{"id":14634,"date":"2014-03-03T22:12:58","date_gmt":"2014-03-03T21:12:58","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=14634"},"modified":"2014-10-20T20:02:58","modified_gmt":"2014-10-20T18:02:58","slug":"nespi-ci-kaslou-cela-leta-a-pritom-lze-pomoci-tak-rychle","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=14634","title":{"rendered":"Nesp\u00ed \u010di ka\u0161lou cel\u00e1 l\u00e9ta. A p\u0159itom lze pomoci tak rychle"},"content":{"rendered":"

Tr\u00e1p\u00ed va\u0161e d\u00edt\u011b ji\u017e roky astma a l\u00e9\u010dba p\u0159\u00edli\u0161 nepom\u00e1h\u00e1? Nebo m\u00e1 \u010dasto z\u00e1n\u011bty ucha? Nyn\u00ed se p\u0159i\u0161lo na to, \u017ee tyto probl\u00e9my m\u016f\u017ee zp\u016fsobovat i pronik\u00e1n\u00ed \u017ealude\u010dn\u00ed \u0161\u0165\u00e1vy do d\u00fdchac\u00edch cest. Pak je l\u00e9\u010dba rychl\u00e1 a d\u00edt\u011b nav\u017edy zbav\u00ed pot\u00ed\u017e\u00ed.\u00a0<\/strong>
\n<\/p>\n

http:\/\/www.idnes.cz<\/a><\/p>\n

Astma a dal\u0161\u00ed onemocn\u011bn\u00ed plicn\u00edch cest nebo z\u00e1n\u011bty st\u0159edn\u00edho ucha mohou m\u00edt podle nov\u00fdch l\u00e9ka\u0159sk\u00fdch zji\u0161t\u011bn\u00ed jednodu\u0161e odstranitelnou p\u0159\u00ed\u010dinu. Um\u00ed to nov\u00e1 ambulance Plicn\u00ed kliniky Fakultn\u00ed nemocnice v Plzni.<\/strong><\/p>\n

Ve Fakultn\u00ed nemocnici v Plzni zakl\u00e1daj\u00ed speci\u00e1ln\u00ed ambulanci, kter\u00e1 bude soust\u0159e\u010fovat pacienty s refluxem. P\u0159i t\u00e9to nemoci doch\u00e1z\u00ed k pr\u016fniku \u017ealude\u010dn\u00edch \u0161\u0165\u00e1v zp\u011bt do j\u00edcnu a dutiny b\u0159i\u0161n\u00ed nebo i do plic a do st\u0159edou\u0161\u00ed.<\/p>\n

A l\u00e9ka\u0159i p\u0159i\u0161li na to, \u017ee reflux je u po\u010d\u00e1tku velk\u00e9ho mno\u017estv\u00ed chorob – astmatu a dal\u0161\u00edch t\u011b\u017ek\u00fdch onemocn\u011bn\u00ed d\u00fdchac\u00edch cest nebo i t\u0159eba z\u00e1n\u011btu st\u0159edou\u0161\u00ed.<\/p>\n

\u017dalude\u010dn\u00ed \u0161\u0165\u00e1vy toti\u017e obsahuj\u00ed zna\u010dn\u011b agresivn\u00ed l\u00e1tky pepsiny ni\u010d\u00edc\u00ed sliznice a jejich obrann\u00e9 mechanismy.<\/p>\n

„A d\u016fsledkem pak m\u016f\u017ee b\u00fdt nap\u0159\u00edklad chronick\u00fd ka\u0161el nebo opakovan\u00e9 z\u00e1n\u011bty st\u0159edou\u0161\u00ed,“ \u0159\u00edk\u00e1 p\u0159ednosta plicn\u00ed kliniky Fakultn\u00ed nemocnice v Plzni Milo\u0161 Pe\u0161ek<\/strong>.<\/p>\n

