• MeSH
• pediatrie MeSH

• MeSH
• dětská urgentní medicína MeSH
• dítě MeSH
• interakce bylin a léků MeSH
• klinická etika MeSH
• klinické kompetence MeSH
• komplementární terapie MeSH
• právní odpovědnost MeSH
• rozhodování MeSH
• Check Tag
• dítě MeSH
• Publikační typ
• sborníky MeSH

• Konspekt
• Pediatrie
• NLK Obory
• pediatrie
• alternativní lékařství

Problém antibiotické rezistence v ČR v různém rozsahu zasáhl všechny bakteriální původce humánních invazivních i lokálních infekcí v nemocnicích i v komunitě. Byl akcelerován počátkem 90. let exponenciálním nárůstem spotřeby antibiotik po uvolnění kvalifikované regulace jejich užívání (17, 18). Zlepšení kvality používání antibiotik a snížení jejich spotřeby omezováním jejich preskripce tam, kde je z hlediska etiologie považována za neúčelnou, a uvážlivý přístup k preskripci může snížit rostoucí trendy antibiotické rezistence bakterií v komunitě a uchovat účinnost starších i nových léků. Nejvyšší spotřeba antibiotik je u respiračních infekcí, na dalším místě jsou močové infekce, u obou je důležitá znalost správných mikrobiologických podkladů (7), kožní infekce tvoří méně než 10 %.

The problem of antibiotic resistance in the Czech Republic has touched to various extent all bacterial agents of invasive and local infections in hospitals and communities. The improvement in quality of antibiotic use and decrease of antibiotic use by limitation of its prescription in cases not considered being effective and responsible approach to prescription could decrease growing trends of antibiotic resistance of bacteria in community with preservation of efficacy of old and new medications. The highest consumption of antibiotics is in respiratory infections followed by urinary tract infections and skin infections. The knowledge of indications and correct antibiotic practice enables to solve the problem and preserve antibiotics even for future.

• MeSH
• antibakteriální látky klasifikace   terapeutické užití   MeSH
• azithromycin farmakologie   terapeutické užití   MeSH
• bakteriální léková rezistence MeSH
• beta-laktamy MeSH
• dítě MeSH
• laktace MeSH
• lidé MeSH
• makrolidy farmakologie   klasifikace   terapeutické užití   MeSH
• pediatrie MeSH
• peniciliny aplikace a dávkování   klasifikace   terapeutické užití   MeSH
• přehledová literatura jako téma MeSH
• těhotenství MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• těhotenství MeSH

• MeSH
• anamnéza MeSH
• dítě MeSH
• hodnocení rizik MeSH
• služby preventivní péče MeSH
• veřejné zdravotnictví MeSH
• zdraví rodiny MeSH
• Check Tag
• dítě MeSH
• Publikační typ
• kongresy MeSH
• sborníky MeSH

• Konspekt
• Pediatrie
• NLK Obory
• pediatrie

BACKGROUND: COVID-19 was declared a global health emergency. Since children are less than 1% of reported cases, there is limited information to develop evidence-based practice recommendations. The objective of this study was to rapidly gather expert knowledge and experience to guide the care of children with chronic kidney disease during the COVID-19 pandemic. METHODS: A four-round multi-center Delphi exercise was conducted among 13 centers in 11 European countries of the European Pediatric Dialysis Working Group (EPDWG) between March, 16th and 20th 2020. Results were analyzed using a mixed methods qualitative approach and descriptive statistics. RESULTS: Thirteen COVID-19 specific topics of particular need for guidance were identified. Main themes encompassed testing strategies and results (n = 4), changes in use of current therapeutics (n = 3), preventive measurements of transmission and management of COVID-19 (n = 3), and changes in standard clinical care (n = 3). Patterns of center-specific responses varied according to regulations and to availability of guidelines. CONCLUSIONS: As limited quantitative evidence is available in real time during the rapid spread of the COVID-19 pandemic, qualitative expert knowledge and experience represent the best evidence available. This Delphi exercise demonstrates that use of mixed methodologies embedded in an established network of experts allowed prompt analysis of pediatric nephrologists' response to COVID-19 during this fast-emerging public health crisis. Such rapid sharing of knowledge and local practices is essential to timely and optimal guidance for medical management of specific patient groups in multi-country health care systems such as those of Europe and the US.

• MeSH
• chronická renální insuficience komplikace   terapie   MeSH
• delfská metoda MeSH
• dialýza ledvin * MeSH
• dítě MeSH
• kojenec MeSH
• kontrola infekce MeSH
• koronavirové infekce komplikace   prevence a kontrola   terapie   MeSH
• lidé MeSH
• medicína založená na důkazech MeSH
• mladiství MeSH
• pandemie prevence a kontrola   MeSH
• předškolní dítě MeSH
• virová pneumonie komplikace   prevence a kontrola   terapie   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

