{"id":11385603,"date":"2014-03-12T00:00:00","date_gmt":"2014-03-11T23:00:00","guid":{"rendered":"https:\/\/alertdiver.eu\/uncategorized-cs_cz\/medici-dan-odpovidaji-na-vase-otazky\/"},"modified":"2014-03-12T00:00:00","modified_gmt":"2014-03-11T23:00:00","slug":"medici-dan-odpovidaji-na-vase-otazky","status":"publish","type":"post","link":"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/medici-dan-odpovidaji-na-vase-otazky\/","title":{"rendered":"Medici DAN odpov\u00eddaj\u00ed na va\u0161e ot\u00e1zky"},"content":{"rendered":"

Ot\u00e1zka: Na pot\u00e1p\u011b\u010dsk\u00e9 dovolen\u00e9 si na z\u00e1v\u011br dne obvykle d\u00e1me n\u011bkolik piv nebo m\u00edchan\u00fdch drink\u016f. A n\u011bkte\u0159\u00ed z na\u0161\u00ed skupiny si ob\u010das vypij\u00ed pivo i mezi jednotliv\u00fdmi ponory – nen\u00ed to nebezpe\u010dn\u00e9?<\/strong><\/p>\n

Odpov\u011b\u010f<\/strong>: \u0158e\u010deno jednodu\u0161e, alkohol se s pot\u00e1p\u011bn\u00edm neslu\u010duje. Alkohol utlum\u00ed funkci centr\u00e1ln\u00edho nervov\u00e9ho syst\u00e9mu, co\u017e m\u00e1 za n\u00e1sledek hor\u0161\u00ed \u00fasudek, prodlou\u017eenou reak\u010dn\u00ed dobu a oslabenou schopnost koordinace. Nav\u00edc si \u010dlov\u011bk zpravidla neuv\u011bdomuje stupe\u0148 sv\u00e9ho “ovlivn\u011bn\u00ed”.
Vyhodnocen\u00edm v\u00edce ne\u017e 15 v\u00fdzkumn\u00fdch studi\u00ed zab\u00fdvaj\u00edc\u00edch se \u00fa\u010dinky alkoholu na lidskou v\u00fdkonnost se zjistilo, \u017ee alkohol byl p\u0159\u00edtomen p\u0159ibli\u017en\u011b u 50 procent nehod dosp\u011bl\u00fdch pot\u00e1p\u011b\u010d\u016f. V \u010dl\u00e1nku Pot\u00e1p\u011bn\u00ed a subakvatick\u00e1 medic\u00edna (Edmonds C, et al., 2002) auto\u0159i uv\u00e1d\u011bj\u00ed, \u017ee alkohol souvis\u00ed a\u017e s 80 procenty utopen\u00ed dosp\u011bl\u00fdch mu\u017e\u016f.
 <\/p>\n

Ne\u017e t\u011blo alkohol zpracuje a jeho \u00fa\u010dinky spolehliv\u011b odezn\u00ed, k tomu je pot\u0159eba ur\u010dit\u00fd \u010das. M. W. Perrine sledoval spolu se sv\u00fdmi kolegy skupinu zku\u0161en\u00fdch pot\u00e1p\u011b\u010d\u016f a dopad po\u017eit\u00ed alkoholu na jejich v\u00fdkonnost. Zjistilo se, \u017ee schopnost spr\u00e1vn\u011b pou\u017e\u00edvat a uplat\u0148ovat sv\u00e9 dovednosti p\u0159i p\u0159\u00edstrojov\u00e9m pot\u00e1p\u011bn\u00ed byla zna\u010dn\u011b oslabena ji\u017e p\u0159i koncentraci alkoholu v krvi ve v\u00fd\u0161i 0,4 promile, \u010deho\u017e se dos\u00e1hne u \u010dlov\u011bka v\u00e1\u017e\u00edc\u00edho 90 kg vypit\u00edm dvou mal\u00fdch desetistup\u0148ov\u00fdch piv (0,33 l) na la\u010dno b\u011bhem jedn\u00e9 hodiny. P\u0159i tomto v\u00fdzkumu se tak\u00e9 prok\u00e1zalo, \u017ee dokonce i ni\u017e\u0161\u00ed koncentrace alkoholu m\u016f\u017ee ovlivnit schopnost orientace a oslabit pud sebez\u00e1chovy a obrann\u00e9 reflexy.<\/p>\n

