MUDr. David Skoumal \u2013\u00a0 ASTD Training Director<\/p>\n
<\/p>\n
Doporu\u010den\u00e1 lodn\u00ed a expedi\u010dn\u00ed pot\u00e1p\u011b\u010dsk\u00e1 l\u00e9k\u00e1rna<\/strong><\/p>\n Vzhledem k\u00a0tomu, \u017ee se m\u016f\u017eeme pohybovat v\u00a0oblastech, kde se mus\u00edme spolehnout jen sami na sebe a zdravotnick\u00e1 p\u00e9\u010de nen\u00ed dostupn\u00e1, je jen na n\u00e1s, jak se k\u00a0tomuto probl\u00e9mu postav\u00edme. Kdo je p\u0159ipraven, nen\u00ed p\u0159ekvapen. A v\u011bt\u0161inou plat\u00ed, \u017ee se n\u011bco stane tehdy, kdy zrovna nic u sebe nem\u00e1me. V\u00a0tomto doporu\u010den\u00ed bych cht\u011bl pouze sezn\u00e1mit na\u0161i pot\u00e1p\u011b\u010dskou ve\u0159ejnost s\u00a0l\u00e9\u010divy a zdravotnick\u00fdm vybaven\u00edm, kter\u00e9 se mi osv\u011bd\u010dilo opakovan\u011b na pot\u00e1p\u011b\u010dsk\u00fdch expedic\u00edch od poloviny 80.let, kdy jsem je\u0161t\u011b jako student l\u00e9ka\u0159sk\u00e9 fakulty vyfasoval funkci expedi\u010dn\u00edho l\u00e9ka\u0159e,musel opakovan\u011b \u0161\u00edt tr\u017en\u00e9 r\u00e1ny v\u00a0tropick\u00e9m podneb\u00ed, \u0159e\u0161it opakovan\u011b t\u011b\u017ek\u00e9 z\u00e1n\u011bty zevn\u00edho zvukovodu a takt\u00e9\u017e \u0159e\u0161it intoxikaci jedovat\u00fdmi mo\u0159sk\u00fdmi \u017eivo\u010dichy, krom\u011b b\u011b\u017en\u00fdch infekt\u016f,alergick\u00fdch reakc\u00ed atd.<\/p>\n Toto doporu\u010den\u00ed nezahrnuje nic ze z\u00e1kladn\u00edho vybaven\u00ed pro pod\u00e1n\u00ed kysl\u00edku- to je zcela samostatn\u00e1 problematika. Takt\u00e9\u017e vzhledem k\u00a0bohat\u00e9mu spektru l\u00e9\u010div, dostupn\u00fdch na na\u0161em trhu, se bude zcela jist\u011b vyskytovat spousta jin\u00fdch doporu\u010den\u00ed.Pokud m\u00e1te vlastn\u00ed zku\u0161enost a sv\u00e9 odzkou\u0161en\u00e9 l\u00e9ky, prim\u00e1rn\u011b berte s\u00a0sebou to,co zn\u00e1te.<\/p>\n V\u011bt\u0161ina uv\u00e1d\u011bn\u00fdch l\u00e9\u010div jsou origin\u00e1ly, existuje v\u0161ak spousta jejich kopi\u00ed- tzv.generik,kter\u00e9 mohou b\u00fdt levn\u011bj\u0161\u00ed.<\/p>\n N\u011bkter\u00e1 l\u00e9\u010diva jsou pouze na l\u00e9ka\u0159sk\u00fd p\u0159edpis. Mnoho koleg\u016f l\u00e9ka\u0159\u016f nemus\u00ed souhlasit s\u00a0t\u00edm, \u017ee pou\u010den\u00fd laik pod\u00e1 n\u011bkter\u00e9 l\u00e9ky naslepo, nicm\u00e9n\u011b opravdu jsme n\u011bkdy p\u0159ed dilematem \u2013\u00a0 zda podat l\u00e9k, \u010di ne. Jsme ale p\u0159ed t\u00edmto dilematem v\u00a0m\u00edst\u011b, kde \u017e\u00e1dn\u00e1 jin\u00e1 zdravotn\u00ed pomoc nen\u00ed mo\u017en\u00e1. A zde neplat\u00ed zaveden\u00fd syst\u00e9m zdravotnictv\u00ed v\u00a0\u010cesk\u00e9 republice. Tak\u017ee pokud m\u00e1te l\u00e9ka\u0159e mezi sv\u00fdmi p\u0159\u00e1teli, mo\u017en\u00e1 v\u00e1m pom\u016f\u017ee radou i l\u00e9\u010divy.Upozorn\u00ed v\u00e1s na eventu\u00e1ln\u00ed interakce l\u00e9k\u016f.L\u00e9\u010diva na l\u00e9ka\u0159sk\u00fd p\u0159edpis lze pak zakoupit,prostudovat p\u0159\u00edbalov\u00fd let\u00e1k a p\u0159ebalit.Origin\u00e1ln\u00ed krabi\u010dky zab\u00edraj\u00ed moc m\u00edsta, tak\u017ee je vhodn\u00e9 l\u00e9\u010diva zabalit do nepromokav\u00e9ho tmav\u00e9ho obalu a p\u0159\u00edbalov\u00e9 let\u00e1ky s\u00a0sebou.<\/p>\n <\/p>\n Prevence p\u0159ed cestou<\/strong><\/p>\n Pokud m\u00ed\u0159\u00edme do tropick\u00e9 exotiky, je vhodn\u00e9 zkonzultovat danou oblast ve speci\u00e1ln\u00ed ambulanci cestovn\u00ed medic\u00edny, kde maj\u00ed k\u00a0dispozici epidemiologick\u00e9 mapy a jsou schopni nab\u00eddnout vhodn\u00e9 o\u010dkov\u00e1n\u00ed. B\u011b\u017en\u00fdm standartem je o\u010dkov\u00e1n\u00ed proti hepatitid\u011b(\u017eloutence) typu A p\u0159enositeln\u00e9 kontaminovanou stravou,\u0161pinav\u00fdma rukama… O\u010dkov\u00e1n\u00ed proti tetanu v\u00e1m zajist\u00ed v\u00e1\u0161 praktick\u00fd l\u00e9ka\u0159.Ostatn\u00ed o\u010dkov\u00e1n\u00ed jsou dle aktu\u00e1ln\u00edch epidemiologick\u00fdch lo\u017eisek \u2013 \u017elut\u00e1 zimnice, tyfus..