\u010cRo<\/p>\n\n\n\n
Kdy\u017e se bav\u00edme o problematice d\u00fdch\u00e1n\u00ed a plicn\u00edch nemoc\u00ed, tak co vlastn\u011b jsou jako nej\u010dast\u011bj\u0161\u00ed probl\u00e9my te\u010f v oblasti t\u011bch plicn\u00edch onemocn\u011bn\u00ed?<\/p>\n\n\n\n
Milan Sova,p\u0159ednosta Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy, FN Brno<\/p>\n\n\n\n
Jestli mysl\u00edte nej\u010dast\u011bj\u0161\u00ed pacienty, kter\u00e9 potk\u00e1v\u00e1me v na\u0161ich ambulanc\u00edch, tak jsou to pacienti s astmatem, astmatik\u016f n\u00e1m p\u0159ib\u00fdv\u00e1. U\u017e se dneska mluv\u00ed o tom…<\/p>\n\n\n\n
Patricie Strouhalov\u00e1,moder\u00e1torka<\/p>\n\n\n\n
A to pro\u010d?<\/p>\n\n\n\n
Milan Sova,p\u0159ednosta Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy, FN Brno<\/p>\n\n\n\n
Teori\u00ed je n\u011bkolik, jednak proto, \u017ee m\u00e1me lep\u0161\u00ed diagnostiku, proto dok\u00e1\u017eeme astma diagnostikovat i v t\u011bch leh\u010d\u00edch p\u0159\u00edpadech, m\u00e1me k dispozici modern\u011bj\u0161\u00ed p\u0159\u00edstroje, kter\u00e9 pou\u017e\u00edv\u00e1me k plicn\u00edmu vy\u0161et\u0159en\u00ed, funk\u010dn\u00edmu vy\u0161et\u0159en\u00ed plic. Mluv\u00ed se hodn\u011b o zne\u010di\u0161t\u011bn\u00ed prost\u0159ed\u00ed, proto\u017ee hlavn\u011b t\u0159eba exhalace ve velk\u00fdch m\u011bstech, a\u0165 u\u017e je to Praha nebo to je Brno nebo dal\u0161\u00ed m\u011bsta, n\u00e1m nar\u016fstaj\u00ed a mluv\u00ed se i o dal\u0161\u00edch v\u011bcech, jako je t\u0159eba imunitn\u00ed teorie, kdy my v\u00edme, \u017ee d\u011bti, kter\u00e9 vyr\u016fstaj\u00ed v agr\u00e1rn\u00edch oblastech, tak v\u011bt\u0161inou maj\u00ed m\u00e9n\u011b astmatu ne\u017e d\u011bti, kter\u00e9 vyr\u016fstaj\u00ed v supersteriln\u00edm prost\u0159ed\u00ed, kdy ta maminka v\u0161ecko ut\u00edr\u00e1 a d\u00edt\u011b se potom s t\u011bmi antigeny setk\u00e1 a\u017e pozd\u011bji v tom \u017eivot\u011b, ne\u017e kdyby bylo t\u0159eba na t\u00e9 vesnici.<\/p>\n\n\n\n
Patricie Strouhalov\u00e1,moder\u00e1torka<\/p>\n\n\n\n
jak jsme na tom s tuberkul\u00f3zou te\u010f v \u010cesk\u00e9 republice, pane profesore?<\/p>\n\n\n\n
Milan Sova,p\u0159ednosta Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy, FN Brno<\/p>\n\n\n\n
U tuberkul\u00f3zy n\u00e1m p\u0159ibyl po\u010det p\u0159\u00edpad\u016f, tuberkul\u00f3zu se n\u00e1m v minulosti da\u0159ilo postupn\u011b omezovat, v\u00fdskyt tuberkul\u00f3zy klesal, klesal, klesal, te\u010f n\u00e1m bohu\u017eel stoupl a p\u0159edpokl\u00e1d\u00e1me, \u017ee ten trend se asi bude dr\u017eet. Je to d\u00e1no jednodu\u0161e migrac\u00ed ze zem\u00ed, a\u0165 u\u017e je to D\u00e1ln\u00fd v\u00fdchod nebo Indie, nebo zem\u011b b\u00fdval\u00e9ho Sov\u011btsk\u00e9ho svazu.<\/p>\n\n\n\n