Po\u017eit\u00ed alkoholu kr\u00e1tce p\u0159ed pot\u00e1p\u011bn\u00edm (jako\u017e i mo\u0159sk\u00e1 nemoc, “cestovatelsk\u00fd” pr\u016fjem, nadm\u011brn\u00e9 pocen\u00ed, mo\u010dopudn\u00e9 a cestov\u00e1n\u00ed letadlem) je potenci\u00e1ln\u00ed p\u0159\u00ed\u010dinou dehydratace pot\u00e1p\u011b\u010d\u016f. A dehydratace, hlavn\u011b siln\u00e1, znamen\u00e1 mo\u017en\u00e9 riziko dekompresn\u00edho onemocn\u011bn\u00ed (DCS). Pot\u00e1p\u011bn\u00ed m\u016f\u017ee tak\u00e9 v\u00e9st k dal\u0161\u00edm ztr\u00e1t\u00e1m tekutin vdechov\u00e1n\u00edm such\u00e9ho vzduchu a vylu\u010dov\u00e1n\u00edm mo\u010di zp\u016fsoben\u00fdm pono\u0159en\u00edm se do chladu. N\u011bkter\u00e9 p\u0159\u00edznaky dehydratace, nap\u0159. \u00fanava nebo ospalost, mohou dokonce p\u0159ipom\u00ednat DSC, co\u017e m\u016f\u017ee zap\u0159i\u010dinit stanoven\u00ed nespr\u00e1vn\u00e9 diagn\u00f3zy.<\/p>\n

P\u0159\u00edjem alkoholu rovn\u011b\u017e posiluje \u00fa\u010dinky dus\u00edkov\u00e9 nark\u00f3zy (tzv. dus\u00edkov\u00e9ho opojen\u00ed). Zv\u00fd\u0161en\u00e1 koncentrace alkoholu, dehydratace a dus\u00edkov\u00e1 nark\u00f3za mohou m\u00edt za n\u00e1sledek zcela zbyte\u010dn\u00e9 nehody zp\u016fsoben\u00e9 sn\u00ed\u017eenou schopnost\u00ed \u0159e\u0161it probl\u00e9my. Mnozi pot\u00e1p\u011b\u010di si r\u00e1di daj\u00ed “jedno vychlazen\u00e9”, ale pit\u00ed ve spojen\u00ed s pot\u00e1p\u011bn\u00edm se m\u016f\u017ee st\u00e1t doslova no\u010dn\u00ed m\u016frou jak pro posti\u017een\u00e9ho pot\u00e1p\u011b\u010de, tak i pro jeho kolegy, kte\u0159\u00ed se jej budou sna\u017eit zachr\u00e1nit, nebo se dokonce stanou sv\u011bdky fat\u00e1ln\u00ed p\u0159\u00edhody.<\/p>\n

Ot\u00e1zka: Mnoho lid\u00ed mi rad\u00ed, jak\u00e9 kapky si m\u00e1m nakapat po pot\u00e1p\u011bn\u00ed do u\u0161\u00ed. Co k tomu \u0159\u00edkaj\u00ed odborn\u00edci z DAN?<\/strong><\/p>\n