<\/p>\n Dal\u0161\u00edm probl\u00e9mem je vhodn\u00e1 volba antimalarika. V m\u00edst\u011b pobytu\u00a0 m\u016f\u017eou m\u00edt zcela jinou zku\u0161enost s\u00a0dan\u00fdm typem l\u00e9ku,kter\u00fd zab\u00edr\u00e1.Tak\u017ee zde je probl\u00e9m, co doporu\u010dit univerz\u00e1ln\u011b. Ze zn\u00e1m\u00fdch v\u00a0sou\u010dasnosti u\u017e\u00edvan\u00fdch l\u00e9k\u016f je to Delagil,\u00a0 Malarone\u2026 Lariam<\/em> jen pro nepot\u00e1p\u011b\u010de vzhledem k\u00a0jeho vedlej\u0161\u00edm \u00fa\u010dink\u016fm.L\u00e9\u010dbu nasazujeme ji\u017e p\u0159ed odjezdem, l\u00e9ky u\u017e\u00edv\u00e1me po celou dobu pobytu a vysazujeme a\u017e po n\u00e1vratu.<\/p>\n Kdo trp\u00ed na opary, m\u016f\u017ee zkusit profylaxi vitam\u00ednem B komplex<\/em> 1 x denn\u011b. P\u0159edcestovn\u00ed stres \u010dasto vyprovokuje exacerbaci oparu na rtu, kter\u00fd je schopen dovolenou opravdu hezky zpest\u0159it.<\/p>\n <\/p>\n P\u0159ed del\u0161\u00edm letem je vhodn\u00e9 prov\u00e9st prevenci trombembolick\u00fdch komplikac\u00ed.P\u0159i st\u00e1ze krve v\u00a0doln\u00edch kon\u010detin\u00e1ch p\u0159i del\u0161\u00ed nehybnosti ve skr\u010den\u00e9 poloze mohou u n\u011bkter\u00fdch jedinc\u016f vzniknout tromby,kter\u00e9 mohou embolizovat do plic a zp\u016fsobit velmi v\u00e1\u017en\u00e9 zdravotn\u00ed komplikace a\u017e smrt.Prevence spo\u010d\u00edv\u00e1 v\u00a0pod\u00e1n\u00ed mal\u00e9 d\u00e1vky kyseliny acetylsalicylov\u00e9<\/p>\n ( Anopyrin 100mg<\/em> 1 x denn\u011b) p\u00e1r dn\u00ed p\u0159ed letem a b\u011bhem letu,d\u00e1le cvi\u010den\u00ed doln\u00edch kon\u010detin b\u011bhem letu a dostate\u010dn\u00fd p\u0159\u00edsun tekutin. Vhodn\u00fdm dopl\u0148kem je pod\u00e1n\u00ed venofarmak k\u00a0pos\u00edlen\u00ed c\u00e9vn\u00ed st\u011bny a prevenci vzniku otok\u016f. Nejlep\u0161\u00edm prepar\u00e1tem v\u00a0sou\u010dasn\u00e9 dob\u011b je Detralex <\/em>minim\u00e1ln\u011b 3×1 op\u011bt p\u00e1r dn\u00ed p\u0159ed odletem a b\u011bhem letu.<\/p>\n <\/p>\n Cesta do trop\u016f v\u00a0dob\u011b zimn\u00edho obdob\u00ed \u00a0Evropy nese s\u00a0sebou zv\u00fd\u0161enou expozici k\u016f\u017ee,kter\u00e1 nen\u00ed p\u0159ipraven\u00e1 na ostr\u00fd slune\u010dn\u00ed svit. Profylaktick\u00e9 pod\u00e1n\u00ed Beta karotenu \u010di n\u00e1v\u0161t\u011bva sol\u00e1ria p\u0159ed cestou je diskutabiln\u00ed. Rad\u011bji b\u00fdt opatrn\u00fd v\u00a0prvn\u00edch dnech a na slunci to nep\u0159eh\u00e1n\u011bt, mechanick\u00e1 ochrana od\u011bvem, \u010depic\u00ed a vysok\u00fd faktor opalovac\u00edho kr\u00e9mu je nutnost\u00ed.<\/p>\n <\/p>\n Preventivn\u00ed pod\u00e1n\u00ed Lactobacillu (bifidogenn\u00ed jogurty, spousta prepar\u00e1t\u016f na trhu) k\u00a0potla\u010den\u00ed pr\u016fjmu nen\u00ed a\u017e tak potvrzeno, nicm\u00e9n\u011b je to vhodn\u00e1 ka\u017edodenn\u00ed prevence, tak\u017ee t\u00edm nic nezkaz\u00edme. Probiotick\u00e9 l\u00e9ky jako Enterol ,Hylak.. budou vhodn\u00e9 pro dol\u00e9\u010den\u00ed na\u0161\u00ed naru\u0161en\u00e9 st\u0159evn\u00ed fl\u00f3ry po n\u00e1vratu z\u00a0cest.<\/p>\n <\/p>\n <\/p>\n Vybaven\u00ed\u00a0 l\u00e9karni\u010dky<\/strong> se skl\u00e1d\u00e1 z\u00a0l\u00e9\u010div a zdravotnick\u00e9ho materi\u00e1lu:<\/p>\n L\u00e9\u010diva: ( P)- jsou voln\u011b prodejn\u00e9 v\u00a0l\u00e9k\u00e1rn\u011b,ostatn\u00ed pouze na l\u00e9ka\u0159sk\u00fd p\u0159edpis<\/p>\n <\/p>\n N\u00e1stroje: \u00a0\u00a0pinzeta, pe\u00e1n, n\u016f\u017eky \u2013 pe\u00e1n je velmi \u0161ikovn\u00fd pomocn\u00edk, hod\u00ed se na cokoliv, vhodn\u011bj\u0161\u00ed se mi jev\u00ed model s lehce zahnut\u00fdmi bran\u017eemi<\/p>\n Kontaktn\u00ed teplom\u011br \u2013 nahrazuje snadno rozbiteln\u00fd klasick\u00fd rtu\u0165ov\u00fd.<\/p>\n Jehly do injek\u010dn\u00ed st\u0159\u00edka\u010dky – k\u00a0vytahov\u00e1n\u00ed zalomen\u00fdch bodlin je\u017eka, t\u0159\u00edsek atd. V\u00edce se mi osv\u011bd\u010dily ten\u010d\u00ed jehly ( 0,6mm modr\u00e9, 0,7mm \u010dern\u00e9)<\/p>\n Esmarchovo \u0161krtidlo k\u00a0zastavov\u00e1n\u00ed tepenn\u00e9ho krv\u00e1cen\u00ed<\/p>\n Obvazov\u00fd materi\u00e1l(Obvaz hotov\u00fd s pol\u0161t\u00e1\u0159ky , obinadlo pru\u017en\u00e9, trojc\u00edp\u00fd \u0161\u00e1tek, n\u00e1plasti s\u00a0pol\u0161t\u00e1\u0159kem a bez, steriln\u00ed \u010dtvere\u010dky kryt\u00ed) Vhodn\u00e9 jsou prody\u0161n\u00e9 plo\u0161n\u00e9 n\u00e1plasti, ze kter\u00fdch lze vyrobit prakticky v\u0161e (nap\u0159. Omnifix od firmy Hartmann).