{"id":40234,"date":"2023-06-16T04:48:24","date_gmt":"2023-06-16T02:48:24","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=40234"},"modified":"2023-06-16T04:48:27","modified_gmt":"2023-06-16T02:48:27","slug":"mame-kazdorocne-az-400-novych-pripadu-tbc-proc-se-neockuje","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=40234","title":{"rendered":"M\u00e1me ka\u017edoro\u010dn\u011b a\u017e 400 nov\u00fdch p\u0159\u00edpad\u016f tbc. Pro\u010d se neo\u010dkuje?\u00a0\u00a0"},"content":{"rendered":"\n

Tuberkul\u00f3za je tady s n\u00e1mi u\u017e p\u011bknou \u0159\u00e1dku l\u00e9ta a nevypad\u00e1 to, \u017ee by se lou\u010dila. Jak vypadaj\u00ed aktu\u00e1ln\u00ed statistiky o po\u010dtu naka\u017een\u00fdch a bude v\u016fbec mo\u017en\u00e9 n\u011bkdy tuberkul\u00f3zu zcela vym\u00fdtit? I na to se ptali v po\u0159adu \u010cRo Dvojka 

moder\u00e1tor
Ve studiu je s n\u00e1mi n\u00e1\u0161 mil\u00fd host, pan\u00ed prof. Martina Koziar Va\u0161\u00e1kov\u00e1, p\u0159edsedkyn\u011b \u010cesk\u00e9 pneumologick\u00e9 a ftyziologick\u00e9 spole\u010dnosti a tak\u00e9 p\u0159ednostka Pneumologick\u00e9 kliniky 1. l\u00e9ka\u0159sk\u00e9 fakulty Univerzity Karlovy a Thomayerovy nemocnice v Praze. Hezk\u00e9 dopoledne.
tuberkul\u00f3za je nemoc, kter\u00e1 u\u017e nepat\u0159\u00ed do t\u00e9 dne\u0161n\u00ed doby. Asi si v\u0161ichni p\u0159edstav\u00edme takovou tu chrl\u00edc\u00ed se krev do kapesn\u00edku. Je to tak, \u017ee ta tuberkul\u00f3za je opravdu po\u0159\u00e1d je\u0161t\u011b aktu\u00e1ln\u00edm probl\u00e9mem a ty p\u0159\u00edznaky jsou v\u017edycky takov\u00e9?<\/p>\n\n\n\n

MUDr. Martina Koziar VA\u0160\u00c1KOV\u00c1,
Tuberkul\u00f3za bohu\u017eel z\u016fst\u00e1v\u00e1 i nad\u00e1le aktu\u00e1ln\u00ed. Ono celosv\u011btov\u011b se po\u010det nov\u00fdch p\u0159\u00edpad\u016f v\u00fdznamn\u011b nezmen\u0161uje a tuberkul\u00f3za, i co se t\u00fd\u010de \u010detnosti a \u00famrtnosti, dr\u017e\u00ed hned druh\u00e9 m\u00edsto v infek\u010dn\u00edch za HIV. P\u0159echodn\u011b tedy covid vyt\u011bsnil ob\u011b tyto infek\u010dn\u00ed nemoci z prvn\u00ed p\u0159\u00ed\u010dky. No a po\u0159\u00e1d je to t\u0159in\u00e1ct\u00e1 nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dina smrti na sv\u011bt\u011b, kdy\u017e vezmeme naprosto v\u0161echny nemoci. Ty p\u0159\u00edznaky mohou b\u00fdt typick\u00e9. To znamen\u00e1 to chrlen\u00ed krve, v\u00e1hov\u00fd \u00fabytek, pocen\u00ed, ale n\u011bkdy i nemocn\u00ed s celkem pokro\u010dil\u00fdmi n\u00e1lezy maj\u00ed p\u0159ekvapiv\u011b minimum obt\u00ed\u017e\u00ed, t\u0159eba jenom ka\u0161el. Tak\u017ee na tuberkul\u00f3zu se mus\u00ed myslet, proto\u017ee kdy\u017e je \u010dasn\u00e1 forma, um\u00edme j\u00ed velmi dob\u0159e l\u00e9\u010dit a vyl\u00e9\u010dit bez n\u00e1sledk\u016f. Za to pokro\u010dil\u00e9 p\u0159\u00edpady bohu\u017eel mohou zp\u016fsobit i smrt.<\/p>\n\n\n\n

