{"id":43537,"date":"2023-11-09T06:02:52","date_gmt":"2023-11-09T05:02:52","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=43537"},"modified":"2023-11-09T06:02:53","modified_gmt":"2023-11-09T05:02:53","slug":"interniste-starnou-bude-jich-treba-vice","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=43537","title":{"rendered":"Internist\u00e9 st\u00e1rnou, bude jich t\u0159eba v\u00edce"},"content":{"rendered":"\n<p><strong>Experti na l\u00e9\u010dbu onemocn\u011bn\u00ed vnit\u0159n\u00edch org\u00e1n\u016f \u2013 internist\u00e9 \u2013 st\u00e1rnou a mlad\u00ed l\u00e9ka\u0159i jejich \u0159ady v\u00a0pln\u00e9 v\u00fd\u0161i nedopl\u0148uj\u00ed. Tento fakt v\u00a0p\u0159\u00ed\u0161t\u00edch letech z\u0159ejm\u011b \u201ezatop\u00ed\u201c p\u0159edev\u0161\u00edm lidem, kte\u0159\u00ed trp\u00ed v\u00edce chronick\u00fdmi chorobami soub\u011b\u017en\u011b. Zat\u00edmco jejich po\u010det bude st\u00e1le vy\u0161\u0161\u00ed, l\u00e9ka\u0159\u016f internist\u016f, kte\u0159\u00ed se o n\u011b staraj\u00ed, ne. \u010cesk\u00e1 populace st\u00e1rne, a pacienti se proto \u010dast\u011bji \u201edo\u017eij\u00ed\u201c \u0159ady vz\u00e1jemn\u011b se prol\u00ednaj\u00edc\u00edch chorob. Jak \u010delit t\u00e9to v\u00fdzv\u011b, budou \u0159e\u0161it tis\u00edce odborn\u00edk\u016f vnit\u0159n\u00edho l\u00e9ka\u0159stv\u00ed na sv\u00e9 nejv\u011bt\u0161\u00ed leto\u0161n\u00ed akci \u2013 XXX. kongresu \u010cesk\u00e9 internistick\u00e9 spole\u010dnosti (\u010cIS). Ten startuje v\u00a0Brn\u011b 8. listopadu. L\u00e9ka\u0159i na n\u011bm p\u0159edstav\u00ed n\u00e1vrh N\u00e1rodn\u00edho programu komplexn\u00ed intern\u00ed p\u00e9\u010de.<\/strong><\/p>\n\n\n\n<h4 class=\"wp-block-heading\"> \u201e<em>Pr\u016fm\u011brn\u00fd v\u011bk ambulantn\u00edch internist\u016f se pohybuje kolem 65 let. Interna je nesm\u00edrn\u011b slo\u017eit\u00fd a n\u00e1ro\u010dn\u00fd obor pro studium a dosa\u017een\u00ed pot\u0159ebn\u00e9 atestace. Nen\u00ed dob\u0159e ohodnocen, a l\u00e9ka\u0159i jsou zat\u00ed\u017eeni slu\u017ebami v\u00a0nemocnic\u00edch. Internista mus\u00ed obs\u00e1hnout obrovsk\u00e9 mno\u017estv\u00ed znalost\u00ed, presti\u017e oboru tomu ale neodpov\u00edd\u00e1. I to je d\u016fvod, pro\u010d se mlad\u00ed l\u00e9ka\u0159i na internu nehrnou,\u201c<\/em> vysv\u011btluje MUDr. Tom\u00e1\u0161 Hauer, p\u0159edseda ambulantn\u00edch internist\u016f \u010cIS. Pr\u00e1v\u011b t\u011bchto l\u00e9ka\u0159\u016f ale bude \u010d\u00edm d\u00e1l v\u00edce t\u0159eba v\u00a0souvislosti s\u00a0rostouc\u00ed skupinou st\u00e1rnouc\u00edch lid\u00ed, kte\u0159\u00ed p\u0159ich\u00e1zej\u00ed do nemocnic se dv\u011bma a v\u00edce chorobami, tedy tzv. polymorbidn\u00edch pacient\u016f. <\/h4>\n\n\n\n<h4 class=\"wp-block-heading\"><em>\u201eTypick\u00fdm p\u0159\u00edpadem