P\u0159ipomn\u011bl i to, \u017ee problematiku za\u010dali l\u00e9ka\u0159i zkoumat pr\u00e1v\u011b nyn\u00ed hlavn\u011b z toho d\u016fvodu, \u017ee se do \u010ceska dostal takzvan\u00fd Pep test vyvinut\u00fd ned\u00e1vno ve Velk\u00e9 Brit\u00e1nii, kter\u00fd jednoduchou metodou zjist\u00ed p\u0159\u00edtomnost pepsinu ve slin\u00e1ch \u010di plicn\u00edm sekretu a reflux tak u pacient\u016f rychle odhal\u00ed.<\/p>\n

– Budete pacient\u016fm nap\u0159\u00edklad s plicn\u00edmi chorobami vy\u0161et\u0159en\u00ed nab\u00edzet?<\/strong><\/p>\n

My u\u017e to d\u011bl\u00e1me. Nev\u00fdhodou vy\u0161et\u0159en\u00ed na p\u0159\u00edtomnost peptinu je zat\u00edm to, \u017ee si mus\u00ed pacient zaplatit n\u00e1klady ve v\u00fd\u0161i 500 korun.<\/p>\n

– Kdy\u017e pacient\u016fm vy\u0161et\u0159en\u00ed nab\u00eddnete, tak v\u011bt\u0161ina s poplatkem souhlas\u00ed?<\/strong><\/p>\n

V\u011bt\u0161ina souhlas\u00ed. Uva\u017eujeme o tom, \u017ee bychom oslovili poji\u0161\u0165ovny, aby test propl\u00e1cely, ale zat\u00edm nenazr\u00e1la doba, proto\u017ee v sou\u010dasnosti pracujeme na studi\u00edch. Ov\u0161em je to na dobr\u00e9 cest\u011b. Loni v kv\u011btnu jsme zjistili, \u017ee Pep test existuje, ale \u017ee nen\u00ed v republice, tak jsme se po n\u011bm za\u010dali p\u00eddit a poda\u0159ilo se n\u00e1m ho pom\u011brn\u011b rychle dostat do fakultn\u00ed nemocnice. Te\u010f jsme z\u00edskali pen\u00edze na v\u00fdzkum a za\u010dali jsme problematiku zkoumat. \u010casto se st\u00e1valo, \u017ee p\u0159i\u0161el pacient s diagn\u00f3zou astmatu. L\u00e9ka\u0159i mu p\u0159edepsali kombinovanou a agresivn\u00ed l\u00e9\u010dbu, ale p\u0159esto nebyl v po\u0159\u00e1dku. Tak jsme p\u0159edepsali vy\u0161et\u0159en\u00ed na p\u0159\u00edtomnost peptinu ve slin\u00e1ch nebo plicn\u00edm sekretu a uk\u00e1zalo se, \u017ee p\u0159\u00ed\u010dinou pot\u00ed\u017e\u00ed je reflux. A kdy\u017e se nemocn\u00fd za\u010dal l\u00e9\u010dit s refluxem, bylo po astmatu.<\/p>\n

– To zn\u00ed hodn\u011b povzbudiv\u011b.<\/strong><\/p>\n

Ano, to je realita. Proto jsme se vrhli na v\u00fdzkum, kter\u00fd slibuje velmi zaj\u00edmav\u00e9 v\u00fdsledky. Existuj\u00ed t\u0159eba d\u011bti, kter\u00e9 maj\u00ed opakovan\u00e9 z\u00e1n\u011bty st\u0159edou\u0161\u00ed. Odhadem t\u0159etina z nich trp\u00ed refluxem, kter\u00fd m\u016f\u017ee b\u00fdt p\u0159\u00ed\u010dinou pot\u00ed\u017e\u00ed. Reflux, co\u017e je posti\u017een\u00ed d\u00fdchac\u00edch a polykac\u00edch cest, m\u016f\u017ee b\u00fdt p\u0159\u00ed\u010dinou spousty onemocn\u011bn\u00ed – kr\u010dn\u00edch, plicn\u00edch, ale i poruchy d\u00fdch\u00e1n\u00ed ve sp\u00e1nku. Problematika je neuv\u011b\u0159iteln\u011b rozs\u00e1hl\u00e1.<\/p>\n