Odpov\u011b\u010f<\/strong>: V\u011bt\u0161ina pot\u00e1p\u011b\u010d\u016f si po ponoru nemus\u00ed kapat do u\u0161\u00ed \u017e\u00e1dn\u00e9 kapky. \u00da\u010delem v\u011bt\u0161iny u\u0161n\u00edch kapek je p\u0159edch\u00e1zet infekci zevn\u00edho zvukovodu (t. j. onemocn\u011bn\u00ed zn\u00e1m\u00e9mu pod pojmem otitis externa neboli plaveck\u00e9 ucho). Infekce zevn\u00edho zvukovodu souvis\u00ed se st\u00e1lou vlhkost\u00ed, a tak\u00e9 s lok\u00e1ln\u00edm poran\u011bn\u00edm k\u016f\u017ee, ke kter\u00e9mu m\u016f\u017ee doj\u00edt p\u0159i vsunut\u00ed vatov\u00fdch ucp\u00e1vek nebo jin\u00fdch p\u0159edm\u011bt\u016f do u\u0161\u00ed. (Takov\u00e9 p\u0159edm\u011bty mohou po\u0161kodit tenkou k\u016f\u017ei\u010dku kryj\u00edc\u00ed zevn\u00ed zvukovod. Zdravotn\u00edci z DAN s oblibou \u0159\u00edkaj\u00ed: “Nestrkejte si do ucha nic men\u0161\u00edho ne\u017e loket.”) Zm\u00edn\u011bn\u00e9 p\u0159\u00ed\u010diny mohou zp\u016fsobit nadm\u011brn\u00e9 rozmno\u017een\u00ed bakteri\u00ed a infekci.<\/p>\n

Pot\u00ed\u017ee s vyrovn\u00e1v\u00e1n\u00edm tlaku, tikav\u00e9 nebo praskav\u00e9 zvuky, pocit ucpan\u00e9ho ucha nebo dojem, \u017ee “m\u00e1m v uchu vodu” zpravidla nazna\u010duj\u00ed m\u00edrn\u00e9 barotrauma st\u0159edn\u00edho ucha. Barotrauma st\u0159edn\u00edho ucha se ov\u0161em ned\u00e1 \u0159e\u0161it kapkami aplikovan\u00fdmi do zevn\u00edho zvukovodu, proto\u017ee poran\u011bn\u00ed se nach\u00e1z\u00ed na vnit\u0159n\u00ed stran\u011b u\u0161n\u00edho bub\u00ednku. Neporu\u0161en\u00fd u\u0161n\u00ed bub\u00ednek tvo\u0159\u00ed bezpe\u010dnou p\u0159ek\u00e1\u017eku, kter\u00e1 zabr\u00e1n\u00ed kapk\u00e1m pros\u00e1knout do st\u0159edn\u00edho ucha. Perforovan\u00fd u\u0161n\u00ed bub\u00ednek by sice kapky do st\u0159edn\u00edho ucha propustil, ale z\u0159ejm\u011b by to nepomohlo, sp\u00ed\u0161e by to mohlo u\u0161kodit.<\/p>\n

Pot\u00e1p\u011b\u010d\u016fm, kter\u00e9 tr\u00e1p\u00ed “plaveck\u00e9 ucho”, zpravidla pom\u00e1h\u00e1 opatrn\u00e9 proplachov\u00e1n\u00ed u\u0161\u00ed norm\u00e1ln\u00ed pitnou vodou po ka\u017ed\u00e9m ponoru. Rovn\u011b\u017e m\u016f\u017ee pom\u00e1hat vysou\u0161en\u00ed u\u0161\u00ed f\u00e9nem (vzduch nesm\u00ed b\u00fdt p\u0159\u00edli\u0161 hork\u00fd). Jestli\u017ee nepom\u00e1h\u00e1 \u017e\u00e1dn\u00e1 z t\u011bchto dvou metod, dal\u0161\u00ed mo\u017enost\u00ed by bylo pou\u017eit\u00ed komer\u010dn\u011b dostupn\u00fdch u\u0161n\u00edch kapek zabra\u0148uj\u00edc\u00edch p\u0159\u00edtomnosti st\u00e1l\u00e9 vlhkosti. B\u011b\u017en\u00fdm slo\u017ekami t\u011bchto slou\u010denin b\u00fdvaj\u00ed kyselina octov\u00e1 (aktivn\u00ed sou\u010d\u00e1st ingredience octu), borov\u00e1 voda, octan hlinit\u00fd, izopropylalkohol a glycerin. Kyseliny m\u011bn\u00ed pH, co\u017e br\u00e1n\u00ed rozmno\u017eov\u00e1n\u00ed bakteri\u00ed; octan hlinit\u00fd a sodn\u00fd jsou adstringentia (sv\u00edrav\u00e9 prost\u0159edky), kter\u00e9 tk\u00e1n\u011b stahuj\u00ed. Izopropylalkohol pom\u00e1h\u00e1 tk\u00e1n\u011b vysu\u0161it a glycerin promaz\u00e1v\u00e1 k\u016f\u017ei a br\u00e1n\u00ed jej\u00edmu nadm\u011brn\u00e9mu vysou\u0161en\u00ed.<\/p>\n