moder\u00e1tor
sly\u0161\u00edme, tenhle um\u0159el na infarkt, t\u00e1mhle ta na rakovinu, to je ka\u017edou chv\u00edli, ale stra\u0161n\u011b dlouho jsem nesly\u0161el, \u017ee ten by um\u0159el na tuberu lidov\u011b \u0159e\u010deno. Pro\u010d pan\u00ed doktorko?<\/p>\n\n\n\n

Prof. MUDr. Martina Koziar VA\u0160\u00c1KOV\u00c1,
No, proto\u017ee my m\u00e1me v \u010cesk\u00e9 republice m\u00e1lo p\u0159\u00edpad\u016f tuberkul\u00f3zy. Je to d\u00e1no dlouhodob\u011b velmi dobrou kontrolou tohoto onemocn\u011bn\u00ed, kter\u00e1 spo\u010d\u00edv\u00e1 zejm\u00e9na v systematick\u00e9 l\u00e9\u010db\u011b nemocn\u00fdch a ve vyhled\u00e1v\u00e1n\u00ed kontakt\u016f. \u010cili t\u011bch lid\u00ed, kte\u0159\u00ed jsou v riziku, kte\u0159\u00ed p\u0159i\u0161li do styku s nemocn\u00fdm a u nich se t\u0159eba zji\u0161\u0165uje, zda-li se nakazili, nenakazili. Tak\u017ee my m\u00e1me posledn\u00ed dv\u011b desetilet\u00ed vlastn\u011b neust\u00e1le n\u00edzk\u00e1 \u010d\u00edsla, setrvale klesaj\u00edc\u00ed trend v\u00fdskytu tuberkul\u00f3zy. Tak\u017ee proto se o tom nemluv\u00ed. Kdy\u017e m\u00e1me ka\u017edoro\u010dn\u011b maxim\u00e1ln\u011b 400 nov\u00fdch p\u0159\u00edpad\u016f, tak samoz\u0159ejm\u011b ten po\u010det mrtv\u00fdch, co to jsou jednotkov\u00e9, maxim\u00e1ln\u011b des\u00edtkov\u00e9 p\u0159\u00edpady, tak\u017ee to nen\u00ed tak viditeln\u00e9.<\/p>\n\n\n\n

moder\u00e1torka
tuberkul\u00f3za se \u0159ad\u00ed mezi infek\u010dn\u00ed onemocn\u011bn\u00ed. Jak\u00fdm zp\u016fsobem tedy doch\u00e1z\u00ed k p\u0159enosu, jak velk\u00fd ten kontakt mus\u00ed b\u00fdt? To je prvn\u00ed ot\u00e1zka a podot\u00e1zka, co tuberkul\u00f3za vlastn\u011b ud\u011bl\u00e1 v na\u0161em t\u011ble, co se tam stane?<\/p>\n\n\n\n

Prof. MUDr. Martina Koziar VA\u0160\u00c1KOV\u00c1,
Tuberkul\u00f3za se p\u0159en\u00e1\u0161\u00ed klasicky kap\u00e9nkovou n\u00e1kazou. \u010cili vy jste ve styku s t\u00edm nemocn\u00fdm, kter\u00fd vyka\u0161l\u00e1v\u00e1 bacily, tuberkul\u00f3zy a v podstat\u011b se \u0159\u00edk\u00e1, \u017ee sta\u010d\u00ed bu\u010f opakovan\u00fd kr\u00e1tkodob\u00fd pobyt, anebo t\u0159eba 8 hodin, kdy\u017e se s n\u011bk\u00fdm zav\u0159en\u00e1 v jedn\u00e9 m\u00edstnosti, tak ta n\u00e1kaza je pravd\u011bpodobn\u00e1, \u017ee dojde k n\u00e1kaze, k p\u0159enosu mykobakteri\u00ed tuberkul\u00f3zy. Nemus\u00ed to je\u0161t\u011b znamenat, \u017ee onemocn\u00edte, proto\u017ee v\u00e1\u0161 imunitn\u00ed syst\u00e9m se m\u016f\u017ee s t\u011bmi mykobakteriemi vypo\u0159\u00e1dat, ani\u017e vzniklo onemocn\u011bn\u00ed. To z\u00e1va\u017en\u00e9 onemocn\u011bn\u00ed s progresivn\u00edm pr\u016fb\u011bhem vznik\u00e1 cirka pouze u t\u0159etiny lid\u00ed, kte\u0159\u00ed jsou v kontaktu s tuberkul\u00f3zou.<\/p>\n\n\n\n