Patricie Strouhalov\u00e1,moder\u00e1torka<\/p>\n\n\n\n
Jak se l\u00e9\u010d\u00ed tuberkul\u00f3za.<\/p>\n\n\n\n
Milan Sova,p\u0159ednosta Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy, FN Brno<\/p>\n\n\n\n
Ta se l\u00e9\u010d\u00ed antituberkulotiky, co\u017e jsou takov\u00e1 speci\u00e1ln\u00ed antibiotika, kter\u00e1 p\u016fsob\u00ed pr\u00e1v\u011b na mycobacterium tuberkul\u00f3zy, co\u017e je vyvol\u00e1vaj\u00edc\u00ed p\u0159\u00ed\u010dina t\u00e9 tuberkul\u00f3zy, ta l\u00e9\u010dba mus\u00ed b\u00fdt dlouh\u00e1, ta l\u00e9\u010dba trv\u00e1 standardn\u011b 6 m\u011bs\u00edc\u016f a pro pacienta l\u00e9\u010dba t\u00e9 z\u00e1kladn\u00ed nebo t\u00e9 citliv\u00e9 tuberkul\u00f3zy spo\u010d\u00edv\u00e1 v tom, \u017ee ka\u017ed\u00fd den mus\u00ed u\u017e\u00edvat tyto l\u00e9ky.<\/p>\n\n\n\n
Patricie Strouhalov\u00e1,moder\u00e1torka<\/p>\n\n\n\n
Zase, pt\u00e1m se na to srovn\u00e1n\u00ed t\u0159eba p\u0159ed 30, 40 lety. Mnoz\u00ed na\u0161i star\u0161\u00ed rodi\u010de \u0159\u00edkaj\u00ed, no, j\u00e1 kdy\u017e jsem byl mal\u00fd, tak jsem tuberkul\u00f3zu m\u011bl. Je to v\u011bc, kter\u00e1 ovlivn\u00ed ty jejich pl\u00edce te\u010f t\u0159eba, kdy\u017e je j\u00edm kolem 75, 80 let.<\/p>\n\n\n\n
Milan Sova,p\u0159ednosta Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy, FN Brno<\/p>\n\n\n\n
M\u016f\u017ee, nemus\u00ed. U t\u011bch star\u0161\u00edch pacient\u016f, kte\u0159\u00ed prod\u011blali tuberkul\u00f3zu dob\u0159e zal\u00e9\u010denou, tak t\u0159eba jenom na plic\u00edch, kdybychom ud\u011blali c\u00e9t\u00e9\u010dko, m\u016f\u017eeme naj\u00edt n\u011bjak\u00fd mal\u00fd uzel, kter\u00fd vlastn\u011b je po t\u00e9 tuberkul\u00f3ze, na druhou stranu tak\u00e9 m\u016f\u017eeme m\u00edt t\u0159eba v\u011bt\u0161\u00ed, \u0159\u00edk\u00e1 se tomu postspecifick\u00e9 zm\u011bny, hlavn\u011b u t\u011bch \u00fapln\u011b star\u00fdch pacient\u016f, kdy je\u0161t\u011b nebyly k dispozici antituberkulotika, tak tam se d\u011blaly i t\u0159eba operace, n\u011bkdy se d\u011blaly operace pom\u011brn\u011b v\u00fdznamn\u00e9, tak\u017ee toho pacienta to pot\u00e9 ovliv\u0148ovalo na cel\u00fd \u017eivot. Ale, jak jste se ptala, t\u011bch 30 let, co vlastn\u011b se m\u011bn\u00ed nebo nem\u011bn\u00ed, tak bohu\u017eel u t\u00e9 tuberkul\u00f3zy extra pozitivn\u00edch zpr\u00e1v nem\u00e1me, proto\u017ee sice m\u00e1me nov\u00e1 antituberkulotika, kter\u00e1 jsou rezervov\u00e1na pro formy rezistentn\u00ed tuberkul\u00f3zy, ale \u017ee by tady byl n\u011bjak\u00fd z\u00e1zra\u010dn\u00fd p\u0159evrat, kdybychom si \u0159ekli super, tuberkul\u00f3zu prost\u011b vyl\u00e9\u010d\u00edme a dok\u00e1\u017eeme, aby zmizela ze sv\u011bta, tak to se n\u00e1m bohu\u017eel asi nepovede.<\/p>\n\n\n\n
