Casopís lékar̆ů c̆eských
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Casopís lékar̆ů c̆eských · Jan 2020
Case ReportsA case of severe course of COVID-19 treated with experimental therapy.
70-year-old high-risk patient with severe course of COVID-19 hospitalized for progressive dyspnea due to extensive bilateral pneumonia caused by SARS-CoV-2. The patient was treated with hydroxychloroquine and azithromycin from day one of hospital stay. ⋯ The patient subsequently improved and was discharged home on day eleven of the hospital stay. Risk factors of severe course of the infection, complications and potential therapies of COVID-19 are discussed.
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Diagnostic approaches to COVID-19 include clinical history, PCR tests for the presence of SARS-CoV-2 virus and detection of antibodies. By combining these three approaches, the seroprevalence of anti-SARS-CoV-2 antibodies can be examined in healthcare teams. The aim of the study was to examine the seroprevalence of anti-SARS-CoV-2 antibodies in a population of healthcare professionals 6 - 8 weeks after the first COVID-19 case was detected in the Czech Republic. ⋯ There was only one PCR positive subject. Anti SARS-CoV-2 antibodies were thus detected in 2.22% of participating health professionals. This article shows the pitfalls of the testing methods and highlights the necessity of using a correct testing algorithm, considering the character of the tested population and the expected low prevalence.
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By the end of 2019 the first cases of severe pneumonia of unknown origin were reported in Wuhan, China. The causative agent was identified as a novel b-coronavirus SARS-CoV-2 and the disease was named COVID-19. Since the beginning of 2020, the infection has spread worldwide, which led the WHO to declare COVID-19 a public health emergency of international concern and to characterize the current situation as a pandemic. ⋯ Typical imaging findings include multifocal peripherally distributed ground-glass opacities or consolidations, interlobular septal thickening, crazy paving appearance and cystic changes. The overall case fatality rate is estimated to range from 1 to 3 %, however, it is dependent on age and underlying medical comorbidities. Current potential treatment options include hydroxychloroquine, remdesivir, lopinavir/ritonavir and convalescent plasma.
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Casopís lékar̆ů c̆eských · Jan 2020
Obesity in childhood and adolescence and what we can do with an obese child in a pediatric health care.
Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and it is steadily affecting health care of many countries. Increase in obesity prevalence has been slowing down in numerous countries recently. ⋯ The most problematic is the incidence of obesity of school children, especially boys. To improve the care of obese children in the Czech Republic, general practitioners for children and adolescents (PLDD) were involved in the health care, the educational program for PLDD was created and implemented in 2015-2017, and in 2020 the Ministry of Health approved examination, which will enable PLDD not only to look for overweight and obese children, but also to treat them effectively. The general recommendations are supplemented by practical knowledge and recommendations of doctors treating obese children.
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Currently, patients are evaluated by a psychiatrist using the phenomenological classification then, first-line treatment is initiated according to the diagnosis; however, this approach is associated with a high rate of etiopathogenetic heterogeneity. The development of mental disorders is likely determined by combined effects of genetic predisposition and environmental adversity. Inter-mutual interaction is regulated by epigenetics processes which determine transcription and translation of gens to corresponding proteins. ⋯ An example is schizophrenia, the most severe mental disorder and prototype of psychotic disorder. The current definition of schizophrenia lacks a biological validity, which is stimulating an effort to alternatively define the psychotic disorders on the base of biomarkers. The goal of integration knowledge from biomedical research and clinical practice is providing more accurate diagnosis and the tailored treatment for each individual patient.