Ka\u017ed\u00fd pot\u00e1p\u011b\u010d, kter\u00fd po pot\u00e1p\u011bn\u00ed poci\u0165uje n\u011bjak\u00e9 n\u00e1padn\u00e9 p\u0159\u00edznaky v u\u0161\u00edch — zvl\u00e1\u0161t\u011b bolest, poruchu sly\u0161en\u00ed nebo tinnitus (zvon\u011bn\u00ed nebo bzu\u010den\u00ed v u\u0161\u00edch) — by m\u011bl pot\u00e1p\u011bn\u00ed p\u0159eru\u0161it a nechat se vy\u0161et\u0159it l\u00e9ka\u0159em. V\u010dasn\u00e1 l\u00e9\u010dba m\u016f\u017ee zabr\u00e1nit dal\u0161\u00edmu podr\u00e1\u017ed\u011bn\u00ed nebo infekci a umo\u017en\u00ed brzk\u00fd n\u00e1vrat do vody.<\/p>\n

Ot\u00e1zka: Minul\u00fd podzim jsem podstoupil ablaci pulmon\u00e1ln\u00ed \u017e\u00edly kv\u016fli fibrilaci s\u00edn\u00ed. Po p\u011bti m\u011bs\u00edc\u00edch na\u0159\u00eddil kardiolog echokardiografick\u00e9 a bublinov\u00e9 vy\u0161et\u0159en\u00ed, aby se ujistil o uzav\u0159en\u00ed otvoru v p\u0159ep\u00e1\u017ece s\u00edn\u00ed. Bohu\u017eel otvor p\u0159etrv\u00e1v\u00e1. Kardiolog p\u0159ipustil nedostate\u010dnou reakci p\u0159\u00edslu\u0161n\u00fdch tk\u00e1n\u00ed a doporu\u010dil mi, abych se vzdal pot\u00e1p\u011bn\u00ed a\u017e do doby, dokud se nepotvrd\u00ed samovoln\u00e9 \u00fapln\u00e9 uzav\u0159en\u00ed otvoru, nebo neprovede chirurgick\u00e1 n\u00e1prava. Co m\u016f\u017eete \u0159\u00edci k m\u00e9mu stavu – mohu se pot\u00e1p\u011bt?<\/strong><\/p>\n