Patricie Strouhalov\u00e1,moder\u00e1torka<\/p>\n\n\n\n
Co imunoterapie, co ta dok\u00e1\u017ee?<\/p>\n\n\n\n
Milan Sova,p\u0159ednosta Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy, FN Brno<\/p>\n\n\n\n
Imunoterapie je dob\u0159e pou\u017eit\u00e1 v l\u00e9\u010db\u011b n\u00e1dor\u016f, kdy my vlastn\u011b dok\u00e1\u017eeme stimulovat n\u00e1\u0161 imunitn\u00ed syst\u00e9m, aby s\u00e1m zab\u00edjel ty n\u00e1dorov\u00e9 bu\u0148ky, kombinuje se v\u011bt\u0161inou s chemoterapi\u00ed, nebo m\u016f\u017ee se kombinovat s chemoterapii nebo se d\u00e1v\u00e1 na monoterapii. A je to druh l\u00e9\u010dby, kter\u00fd pr\u00e1v\u011b zaznamenal obrovsk\u00fd pokrok, proto\u017ee, kdy\u017e si vzpomenu, kdy jsem nastupoval do pr\u00e1ce, tak pacienti, kte\u0159\u00ed m\u011bli nemalobun\u011b\u010dn\u00fd karcinom plic ve \u010dtvrt\u00e9m stadiu, tak bohu\u017eel v\u011bt\u0161inou do roka um\u00edrali, dneska u\u017e u \u0159ady pacient\u016f se z toho st\u00e1v\u00e1 chronick\u00e9 onemocn\u011bn\u00ed, kdy dok\u00e1\u017eeme tyto pacienty l\u00e9\u010dit a pacienti jsou stabiln\u00ed n\u011bkolik let, i t\u0159eba 5, 10 let mohou b\u00fdt.<\/p>\n\n\n\n
Patricie Strouhalov\u00e1,moder\u00e1torka<\/p>\n\n\n\n
Ten screening, o kter\u00e9m jsme se bavili, kter\u00fd tady funguje od roku 2002, na \u010dasn\u00fd z\u00e1chyt karcinomu plic, tak nakolik vlastn\u011b dok\u00e1\u017ee zachytit tu rakovinu, aby se dala vyl\u00e9\u010dit?<\/p>\n\n\n\n
Milan Sova,p\u0159ednosta Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy, FN Brno<\/p>\n\n\n\n
On ji dok\u00e1\u017ee zachytit v tom stadiu, ve kter\u00e9m je \u00fapln\u011b…<\/p>\n\n\n\n
Patricie Strouhalov\u00e1,moder\u00e1torka<\/p>\n\n\n\n
V tom \u00fapln\u00e9m za\u010d\u00e1tku…<\/p>\n\n\n\n
Milan Sova,p\u0159ednosta Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy, FN Brno<\/p>\n\n\n\n
Dok\u00e1\u017ee zachytit, d\u00e1 se poznat. Vy najdete na tom c\u00e9t\u00e9\u010dku n\u011bjak\u00fd nodulus, co\u017e je v podstat\u011b jako kuli\u010dka, abych to \u0159ekl laicky, kter\u00e1 v t\u011bch plic\u00edch nem\u00e1 b\u00fdt a my potom pot\u0159ebujeme \u0159e\u0161it jak, co s n\u00ed d\u00e1l. Tak\u017ee provedeme bronchoskopii, vezmeme si z toho vzore\u010dek a zjist\u00edme, je to n\u00e1dor, nen\u00ed to n\u00e1dor, nebo provedeme t\u0159eba CT, kter\u00e9 n\u00e1m uk\u00e1\u017ee, jak se vlastn\u011b ta kuli\u010dka chov\u00e1, jestli akumuluje gluk\u00f3zu a t\u00edm p\u00e1dem je metabolicky aktivn\u00ed, nebo nen\u00ed, no, a potom m\u016f\u017ee n\u00e1sledovat pr\u00e1v\u011b ta chirurgick\u00e1 l\u00e9\u010dba, odstran\u011bn\u00ed t\u00e9 \u010d\u00e1sti plic, kter\u00e1, jak \u0159\u00edk\u00e1me, je po\u0159\u00e1d v l\u00e9\u010db\u011b rakoviny plic nej\u00fa\u010dinn\u011bj\u0161\u00ed.<\/p>\n\n\n\n