moder\u00e1tor
poslucha\u010dsk\u00fd dotaz. Pt\u00e1 se pan\u00ed Hana, zda je onemocn\u011bn\u00ed tuberkul\u00f3zou pouze onemocn\u011bn\u00edm plic, anebo mohou b\u00fdt zasa\u017eeny i jin\u00e9 org\u00e1ny, p\u0159\u00edpadn\u011b kosti a podobn\u011b? A pokud ano, jak se l\u00e9\u010d\u00ed?<\/p>\n\n\n\n

Prof. MUDr. Martina Koziar VA\u0160\u00c1KOV\u00c1,
Jeliko\u017e branou vstupu infekce jsou pl\u00edce, proto\u017ee je to kap\u00e9nkov\u00e1 n\u00e1kaza. Ty kap\u00e9nky, infekce vdechujeme. Nej\u010dast\u011bji jsou posti\u017een\u00e9<\/strong> samoz\u0159ejm\u011b pl\u00edce, tak\u017ee plicn\u00ed formy jednozna\u010dn\u011b p\u0159eva\u017euj\u00ed. I u n\u00e1s v podstat\u011b z t\u011bch hl\u00e1\u0161en\u00fdch p\u0159\u00edpad\u016f 374 byly 325, 329 tuberkul\u00f3zy plicn\u00ed. Samoz\u0159ejm\u011b tuberkul\u00f3za je infekce a m\u016f\u017ee postihovat i jin\u00e9 org\u00e1ny. Dokonce m\u016f\u017ee postihovat krom\u011b, jak jste sama zm\u00ednila i kosti, tak m\u016f\u017ee postihovat ledviny, m\u016f\u017ee postihovat dokonce mozek, mozkom\u00ed\u0161n\u00ed pleny. M\u00e1me te\u010f jednu pacientku bohu\u017eel, kter\u00e1 m\u00e1 posti\u017een\u00ed<\/strong> mozku a mozkom\u00ed\u0161n\u00ed plen. Krom\u011b t\u011bch ledvin jsou to t\u0159eba i mu\u017esk\u00e9 i \u017eensk\u00e9 pohlavn\u00ed org\u00e1ny. St\u0159eva, m\u016f\u017ee b\u00fdt z\u00e1n\u011bt pob\u0159i\u0161nice tuberkul\u00f3zn\u00ed. No a l\u00e9\u010d\u00ed se to v\u0161echno stejn\u011b. To znamen\u00e1 antituberkulotiky jenom v t\u011bch z\u00e1va\u017en\u011bj\u0161\u00edch t\u011b\u017e\u0161\u00edch form\u00e1ch mus\u00edme volit t\u0159eba vy\u0161\u0161\u00ed d\u00e1vky antituberkulotika. Pod\u00e1vat je nejenom v t\u011bch tabletk\u00e1ch, z\u00e1kladn\u00ed l\u00e9\u010dba tuberkul\u00f3zy jsou v podstat\u011b \u010dty\u0159i typy l\u00e9k\u016f po t\u0159ech a\u017e \u010dty\u0159ech tablet\u00e1ch. Tak\u017ee r\u00e1no spolknete ohromnou hrst l\u00e9k\u016f chemoterapeutik na l\u00e9\u010dbu tuberkul\u00f3zy. A v p\u0159\u00edpad\u011b pr\u00e1v\u011b t\u0159eba posti\u017een\u00ed<\/strong> mozku nebo jin\u00fdch z\u00e1va\u017en\u00fdch lokalizac\u00ed, se p\u0159id\u00e1vaj\u00ed injek\u010dn\u00ed formy, vy\u0161\u0161\u00ed d\u00e1vky, p\u0159\u00edpadn\u011b kortikoidy, nebo je ten nemocn\u00fd p\u0159\u00edmo v intenzivn\u00ed p\u00e9\u010di, t\u0159eba p\u0159echodn\u011b um\u011ble ventilov\u00e1n. I to se m\u016f\u017ee st\u00e1t.<\/p>\n\n\n\n