Odpov\u011b\u010f<\/strong>: Fibrilace s\u00edn\u00ed (angl. zkratka a-fib) je v klinick\u00e9 kardiologii jednou z nej\u010dast\u011bji se vyskytuj\u00edc\u00edch poruch srde\u010dn\u00edho rytmu. V podstat\u011b jde o to, \u017ee atria (t. j. horn\u00ed p\u0159eds\u00edn\u011b srdce) sp\u00ed\u0161e kmitaj\u00ed, ne\u017e aby se spr\u00e1vn\u011b a pravideln\u011b stahovala. To vede k velmi rychl\u00e9mu a nepravideln\u00e9mu srde\u010dn\u00edmu rytmu, co\u017e m\u016f\u017ee b\u00fdt velmi nep\u0159\u00edjemn\u00e9 (i kdy\u017e n\u011bkte\u0159\u00ed lid\u00e9 \u017e\u00e1dn\u00e9 zvl\u00e1\u0161tn\u00ed p\u0159\u00edznaky nepoci\u0165uj\u00ed) a m\u016f\u017ee v\u00e9st k zna\u010dn\u011b vy\u0161\u0161\u00edmu riziku mrtvice. Rizikov\u00fdmi faktory pro vznik fibrilace s\u00edn\u00ed je vysok\u00fd krevn\u00ed tlak, onemocn\u011bn\u00ed srde\u010dn\u00edch tepen, vy\u0161\u0161\u00ed v\u011bk a onemocn\u011bn\u00ed (vada) srde\u010dn\u00edch chlopn\u00ed.
V minulosti se l\u00e9\u010dba soust\u0159e\u010fovala bu\u010f na sn\u00ed\u017een\u00ed rychlosti fibrilace (nasazen\u00edm l\u00e9k\u016f \u010di katetrovou radiofrekven\u010dn\u00ed ablac\u00ed) nebo \u00fapravou rytmu pomoc\u00ed l\u00e9k\u016f. \u00dasp\u011b\u0161nost dosa\u017een\u00ed a udr\u017eov\u00e1n\u00ed norm\u00e1ln\u00edho rytmu v roce bezprost\u0159edn\u011b n\u00e1sleduj\u00edc\u00edm po zm\u00edn\u011bn\u00fdch z\u00e1saz\u00edch se pohybovala v rozmez\u00ed 50 a\u017e 70 procent.<\/p>\n

V sou\u010dasn\u00e9 dob\u011b se fibrilace s\u00edn\u00ed l\u00e9\u010d\u00ed u n\u011bkter\u00fdch pacient\u016f katetrovou izolac\u00ed pulmon\u00e1ln\u00edch \u017eil v lev\u00e9 srde\u010dn\u00ed s\u00edni. Touto metodou se dosahuje dlouhodob\u011b sledovan\u00e1 \u00fasp\u011b\u0161nost a\u017e ve v\u00fd\u0161i 80 procent, ale l\u00e9\u010debn\u00fd z\u00e1sah vy\u017eaduje, aby kardiochirurg prop\u00edchnul s\u00ed\u0148ovou p\u0159ep\u00e1\u017eku tak, aby se dostal z prav\u00e9 srde\u010dn\u00ed s\u00edn\u011b do lev\u00e9. Otvor (nebo otvory) se po n\u011bjak\u00e9 dob\u011b spont\u00e1nn\u011b uzav\u0159e (uzav\u0159ou), ale nemus\u00ed k tomu doj\u00edt poka\u017ed\u00e9. A dokud k \u00fapln\u00e9mu uzav\u0159en\u00ed nedojde, p\u0159etrv\u00e1v\u00e1 u pacienta ur\u010dit\u00fd defekt s\u00ed\u0148ov\u00e9 p\u0159ep\u00e1\u017eky – podobn\u00fd vrozen\u00e9mu defektu (otvoru) mezis\u00ed\u0148ov\u00e9 p\u0159ep\u00e1\u017eky. To znamen\u00e1, \u017ee \u017eiln\u00ed bublinky mohou obej\u00edt pl\u00edce (pl\u00edce funguj\u00ed jako filtry bublin) a dostat se do arteri\u00e1ln\u00edho ob\u011bhu. Tento stav by vystavil pot\u00e1p\u011b\u010de zv\u00fd\u0161en\u00e9mu riziku dekompresn\u00edho onemocn\u011bn\u00ed (DCI).<\/p>\n

I kdy\u017e neexistuj\u00ed zcela p\u0159esn\u00e9 statistick\u00e9 informace, odhaduje se, \u017ee zm\u00edn\u011bn\u00e9 riziko je asi p\u011btin\u00e1sobn\u011b vy\u0161\u0161\u00ed a tak\u00e9 z\u00e1vis\u00ed na velikosti otvoru (otvor\u016f). To se m\u016f\u017ee na prvn\u00ed pohled jevit a\u017e jako dramatick\u00fd n\u00e1r\u016fst rizika, ve skute\u010dnosti je v\u0161ak riziko DCI u rekrea\u010dn\u00edho pot\u00e1p\u011bn\u00ed v \u0159\u00e1du 2 p\u0159\u00edpad\u016f na 10 000 ponor\u016f. P\u011btin\u00e1sobn\u00fd n\u00e1r\u016fst tedy znamen\u00e1 1 p\u0159\u00edpad na 1 000 ponor\u016f, co\u017e je st\u00e1le velmi mal\u00e9 absolutn\u00ed riziko. Co se t\u00fd\u010de rizika DCI, hlavn\u00edm probl\u00e9mem nen\u00ed existence otvoru v srde\u010dn\u00ed p\u0159ep\u00e1\u017ece, ale rozsah zat\u00ed\u017een\u00ed bublinkami.<\/p>\n

Proto by se m\u011blo “bublinkov\u00e9” zat\u00ed\u017een\u00ed minimalizovat tzv. konzervativn\u00edm pot\u00e1p\u011bn\u00edm. Kdybyste byl m\u016fj pacient, tak bych v\u00e1m doporu\u010dil rekrea\u010dn\u00ed pot\u00e1p\u011bn\u00ed s nejbohat\u0161\u00ed mo\u017enou nitroxovou sm\u011bs\u00ed pro va\u0161e hloubky a k tomu prodlou\u017een\u00e9 bezpe\u010dnostn\u00ed zast\u00e1vky – samoz\u0159ejm\u011b m\u00e1m na mysli takovou sm\u011bs, jakou dovol\u00ed v\u00e1\u0161 stupe\u0148 certifikace. Rozhodn\u011b bych NEDOPORU\u010cOVAL nechat si uzav\u0159\u00edt otvor p\u0159edt\u00edm, ne\u017e se vr\u00e1t\u00edte k pot\u00e1p\u011bn\u00ed (nebo abyste se k n\u011bmu mohl vr\u00e1tit). Riziko v\u00e1\u017en\u00e9 komplikace p\u0159i takov\u00e9m z\u00e1sahu je asi 1 procento, co\u017e je v\u00fdznamn\u011b vy\u0161\u0161\u00ed hodnota ne\u017e nebezpe\u010d\u00ed mo\u017en\u00e9ho DCI (0,1 procenta), ponech\u00e1-li se sou\u010dasn\u00fd stav bez z\u00e1sahu.
I kdy\u017e je rozumn\u00e9 po\u010dkat a sledovat, zdali se otvor uzav\u0159e spont\u00e1nn\u011b a teprve potom se vr\u00e1tit k pot\u00e1p\u011bn\u00ed, nen\u00ed zcela vylou\u010den\u00e9 za\u010d\u00edt se znovu pot\u00e1p\u011bt (za shora uveden\u00fdch p\u0159edpoklad\u016f) i se zm\u00edn\u011bn\u00fdm defektem, ov\u0161em s v\u011bdom\u00edm ur\u010dit\u00e9ho, av\u0161ak nepodstatn\u011b zv\u00fd\u0161en\u00e9ho rizika DCI.
— Douglas Ebersole, M.D.<\/em><\/p>\n

Ot\u00e1zka: I do a lot of diving; as a result of handling tanks, lines, ladders and other gear, I usually have a cut or two somewhere — typically on my hands. Should I be concerned about getting an infection while diving?<\/strong><\/p>\n