je babi\u010dka, kterou p\u0159iveze do nemocnice sanitka pro zhor\u0161en\u00ed celkov\u00e9ho stavu. T\u00e9 se uj\u00edm\u00e1 pr\u00e1v\u011b internista, kter\u00fd mus\u00ed zv\u00e1\u017eit p\u0159\u00ed\u010diny, pro\u010d je j\u00ed \u0161patn\u011b. Od z\u00e1palu plic p\u0159es dehydrataci, selh\u00e1n\u00ed ledvin, diabetick\u00fd \u0161ok a\u017e po infarkt. Tito pacienti obvykle trp\u00ed mnoha soub\u011b\u017en\u00fdmi chronick\u00fdmi chorobami a nen\u00ed mo\u017en\u00e9, aby ka\u017edou nemoc zvl\u00e1\u0161\u0165 \u0159e\u0161il specialista. Internista dok\u00e1\u017ee vz\u00edt v\u00a0potaz v\u0161echny nemoci dohromady a vytvo\u0159it takov\u00fd pl\u00e1n l\u00e9\u010dby, aby se l\u00e9ky, vy\u0161et\u0159en\u00ed a terapie navz\u00e1jem nebily,\u201c<\/em> vysv\u011btluje prof. MUDr. Jan V\u00e1clav\u00edk, Ph.D., FESC, FEFIM, p\u0159ednosta Intern\u00ed a kardiologick\u00e9 kliniky Fakultn\u00ed nemocnice Ostrava. Podle n\u011bj je typick\u00fdm p\u0159\u00edpadem polymorbidn\u00edho pacienta \u010dlov\u011bk trp\u00edc\u00ed cukrovkou druh\u00e9ho typu, kter\u00e1 mu po\u0161kozuje ledviny, srdce, c\u00e9vy.<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\"> <em>\u201eTakov\u00fdch pacient\u016f bude v\u00a0dal\u0161\u00edch letech p\u0159ib\u00fdvat, a internist\u016f tak bude t\u0159eba v\u00edce ne\u017e nyn\u00ed \u2013 zat\u00edm tomu v\u0161ak na\u0161e kapacity neodpov\u00eddaj\u00ed,\u201c <\/em>dod\u00e1v\u00e1 prof. V\u00e1clav\u00edk. Podle p\u0159edsedy \u010cesk\u00e9 internistick\u00e9 spole\u010dnosti prof. MUDr. Richarda \u010ce\u0161ky, CSc., FACP, FEFIM,\u00a0budou internist\u00e9 nejpal\u010div\u011bji chyb\u011bt v\u00a0nemocnic\u00edch. <em>\u201eNyn\u00ed je na intern\u00edch odd\u011blen\u00edch \u010desk\u00fdch nemocnic asi 8 500 l\u016f\u017eek, pro srovn\u00e1n\u00ed pneumologov\u00e9 maj\u00ed asi 1 150, kardiologov\u00e9 1 200. Na intern\u00edch l\u016f\u017ek\u00e1ch le\u017e\u00ed pacienti, o n\u011b\u017e se star\u00e1 \u0161iroce vzd\u011blan\u00fd l\u00e9ka\u0159, internista, a je ot\u00e1zka, kdo jeho pr\u00e1ci p\u0159evezme, pokud n\u00e1s bude m\u00e9n\u011b a pacient\u016f v\u00edce,\u201c <\/em>\u0159\u00edk\u00e1 prof. \u010ce\u0161ka.<\/h4>\n\n\n\n<p>Jak uv\u00e1d\u00ed prezident leto\u0161n\u00edhointernistick\u00e9ho kongresu prim. MUDr. Zden\u011bk Monhart, Ph.D., FEFIM, lze s&nbsp;trochou nads\u00e1zky lze \u0159\u00edci, \u017ee internista sed\u00ed jak kvo\u010dna nad pacientem a hl\u00edd\u00e1 v\u0161e kolem n\u011bj. \u201e<em>Abychom mohli \u0159adu nemoc\u00ed, kter\u00e9 se u jednoho pacienta objevuj\u00ed, po\u0159\u00e1dn\u011b l\u00e9\u010dit, pot\u0159ebujeme dostatek \u0161iroce vzd\u011blan\u00fdch internist\u016f, kte\u0159\u00ed budou spolupracovat s&nbsp;dal\u0161\u00edmi odbornostmi, \u010dasto i s&nbsp;p\u0159esahem do jejich kompetenc\u00ed. I toto obsahuje N\u00e1rodn\u00ed program komplexn\u00ed intern\u00ed p\u00e9\u010de,\u201c <\/em>pokra\u010duje prim. Monhart, kter\u00fd s&nbsp;dal\u0161\u00edmi autory program p\u0159ipravuje.