moder\u00e1torka
Je\u0161t\u011b jeden dotaz od na\u0161\u00ed poslucha\u010dky Aleny, kter\u00e1 p\u00ed\u0161e, pros\u00edm o d\u016fvod, pro\u010d se neo\u010dkuje proti tuberkul\u00f3ze.<\/p>\n\n\n\n

Prof. MUDr. Martina Koziar VA\u0160\u00c1KOV\u00c1,
D\u016fvod je velmi jednoduch\u00fd, proto\u017ee doposud nem\u00e1me \u017e\u00e1dnou opravdu \u00fa\u010dinnou vakc\u00ednu proti tuberkul\u00f3ze. Jinak by byla tuberkul\u00f3za u\u017e d\u00e1vno, d\u00e1vno vym\u00fdcena. \u010cili m\u00e1me vakc\u00ednu, kter\u00e1 do jist\u00e9 m\u00edry d\u011bl\u00e1 prevenci t\u011b\u017ek\u00e9ho pr\u016fb\u011bhu tuberkul\u00f3zy u mal\u00fdch d\u011bt\u00ed, kter\u00e9 by byly v kontaktu s tuberkul\u00f3zou u t\u011bch opravdu nejmen\u0161\u00edch. A ta prevence je p\u0159edev\u0161\u00edm jako prevenci smrti. Tak\u017ee v\u0161ichni v podstat\u011b, t\u00e9m\u011b\u0159 v\u0161ichni nebo v\u0161ichni, kte\u0159\u00ed v sou\u010dasn\u00e9 dob\u011b jsou u n\u00e1s l\u00e9\u010den\u00ed pro tuberkul\u00f3zu, jsou lid\u00e9, kte\u0159\u00ed byli o\u010dkov\u00e1n\u00ed na tuberkul\u00f3zu. A to o\u010dkov\u00e1n\u00ed prost\u011b nedok\u00e1\u017ee jako takov\u00e9 zabr\u00e1nit tuberkul\u00f3ze. Tak\u017ee a\u017e bude prost\u011b vakc\u00edna na tuberkul\u00f3zu natolik \u00fa\u010dinn\u00e1, aby zabr\u00e1nila rozvoji onemocn\u011bn\u00ed, tak ur\u010dit\u011b se klidn\u011b navr\u00e1t\u00ed vakcinace nejen t\u00e9 rizikov\u00e9 populace, ale t\u0159eba v\u0161ech. Tak\u017ee skute\u010dn\u011b m\u00e1 cenu v takov\u00fdch populac\u00edch, kde je t\u00e9 tuberkul\u00f3zy m\u00e1lo jako v na\u0161\u00ed, o\u010dkovat jenom d\u011bti z rizikov\u00fdch rodin. To znamen\u00e1 ty, kte\u0159\u00ed m\u011bli, nebo maj\u00ed v rodin\u011b n\u011bkoho, kdo m\u011bl tuberkul\u00f3zu, p\u0159\u00edpadn\u011b jsou ze zem\u00ed, kde je vysok\u00fd v\u00fdskyt tuberkul\u00f3zy.<\/p>\n\n\n\n

moder\u00e1tor
Je t\u0159eba z na\u0161eho pohledu jako pacient\u016f, ob\u010dan\u016f d\u011blat n\u011bco pro to, aby ta p\u0159\u00edzniv\u00e1 situace vlastn\u011b, kter\u00e1 u n\u00e1s panuje, u\u017e jste o tom mluvila vydr\u017eela? Anebo u\u017e jsme prost\u011b tak nastaven\u00ed a ty procesy jsou u n\u00e1s takov\u00e9, \u017ee to s nejv\u011bt\u0161\u00ed pravd\u011bpodobnost\u00ed vydr\u017e\u00ed na t\u011bch hezk\u00fdch \u010d\u00edslech.<\/p>\n\n\n\n

