{"id":37654,"date":"2022-05-19T13:52:37","date_gmt":"2022-05-19T11:52:37","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=37654"},"modified":"2022-05-19T13:59:30","modified_gmt":"2022-05-19T11:59:30","slug":"lide-s-roztrousenou-sklerozou-se-dostanou-rychle-k-nove-lecbe","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=37654","title":{"rendered":"Lid\u00e9 s\u00a0roztrou\u0161enou skler\u00f3zou se rychleji dostanou k\u00a0nov\u00e9 l\u00e9\u010db\u011b"},"content":{"rendered":"\n

V\u00edce pacient\u016f s\u00a0roztrou\u0161enou skler\u00f3zou se od leto\u0161n\u00edho jara dostane rychleji k\u00a0nov\u00fdm l\u00e9k\u016fm. Zdravotn\u00ed poji\u0161\u0165ovny za\u010daly hradit vysoce efektivn\u00ed l\u00e9\u010dbu<\/strong>, kterou dosud neurologov\u00e9 mohli nasazovat a\u017e v\u00a0pozd\u011bj\u0161\u00edch f\u00e1z\u00edch nemoci. <\/strong><\/p>\n\n\n\n

\u201eTo, \u017ee m\u016f\u017eeme na\u0161im pacient\u016fm rovnou nasadit nej\u00fa\u010dinn\u011bj\u0161\u00ed l\u00e9ky, na n\u011b\u017e d\u0159\u00edve \u010dekali, dokud se jim nemoc dostate\u010dn\u011b \u201anezhor\u0161\u00ed\u2018, je pro n\u00e1s velk\u00fd pr\u016flom. Tzv. vysoce efektivn\u00ed l\u00e9\u010dba dramaticky m\u011bn\u00ed progn\u00f3zu pacienta, um\u00ed o cel\u00e9 roky odsunout n\u00e1stup invalidity, kter\u00e1 se s nemoc\u00ed poj\u00ed. Dokazuj\u00ed to zahrani\u010dn\u00ed studie,\u201c<\/em> \u0159\u00edk\u00e1 neurolo\u017eka z pra\u017esk\u00e9ho centra p\u0159i VFN prof. MUDr. Eva Kubala Havrdov\u00e1, CSc. <\/em>Dod\u00e1v\u00e1, \u017ee tuto \u201erevoluci\u201c umo\u017enil jak pokles cen l\u00e9k\u016f, tak v\u011bt\u0161\u00ed ochota poji\u0161\u0165oven je platit. \u201eOdhaduji, \u017ee v na\u0161em centru, kter\u00e9 je nejv\u011bt\u0161\u00ed v \u010cesk\u00e9 republice, zah\u00e1j\u00edme vysoce efektivn\u00ed l\u00e9\u010dbu u poloviny nov\u011b diagnostikovan\u00fdch pacient\u016f,\u201c <\/em>dod\u00e1v\u00e1 prof. Kubala Havrdov\u00e1.<\/p>\n\n\n\n

Jak se bude nad\u00e1le vyv\u00edjet stav \u010desk\u00fdch pacient\u016f, budou l\u00e9ka\u0159i sledovat prost\u0159ednictv\u00edm registru ReMuS. \u201eRo\u010dn\u011b v \u010cR p\u0159ibude 700 a\u017e 800 lid\u00ed s roztrou\u0161enou skler\u00f3zou \u2013 podle na\u0161ich odhad\u016f by novou l\u00e9\u010dbu mohlo dostat 50\u201370 % z nich,\u201c <\/em>uv\u00e1d\u00ed neurolo\u017eka a odborn\u00e1 garantka registru doc. MUDr. Dana Hor\u00e1kov\u00e1, Ph.D.<\/p>\n\n\n\n

L\u00e9\u010dbu neurologov\u00e9 poskytnou tak\u00e9 uprchl\u00edk\u016fm z Ukrajiny \u2013 celkem se jich v \u010cesku zat\u00edm l\u00e9\u010d\u00ed kolem t\u0159iceti. \u201eV na\u0161em centru se nyn\u00ed star\u00e1me o p\u011bt ukrajinsk\u00fdch pacient\u016f, p\u0159edpokl\u00e1d\u00e1m, \u017ee dal\u0161\u00ed budou p\u0159ich\u00e1zet. Nemoc toti\u017e propuk\u00e1 u relativn\u011b mlad\u00fdch lid\u00ed, mezi 20. a 40. rokem, a t\u00fdk\u00e1 se \u010dast\u011bji \u017een. Z v\u00e1le\u010dn\u00e9 Ukrajiny sem p\u0159ich\u00e1zej\u00ed uprchl\u00edci v podobn\u00e9m v\u011bku,\u201c <\/em>\u0159\u00edk\u00e1 MUDr. Michal Dufek, Ph.D., vedouc\u00ed l\u00e9ka\u0159 MS Centra p\u0159i Neurologick\u00e9 klinice FN u sv. Anny.<\/p>\n\n\n\n

Neurologov\u00e9 aktu\u00e1ln\u011b vn\u00edmaj\u00ed, jak vysok\u00e1 m\u00edra stresu p\u0159isp\u00edv\u00e1 k atak\u00e1m nemoci a k jej\u00edmu zhor\u0161en\u00ed. \u201ePro\u017eili jsme covidovou pandemii, na kterou nav\u00e1zala v\u00e1lka na Ukrajin\u011b, a \u010dek\u00e1me zhor\u0161en\u00ed ekonomick\u00e9 situace \u2013 to v\u0161e jsou velk\u00e9 stresory, kter\u00e9 na\u0161i pacienti siln\u011b pro\u017e\u00edvaj\u00ed a bohu\u017eel mohou zap\u0159\u00ed\u010dinit ataku,\u201c<\/em> uv\u00e1d\u00ed doc. Hor\u00e1kov\u00e1. A jak p\u0159ipom\u00edn\u00e1 prof. Havrdov\u00e1, roztrou\u0161en\u00e1 skler\u00f3za se s depresemi poj\u00ed. \u201eImunitn\u00ed syst\u00e9m, kter\u00fd zp\u016fsobuje z\u00e1n\u011bt v mozku, blokuje serotoninov\u00e9 cesty, kter\u00e9 maj\u00ed vliv na du\u0161evn\u00ed pohodu,\u201c<\/em> \u0159\u00edk\u00e1 prof. Havrdov\u00e1.

Siln\u00fd stres m\u016f\u017ee dokonce st\u00e1t za spu\u0161t\u011bn\u00edm nemoci. \u201eU\u017e n\u011bjak\u00fd \u010das vedeme s kolegy psychoterapeuty diskuzi o tom, jak se na\u0161i klienti vyrovnaj\u00ed se sv\u00fdmi traumaty v dob\u011b zat\u00ed\u017een\u00e9 nedalek\u00fdm v\u00e1le\u010dn\u00fdm konfliktem, kdy\u017e jsme se je\u0161t\u011b ani nezregenerovali z dvoulet\u00e9 z\u00e1t\u011b\u017ee zp\u016fsoben\u00e9 pandemi\u00ed. N\u00e1r\u016fst v\u0161udyp\u0159\u00edtomn\u00e9ho stresu je z\u0159ejm\u00fd a jako u ka\u017ed\u00e9 autoimunitn\u00ed nemoci se du\u0161evn\u00ed rozpolo\u017een\u00ed do zdravotn\u00edho stavu prom\u00edt\u00e1 a m\u016f\u017ee zp\u016fsobit jeho zhor\u0161en\u00ed. Leckdy se um\u00edme l\u00e9pe poprat s p\u0159\u00edm\u00fdm ohro\u017een\u00edm \u2013 tv\u00e1\u0159\u00ed v tv\u00e1\u0159 \u0161avlozub\u00e9mu tygrovi bu\u010f bojujeme, nebo ute\u010deme. Ale tady nem\u00e1me kam ut\u00e9ct a proti \u010demu bojovat. Ve zvl\u00e1d\u00e1n\u00ed takov\u00e9 situace jsme bezradn\u00ed. V\u00fdhodu m\u00e1 ten, kdo na sv\u00e9 psychice dlouhodob\u011b pracuje a u\u010d\u00ed se pr\u016fb\u011b\u017en\u011b poryvy \u017eivota sn\u00e1\u0161et,\u201c<\/em>\u0159\u00edk\u00e1 Renata Malinov\u00e1, psychoterapeutka p\u016fsob\u00edc\u00ed na Neurologick\u00e9 klinice 1. LF UK a VFN. <\/p>\n\n\n\n