<\/p>\n Dezinfekce – jednotliv\u011b balen\u00e9 desinfek\u010dn\u00ed pol\u0161t\u00e1\u0159ky( Alco Tamp) \u010di ubrousky (Sterilium), Septonex ve sprayi, 3% peroxid vod\u00edku- ten p\u0159i styku s\u00a0krv\u00ed \u010di sliznic\u00ed uvol\u0148uje kysl\u00edk reakc\u00ed s\u00a0tk\u00e1\u0148ov\u00fdmi peroxid\u00e1zami a \u010dist\u00ed r\u00e1nu.<\/p>\n Tea tree oil- \u010dajovn\u00edkov\u00fd olej pro v\u0161estrann\u00e9 pou\u017eit\u00ed (hnis\u00e1n\u00ed ran,po\u0161t\u00edp\u00e1n\u00ed hmyzem)<\/p>\n Vinn\u00fd ocet do oblast\u00ed, kde se vyskytuje med\u016fza \u010dty\u0159hranka<\/p>\n Aloe vera ve sprayi \u010di gelu<\/p>\n <\/p>\n Obsah l\u00e9karni\u010dky by m\u011bl postihovat univerz\u00e1ln\u011b co nej\u0161ir\u0161\u00ed spektrum mo\u017en\u00fdch nemoc\u00ed a poran\u011bn\u00ed,kter\u00e9 jsme schopni zvl\u00e1dnout.<\/p>\n Prvn\u00ed \u010d\u00e1st t\u011bla, kter\u00e1 p\u0159ich\u00e1z\u00ed do kontaktu s\u00a0okol\u00edm je k\u016f\u017ee.<\/p>\n K\u016f\u017ee<\/strong> vystavena slune\u010dn\u00edmu z\u00e1\u0159en\u00ed m\u016f\u017ee b\u00fdt podr\u00e1\u017ed\u011bna a\u017e sp\u00e1lena.Pokud jsme prokau\u010dovali prevenci, \u0159e\u0161\u00edme n\u00e1sledky \u2013 zde je vhodn\u00fd Panthenol spray<\/em> (P) \u2013 chlad\u00ed a podporuje epitelizaci sp\u00e1len\u00e9 k\u016f\u017ee a d\u00e1le Aloe Vera spray<\/em> ( distribuce p\u0159es firmy Forever Living \u010di LR cosmetics) .Aloe vera kudy te\u010de,tudy hoj\u00ed. Jinak p\u0159i b\u011b\u017en\u00e9 sol\u00e1rn\u00ed dermatitid\u011b \u2013 pouze zarudnut\u00ed v\u00a0nevelk\u00e9m rozsahu pom\u016f\u017eou i ml\u00e9ka po opalov\u00e1n\u00ed.Na ko\u017en\u00ed opruzeniny a vlka je vhodn\u00e1 d\u011btsk\u00e1 mast na opruzeniny<\/em>(P), kter\u00e1 je b\u011b\u017en\u011b k\u00a0dost\u00e1n\u00ed v\u00a0ka\u017ed\u00e9m supermarketu-v\u00fdrobce Nivea,Johnson..\u00a0 a d\u00e1le Aviril z\u00e1syp<\/em>(P) \u2013 pou\u017e\u00edv\u00e1me mimo jin\u00e9 i k\u00a0pudrov\u00e1n\u00ed man\u017eet such\u00e9ho obleku.<\/p>\n Na hnisav\u00fd proces se hod\u00ed antibiotick\u00e1 mast nap\u0159.Framykoin,Bactroban<\/em>, \u010di antiseptick\u00e1 mast na b\u00e1zi povidonu j\u00f3du- Betadine<\/em>. Jod pat\u0159\u00ed po\u0159\u00e1d mezi nep\u0159ekonanou dezinfekci, b\u00fdvaj\u00ed na n\u011bj ale alergick\u00e9 reakce. Povidon se mus\u00ed vyzkou\u0161et,alergizuje daleko m\u00e9n\u011b,ne\u017e b\u011b\u017en\u00e1 jodov\u00e1 dezinfekce,jako je Jodonal. Sv\u011bd\u011bn\u00ed k\u016f\u017ee m\u016f\u017ee b\u00fdt zp\u016fsoben\u00e9 bu\u010f alergickou reakc\u00ed lok\u00e1ln\u00ed \u2013 zde se osv\u011bd\u010dil Fenistil gel<\/em>, nebo celkovou alergickou reakc\u00ed. Celkov\u00e1 alergick\u00e1 reakce je nej\u010dast\u011bji na j\u00eddlo, l\u00e9ky – zde mus\u00edme podat celkov\u011b protialergick\u00e9 l\u00e9ky antihistaminika.Tato l\u00e9kov\u00e1 skupina je v\u00a0sou\u010dasn\u00e9 dob\u011b velmi frekventovan\u00e1. Od star\u00e9ho dobr\u00e9ho Dithiadenu<\/em>, kter\u00fd m\u00e1 v\u0161ak v\u00fdrazn\u00e9 sedativn\u00ed \u00fa\u010dinky a tedy usp\u00e1v\u00e1 ,dosp\u011bjeme k\u00a0modern\u00edm prepar\u00e1t\u016fm,kter\u00fdch je cel\u00e1 \u0159ada \u2013 uvedu pouze origin\u00e1ln\u00ed Zyrtec<\/em> \u010di Claritine<\/em>, \u010di nejmodern\u011bj\u0161\u00ed Aerius<\/em> a Xyzal<\/em>. \u00da\u010dinn\u00e9 jsou v\u0161echny, v\u00a0prvn\u00ed pomoci je jedno,kter\u00fd z\u00a0nich budeme m\u00edt.<\/p>\n Alergick\u00e9 reakce se projevuje sv\u011bd\u011bn\u00edm, zarudnut\u00edm \u010di vznikem kop\u0159ivkov\u00fdch pupenc\u016f.<\/p>\n Jin\u00fd d\u016fvod sv\u011bd\u011bn\u00ed k\u016f\u017ee v\u00a0typick\u00fdch lokalizac\u00edch, jak\u00fdmi jsou t\u0159\u00edsla \u010di mezi prsty nohou jsou ko\u017en\u00ed myk\u00f3zy \u2013 pl\u00eds\u0148ov\u00e1 onemocn\u011bn\u00ed. Vhodn\u00e9 je vz\u00edt s\u00a0sebou n\u011bjak\u00e9 antimykotikum \u2013 Lamisil,Batrafen,Canesten<\/em>\u2026Mazat minim\u00e1ln\u011b 2 x denn\u011b. V\u011bt\u0161inou to jsou kr\u00e9my, tak\u017ee se p\u0159\u00edjemn\u011b aplikuj\u00ed.<\/p>\n <\/p>\n Opar v\u00a0klasick\u00e9 lokalizaci okolo rtu dok\u00e1\u017ee neuv\u011b\u0159iteln\u011b prudit. Slan\u00e1 voda do rozpraskan\u00e9ho rtu je opravdu lah\u016fdka.