<\/p>\n\n\n\n<p>V&nbsp;\u010cesku p\u0159ijde ka\u017ed\u00fd des\u00e1t\u00fd \u010dlov\u011bk minim\u00e1ln\u011b jednou za rok do styku s&nbsp;intern\u00edm l\u00e9ka\u0159em. T\u011bch je nyn\u00ed p\u0159es dva tis\u00edce. Po\u010dty polymorbidn\u00edch pacient\u016f, kte\u0159\u00ed budou pot\u0159ebovat \u201eslu\u017eby\u201c internist\u016f, porostou tak\u00e9 podle dat epidemiologa doc. MUDr. Rastislava Ma\u010fara, PhD., MBA, FRCPS. <em>\u201eJak ukazuj\u00ed mnoh\u00e9 studie a data ze zahrani\u010d\u00ed<\/em><strong>, <\/strong><em>polymorbidita je celosv\u011btov\u00fdm probl\u00e9mem. O\u010dek\u00e1v\u00e1 se trend zhor\u0161ov\u00e1n\u00ed zdravotn\u00edho stavu populace a nar\u016fstaj\u00edc\u00ed frekvence pacient\u016f se dv\u011bma a v\u00edce chronick\u00fdmi neinfek\u010dn\u00edmi onemocn\u011bn\u00edmi z\u00e1rove\u0148. Data z&nbsp;Anglie ukazuj\u00ed, \u017ee pacienti s&nbsp;polymorbiditou tvo\u0159\u00ed a\u017e 50 % v\u0161ech konzultac\u00ed v&nbsp;prim\u00e1rn\u00ed p\u00e9\u010di a 75 % ze v\u0161ech p\u0159edepsan\u00fdch l\u00e9k\u016f. Vzhledem k&nbsp;o\u010dek\u00e1van\u00e9mu demografick\u00e9mu v\u00fdvoji s&nbsp;pokra\u010duj\u00edc\u00edm st\u00e1rnut\u00edm \u010desk\u00e9 populace lze p\u0159edpokl\u00e1dat, \u017ee zastoupen\u00ed pacient\u016f s&nbsp;v\u00edce diagn\u00f3zami se bude nad\u00e1le zvy\u0161ovat,\u201c <\/em>dod\u00e1v\u00e1 doc. Ma\u010far.<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Experti na l\u00e9\u010dbu onemocn\u011bn\u00ed vnit\u0159n\u00edch org\u00e1n\u016f \u2013 internist\u00e9 \u2013 st\u00e1rnou a mlad\u00ed l\u00e9ka\u0159i jejich \u0159ady v\u00a0pln\u00e9 v\u00fd\u0161i nedopl\u0148uj\u00ed. Tento fakt v\u00a0p\u0159\u00ed\u0161t\u00edch letech z\u0159ejm\u011b \u201ezatop\u00ed\u201c p\u0159edev\u0161\u00edm <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=43537\" title=\"Internist\u00e9 st\u00e1rnou, bude jich t\u0159eba v\u00edce\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14888,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-43537","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\/43537","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=43537"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/43537\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14888"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=43537"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=43537"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=43537"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}