Jak se situace prom\u00edtne do stavu pacient\u016f, po\u010dtu atak, nutn\u00fdch hospitalizac\u00ed a dal\u0161\u00edch aspekt\u016f, kter\u00e9 se s nemoc\u00ed poj\u00ed, bude podle \u0159editele registru ReMuS Ing. Ji\u0159\u00edho Drahoty i letos zaznamen\u00e1vat patn\u00e1ct center vysoce specializovan\u00e9 p\u00e9\u010de, kde se pacienti l\u00e9\u010d\u00ed. \u201eReMuS pat\u0159\u00ed v mezin\u00e1rodn\u00edm srovn\u00e1n\u00ed ke \u0161pi\u010dce, jeho data slou\u017e\u00ed v mnoha v\u00fdzkumn\u00fdch projektech,<\/em> pom\u00e1h\u00e1 n\u00e1m zmapovat nemoc jako takovou. D\u00edky n\u011bmu m\u016f\u017eeme v \u010dase posuzovat nejen \u00fa\u010dinnost pod\u00e1van\u00fdch l\u00e9k\u016f, ale i jejich bezpe\u010dnost,\u201c <\/em>\u0159\u00edk\u00e1 Ing. Drahota. Jako p\u0159\u00edklad uv\u00e1d\u00ed sledov\u00e1n\u00ed vlivu covidu-19 na pacienty s RS stejn\u011b jako vliv o\u010dkov\u00e1n\u00ed. <\/p>\n\n\n\n

\u201eV registru jsme sledovali 1 600 pacient\u016f, kte\u0159\u00ed dosud nem\u011bli covid, a to t\u0159i m\u011bs\u00edce po o\u010dkov\u00e1n\u00ed \u2013 p\u0159ibli\u017en\u011b u 5 % z nich jsme zaznamenali ataku. Ve srovn\u00e1n\u00ed s dobou p\u0159ed o\u010dkov\u00e1n\u00edm to u stejn\u00fdch pacient\u016f znamenalo n\u00e1r\u016fst o cca 1,5 %. Stejn\u011b tak jsme sledovali 469 pacient\u016f, kte\u0159\u00ed hned zpo\u010d\u00e1tku pandemie \u2013 kdy je\u0161t\u011b nebylo o\u010dkov\u00e1n\u00ed k dispozici \u2013 covidem onemocn\u011bli a zde se do t\u0159\u00ed m\u011bs\u00edc\u016f projevila ataka u asi 7 % z nich,\u201c<\/em> popisuje v\u00fdsledky doc. Hor\u00e1kov\u00e1. <\/p>\n\n\n\n

St\u00e1le tak plat\u00ed, \u017ee neurologov\u00e9 o\u010dkov\u00e1n\u00ed obecn\u011b sp\u00ed\u0161e doporu\u010duj\u00ed, a to i posilovac\u00ed d\u00e1vkou. K pacient\u016fm je nicm\u00e9n\u011b t\u0159eba p\u0159istupovat individu\u00e1ln\u011b. \u201eCovidov\u00e1 infekce je pro na\u0161e pacienty ne\u017e\u00e1douc\u00ed, m\u016f\u017ee spustit ataky, zhor\u0161it pr\u016fb\u011bh nemoci, nav\u00edc vzhledem k mutac\u00edm nem\u016f\u017eeme v\u011b\u0159it tomu, \u017ee zde u\u017e budou jen m\u00edrn\u011bj\u0161\u00ed varianty. Je t\u0159eba pamatovat na to, \u017ee lid\u00e9 s RS berou l\u00e9ky potla\u010duj\u00edc\u00ed imunitu, a tak mohou b\u00fdt k n\u00e1kaze n\u00e1chyln\u011bj\u0161\u00ed,\u201c<\/em> dod\u00e1v\u00e1 neurolo\u017eka.<\/p>\n\n\n\n