• MeSH
• zubní lékařství dětské MeSH

• Konspekt
• Stomatologie
• NLK Obory
• zubní lékařství

BACKGROUND: Over 16 000 children under the age of 15 died worldwide in 2017 because of liver disease. Pediatric liver transplantation (PLT) is currently the standard of care for these patients. The aim of this study is to describe global PLT activity and identify variations between regions. METHODS: A survey was conducted from May 2018 to August 2019 to determine the current state of PLT. Transplant centers were categorized into quintile categories according to the year they performed their first PLT. Countries were classified according to gross national income per capita. RESULTS: One hundred eight programs from 38 countries were included (68% response rate). 10 619 PLTs were performed within the last 5 y. High-income countries performed 4992 (46.4%) PLT, followed by upper-middle- (4704 [44·3%]) and lower-middle (993 [9·4%])-income countries. The most frequently used type of grafts worldwide are living donor grafts. A higher proportion of lower-middle-income countries (68·7%) performed ≥25 living donor liver transplants over the last 5 y compared to high-income countries (36%; P = 0.019). A greater proportion of programs from high-income countries have performed ≥25 whole liver transplants (52.4% versus 6.2%; P = 0.001) and ≥25 split/reduced liver transplants (53.2% versus 6.2%; P < 0.001) compared to lower-middle-income countries. CONCLUSIONS: This study represents, to our knowledge, the most geographically comprehensive report on PLT activity and a first step toward global collaboration and data sharing for the greater good of children with liver disease; it is imperative that these centers share the lead in PLT.

• MeSH
• dítě MeSH
• lidé MeSH
• nemoci jater * MeSH
• sčítání lidu MeSH
• smrt MeSH
• transplantace jater * škodlivé účinky   MeSH
• žijící dárci MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

While children approaching end-stage kidney disease (ESKD) are considered at risk of uremic anorexia and underweight they are also exposed to the global obesity epidemic. We sought to investigate the variation of nutritional status in children undergoing chronic peritoneal dialysis (CPD) around the globe. The distribution and course of body mass index (BMI) standard deviation score over time was examined prospectively in 1001 children and adolescents from 35 countries starting CPD who were followed in the International Pediatric PD Network (IPPN) Registry. The overall prevalence of underweight, and overweight/obesity at start of CPD was 8.9% and 19.7%, respectively. Underweight was most prevalent in South and Southeast Asia (20%), Central Europe (16.7%) and Turkey (15.2%), whereas overweight and obesity were most common in the Middle East (40%) and the US (33%). BMI SDS at PD initiation was associated positively with current eGFR and gastrostomy feeding prior to PD start. Over the course of PD BMI SDS tended to increase on CPD in underweight and normal weight children, whereas it decreased in initially overweight patients. In infancy, mortality risk was amplified by obesity, whereas in older children mortality was markedly increased in association with underweight. Both underweight and overweight are prevalent in pediatric ESKD, with the prevalence varying across the globe. Late dialysis start is associated with underweight, while enteral feeding can lead to obesity. Nutritional abnormalities tend to attenuate with time on dialysis. Mortality risk appears increased with obesity in infants and with underweight in older children.

• MeSH
• chronické selhání ledvin epidemiologie   terapie   MeSH
• dítě MeSH
• enterální výživa škodlivé účinky   MeSH
• hubenost epidemiologie   MeSH
• kojenec MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladiství MeSH
• nadváha epidemiologie   MeSH
• nutriční stav * MeSH
• obezita dětí a dospívajících epidemiologie   MeSH
• peritoneální dialýza mortalita   MeSH
• předškolní dítě MeSH
• prevalence MeSH
• registrace MeSH
• rizikové faktory MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Amerika MeSH
• Asie MeSH
• Evropa MeSH

• MeSH
• pediatrie MeSH
• počítače využití   MeSH
• průzkumy a dotazníky MeSH
• výzkum MeSH

Parenteral nutrition is used to treat children that cannot be fully fed by the enteral route. While the revised ESPGHAN/ESPEN/ESPR/CSPEN pediatric parenteral nutrition guidelines provide clear guidance on the use of parenteral nutrition in neonates, infants, and children based on current available evidence, they have helped to crystallize areas where research is lacking or more studies are needed in order to refine recommendations. This paper collates and discusses the research gaps identified by the authors of each section of the guidelines and considers each nutrient or group of nutrients in turn, together with aspects around delivery and organization. The 99 research priorities identified were then ranked in order of importance by clinicians and researchers working in the field using a survey methodology. The highest ranked priority was the need to understand the relationship between total energy intake, rapid catch-up growth, later metabolic function, and neurocognitive outcomes. Research into the optimal intakes of macronutrients needed in order to achieve optimal outcomes also featured prominently. Identifying research priorities in PN should enable research to be focussed on addressing key issues. Multicentre trials, better definition of exposure and outcome variables, and long-term metabolic and developmental follow-up will be key to achieving this. IMPACT: The recent ESPGHAN/ESPEN/ESPR/CSPEN guidelines for pediatric parenteral nutrition provided updated guidance for providing parenteral nutrition to infants and children, including recommendations for practice. However, in several areas there was a lack of evidence to guide practice, or research questions that remained unanswered. This paper summarizes the key priorities for research in pediatric parenteral nutrition, and ranks them in order of importance according to expert opinion.

• MeSH
• dítě MeSH
• fyziologie výživy dětí * MeSH
• kojenec MeSH
• konsensus MeSH
• lidé MeSH
• novorozenec MeSH
• parenterální výživa úplná MeSH
• parenterální výživa * MeSH
• výzkum MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH