{"id":2182,"date":"2020-09-07T14:43:06","date_gmt":"2020-09-07T12:43:06","guid":{"rendered":"https:\/\/www.newslab.sk\/rizika-pri-vyberani-pricicaneho-kliesta\/"},"modified":"2020-09-07T14:45:41","modified_gmt":"2020-09-07T12:45:41","slug":"risks-associated-with-the-removal-of-an-attached-tick","status":"publish","type":"post","link":"https:\/\/www.newslab.sk\/en\/risks-associated-with-the-removal-of-an-attached-tick\/","title":{"rendered":"Risks associated with the removal of an attached tick"},"content":{"rendered":"<p><span style=\"color: #ff0000;\"><strong>*All tables, charts, graphs and pictures that are featured in this article can be found in the .pdf attachment at the end of the paper.<\/strong><\/span><\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u00davod<\/strong><\/p>\n<p>Ako spr\u00e1vne a bezpe\u010dne vybra\u0165 pricican\u00e9ho klie\u0161\u0165a, je predmetom mnoh\u00fdch medi\u00e1lnych, ale aj odborn\u00fdch diskusi\u00ed. R\u00fdchle odstr\u00e1nenie pricican\u00e9ho klie\u0161\u0165a nie je v\u017edy to ist\u00e9, ako spr\u00e1vne a bezpe\u010dn\u00e9 vybratie. \u010casto pou\u017e\u00edvanou met\u00f3dou je vyberanie klie\u0161\u0165a mierne navlh\u010den\u00fdm vatov\u00fdm tamp\u00f3nom, ktor\u00fd sa prilo\u017e\u00ed na ko\u017eu v mieste pricican\u00e9ho klie\u0161\u0165a a miernym kr\u00fa\u017eiv\u00fdm pohybom sa klie\u0161\u0165 uvo\u013en\u00ed. In\u00e1 met\u00f3da odpor\u00fa\u010da pou\u017ei\u0165 jemn\u00fa pinzetu, klie\u0161\u0165a uchopi\u0165 \u010do najbli\u017e\u0161ie pri ko\u017ei za tvrd\u00fa chit\u00ednov\u00fa hlavi\u010dku a pomal\u00fdm \u0165ahan\u00edm kolmo proti ko\u017ei vybra\u0165 klie\u0161\u0165a. Pri tomto sp\u00f4sobe klie\u0161\u0165 pevne dr\u017e\u00ed a mus\u00ed sa vyvin\u00fa\u0165 aj v\u00e4\u010d\u0161ia sila. Pr\u00ed\u010dinou je cement, ktor\u00fdm sa klie\u0161\u0165 v rane prilep\u00ed. S \u00faspechom sa pou\u017e\u00edva aj h\u00e1\u010dik, ktor\u00fdm sa klie\u0161\u0165 podoberie, nieko\u013ekokr\u00e1t sa n\u00edm zato\u010d\u00ed do jednej strany a klie\u0161\u0165 sa r\u00fdchle uvo\u013en\u00ed. Rizik\u00e1 uveden\u00fdch sp\u00f4sobov v\u00fdberu rozober\u00e1 predlo\u017een\u00e1 \u0161t\u00fadia.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Materi\u00e1l a metodika<\/strong><\/p>\n<p>Analyzovan\u00fd materi\u00e1l predstavuje s\u00fabor 69 klie\u0161\u0165ov oby\u010dajn\u00fdch, 41 n\u00fdmf a 28 sami\u010diek odobran\u00fdch od 64 pacientov pomocou navlh\u010den\u00e9ho tamp\u00f3nu kr\u00fa\u017eiv\u00fdm pohybom. Vybran\u00e9 klie\u0161te boli ulo\u017een\u00e9 do 70 % alkoholu v Eppendorf sk\u00famavk\u00e1ch. V\u0161etky klie\u0161te boli mikroskopicky vy\u0161etren\u00e9 pomocou stereolupy s d\u00f4razom na celistvos\u0165 klie\u0161\u0165a a jeho \u00fastneho \u00fastrojenstva na prednej strane tela, pozost\u00e1vaj\u00faceho zo z\u00e1kladne hlavi\u010dky (basis capituli) s dopredu vyrastaj\u00facim centr\u00e1lnym fixa\u010dn\u00fdm \u00fatvarom hypost\u00f3mom v podobe dlhej skoby s p\u00e1rov\u00fdmi klepietkami na vys\u00favate\u013en\u00fdch trubicov\u00fdch nosi\u010doch (chelicerami) nad n\u00edm a p\u00e1rom hmatadiel (p\u00e1lp) po stran\u00e1ch z\u00e1kladne hlavi\u010dky, s fotodokument\u00e1ciou. Analyzovan\u00e9 klie\u0161te boli kategorizovan\u00e9 do troch skup\u00edn. V prvej boli klie\u0161te s cel\u00fdm a nepo\u0161koden\u00fdm hypost\u00f3mom, v druhej skupine s ulomen\u00fdm hypost\u00f3mom a v tretej skupine klie\u0161te s utrhnutou hlavi\u010dkou.