Prof. MUDr. Koziar VA\u0160\u00c1KOV\u00c1,
J\u00e1 si mysl\u00edm, \u017ee to je t\u00edm, \u017ee jsou nastaveny ty procesy. Ale nechci b\u00fdt zase tak jako p\u0159ehnan\u00fd optimista. My te\u010f vid\u00edme relativn\u00ed zv\u00fd\u0161en\u00ed t\u00e9 tuberkul\u00f3zy rezistentn\u00ed, necitliv\u00e9 na l\u00e9ky. Je to d\u00e1no p\u0159\u00edlivem vlastn\u011b migra\u010dn\u00ed vlnou z Ukrajiny, kter\u00e1 k n\u00e1m p\u0159inesla v\u011bt\u0161\u00ed pod\u00edl cizinc\u016f, jako zastoupen\u00ed cizinc\u016f v tuberkul\u00f3ze a zejm\u00e9na v t\u00e9 vysoce rezistentn\u00ed tuberkul\u00f3ze, kter\u00e1 u\u017e se tak hezky nel\u00e9\u010d\u00ed a jej\u00ed l\u00e9\u010dba hodn\u011b stoj\u00ed a vlastn\u011b d\u00e9le trv\u00e1. Tak\u017ee to je n\u011bco, co n\u00e1m starosti d\u011bl\u00e1. Nicm\u00e9n\u011b procesy jsou nastaveny. To znamen\u00e1, kdy\u017e n\u011bkdo ka\u0161le, ud\u011bl\u00e1 se mu rentgen, tak dobr\u00fd radiolog i plicn\u00ed l\u00e9ka\u0159 dok\u00e1\u017ee \u0159\u00edct, tohle to m\u016f\u017ee b\u00fdt tuberkul\u00f3za a vy\u0161et\u0159\u00ed se pak ten hlen, kter\u00fd se vyka\u0161le na bacily tuberkul\u00f3zy a ta diagn\u00f3za je jasn\u00e1, nemocn\u00fd se za\u010dne l\u00e9\u010dit. Je d\u016fle\u017eit\u00e9 na to myslet. A nebo bohu\u017eel te\u010f t\u0159eba m\u00e1me p\u0159\u00edpad jednoho velmi mlad\u00e9ho chlapce, kter\u00fd k l\u00e9ka\u0159i s obt\u00ed\u017eemi ne\u0161el, tak ten m\u00e1 velice obt\u00ed\u017enou a t\u011b\u017ekou formu tuberkul\u00f3zy, se kterou bojuje.<\/p>\n\n\n\n

moder\u00e1torka
ta v\u010dasnost odhalen\u00ed diagn\u00f3zy a v\u010dasn\u00e1 l\u00e9\u010dba, jsou velmi d\u016fle\u017eit\u00e1 komponenty, aby to dob\u0159e dopadlo. Kdy j\u00edt k l\u00e9ka\u0159i?<\/p>\n\n\n\n