– D\u00e1 se odhadnout procento lid\u00ed s refluxem?<\/strong><\/p>\n

Mluv\u00ed se o \u0161esti a\u017e deseti procentech. Dokonce jsem \u010detl odhad, \u017ee je to ka\u017ed\u00fd p\u00e1t\u00fd \u010dlov\u011bk. To je alarmuj\u00edc\u00ed \u010d\u00edslo.<\/p>\n

– Jsou ale p\u0159ece r\u016fzn\u00e9 druhy refluxn\u00ed choroby?<\/strong><\/p>\n

Existuje j\u00edcnov\u00fd reflux, kdy se tekutina z \u017ealudku obsahuj\u00edc\u00ed kyselinu a pepsin dostane jen do j\u00edcnu. Reakc\u00ed b\u00fdv\u00e1 p\u00e1len\u00ed \u017e\u00e1hy. Pak existuje mimoj\u00edcnov\u00fd reflux, kdy se dost\u00e1vaj\u00ed \u017ealude\u010dn\u00ed \u0161\u0165\u00e1vy, co\u017e je tekutina nebo aerosol, nad horn\u00ed j\u00edcnov\u00fd sv\u011bra\u010d, d\u00e1le do hltanu, a pak se mohou dost\u00e1vat do plic nebo do st\u0159edou\u0161\u00ed. Mimoj\u00edcnov\u00fd reflux je m\u00e9n\u011b n\u00e1padn\u00fd. U \u010d\u00e1sti pacient\u016f mohou ale existovat oba druhy refluxu. Proto spolupracujeme s gastroenterology, aby n\u00e1m stav pacienta p\u0159esn\u011b ur\u010dili a sd\u011blili, jak je onemocn\u011bn\u00ed z\u00e1va\u017en\u00e9. L\u00e9\u010den\u00ed by mohlo pomoci pom\u011brn\u011b velk\u00e9mu po\u010dtu lid\u00ed, kte\u0159\u00ed maj\u00ed chronick\u00fd ka\u0161el. Ten je velice obt\u011b\u017euje, nenech\u00e1 je sp\u00e1t a oni chod\u00ed z jedn\u00e9 ambulance do druh\u00e9 a nikdo jim nen\u00ed schopen \u0159\u00edci, \u010d\u00edm jsou jejich probl\u00e9my d\u00e1ny. A pr\u00e1v\u011b u t\u011bchto pacient\u016f m\u016f\u017eeme zjistit, \u017ee p\u0159\u00ed\u010dinou je reflux. Dostanou l\u00e9ky omezuj\u00edc\u00ed tvorbu \u017ealude\u010dn\u00edch \u0161\u0165\u00e1v a za t\u0159i dny je po ka\u0161li. To jsou fantastick\u00e9 v\u011bci.<\/p>\n

– P\u0159ib\u00fdv\u00e1 pacient\u016f s refluxn\u00ed chorobou?<\/strong><\/p>\n

P\u0159ib\u00fdv\u00e1. Je to stylem \u017eivota. Velk\u00fd v\u00fdznam m\u00e1 zp\u016fsob stravov\u00e1n\u00ed.<\/p>\n

Lid\u00e9 jed\u00ed ve sp\u011bchu, nepo\u0159\u00e1dn\u011b, nestaraj\u00ed se o sebe, p\u0159ej\u00eddaj\u00ed se na noc, hodn\u011b kou\u0159\u00ed, pij\u00ed hodn\u011b k\u00e1vy. Reflux zp\u016fsobuj\u00ed i n\u011bkter\u00e9 l\u00e9ky. Ve h\u0159e je toho hodn\u011b. \u010cas od \u010dasu m\u016f\u017ee reflux vzniknout i fyziologicky, kdy\u017e se \u010dlov\u011bk t\u0159eba p\u0159ej\u00ed, pak ho p\u00e1l\u00ed \u017e\u00e1ha. To \u017e\u00e1dn\u00e9 n\u00e1sledky m\u00edt nemus\u00ed. Kdy\u017e se jedn\u00e1 o chronickou z\u00e1le\u017eitost, tak je v\u0161e spojen\u00e9 s celou \u0159adou probl\u00e9m\u016f. V\u0161e je ale je\u0161t\u011b komplikovan\u011bj\u0161\u00ed. Reflux nap\u0159\u00edklad vyvol\u00e1 nebo zhor\u0161\u00ed plicn\u00ed onemocn\u011bn\u00ed a to zp\u011btn\u011b zhor\u0161\u00ed pr\u016fb\u011bh refluxn\u00ed choroby a vznikne bludn\u00fd kruh. V USA, kde jsou refluxy hodn\u011b roz\u0161\u00ed\u0159en\u00e9, se ve studi\u00edch do\u010dtete o tom, \u017ee jen za z\u00e1kladn\u00ed l\u00e9ky ro\u010dn\u011b utrat\u00ed deset miliard dolar\u016f. T\u011bchto l\u00e9k\u016f se ale bude pod\u00e1vat je\u0161t\u011b v\u00edc.<\/p>\n