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>V\u00fdsledky<\/strong><\/p>\n<p>Zo 41 n\u00fdmf vybran\u00fdch kr\u00fa\u017eiv\u00fdm pohybom vatov\u00fdm tamp\u00f3nom bolo 5 n\u00fdmf (12,2 %) a len jedna sami\u010dka z 28 (3,6 %) vybran\u00e1 s nepo\u0161koden\u00fdm hypost\u00f3mom (obr\u00e1zok 1). A\u017e 35 n\u00fdmf (85,4 %) a 27 sami\u010diek (96,4 %) malo hypost\u00f3m odlomen\u00fd v polovici d\u013a\u017eky alebo v dolnej tretine (obr\u00e1zok 2), jedna nymfa mala odtrhnut\u00fa cel\u00fa hlavi\u010dku (2,4 %).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Diskusia<\/strong><\/p>\n<p>Pr\u00ed\u010dinou, pre\u010do klie\u0161\u0165 dr\u017e\u00ed \u201eako klie\u0161\u0165\u201c, je jeho prilepenie cementom po obvode hypost\u00f3mu a z\u00e1kladne hlavi\u010dky. Cement je bielkovinov\u00e1 l\u00e1tka, ktor\u00e1 na vzduchu r\u00fdchle tvrdne, podobne ako sekundov\u00e9 lepidlo. Je to ochrana klie\u0161\u0165a pred vypadnut\u00edm z miesta uchytenia po\u010das cicania krvi, ke\u010f sa jeho hmotnos\u0165 postupne zv\u00e4\u010d\u0161uje a\u017e 200-n\u00e1sobne. Po nacican\u00ed krvi klie\u0161\u0165 najprv slinami cement rozpust\u00ed a samovo\u013ene odpadne z miesta prichytenia. Pri vyberan\u00ed klie\u0161\u0165a preto najprv mus\u00edme uvo\u013eni\u0165 cementov\u00fa vrstvu. To dosiahneme pomocou pinzety, alebo e\u0161te lep\u0161ie pomocou lopatky so z\u00e1rezom, ktor\u00fd podsunieme pod pricican\u00e9ho klie\u0161\u0165a a najprv do polkruhu striedavo nieko\u013ekokr\u00e1t zato\u010d\u00edme na jednu i druh\u00fa stranu, najviac v\u0161ak do 360 stup\u0148ov. Ak by sme klie\u0161\u0165a takto vyt\u00e1\u010dali len v jednom smere, hypost\u00f3m sa po nieko\u013ek\u00fdch oto\u010deniach odlom\u00ed v jeho dolnej \u010dasti pri z\u00e1kladni hlavi\u010dky, odkia\u013e vyrast\u00e1. Podobn\u00fd torzn\u00fd tlak na hypost\u00f3m nastane, ak klie\u0161\u0165a vyber\u00e1me pomocou vatov\u00e9ho tamp\u00f3nu kr\u00fa\u017eiv\u00fdm pohybom. Klie\u0161\u0165 pritla\u010den\u00fd ku ko\u017ei sa proti hypost\u00f3mu oh\u00fdna na v\u0161etky strany, \u010do vedie takmer v\u017edy k jeho vylomeniu. Pr\u00edkladom je zdokladovan\u00fdch 96,4 % sami\u010diek a 85,4 % n\u00fdmf zo s\u00faboru 69 klie\u0161\u0165ov. Klie\u0161\u0165 sa s\u00edce z tela odstr\u00e1ni pomerne \u013eahko a r\u00fdchlo, \u010do nepochybne vyvol\u00e1 rados\u0165 pacienta i lek\u00e1ra, ale \u010das\u0165 hypost\u00f3mu ostane v ko\u017ei. Ten nevyhnis\u00e1 ako napr. trieska, ale sa opuzdr\u00ed a vytvor\u00ed sa mal\u00e1 hr\u010dka, ktor\u00e1 m\u00f4\u017ee dlhodobo pretrv\u00e1va\u0165 ako ko\u017en\u00fd defekt. Zvy\u0161ok hypost\u00f3mu u\u017e nie je nebezpe\u010dn\u00fd z h\u013eadiska prenosu infekcie, lebo u\u017e nie je spojen\u00fd so slinn\u00fdmi \u017e\u013eazami klie\u0161\u0165a, ktor\u00e9 u infikovan\u00fdch jedincov obsahuj\u00fa v\u00edrus klie\u0161\u0165ovej encefalit\u00eddy i \u010fal\u0161ie patog\u00e9ny, ani s \u010drevom klie\u0161\u0165a, ktor\u00e9 je zdrojom bor\u00e9li\u00ed. Pri takomto vybrat\u00ed klie\u0161\u0165a pri kontrole celistvosti hlavi\u010dky poh\u013eadom zhora proti svetlu vid\u00edme hmatadl\u00e1 po okrajoch hlavi\u010dky a medzi nimi chelicery, \u010do bud\u00ed dojem \u00faplnosti \u00fastneho \u00fastrojenstva klie\u0161\u0165a, ako je to mo\u017en\u00e9 vidie\u0165 aj na obr\u00e1zku 2. Ulomen\u00fd hypost\u00f3m je vidite\u013en\u00fd len odspodu pomocou lupy (obr\u00e1zok 2). Pri vyberan\u00ed klie\u0161\u0165a pinzetou je nutn\u00e9 klie\u0161\u0165a zachyti\u0165 za tvrd\u00fa chit\u00ednov\u00fa hlavi\u010dku \u010do najbli\u017e\u0161ie pri ko\u017ei jemnou a na konci zahnutou pinzetou, najprv mierne pooto\u010di\u0165 striedavo na obe strany a potom kolmo proti ko\u017ei opatrne \u0165aha\u0165. Pri uchopen\u00ed hrub\u0161ou pinzetou nad hlavi\u010dkou za m\u00e4kk\u00e9 bru\u0161ko sa klie\u0161\u0165 m\u00f4\u017ee roztrhn\u00fa\u0165 a cel\u00e1 hlavi\u010dka s hypost\u00f3mom, chelicerami a palpami zostane v ko\u017ei. T\u00fa potom mo\u017eno vybra\u0165 ihlou ako napr. triesku. Po vybrat\u00ed klie\u0161\u0165a je nutn\u00e9 ranu vydezinfikova\u0165, najlep\u0161ie j\u00f3dov\u00fdm prepar\u00e1tom, ktor\u00fd prenik\u00e1 aj do rany.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Z\u00e1ver<\/strong><\/p>\n<p>Odstr\u00e1nenie pricican\u00e9ho klie\u0161\u0165a z tela pomocou navlh\u010den\u00e9ho tamp\u00f3nu kr\u00fa\u017eiv\u00fdm pohybom nie je spr\u00e1vny a bezpe\u010dn\u00fd sp\u00f4sob vybratia, preto\u017ee klie\u0161\u0165a ve\u013emi \u010dasto nevyberieme cel\u00e9ho. Podobne k\u00fdvanie klie\u0161\u0165om v ko\u017ei pinzetou \u010dasto vedie k odlomeniu hypost\u00f3mu. Klie\u0161\u0165a je potrebn\u00e9 vybra\u0165 cel\u00e9ho a nepo\u0161koden\u00e9ho. Odpor\u00fa\u010da sa pou\u017ei\u0165 tenk\u00fa zahnut\u00fa pinzetu alebo h\u00e1\u010dik so z\u00e1rezom a len mierne poot\u00e1\u010da\u0165 klie\u0161\u0165om do polkruhu striedavo na obe strany kolmo proti ko\u017ei s n\u00e1sledn\u00fdm miernym \u0165ahom.<\/p>\n<p><strong>Po\u010fakovanie:<\/strong> T\u00e1to publik\u00e1cia bola podporen\u00e1 projektom APVV-17-0372 \u201eEMITICK\u201c.<br \/>\n<strong>Konflikt z\u00e1ujmov:<\/strong> Autori vyhlasuj\u00fa, \u017ee nemaj\u00fa \u017eiadny konflikt z\u00e1ujmov.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>*All tables, charts, graphs and pictures that are featured in this article can be found in the .pdf attachment at the end of the paper. &nbsp; \u00davod Ako spr\u00e1vne a bezpe\u010dne vybra\u0165 pricican\u00e9ho klie\u0161\u0165a, je predmetom mnoh\u00fdch medi\u00e1lnych, ale aj odborn\u00fdch diskusi\u00ed. R\u00fdchle odstr\u00e1nenie pricican\u00e9ho klie\u0161\u0165a nie je v\u017edy to ist\u00e9, ako spr\u00e1vne a bezpe\u010dn\u00e9<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false,"footnotes":""},"categories":[1596],"tags":[1671,1666],"class_list":["post-2182","post","type-post","status-publish","format-standard","hentry","category-parazitologia-en","tag-remove","tag-tick","typ_clanku-original-work"],"acf":{"abstrakt":"<p>It