Jak p\u0159ipom\u00edn\u00e1 \u0159editel ReMuS Ing. Drahota, registr poskytuje podklady pro dal\u0161\u00ed studie, jako je nap\u0159\u00edklad zkoum\u00e1n\u00ed vlivu l\u00e9\u010dby RS na t\u011bhotn\u00e9 a koj\u00edc\u00ed \u017eeny atp. <\/p>\n\n\n\n

Pr\u016fm\u011brn\u00fd v\u011bk za\u010d\u00e1tku onemocn\u011bn\u00ed je 32,4 let, dvan\u00e1ct pacient\u016f je mlad\u0161\u00edch 15 let. <\/p>\n\n\n\n

O roztrou\u0161en\u00e9 skler\u00f3ze<\/strong><\/p>\n\n\n\n

Je to z\u00e1n\u011btliv\u00e9 onemocn\u011bn\u00ed centr\u00e1ln\u00edho nervov\u00e9ho syst\u00e9mu, jeho\u017e p\u0159\u00ed\u010dina nen\u00ed dosud zn\u00e1m\u00e1. \u010cast\u011bji postihuje \u017eeny. Pro RS je typick\u00e9 st\u0159\u00edd\u00e1n\u00ed obdob\u00ed z\u00e1chvat\u016f (atak) a obdob\u00ed zd\u00e1nliv\u00e9ho klidu. Tento proces je nep\u0159edv\u00eddateln\u00fd, a proto i l\u00e9\u010dba \u010di prevence je t\u011b\u017ek\u00e1. V \u010cesku se odhaduje po\u010det pacient\u016f na 22 tis\u00edc. Rizikov\u00fdmi faktory nemoci jsou krom\u011b genetick\u00e9 dispozice EB virus (Epsteina-Barrov\u00e9 virus), kou\u0159en\u00ed a nedostatek vitaminu D.<\/p>\n\n\n\n

O Nada\u010dn\u00edm fondu IMPULS<\/strong><\/p>\n\n\n\n

Jeho c\u00edlem je podporovat projekty v oblasti v\u00fdzkumu a terapie pacient\u016f s roztrou\u0161enou skler\u00f3zou mozkom\u00ed\u0161n\u00ed v \u010cR. P\u0159isp\u00edv\u00e1 zejm\u00e9na na fyzioterapii a psychoterapii, kter\u00e9 nejsou hrazeny z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. Vede celost\u00e1tn\u00ed registr pacient\u016f s roztrou\u0161enou skler\u00f3zou (ReMuS) a jeho financov\u00e1n\u00ed zaji\u0161\u0165uje z vlastn\u00edch zdroj\u016f. V\u00edce informac\u00ed na www.multiplesclerosis.cz<\/em><\/a>. O roztrou\u0161en\u00e9 skler\u00f3ze lze dohledat informace tak\u00e9 na www.rskompas.cz.<\/p>\n","protected":false},"excerpt":{"rendered":"

V\u00edce pacient\u016f s\u00a0roztrou\u0161enou skler\u00f3zou se od leto\u0161n\u00edho jara dostane rychleji k\u00a0nov\u00fdm l\u00e9k\u016fm. Zdravotn\u00ed poji\u0161\u0165ovny za\u010daly hradit vysoce efektivn\u00ed l\u00e9\u010dbu, kterou dosud neurologov\u00e9 mohli nasazovat a\u017e […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14162,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,9],"tags":[],"class_list":["post-37654","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/37654","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=37654"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/37654\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14162"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=37654"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=37654"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=37654"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}