<\/p>\n Klasick\u00e1 lok\u00e1ln\u00ed antivirotika(acyklovir Zovirax<\/em> a spousta jin\u00fdch\u2026) je t\u0159eba nasadit ihned p\u0159i prvn\u00edch p\u0159\u00edznac\u00edch sv\u011bd\u011bn\u00ed, v\u00a0p\u0159\u00edpad\u011b v\u00fdsevu puch\u00fd\u0159k\u016f ji\u017e nefunguj\u00ed.Celkov\u00e9 pod\u00e1n\u00ed acykloviru (Herpesin<\/em> tbl) v\u00a0p\u0159\u00edpad\u011b p\u00e1sov\u00e9ho oparu pat\u0159\u00ed ji\u017e do rukou l\u00e9ka\u0159e. Z\u016fstaneme u l\u00e9\u010dby oparu rtu a okol\u00ed \u2013 pokud jsou puch\u00fd\u0159ky, tak m\u016f\u017eeme zkusit Tea Tree olej. a mokvaj\u00edc\u00ed puch\u00fd\u0159ky kr\u00fdt zubn\u00ed pastou. Zkuste taky k\u00a0hojen\u00ed oparu Aloe Vera gel.<\/p>\n B\u011b\u017en\u00e9 po\u0161t\u00edp\u00e1n\u00ed hmyzem m\u016f\u017eeme zkusit \u0159e\u0161it obkladem z\u00a0roz\u0159\u00edznut\u00e9 cibule, d\u00e1le Fenistil gel.<\/p>\n Generalizovan\u00e9 sv\u011bd\u011bn\u00ed \u0159e\u0161\u00edme antihistaminiky celkov\u011b \u2013 v\u00a0tablet\u00e1ch ,mo\u017eno zkusit i homeopatikum Ledum pallustre 5CH<\/em> 3 gran opakovan\u011b.Pokud nastanou hnisav\u00e9 komplikace \u2013 \u0159e\u0161\u00edme lok\u00e1ln\u011b antibiotickou mast\u00ed, u bolesti a hore\u010dky pod\u00e1v\u00e1me analgetika\/antipyretika, kter\u00e9 budou pops\u00e1ny d\u00e1le.<\/p>\n O\u010di <\/strong>\u2013 kdy\u017e nevid\u00edme, nic moc z\u00a0dovolen\u00e9 nem\u00e1me. Ostr\u00fd slune\u010dn\u00ed svit, prach p\u0159i cestov\u00e1n\u00ed v\u00a0pou\u0161ti, r\u016fzn\u00e1 mechanick\u00e1 t\u011bl\u00edska mohou podr\u00e1\u017edit spojivky a rohovku, zvl\u00e1\u0161t\u011b u nechr\u00e1n\u011bn\u00e9ho oka. Tak\u017ee op\u011bt prevence jak\u00fdmkoliv druhem br\u00fdl\u00ed, nemus\u00ed to b\u00fdt zrovna Oakley. Na podr\u00e1\u017ed\u011bn\u00e9 o\u010di se n\u00e1m osv\u011bd\u010dil Evercil kapky<\/em> (P) , \u010di Spersallerg kapky<\/em> ( zde je ale preskrip\u010dn\u00ed omezen\u00ed- pouze l\u00e9ka\u0159 specialista). Na noc p\u0159ilo\u017eit na v\u00ed\u010dka obklad ze siln\u00e9ho \u010dern\u00e9ho \u010daje. P\u0159i vniknut\u00ed ciz\u00edch t\u011bles pod v\u00ed\u010dka m\u016f\u017eeme zkusit oko propl\u00e1chnout \u010distou vodou, tahat fla\u0161ku o\u010dn\u00ed vody Opthal<\/em> je vzhledem k\u00a0objemu a hmotnosti problematick\u00e9. Ciz\u00ed t\u011blesa pod spodn\u00edm v\u00ed\u010dkem se daj\u00ed odstranit opatrn\u00fdm ot\u0159en\u00edm \u010dist\u00fdm kapesn\u00ed\u010dkem,obvazem. Horn\u00ed v\u00ed\u010dko se d\u00e1 obr\u00e1tit \u2013 takzvan\u00e1 everze a ot\u0159\u00edt stejn\u011b. Tento grif se ale mus\u00ed um\u011bt,ale jsou jedinci,kte\u0159\u00ed jej zvl\u00e1dnou sami. Zap\u00edchnut\u00e9 ciz\u00ed t\u011bleso do rohovky-tak\u017ee do vlastn\u00edho oka, je probl\u00e9m,pokud nejde odstranit lehk\u00fdm ot\u011brem, jeho vyta\u017een\u00ed pat\u0159\u00ed do rukou l\u00e9ka\u0159e specialisty.<\/p>\n V\u00a0p\u0159\u00edpad\u011b hnisav\u00fdch komplikac\u00ed se hod\u00ed Opthalmo Septonex kapky<\/em>(P) a na noc o\u010dn\u00ed mast \u2013t\u0159eba Opthalmo Framykoin , \u010di l\u00e9pe Opthalmo Framykoin comp<\/em>.<\/p>\n Antibiotick\u00e9 kapky Garasone <\/em>se daj\u00ed pou\u017e\u00edt jak do oka, tak do ucha \u2013 tak\u017ee je to dal\u0161\u00ed vhodn\u00e9 \u0159e\u0161en\u00ed.<\/p>\n U\u0161i<\/strong> \u2013 nejtypi\u010dt\u011bj\u0161\u00ed problematick\u00e9 m\u00edsto p\u0159i b\u011b\u017en\u00fdch pot\u00e1p\u011b\u010dsk\u00fdch v\u00fdletech. Pobyt ve slan\u00e9 vod\u011b nese s\u00a0sebou radost z\u016fstatku slan\u00e9 vody v\u00a0zevn\u00edm zvukovodu, kde m\u016f\u017ee b\u00fdt p\u0159\u00edtomnost hr\u00e1zek z\u00a0u\u0161n\u00edho mazu-cerumenu,zamezuj\u00edc\u00edch vysu\u0161en\u00ed zvukovodu p\u0159irozenou cestou. Slan\u00e1 voda zp\u016fsobuje mokv\u00e1n\u00ed, nas\u00e1v\u00e1 vzdu\u0161nou vlhkost a tedy dobr\u00e9 podm\u00ednky pro vznik z\u00e1n\u011btu zevn\u00edho zvukovodu. Na tomto m\u00edst\u011b m\u011b budou ORL specialisti pran\u00fd\u0159ovat,nebo\u0165 tvrd\u00ed, \u017ee nejmen\u0161\u00ed n\u00e1stroj laika pro \u0161\u0165\u00e1r\u00e1n\u00ed se v\u00a0uchu je loket. M\u00e9 doporu\u010den\u00ed je ryze praktick\u00e9 \u2013 mus\u00edme zvukovod nejd\u0159\u00edve vysu\u0161it a eventu\u00e1ln\u011b odstranit mechanick\u00e9 p\u0159ek\u00e1\u017eky,pokud to jde.