– Budete tedy tla\u010dit na poji\u0161\u0165ovnu, aby vy\u0161et\u0159en\u00ed platila? Jak je mo\u017en\u00e9, \u017ee Pep test v \u010cesku nebyl vyu\u017e\u00edv\u00e1n d\u0159\u00edve?<\/strong><\/p>\n

Z jednoduch\u00e9ho d\u016fvodu. Ve Velk\u00e9 Brit\u00e1nii ho p\u0159ed ned\u00e1vnem vyvinuli a je\u0161t\u011b se sem nesta\u010dil dostat. Probl\u00e9m je v tom, \u017ee po orienta\u010dn\u00edm Pep testu n\u00e1sleduje klasick\u00e1 vy\u0161et\u0159ovac\u00ed metoda, kterou se poruchy funkce j\u00edcn\u016f prokazuj\u00ed. Tu d\u011blaj\u00ed gastroenterologov\u00e9 a vy\u0161et\u0159en\u00ed je z kapacitn\u00edch d\u016fvod\u016f k dispozici relativn\u011b m\u00e1lo. S gastroenterology m\u00e1me sice v\u00fdbornou spolupr\u00e1ci, ale probl\u00e9m je, \u017ee n\u00e1m ud\u011blaj\u00ed t\u0159i vy\u0161et\u0159en\u00ed za t\u00fdden. A lid\u00ed, u kter\u00fdch je podez\u0159en\u00ed na reflux, jsou nyn\u00ed z\u00e1stupy.<\/p>\n

– Z\u00e1jem o Pep test maj\u00ed i v jin\u00fdch nemocnic\u00edch?<\/strong><\/p>\n

Mluvil jsem se z\u00e1stupcem firmy, kter\u00e1 do \u010ceska Pep test voz\u00ed, a \u0159\u00edkal, \u017ee se o n\u011bj zaj\u00edmaj\u00ed kr\u010da\u0159i na ORL v ostravsk\u00e9 nemocnici nebo v nemocnici v Motole. My jsme zat\u00edm vy\u0161et\u0159ili nejv\u00edc pacient\u016f, ale d\u016fle\u017eit\u011bj\u0161\u00ed je, \u017ee m\u00e1me vytvo\u0159en\u00fd syst\u00e9m vy\u0161et\u0159ov\u00e1n\u00ed i l\u00e9\u010den\u00ed.<\/p>\n

Jitka \u0160r\u00e1mkov\u00e1
\nMlad\u00e1 fronta DNES\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 http:\/\/www.idnes.cz<\/a><\/p>\n

ilustra\u010dn\u00ed foto: PhotoXpress<\/p>\n","protected":false},"excerpt":{"rendered":"

Tr\u00e1p\u00ed va\u0161e d\u00edt\u011b ji\u017e roky astma a l\u00e9\u010dba p\u0159\u00edli\u0161 nepom\u00e1h\u00e1? Nebo m\u00e1 \u010dasto z\u00e1n\u011bty ucha? Nyn\u00ed se p\u0159i\u0161lo na to, \u017ee tyto probl\u00e9my m\u016f\u017ee zp\u016fsobovat […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14646,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-14634","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/14634","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14634"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/14634\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14646"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14634"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14634"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14634"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}