Prof. MUDr. Koziar VA\u0160\u00c1KOV\u00c1,
Ano, to je dobr\u00e1 komponenta, aby to dob\u0159e dopadlo nejen pro jedince samotn\u00e9ho, ale i pro spole\u010dnost, proto\u017ee \u010d\u00edm d\u00e9le setrv\u00e1v\u00e1 ten \u010dlov\u011bk, kter\u00fd vyka\u0161l\u00e1v\u00e1 miliony a miliony mykobakteri\u00ed mezi sv\u00fdmi bl\u00edzk\u00fdmi a pracovn\u00ed prost\u0159ed\u00ed, t\u00edm je pravd\u011bpodobn\u011bj\u0161\u00ed, \u017ee n\u011bkoho nakaz\u00ed. Tak\u017ee pozor na dlouhodob\u00fd ka\u0161el. Je to alarmuj\u00edc\u00ed p\u0159\u00edznak, kter\u00fd nen\u00ed sice specifick\u00fd. Je t\u0159eba i u jin\u00fdch nemoc\u00ed, jako je plicn\u00ed fibr\u00f3za, zejm\u00e9na rakovina plic t\u0159eba nebo chronick\u00e1 obstruk\u010dn\u00ed plicn\u00ed nemoc. Ale ka\u0161le-li n\u011bkdo dlouhodob\u011b, by\u0165 je ku\u0159\u00e1k, tak pros\u00edm nebagatelizovat. Ka\u0161lu proto, \u017ee kou\u0159\u00edm a nic to nen\u00ed, nen\u00ed pravda a v \u0159ad\u011b p\u0159\u00edpad\u016f to n\u011bco skute\u010dn\u011b je. Tak\u017ee ka\u0161laj\u00edc\u00ed \u010dlov\u011bk, vyka\u0161l\u00e1n\u00ed krve, to je naprosto alarmuj\u00edc\u00ed. Tak to je v\u017edycky jakoby v\u00e1\u017en\u00e1 v\u011bc, to je v\u017edycky v\u00e1\u017en\u00e1 diagn\u00f3za, mus\u00ed p\u0159ij\u00edt. No, ale i nespecifick\u00e9 p\u0159\u00edznaky. My jsme m\u011bli p\u0159\u00edpad t\u0159eba p\u0159ed del\u0161\u00edm \u010dase mlad\u00e9 maminky, kter\u00e1 byla po porodu vy\u010derpan\u00e1, unaven\u00e1, hubla, potila se. Oni j\u00ed \u0159\u00edkali, \u017ee m\u00e1 neurovegetativn\u00ed distonii, tud\u00ed\u017e je v podstat\u011b psychicky labiln\u00ed a podobn\u011b. A ona m\u011bla tak rozesetou tuberkul\u00f3zu v obou plic\u00edch chudinka, \u017ee dlouho, dlouho jsme j\u00ed l\u00e9\u010dili, ne\u017e jsme j\u00ed dali dohromady. Tak\u017ee i nespecifick\u00e9 p\u0159\u00edznaky, tuberkul\u00f3za se rovn\u00e1 \u00fabyt\u011b, tak\u00e9 si j\u00ed \u0159\u00edkalo \u00fabyt\u011b, \u010dili kdy\u017e n\u011bkdo jenom neprosp\u00edv\u00e1, pot\u00ed se, neda\u0159\u00ed se mu prost\u011b celkov\u011b fyzicky, tak ur\u010dit\u011b stoj\u00ed za to tak\u00e9 myslet na tuberkul\u00f3zu.<\/p>\n\n\n\n

moder\u00e1tor
Pan\u00ed profesorko, co je z va\u0161eho hlediska ta dlouhodobost u toho ka\u0161le? Jsou to t\u00fddny, m\u011bs\u00edce, roky?<\/p>\n\n\n\n

Prof. MUDr. Koziar VA\u0160\u00c1KOV\u00c1,
my \u0159\u00edk\u00e1me, \u017ee kdy\u017e ka\u0161el p\u0159etrv\u00e1v\u00e1 m\u011bs\u00edc po prod\u011bl\u00e1n\u00ed n\u011bjak\u00e9ho respira\u010dn\u00edho infektu, tak u\u017e by m\u011bl doty\u010dn\u00fd zbyst\u0159et a vyhledat prost\u011b n\u011bjak\u00e9 vy\u0161et\u0159en\u00ed, proto\u017ee ka\u0161el je symptom, kter\u00fd n\u00e1m v\u017edycky \u0159\u00edk\u00e1, \u017ee je n\u011bjak\u00fd z\u00e1n\u011bt nebo p\u0159ek\u00e1\u017eka v d\u00fdchac\u00edch cest\u00e1ch. N\u011bjak\u00fd probl\u00e9m, prost\u011b struktur\u00e1ln\u00ed probl\u00e9m s pl\u00edcemi. Prost\u011b \u010dlov\u011bk jako neka\u0161le jen tak. Tak\u017ee m\u016f\u017ee to b\u00fdt samoz\u0159ejm\u011b i zn\u00e1mka mimoplicn\u00edho onemocn\u00ed, jako je reflux, ale prost\u011b, kdy\u017e ka\u0161lete d\u00e9le ne\u017e m\u011bs\u00edc, nechte se vy\u0161et\u0159it.<\/p>\n\n\n\n

moder\u00e1torka
kdo pat\u0159\u00ed mezi ohro\u017eenou skupinu tuberkul\u00f3zou?<\/p>\n\n\n\n