<\/p>\n Ide\u00e1ln\u00ed je sirka, na kterou namot\u00e1me dobr\u00fd z\u00e1chodov\u00fd pap\u00edr tak,aby byl del\u0161\u00ed cca o 1cm. Tak bude konec m\u011bkk\u00fd a my si neporan\u00edme bub\u00ednek p\u0159i doteku, z\u00e1rove\u0148 pap\u00edr celou dobu dr\u017e\u00edme v\u00a0prstech. N\u00e1\u0161 \u010dist\u00edc\u00ed p\u0159\u00edpravek pokapeme 3% boralkoholem \u010di jin\u00fdm kvalitn\u00edm alkoholem s\u00a0vysok\u00fdmi volty \u2013 nejide\u00e1ln\u011bj\u0161\u00ed a nejuniverz\u00e1ln\u011bj\u0161\u00ed je slivovice. U\u0161n\u00ed boltec pot\u00e1hneme dozadu a nahoru- t\u00edm se n\u00e1m nap\u0159\u00edm\u00ed zevn\u00ed zvukovod. A vyt\u0159eme , teprve pak lze aplikovat lok\u00e1ln\u011b antibiotika \u2013 Garasone kapky.<\/p>\n P\u0159i tlakov\u00e9m namo\u017een\u00ed bub\u00ednku (barotraumatu,v\u011bt\u0161inou z\u00a0p\u0159etlaku okol\u00ed),kter\u00fd byl neadekv\u00e1tn\u011b exponov\u00e1n , nap\u0159. p\u0159i \u0161patn\u00e9m vyrovn\u00e1n\u00ed tlaku, je dobr\u00e9 si d\u00e1t n\u011bjak\u00fd den oraz od pot\u00e1p\u011bn\u00ed. Na bolestiv\u00fd bub\u00ednek m\u016f\u017eeme zkusit aplikovat analgetick\u00e9 a anestetick\u00e9 u\u0161n\u00ed kapky Otipax.<\/em>Pokud dojde k\u00a0perforaci bub\u00ednku,kterou pozn\u00e1te tak, \u017ee p\u0159i Valsalvov\u011b man\u00e9vru lze pozorovat \u00fanik bublinek z\u00a0ucha, tak m\u00e1me s\u00a0pot\u00e1p\u011bn\u00edm utrum.L\u00e9ka\u0159 znal\u00fd problematiky diagnostikuje perforaci bub\u00ednku otoskopem,ale ten nem\u00e1te. Pot\u00e1p\u011bt se s\u00a0perforovan\u00fdm bub\u00ednkem ve studen\u00e9 vod\u011b nelze prov\u00e1d\u011bt z\u00a0d\u016fvodu z\u00e1vrat\u011b p\u0159i ochlazen\u00ed vnit\u0159n\u00edho ucha, v\u00a0tepl\u00e9 vod\u011b toto nehroz\u00ed,ale v\u017edy riskujeme vznik infekce, tak\u017ee je pot\u0159eba se nechat vy\u0161et\u0159it specialistou ORL a kone\u010dn\u00fd verdikt nechat na n\u011bm.<\/p>\n Nos\u00a0 <\/strong>R\u00fdma je nep\u0159\u00edtel pot\u00e1p\u011b\u010de \u010d\u00edslo 1.Sliznice v\u00a0nosohltanu ote\u010de ,v\u010detn\u011b Eustachovy trubice a my nem\u016f\u017eeme vyrovnat tlak. Jedin\u00fd pomocn\u00edk, kter\u00fd je povolen p\u0159ed ponorem, je \u017ev\u00fdka\u010dka. \u017dv\u00fdk\u00e1n\u00ed uvol\u0148uje Eustachovu trubici p\u0159irozen\u011b. V\u00a0\u017e\u00e1dn\u00e9m p\u0159\u00edpad\u011b nesm\u00edme pou\u017e\u00edt nosn\u00ed kapky t\u011bsn\u011b p\u0159ed ponorem.Jejich \u00fa\u010dinek m\u016f\u017ee odezn\u00edt kdykoliv b\u011bhem ponoru a my jsme ohro\u017eeni barotraumatem st\u0159edn\u00edho ucha z\u00a0p\u0159etlaku ve st\u0159edou\u0161\u00ed, kdy krom\u011b protr\u017een\u00ed bub\u00ednku m\u016f\u017ee doj\u00edt i k\u00a0luxaci p\u0159evodn\u00edch k\u016fstek a vzniku te\u017ek\u00e9 sluchov\u00e9 vady.<\/p>\n V\u00a0mezidob\u00ed mezi ponory lze prov\u00e1d\u011bt pr\u016fplachy nosu vodou, d\u00e1le pou\u017e\u00edt b\u011b\u017en\u00e9 dekongescen\u010dn\u00ed \u00a0nosn\u00ed kapky\u00a0 – Olynth (P),Nasivin(P).<\/em><\/p>\n Akutn\u00ed r\u00fdma je zp\u016fsobena bu\u010f virovou infekc\u00ed, nebo alergickou reakc\u00ed. Chronick\u00e1 r\u00fdma je pov\u011bt\u0161inou na podklad\u011b alergick\u00e9 reakce. Zde m\u016f\u017eeme podat celkov\u011b antihistaminika-viz k\u016f\u017ee a alergick\u00e1 reakce.<\/p>\n U lid\u00ed s\u00a0chronickou r\u00fdmou jsou d\u00e1le obl\u00edben\u00e9 kapky na b\u00e1zi kortikosteroid\u016f, zvl\u00e1\u0161t\u011b u chronick\u00fdch z\u00e1n\u011bt\u016f dutin. Zde jsou obl\u00edben\u00e9 kapky Avamys , Nasobec<\/em> atd.<\/p>\n L\u00e9pe je se s\u00a0chronickou r\u00fdmou nepot\u00e1p\u011bt,ale provediteln\u00e9 to je. Zvl\u00e1\u0161t\u011b ov\u011b\u0159eno u pot\u00e1p\u011b\u010d\u016f na n\u00e1dech – freediver\u016f,kte\u0159\u00ed prov\u00e1d\u011bj\u00ed opakovan\u011b sestupy s\u00a0rychl\u00fdmi zm\u011bnami tlaku.<\/p>\n <\/p>\n Krk<\/strong> \u2013 spolu s\u00a0nosem prvn\u00ed m\u00edsto,kde se infekt d\u00fdchac\u00edch cest projev\u00ed. Bolest v\u00a0krku, \u0161kr\u00e1b\u00e1n\u00ed, p\u00e1len\u00ed atd. \u010dasto spole\u010dn\u011b s\u00a0r\u00fdmou.Celkov\u011b se m\u016f\u017ee brzy p\u0159idru\u017eit vysok\u00e1 teplota.