Česky
Doctor, how did you get into pediatrics? Why did you choose pneumology as your specialty?
When I was studying medicine, I was more interested in surgery. Before my final year, I did a surgical internship in the USA, where I went to the operating room almost every day. At that time, I realized that there was something I would miss about surgery, and that was communicating with patients. So I started thinking about what other field to choose. I was studying at the 1st Medical Faculty of Charles University, where we didn't have much contact with pediatric patients before the 6th year. That's why I didn't even consider pediatrics until then, I thought I would feel too sorry for sick children. During my internships in pediatrics in 6th grade, I found that pity didn't come when I felt like I was helping children. After my studies, I started working at the 1st Children's Clinic of Motol University Hospital. There I soon started working in a department that focused on acute admissions and also on respiratory diseases. We also took care of patients with cystic fibrosis, which I started to take care of in the outpatient clinic, and that's how I got into paediatric pneumology.
What are the possibilities of Hořovice Hospital in the field of pneumological diagnosis and treatment of paediatric patients with respiratory diseases?
In the pulmonary outpatient department of Hořovice Hospital we have modern diagnostic and treatment methods at our disposal. One of the main examination methods is spirometric examination, as well as the examination of exhaled nitric oxide. Both of these methods help us to diagnose bronchial asthma and other respiratory diseases in children. We also perform allergen specific skin tests to diagnose allergies. We also have all laboratory methods, immunological sampling to determine allergies, immune deficiencies and other autoimmune diseases. In addition, microbiological methods are used to determine the causative agents of infectious diseases. Of course, imaging methods such as X-ray, ultrasound and CT of the lungs are also used. In terms of therapeutic methods, we have a wide range of modern drugs. For asthma, these include inhaled corticosteroids and combination inhalers. We also use a wide range of antibiotics, which can be administered both orally in outpatient treatment and intravenously during hospitalisation for more serious conditions such as pneumonia. In the outpatient clinic, we provide allergy-specific allergen immunotherapy. We treat immunocompromised patients on an outpatient basis by administering antibodies intramuscularly or subcutaneously.
Which patients visit the pneumology outpatient clinic most often?
My outpatient clinic is most often visited by patients who suffer from frequent upper and lower airway inflammation, as well as patients with bronchial asthma, patients who have had pneumonia, premature babies with pulmonary disabilities and patients with congenital airway defects. Because of the close connection between pulmonary and allergy medicine, I also see patients with atopic eczema.
Allergies, asthma and other respiratory diseases afflict a large number of children chronically. Is this due to genes or environment or other causes?
Allergies and bronchial asthma have a multifactorial origin. This means that both genetics and environmental influences are involved.
What shifts are you seeing in the treatment of childhood respiratory diseases today?
We are fortunate that the most common childhood respiratory diseases today are in most cases well treatable. Thanks to inhaled corticosteroid treatment options for asthma, we are able to treat these patients very effectively without unpleasant side effects. Thanks to this treatment, most patients with asthma are able to live without limitations, including top athletes. Thanks to the specific allergen immunotherapy, which is also available in oral form, we are able to virtually cure allergies in some cases and thus prevent the development of asthma.
There is a great deal of debate about the need for vaccination. In your opinion, is the trend not to vaccinate, or the trend to delay vaccination until later in a child's life, a sensible one?
I am a big opponent of not vaccinating. Thanks to vaccination, smallpox, for example, has been eradicated. Some diseases, such as measles, were rare until recently. Thanks to the current trend of not vaccinating, measles is occurring again at an increased rate. The attitude of not vaccinating is, in my opinion, very selfish. "I will not vaccinate my child because others are vaccinated." What about the ones that can't be vaccinated because they're too young? Or those who have medical reasons that prevent vaccination? They're often the ones most at risk for a given disease. I think that healthy children should be vaccinated according to the calendar, precisely so that those who cannot be vaccinated for whatever reason are protected by the fact that others will be vaccinated.