Prof. MUDr. Koziar VA\u0160\u00c1KOV\u00c1,
V\u017edycky to jsou situace a cel\u00e9 skupiny obyvatel. Tak\u017ee te\u010f ve v\u00e1le\u010dn\u00e9m konfliktu m\u016f\u017eeme \u010dekat, \u017ee data tuberkul\u00f3zy epidemiologick\u00e1 zhor\u0161\u00ed. Jsou to lid\u00e9 prost\u011b, kte\u0159\u00ed maj\u00ed ni\u017e\u0161\u00ed soci\u00e1ln\u00ed statut. Jsou prost\u011b n\u011bjak\u00fdm zp\u016fsobem, co se t\u00fd\u010de stravy, jakoby nedostate\u010dn\u011b vy\u017eiveni alkoholici, lid\u00e9 bez domova. Ale i t\u0159eba jsou to lid\u00e9, kte\u0159\u00ed maj\u00ed cukrovku nebo ty vylou\u010den\u00e9 populace, jako t\u0159eba romsk\u00e1 populace, co je velk\u00fd probl\u00e9m na Slovensku. Ale mus\u00edme na tuberkul\u00f3zu myslet paradoxn\u011bji u t\u011bch jakoby jinak zdrav\u00fdch, mlad\u00fdch, dob\u0159e \u017eiven\u00fdch lid\u00ed, ale kte\u0159\u00ed maj\u00ed n\u011bjakou chronickou nemoc nebo nev\u00fdhodu. Jsou to t\u0159eba lid\u00e9, kte\u0159\u00ed jsou l\u00e9\u010deni takzvanou biologickou l\u00e9\u010dbou. Tam to riziko stoup\u00e1 n\u00e1sobn\u011bkr\u00e1t, p\u011btadvacetkr\u00e1t a v\u00edckr\u00e1t. Lid\u00e9 po transplantaci sedmdes\u00e1tkr\u00e1t v\u011bt\u0161\u00ed riziko tuberkul\u00f3zy. Tak\u00e9 tyto jedince vlastn\u011b je\u0161t\u011b p\u0159ed transplantac\u00ed nebo p\u0159ed zah\u00e1jen\u00edm biologick\u00e9 l\u00e9\u010dby vy\u0161et\u0159ujeme na takzvanou latentn\u00ed tuberkul\u00f3zn\u00ed infekci. To znamen\u00e1, jestli v nich nesp\u00ed n\u011bjak\u00e1 mykobakterie a tuberkul\u00f3zy, kter\u00e1 by se mohla probudit pr\u00e1v\u011b po transplantaci, kdy\u017e budou m\u00edt l\u00e9\u010dbu potla\u010duj\u00edc\u00ed imunitu nebo t\u0159eba s n\u00e1stupem t\u00e9 biologick\u00e9 l\u00e9\u010dby, a\u0165 u\u017e je to revmatick\u00e9 onemocn\u011bn\u00ed, st\u0159evn\u00ed onemocn\u011bn\u00ed, neurologick\u00e9 onemocn\u011bn\u00ed. Tak\u017ee ty mi vylo\u017een\u011b screenujeme proto, jestli maj\u00ed riziko rozvoje tuberkul\u00f3zy.<\/p>\n\n\n\n

moder\u00e1tor
Mockr\u00e1t d\u011bkujeme. M\u011bjte se hezky.<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Tuberkul\u00f3za je tady s n\u00e1mi u\u017e p\u011bknou \u0159\u00e1dku l\u00e9ta a nevypad\u00e1 to, \u017ee by se lou\u010dila. Jak vypadaj\u00ed aktu\u00e1ln\u00ed statistiky o po\u010dtu naka\u017een\u00fdch a bude […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":40275,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-40234","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\/40234","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=40234"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/40234\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/40275"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=40234"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=40234"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=40234"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}