3.4-4.2) increased risk of dying, while early hospital admission after symptom onset decreased risk (aOR 0.91, 95% CI: 0.90-0.93). NAI treatment initiation within 48 hours and up to 7 days reduced risk of dying (0-48 hours aOR 0.51, 95% CI: 0.45-0.59; 3-4 days 0.59 (0.51-0.67); 5-7 days 0.64 (0.56-0.74)), in particular in patients 40 years and older (e.g. treatment within 48 hours: 40-59 years aOR 0.43, 95% CI: 0.28-0.66; 60-79 years 0.50 (0.39-0.63); ≥80 years 0.51 (0.42-0.63)).ConclusionNAI treatment given within 48 hours and possibly up to 7 days after symptom onset reduced risk of in-hospital death. NAI treatment should be considered in older patients to prevent severe outcomes.
- MeSH
- antivirové látky terapeutické užití MeSH
- chřipka lidská * farmakoterapie epidemiologie MeSH
- guanidiny terapeutické užití MeSH
- inhibitory enzymů terapeutické užití MeSH
- lidé MeSH
- mortalita v nemocnicích MeSH
- neuraminidasa MeSH
- oseltamivir * terapeutické užití MeSH
- senioři MeSH
- výsledek terapie MeSH
- zanamivir terapeutické užití MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
BackgroundUnderlying conditions are risk factors for severe COVID-19 outcomes but evidence is limited about how risks differ with age.AimWe sought to estimate age-specific associations between underlying conditions and hospitalisation, death and in-hospital death among COVID-19 cases.MethodsWe analysed case-based COVID-19 data submitted to The European Surveillance System between 2 June and 13 December 2020 by nine European countries. Eleven underlying conditions among cases with only one condition and the number of underlying conditions among multimorbid cases were used as exposures. Adjusted odds ratios (aOR) were estimated using 39 different age-adjusted and age-interaction multivariable logistic regression models, with marginal means from the latter used to estimate probabilities of severe outcome for each condition-age group combination.ResultsCancer, cardiac disorder, diabetes, immunodeficiency, kidney, liver and lung disease, neurological disorders and obesity were associated with elevated risk (aOR: 1.5-5.6) of hospitalisation and death, after controlling for age, sex, reporting period and country. As age increased, age-specific aOR were lower and predicted probabilities higher. However, for some conditions, predicted probabilities were at least as high in younger individuals with the condition as in older cases without it. In multimorbid patients, the aOR for severe disease increased with number of conditions for all outcomes and in all age groups.ConclusionWhile supporting age-based vaccine roll-out, our findings could inform a more nuanced, age- and condition-specific approach to vaccine prioritisation. This is relevant as countries consider vaccination of younger people, boosters and dosing intervals in response to vaccine escape variants.
- MeSH
- COVID-19 * MeSH
- hospitalizace MeSH
- lidé MeSH
- mortalita v nemocnicích MeSH
- SARS-CoV-2 MeSH
- senioři MeSH
- věkové faktory MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
Prioritisation of elderly people in COVID-19 vaccination campaigns aimed at reducing severe outcomes in this group. Using EU/EEA surveillance and vaccination uptake, we estimated the risk ratio of case, hospitalisation and death notifications in people 80 years and older compared with 25-59-year-olds. Highest impact was observed for full vaccination uptake 80% or higher with reductions in notification rates of cases up to 65% (IRR: 0.35; 95% CI: 0.13-0.99), hospitalisations up to 78% (IRR: 0.22; 95% CI: 0.13-0.37) and deaths up to 84% (IRR: 0.16; 95% CI: 0.13-0.20).
- MeSH
- COVID-19 * MeSH
- hospitalizace MeSH
- lidé MeSH
- SARS-CoV-2 MeSH
- senioři MeSH
- vakcinace MeSH
- vakcíny proti COVID-19 * MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- epidemiologie * MeSH
- Publikační typ
- biografie MeSH
- nekrology MeSH
- osobní vyprávění MeSH
- O autorovi
- Jílková, Eva Autorita
Background: Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. Methods: We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Results: Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. Conclusions: This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