<\/p>\n Lok\u00e1ln\u00edch p\u0159\u00edpravk\u016f na bolest v\u00a0krku je cel\u00e1 \u0159ada \u2013\u00a0 od cumlav\u00fdch tablet, p\u016fsob\u00edc\u00edch hlavn\u011b od bolesti obsahem lok\u00e1ln\u00edho anestetika ( Strepsils (P) a spol.) a\u017e po lok\u00e1ln\u011b p\u016fsob\u00edc\u00ed slizni\u010dn\u00ed dezinfekci \u2013 nap\u0159. Jox spray<\/em>(P). Toto v\u0161e bych \u0159e\u0161il rad\u011bji klokt\u00e1n\u00edm slivovic\u00ed. Z\u00a0lok\u00e1ln\u00edch p\u0159\u00edpravk\u016f na onemocn\u011bn\u00ed horn\u00edch cest d\u00fdchac\u00edch lze doporu\u010dit lok\u00e1ln\u00ed antibiotikum Bioparox <\/em>spray (P) s\u00a0aplik\u00e1torem do nosu a \u00fast.<\/p>\n Univerz\u00e1ln\u00ed p\u0159\u00edpravek je z\u00e1zvor \u2013 pokud se\u017eenete ko\u0159en, d\u00e1 se vyluhovat v\u00a0\u010daji, \u010di koupit Ginger Beer a pop\u00edjet. P\u016fsob\u00ed krom\u011b infektu d\u00fdchac\u00edch cest tak\u00e9 preventivn\u011b u mo\u0159sk\u00e9 nemoci.<\/p>\n Pokud nic nezabere, l\u00e9ka\u0159sk\u00e1 p\u00e9\u010de nen\u00ed dostupn\u00e1, teplota nar\u016fst\u00e1 – nezb\u00fdv\u00e1 ne\u017e naslepo nasadit \u0161irokospektr\u00e1 antibiotika. Penicil\u00edny jsou skv\u011bl\u00e9, ale mnoho lid\u00ed je na n\u011b alergick\u00e1. Obdobn\u00e9 bakteri\u00e1ln\u00ed spektrum maj\u00ed makrolidy \u2013 doporu\u010dil bych clarithromycinum \u2013Klacid<\/em> 500mg u dosp\u011bl\u00e9ho co 12 hodin \u010di bun\u011b\u010dn\u00e9 antibiotikum azithromycinum \u2013Sumamed<\/em> 3x 500mg \u2013 t\u0159i r\u00e1na po sob\u011b 1tbl, antibiotikum se pak uvol\u0148uje z\u00a0bun\u011bk dal\u0161\u00ed t\u00fdden.<\/p>\n <\/p>\n U vysok\u00fdch teplot nad 37,5 a p\u0159i hore\u010dnat\u00fdch bolestech kloub\u016f a sval\u016f p\u0159id\u00e1me antipyretika\/analgetika. B\u011b\u017en\u011b paracetamol 500mg \u2013Paralen<\/em> (P) 3 x denn\u011b \u00a0\u010di ibuprofen<\/em> 400mg \u2013 Ibalgin<\/em> (P) lidov\u011b zvan\u00fd r\u016f\u017eov\u00fd kouzeln\u00edk \u010di dle sv\u011btov\u00e9ho jesky\u0148\u00e1\u0159e Billa Stonea- vitam\u00edn I.<\/p>\n Na salicyl\u00e1ty je spousta lid\u00ed alergick\u00e1 ( Acylpyrin,Aspirin<\/em>..) B\u011b\u017en\u011b je v\u0161ak u\u017e\u00edv\u00e1me jako prevenci \u00a0– p\u0159ed n\u00e1ro\u010dn\u00fdmi dekompresn\u00edmi ponory, p\u0159ed cestov\u00e1n\u00edm. Je t\u0159eba vyzkou\u0161et \u010di zeptat se na alergii p\u0159ed vlastn\u00edm pod\u00e1n\u00edm.Preventivn\u011b p\u0159ed n\u00e1ro\u010dn\u00fdmi dekompresn\u00edmi ponory pod\u00e1v\u00e1me 100mg, l\u00e9\u010debn\u011b p\u0159i vysok\u00e9 teplot\u011b 400 mg Anopyrinu<\/em>,(P) co\u017e je pufrovan\u00e1 forma kyseliny acetylosalicylov\u00e9, nedr\u00e1\u017ed\u00edc\u00ed tolik \u017ealudek.<\/p>\n Tato neju\u017e\u00edvan\u011bj\u0161\u00ed l\u00e9kov\u00e1 skupina \u2013 nesteroidn\u00ed antipyretika\/analgetika\/antirevmatika\/antiflogistika zahrnuje l\u00e9ky, kter\u00e9 pou\u017e\u00edv\u00e1me p\u0159i l\u00e9\u010db\u011b bolesti, vysok\u00e9 teploty a z\u00e1n\u011btu \u2013 tak\u017ee od bolesti hlavy,zad a\u017e po bolest nejmen\u0161\u00edho kloubu.<\/p>\n <\/p>\n B\u0159icho:<\/strong> Asi nefrekventovan\u011bj\u0161\u00ed oblast na\u0161ich pot\u00ed\u017e\u00ed. Cizorod\u00e1 strava a kontaminovan\u00e1 voda vykonaj\u00ed sv\u00e9. Cizorod\u00e1 strava m\u016f\u017ee v\u00e9st k\u00a0b\u011b\u017en\u00e9 \u017ealude\u010dn\u00ed dyspepsii s\u00a0pyr\u00f3zou-p\u00e1len\u00edm \u017e\u00e1hy. Zde se osv\u011bd\u010dily b\u011b\u017en\u00e1 antacida \u2013Anacid(P),Maalox(P<\/em>)\u2026aj.,v nouzi ml\u00e9\u010dn\u00e9 v\u00fdrobky. Jinak plat\u00ed d\u016frazn\u00e1 prevence \u2013 pit\u00ed z\u00a0ov\u011b\u0159en\u00e9ho zdroje a r\u00e1no preventivn\u011b pan\u00e1k slivovice,to je jen z\u00e1klad, \u010dasto v\u0161ak nesta\u010d\u00ed. Pokud se budeme pohybovat na \u00farovni k\u0159e\u010d\u00ed v\u00a0b\u0159i\u0161e \u2013 m\u016f\u017eeme zkusit b\u011b\u017en\u00e1 spasmolytika \u2013 NoSpa , Algifen ,Buscopan<\/em>\u2026\u010casto se z\u00e1hy p\u0159idru\u017e\u00ed