Odpov\u011b\u010f<\/strong>: Poko\u017eka p\u0159edstavuje hlavn\u00ed ochranu proti infekci. Poru\u0161en\u00e1 m\u00edsta v poko\u017ece proto umo\u017e\u0148uj\u00ed ko\u017en\u00edm bakteri\u00edm a ohromn\u00e9mu mno\u017estv\u00ed r\u016fzn\u00fdch mo\u0159sk\u00fdch organism\u016f mikroskopick\u00e9 velikosti kontaminovat citliv\u00e9 subderm\u00e1ln\u00ed (podko\u017en\u00ed) tk\u00e1n\u011b.
Pot\u00e1p\u011b\u010dsk\u00e9 prost\u0159ed\u00ed m\u016f\u017ee \u010dasto zp\u016fsobovat poru\u0161en\u00ed celistvosti poko\u017eky. Del\u0161\u00ed doba pod vodou a vysok\u00e1 vlhkost mohou zm\u011bnit ko\u017en\u00ed pH a oslabit vn\u011bj\u0161\u00ed vrstvu k\u016f\u017ee (epidermis), n\u00e1sledkem \u010deho\u017e doch\u00e1z\u00ed k loup\u00e1n\u00ed k\u016f\u017ee. T\u00edm se sni\u017euje p\u0159irozen\u00fd ochrann\u00fd \u00fa\u010dinek poko\u017eky a usnad\u0148uje mo\u017enost vzniku infekce, co\u017e je vlastn\u011b n\u00e1r\u016fst po\u010dtu bakteri\u00ed a jin\u00fdch mikroorganism\u016f v r\u00e1n\u011b. V p\u0159\u00edpad\u011b \u0159ezn\u00fdch ran nebo od\u0159enin, ke kter\u00fdm do\u0161lo n\u011bkde ve vodn\u00edm prost\u0159ed\u00ed (v\u010detn\u011b jezer, \u0159ek a oce\u00e1n\u016f), se doporu\u010duje vymyt\u00ed \u010distou vodou a m\u00fddlem s n\u00e1sledn\u00fdm ochrann\u00fdm obvazem. \u010clov\u011bk s otev\u0159en\u00fdm poran\u011bn\u00edm by se m\u011bl zdr\u017eovat mimo vodu, dokud se r\u00e1na zcela nezahoj\u00ed. A tak\u00e9 je pot\u0159eba si hl\u00eddat nepro\u0161lou lh\u016ftu protitetanov\u00e9ho o\u010dkov\u00e1n\u00ed, aby se minimalizovalo nebezpe\u010d\u00ed infekce t\u00edmto patogenem.<\/p>\n","protected":false},"excerpt":{"rendered":"

Ot\u00e1zka: Na pot\u00e1p\u011b\u010dsk\u00e9 dovolen\u00e9 si na z\u00e1v\u011br dne obvykle d\u00e1me n\u011bkolik piv nebo m\u00edchan\u00fdch drink\u016f. A n\u011bkte\u0159\u00ed z na\u0161\u00ed skupiny si ob\u010das vypij\u00ed pivo i…<\/p>\n","protected":false},"author":1,"featured_media":11374890,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[384],"tags":[],"authors":[1207],"class_list":["post-11385603","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clanky","authors-john-lee-cs_cz"],"acf":[],"yoast_head":"\nMedici DAN odpov\u00eddaj\u00ed na va\u0161e ot\u00e1zky - Alert Diver<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/medici-dan-odpovidaji-na-vase-otazky\/\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Medici DAN odpov\u00eddaj\u00ed na va\u0161e ot\u00e1zky - Alert Diver\" \/>\n<meta property=\"og:description\" content=\"Ot\u00e1zka: Na pot\u00e1p\u011b\u010dsk\u00e9 dovolen\u00e9 si na z\u00e1v\u011br dne obvykle d\u00e1me n\u011bkolik piv nebo m\u00edchan\u00fdch drink\u016f. 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