is not always easy to remove a bitten tick safely and correctly. The recommended quick method of removing it is with a damp cotton swab applied to the skin at the pliers in a circular motion. In this method, the hypostome of tick often breaks off at the bottom, which remains in the skin. It is also broken off by rotating the tick in its axis in one direction. The correct way to remove it is to initially release the cement by turning it slightly, alternately on both sides, for at most one turn, gripping the tick with fine tweezers by the hard head and then pulling it slightly perpendicular to the skin.<\/p>\n<p><strong>Keywords:<\/strong> tick, remove<\/p>\n","casopis":[{"ID":2132,"post_author":"7","post_date":"2020-09-04 08:09:57","post_date_gmt":"2020-09-04 06:09:57","post_content":"SUPPLEMENT\r\n\r\nPri pr\u00edle\u017eitosti odbornej konferencie\r\n\r\n<strong>I. Aktu\u00e1lne probl\u00e9my hum\u00e1nnej parazitol\u00f3gie<\/strong>\r\n<ul>\r\n \t<li>Diagnosis of rickettsial infection using ELISA test developed at BMC SAS: Comparison to commercial tests on samples of patients from Slovakia<\/li>\r\n \t<li>Monitoring and diagnostics of intestinal parasitoses in children from a segregated settlement<\/li>\r\n \t<li>Prevention of toxoplasmosis in pregnancy in Slovakia<\/li>\r\n \t<li>Global changes and their impact on the occurrence of parasitosis in Slovakia<\/li>\r\n<\/ul>","post_title":"newsLab","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"newslab-6","to_ping":"","pinged":"","post_modified":"2020-09-04 13:36:36","post_modified_gmt":"2020-09-04 11:36:36","post_content_filtered":"","post_parent":0,"guid":"https:\/\/www.newslab.sk\/casopis\/newslab-6\/","menu_order":0,"post_type":"casopis","post_mime_type":"","comment_count":"0","filter":"raw"}],"strana":"96 - 97","upload_clanok":{"ID":2180,"id":2180,"title":"NEWSLAB_2-2020_PP_Petko_96_97str","filename":"NEWSLAB_2-2020_PP_Petko_96_97str.pdf","filesize":541062,"url":"https:\/\/www.newslab.sk\/wp-content\/uploads\/2020\/09\/NEWSLAB_2-2020_PP_Petko_96_97str.pdf","link":"https:\/\/www.newslab.sk\/en\/risks-associated-with-the-removal-of-an-attached-tick\/newslab_2-2020_pp_petko_96_97str-2\/","alt":"","author":"7","description":"","caption":"","name":"newslab_2-2020_pp_petko_96_97str-2","status":"inherit","uploaded_to":2182,"date":"2020-09-07 12:38:16","modified":"2020-09-07 12:38:16","menu_order":0,"mime_type":"application\/pdf","type":"application","subtype":"pdf","icon":"https:\/\/www.newslab.sk\/wp-includes\/images\/media\/document.png"}},"_links":{"self":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/2182","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/comments?post=2182"}],"version-history":[{"count":0,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/2182\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/media?parent=2182"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/categories?post=2182"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/tags?post=2182"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}