pr\u016fjem. B\u011bhem pr\u016fjmu hroz\u00ed hlavn\u011b v\u00a0tepl\u00fdch oblastech dehydratace a miner\u00e1ln\u00ed dysbalance- proto jako prvn\u00ed pomoc je rehydratace- ho\u0159k\u00fd \u010dern\u00fd \u010daj,voda a n\u00e1hrada miner\u00e1l\u016f- drasl\u00edku,ho\u0159\u010d\u00edku atd. Jsme sv\u011btovou velmoc\u00ed stran \u0161pi\u010dkov\u00fdch miner\u00e1ln\u00edch vod, ale na n\u011b v\u00a0cizin\u011b m\u016f\u017eeme zapomenout. Zde se nab\u00edz\u00ed zkusit nam\u00edchat iontov\u00fd n\u00e1poj od sportovn\u00edch firem \u2013IsoStar,IsoSprint\u2026\u00a0 \u010di d\u011btsk\u00fd p\u0159\u00edpravek Kul\u00ed\u0161ek forte<\/em>.<\/p>\n Pr\u016fjem<\/u> zkus\u00edme p\u0159el\u00e9\u010dit fyzik\u00e1ln\u00edm adsorb\u00e9rem- co\u017e je zn\u00e1m\u00e9 \u017eivo\u010di\u0161n\u00e9 uhl\u00ed \u2013Carbo<\/em> medicinalis <\/em>3x2tbl, kter\u00fd na sebe nav\u00e1\u017ee spoustu ne\u017e\u00e1douc\u00edch l\u00e1tek a p\u0159irozen\u011b je dost\u00e1v\u00e1 ven.Dal\u0161\u00ed vhodn\u00fd l\u00e9k je protiz\u00e1n\u011btliv\u00fd st\u0159evn\u00ed p\u0159\u00edpravek na b\u00e1zi purifikovan\u00e9ho j\u00edlu- Smecta<\/em>.<\/p>\n 3 x1 s\u00e1\u010dek. Posledn\u00ed je vhodn\u00e9 st\u0159evn\u00ed dezinficiens- nap\u0159.nifuroxazid -l\u00e9k s\u00a0mikrobi\u00e1ln\u00edm \u00fa\u010dinkem p\u016fsob\u00edc\u00edm pouze ve st\u0159ev\u011b jako je Ercefuryl <\/em>3x1tob. Jeho generick\u00e9 kopie jsou v\u00a0Egypt\u011b Antinal \u010di Drotazide \u2013 zde v\u0161ak kvalita l\u00e9k\u016f \u010dasto kol\u00eds\u00e1, l\u00e9pe jet vybaven od n\u00e1s. Jin\u00fdm vhodn\u00fdm l\u00e9kem je Normix. Endiaron v\u00a0dne\u0161n\u00ed dob\u011b ji\u017e moc nezab\u00edr\u00e1. D\u016frazn\u011b nedoporu\u010duji u\u017e\u00edvat l\u00e9ky tlum\u00edc\u00ed st\u0159evn\u00ed motilitu jako je Reasec \u010di Imodium. Ty jsou ur\u010deny pro pr\u016fjmy jin\u00e9 etiologie, ne\u017e je infekce a v\u00a0tomto p\u0159\u00edpad\u011b p\u016fsob\u00ed kontraproduktivn\u011b.<\/p>\n Postupn\u011b po zklidn\u011bn\u00ed pokra\u010dujeme v\u00a0realimentaci \u2013 dietn\u00ed nedr\u00e1\u017ediv\u00e1 strava,dle podm\u00ednek na m\u00edst\u011b \u2013 ban\u00e1n, r\u00fd\u017ee\u2026<\/p>\n Zvracen\u00ed<\/u> m\u016f\u017ee m\u00edt na cest\u00e1ch v\u00a0z\u00e1sad\u011b dv\u011b hlavn\u00ed p\u0159\u00ed\u010diny \u2013 nesn\u00e1\u0161enlivost po\u017eit\u00e9 stravy s\u00a0mo\u017enou kontaminac\u00ed \u010di mo\u0159sk\u00e1 nemoc.V prvn\u00edm p\u0159\u00edpad\u011b je vhodn\u00e9 zkusit vyzvracet,co se d\u00e1 ,pak \u017eivo\u010di\u0161n\u00e9 uhl\u00ed,ho\u0159k\u00fd \u010daj..<\/p>\n U mo\u0159sk\u00e9 nemoci,kter\u00e1 pat\u0159\u00ed mezi kinet\u00f3zy mus\u00ed b\u00fdt l\u00e9\u010dba komplexn\u00ed.<\/p>\n Prvn\u00ed pomoc\u00ed je \u010derstv\u00fd vzduch.Pokud situace a zdravotn\u00ed stav dovol\u00ed, um\u00edst\u00edme posti\u017een\u00e9ho co nejbl\u00ed\u017ee t\u011b\u017ei\u0161t\u011b lodi, kde jsou nejmen\u0161\u00ed v\u00fdkyvy a sna\u017e\u00edme se, aby m\u011bl v\u00fdhled na horizont. Pohled do d\u00e1lky na horizont velmi pom\u00e1h\u00e1.<\/p>\n Prevence mo\u0159sk\u00e9 nemoci je dostate\u010dn\u011b dlouh\u00fd sp\u00e1nek, dobr\u00e1 \u017eivotospr\u00e1va,vhodn\u00fd v\u00fdb\u011br m\u00edsta na lodi a preventivn\u00ed pod\u00e1n\u00ed l\u00e9k\u016f.<\/p>\n L\u00e9ky, kter\u00e9 se daj\u00ed pou\u017e\u00edt na prevenci a l\u00e9\u010dbu kinet\u00f3z, jsou v\u00a0z\u00e1klad\u011b dvoj\u00ed:<\/p>\n Homeopatika \u2013polykomponentn\u00ed Cocculine(P),VertigoHeel(P)<\/em> tbl opakovan\u011b co 1\/2hod a\u017e hod.<\/p>\n V\u00fdhodou je,\u017ee nep\u016fsob\u00ed na CNS( centr\u00e1ln\u00ed nervov\u00fd syst\u00e9m) tlumiv\u011b, tak\u017ee nesni\u017euj\u00ed psychickou v\u00fdkonost<\/p>\n Alopatika \u00a0-b\u011b\u017en\u00e9 l\u00e9ky, tlum\u00ed CNS, co\u017e je pro pot\u00e1p\u011bn\u00ed v\u0161ak naprosto nevhodn\u00e9 –<\/p>\n Neuroleptika \u2013 Kinedryl\/Nokinal(P),Torecan<\/em> aj. , jejich sedativn\u00ed \u00fa\u010dinek je opravdu odzkou\u0161en a funguj\u00ed,doch\u00e1z\u00ed v\u0161ak k\u00a0\u00fatlumu CNS,tak\u017ee event.n\u00e1sledn\u00e9 pot\u00e1p\u011bn\u00ed nelze v\u00a0\u017e\u00e1dn\u00e9m p\u0159\u00edpad\u011b doporu\u010dit .