Patricie Strouhalov\u00e1,moder\u00e1torka<\/p>\n\n\n\n
Nakolik, pane profesore, jste i psycholog? Proto\u017ee, co si budeme pov\u00eddat, tak lidi se prost\u011b boj\u00ed a ku\u0159\u00e1ci se boj\u00ed je\u0161t\u011b v\u00edc.<\/p>\n\n\n\n
Milan Sova,p\u0159ednosta Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy, FN Brno<\/p>\n\n\n\n
Psycholog nejsem, ale samoz\u0159ejm\u011b psychologicky \u010dlov\u011bk mus\u00ed p\u016fsobit, s t\u011bma lidma se domluvit, proto\u017ee p\u0159esn\u011b, jak \u0159\u00edk\u00e1te, strach je hrozn\u011b mocn\u00fd, ale na druhou stranu, kdy\u017e si to uv\u011bdom\u00edme, \u017ee odpov\u011b\u010f, j\u00e1 rad\u0161i nikam nep\u016fjdu, co kdyby mi n\u011bco na\u0161li, tak ono se t\u00edm stejn\u011b nic nezm\u011bn\u00ed, tak\u017ee je lep\u0161\u00ed prost\u011b o tom v\u011bd\u011bt dop\u0159edu, lep\u0161\u00ed je v\u011bd\u011bt, \u017ee m\u00e1m t\u0159eba tady ten n\u00e1dor a odstran\u00ed se to opera\u010dn\u011b, bude to nep\u0159\u00edjemn\u00e9, ale m\u00e1m velkou \u0161anci, \u017ee u\u017e se mi to v \u017eivot\u011b neobjev\u00ed, varianta B je, p\u0159ijdu, a\u017e budu m\u00edt pot\u00ed\u017ee, a\u017e budu m\u00edt pokro\u010dil\u00e9 onemocn\u011bn\u00ed, metast\u00e1zy b\u016fhv\u00edkde, no, a s t\u00edm u\u017e potom…. ne\u0159\u00edk\u00e1m, \u017ee se ned\u00e1 nic d\u011blat, ale ta l\u00e9\u010dba je n\u00e1ro\u010dn\u011bj\u0161\u00ed a je to l\u00e9\u010dba paliativn\u00ed.<\/p>\n\n\n\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
\u010cRo Kdy\u017e se bav\u00edme o problematice d\u00fdch\u00e1n\u00ed a plicn\u00edch nemoc\u00ed, tak co vlastn\u011b jsou jako nej\u010dast\u011bj\u0161\u00ed probl\u00e9my te\u010f v oblasti t\u011bch plicn\u00edch onemocn\u011bn\u00ed? Milan Sova,p\u0159ednosta […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":17175,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-60467","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\/60467","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=60467"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/60467\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/17175"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=60467"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=60467"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=60467"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}