<\/p>\n <\/p>\n Z\u00a0dal\u0161\u00edch alopatick\u00fdch l\u00e9k\u016f –\u00a0 Aplikace lok\u00e1ln\u00edch anestetik okolo u\u0161n\u00edho boltce lze vn\u00edmat sp\u00ed\u0161e jako placebo efekt,nebo\u0165 se nevst\u0159eb\u00e1vaj\u00ed k\u016f\u017e\u00ed<\/p>\n – Centr\u00e1ln\u00ed vasoaktivn\u00ed l\u00e1tky ( nap\u0159.Cinnarizin)\u00a0 – zde je efekt sporn\u00fd<\/p>\n Alkohol m\u00e1 zpo\u010d\u00e1tku excita\u010dn\u00ed \u00fa\u010dinek na CNS,kter\u00fd je z\u00e1hy vyst\u0159\u00edd\u00e1n siln\u011b tlumiv\u00fdm efektem ,tedy nen\u00ed nejvhodn\u011bj\u0161\u00ed.<\/p>\n <\/p>\n Bolesti kloub\u016f,sval\u016f po namo\u017een\u00ed, zhmo\u017ed\u011bn\u00ed, v\u010detn\u011b mod\u0159in v\u00a0podko\u017e\u00ed m\u016f\u017eeme zkusit \u0159e\u0161it lok\u00e1ln\u00ed aplikac\u00ed nap\u0159. kombinovan\u00e9 masti Ibu Hepa<\/em>,obsahuj\u00edc\u00ed protiz\u00e1n\u011btliv\u00fd ibuprofen a heparin k\u00a0urychlen\u00ed vst\u0159eb\u00e1n\u00ed podko\u017en\u00edho hematomu. Obl\u00edben\u00fd ketoprofen \u2013 Fastum gel,Profenid.. nelze doporu\u010dit vzhledem k\u00a0fotosenzitivn\u011b. Po aplikaci na k\u016f\u017ei vznikne p\u016fsoben\u00edm slunce dermatitida \u2013 ko\u017en\u00ed reakce.<\/p>\n <\/p>\n <\/p>\n <\/p>\n Souhrn l\u00e9k\u016f \u2013 pouze jedna z\u00a0mnoha mo\u017en\u00fdch variant:<\/p>\n Analgetika\/antipyretika: Ibalgin,Paralen<\/p>\n Antialergika: Zyrtec, Fenistil gel<\/p>\n Antibiotika: Summamed<\/p>\n B\u0159i\u0161n\u00ed pot\u00ed\u017ee: \u017divo\u010di\u0161n\u00e9 uhl\u00ed,Smecta,Ercefuryl,NoSpa,Anacid<\/p>\n Onemocn\u011bn\u00ed o\u010d\u00ed: kapky Evercil,Garasone,Opthalmo Framykoin comp. mast<\/p>\n Onemocn\u011bn\u00ed u\u0161\u00ed a nosu: kapky Otipax,Garasone,Olynth<\/p>\n Lok\u00e1ln\u011b p\u016fsob\u00edc\u00ed l\u00e9ky: Betadine,Lamisil,Ibu Hepa,AloeVera gel,Panthenol spray,Tea Tree olej,Septonex spray,Bioparox spray,Mast na opruzeniny<\/p>\n Kinet\u00f3zy: Cocculine,Torecan<\/p>\n Detralex, Anopyrin pro zp\u00e1te\u010dn\u00ed let<\/p>\n <\/p>\n Z\u00e1v\u011brem p\u0159eji a\u0165 pouze obm\u011b\u0148ujete pro\u0161l\u00e9 l\u00e9ky p\u0159i dal\u0161\u00edch cest\u00e1ch a b\u011bhem pobytu nemus\u00edte ze sebe d\u011blat dr.House, i kdy\u017e expedi\u010dn\u00ed l\u00e9ka\u0159 je v\u00e1\u017een\u00e1 osoba se spoustou benefit\u016f.<\/p>\n <\/p>\n [av_gallery ids=’4615,4616,4617,4618,4619,4620′ style=’thumbnails‘ preview_size=’portfolio‘ crop_big_preview_thumbnail=’avia-gallery-big-crop-thumb‘ thumb_size=’square‘ columns=’4′ imagelink=’lightbox‘ lazyload=’avia_lazyload‘]<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" MUDr. David Skoumal \u2013\u00a0 ASTD Training Director Doporu\u010den\u00e1 lodn\u00ed a expedi\u010dn\u00ed pot\u00e1p\u011b\u010dsk\u00e1 l\u00e9k\u00e1rna Vzhledem k\u00a0tomu, \u017ee se m\u016f\u017eeme pohybovat v\u00a0oblastech, kde se mus\u00edme spolehnout jen sami na sebe a zdravotnick\u00e1 p\u00e9\u010de nen\u00ed dostupn\u00e1, je jen na n\u00e1s, jak se k\u00a0tomuto probl\u00e9mu postav\u00edme. Kdo je p\u0159ipraven, nen\u00ed p\u0159ekvapen. A v\u011bt\u0161inou plat\u00ed, \u017ee se n\u011bco stane […]<\/p>\n","protected":false},"author":1,"featured_media":4426,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[22],"tags":[],"class_list":["post-4425","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-prakticke"],"_links":{"self":[{"href":"http:\/\/astd.eu\/pl\/wp-json\/wp\/v2\/posts\/4425","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/astd.eu\/pl\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/astd.eu\/pl\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/astd.eu\/pl\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/astd.eu\/pl\/wp-json\/wp\/v2\/comments?post=4425"}],"version-history":[{"count":0,"href":"http:\/\/astd.eu\/pl\/wp-json\/wp\/v2\/posts\/4425\/revisions"}],"wp:attachment":[{"href":"http:\/\/astd.eu\/pl\/wp-json\/wp\/v2\/media?parent=4425"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/astd.eu\/pl\/wp-json\/wp\/v2\/categories?post=4425"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/astd.eu\/pl\/wp-json\/wp\/v2\/tags?post=4425"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}