{"id":4737,"date":"2023-06-13T13:18:19","date_gmt":"2023-06-13T11:18:19","guid":{"rendered":"https:\/\/www.ptc.cz\/moderni-diagnostika\/pet-ct\/zadanka-na-pet-ct-vysetreni-k-vyplneni-online\/"},"modified":"2024-06-21T13:53:47","modified_gmt":"2024-06-21T11:53:47","slug":"zahtjev-za-pet-ct-pregled-za-ispunjavanje-online","status":"publish","type":"page","link":"https:\/\/www.ptc.cz\/hr\/moderna-dijagnostika\/pet-ct\/zahtjev-za-pet-ct-pregled-za-ispunjavanje-online\/","title":{"rendered":"Zahtjev za PET\/CT pregled <br>(za ispunjavanje online)"},"content":{"rendered":"<div class=\"wpcf7 no-js\" id=\"wpcf7-f2579-o1\" lang=\"cs-CZ\" dir=\"ltr\" data-wpcf7-id=\"2579\">\n<div class=\"screen-reader-response\">\n<p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\">\n<ul><\/ul>\n<\/div>\n<form action=\"\/hr\/wp-json\/wp\/v2\/pages\/4737#wpcf7-f2579-o1\" method=\"post\" class=\"wpcf7-form init wpcf7-acceptance-as-validation\" aria-label=\"Kontaktn\u00ed formul\u00e1\u0159\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"2579\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"cs_CZ\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f2579-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_group_fields\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_hidden_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_visible_groups\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_repeaters\" value=\"[]\" \/><input type=\"hidden\" name=\"_wpcf7cf_steps\" value=\"{}\" \/><input type=\"hidden\" name=\"_wpcf7cf_options\" value=\"{&quot;form_id&quot;:2579,&quot;conditions&quot;:[{&quot;then_field&quot;:&quot;group-465&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;radiofarmakum&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;jin\\u00e9&quot;}]},{&quot;then_field&quot;:&quot;group-555&quot;,&quot;and_rules&quot;:[{&quot;if_field&quot;:&quot;diabetes&quot;,&quot;operator&quot;:&quot;equals&quot;,&quot;if_value&quot;:&quot;Ano&quot;}]}],&quot;settings&quot;:{&quot;animation&quot;:&quot;yes&quot;,&quot;animation_intime&quot;:200,&quot;animation_outtime&quot;:200,&quot;conditions_ui&quot;:&quot;normal&quot;,&quot;notice_dismissed&quot;:false,&quot;notice_dismissed_update-cf7-6.1&quot;:true,&quot;notice_dismissed_update-cf7-6.1.1&quot;:true}}\" \/><input type=\"hidden\" name=\"_uacf7_hidden_conditional_fields\" value=\"\" \/><br \/>\n<\/fieldset>\n<div class=\"uacf7-form-2579\">\n<p style=\"margin-bottom: 20px !important;\"><strong>Polo\u017eky ozna\u010den\u00e9 * jsou povinn\u00e9<\/strong><\/p>\n<div class=\"rowex__section\">\n<h3 class=\"rowex__section__title\">Telefonn\u00ed \u010d\u00edslo pro objedn\u00e1n\u00ed PET\/CT vy\u0161et\u0159en\u00ed: + 420 222 999 046<\/h3>\n<div class=\"rowex\">\n<div class=\"item\">\n      <span class=\"labelex\">Po\u017eadovan\u00e9 radiofarmakum<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"radiofarmakum\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"radiofarmakum\" value=\"FDG\" \/><span class=\"wpcf7-list-item-label\">FDG<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radiofarmakum\" value=\"F-cholin\" \/><span class=\"wpcf7-list-item-label\">F-cholin<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radiofarmakum\" value=\"AXUMIN\" \/><span class=\"wpcf7-list-item-label\">AXUMIN<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radiofarmakum\" value=\"FMISO\" \/><span class=\"wpcf7-list-item-label\">FMISO<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"radiofarmakum\" value=\"FES\" \/><span class=\"wpcf7-list-item-label\">FES<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"radiofarmakum\" value=\"F-PSMA\" \/><span class=\"wpcf7-list-item-label\">F-PSMA<\/span><\/label><\/span><\/span><\/span><\/p>\n<div data-id=\"group-465\" data-orig_data_id=\"group-465\" data-clear_on_hide class=\"\" data-class=\"wpcf7cf_group\"><span class=\"wpcf7-form-control-wrap\" data-name=\"radiofarmakum-jine\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"uve\u010fte\" value=\"\" type=\"text\" name=\"radiofarmakum-jine\" \/><\/span><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"rowex twice\">\n<div class=\"item\">\n      <span class=\"labelex\">Datum vy\u0161et\u0159en\u00ed<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"datum-vysetreni\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"dd.mm.rrrr\" value=\"\" type=\"text\" name=\"datum-vysetreni\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">\u010cas p\u0159\u00edchodu do PTC<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"cas-prichodu\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"cas-prichodu\" \/><\/span>\n    <\/div>\n<\/p><\/div>\n<\/div>\n<div class=\"rowex__section\">\n<h3 class=\"rowex__section__title\">ODES\u00cdLAJ\u00cdC\u00cd L\u00c9KA\u0158 JE ZODPOV\u011aDN\u00dd ZA \u0158\u00c1DN\u00c9 VYPLN\u011aN\u00cd \u017d\u00c1DANKY A POU\u010cEN\u00cd PACIENTA<\/h3>\n<div class=\"rowex twice\">\n<div class=\"item\">\n      <span class=\"labelex\">P\u0159\u00edjmen\u00ed a jm\u00e9no pacienta *<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"jmeno-pacienta\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"jmeno-pacienta\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Rodn\u00e9 \u010d\u00edslo (\u010d. poji\u0161t\u011bnce) *<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"rodne-cislo\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"rodne-cislo\" \/><\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"rowex\">\n<div class=\"item\">\n      <span class=\"labelex\">Adresa *<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"adresa\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"adresa\" \/><\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"rowex third\">\n<div class=\"item\">\n      <span class=\"labelex\">Kontaktn\u00ed telefon *<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"telefon-pacient\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"+420\" type=\"text\" name=\"telefon-pacient\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">K\u00f3d dg. *<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"kod-dg\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"kod-dg\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Poji\u0161\u0165ovna *<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"pojistovna\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"pojistovna\" \/><\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"rowex third\">\n<div class=\"item\">\n      <span class=\"labelex\">V\u00fd\u0161ka *<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"vyska\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"vyska\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">V\u00e1ha *<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"vaha\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"vaha\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Samopl\u00e1tce<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"samoplatce\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"samoplatce\" value=\"Ne\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Ne<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"samoplatce\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><\/span><\/span>\n    <\/div>\n<\/p><\/div>\n<\/div>\n<div class=\"rowex__section subsection\">\n<h3 class=\"rowex__section__subtitle\">Onemocn\u011bn\u00ed a jeho pr\u016fb\u011bh \/ epikr\u00edza<\/h3>\n<div class=\"rowex\">\n<div class=\"item\">\n      <span class=\"labelex\">Z\u00e1kladn\u00ed diagn\u00f3za a epikr\u00edza (podrobn\u011b rozepi\u0161te) *<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"diagnoza-epikriza\"><input size=\"40\" maxlength=\"8000\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"diagnoza-epikriza\" \/><\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"rowex third\">\n<div class=\"item\">\n      <span class=\"labelex\">L\u00e9\u010dba CHT<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"lecba-cht\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"lecba-cht[]\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><\/span><\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"poznamka-lecba-cht\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"pozn\u00e1mka k l\u00e9\u010db\u011b\" value=\"\" type=\"text\" name=\"poznamka-lecba-cht\" \/><\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"lecba-cht-ukoncena\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"ukon\u010dena kdy\" value=\"\" type=\"text\" name=\"lecba-cht-ukoncena\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">L\u00e9\u010dba RT<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"lecba-rt\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"lecba-rt[]\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><\/span><\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"poznamka-lecba-rt\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"pozn\u00e1mka k l\u00e9\u010db\u011b\" value=\"\" type=\"text\" name=\"poznamka-lecba-rt\" \/><\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"lecba-rt-ukoncena\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"ukon\u010dena kdy\" value=\"\" type=\"text\" name=\"lecba-rt-ukoncena\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">L\u00e9\u010dba hormon\u00e1ln\u00ed<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"lecba-hormonalni\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><label><input type=\"checkbox\" name=\"lecba-hormonalni[]\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><\/span><\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"poznamka-lecba-hormonalni\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"pozn\u00e1mka k l\u00e9\u010db\u011b\" value=\"\" type=\"text\" name=\"poznamka-lecba-hormonalni\" \/><\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"lecba-hormonalni-ukoncena\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"ukon\u010dena kdy\" value=\"\" type=\"text\" name=\"lecba-hormonalni-ukoncena\" \/><\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"rowex third\">\n<div class=\"item\">\n      <span class=\"labelex\">Opera\u010dn\u00ed v\u00fdkony souvisej\u00edc\u00ed s diagn\u00f3zou<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"operacni-vykony\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"operacni-vykony\" \/><\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"operacni-vykony-kdy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"kdy\" value=\"\" type=\"text\" name=\"operacni-vykony-kdy\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Ev. z\u00e1n\u011btliv\u00e9 komplikace<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"zanetlive-komplikace\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zanetlive-komplikace\" \/><\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"zanetlive-komplikace-kdy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"kdy\" value=\"\" type=\"text\" name=\"zanetlive-komplikace-kdy\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">P\u0159edchoz\u00ed vy\u0161et\u0159en\u00ed<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"predchozi-vysetreni\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"predchozi-vysetreni\" \/><\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"predchozi-vysetreni-kde\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"kde\" value=\"\" type=\"text\" name=\"predchozi-vysetreni-kde\" \/><\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"predchozi-vysetreni-kdy\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text mt8\" aria-invalid=\"false\" placeholder=\"kdy\" value=\"\" type=\"text\" name=\"predchozi-vysetreni-kdy\" \/><\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"rowex\">\n<div class=\"item\">\n      <span class=\"labelex\">Sd\u011blen\u00ed pro l\u00e9ka\u0159e ONM (o\u010dek\u00e1van\u00fd p\u0159\u00ednos vy\u0161et\u0159en\u00ed)<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"ocekavany-prinos-vysetreni\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ocekavany-prinos-vysetreni\" \/><\/span>\n    <\/div>\n<\/p><\/div>\n<\/div>\n<div class=\"rowex__section subsection\">\n<div class=\"rowex third\">\n<div class=\"item\">\n      <span class=\"labelex\">Alergie na<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"alergie-na\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"alergie-na\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Aktu\u00e1ln\u00ed hodnota glyk\u00e9mie<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"aktualni-hodnota-glykemie\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"aktualni-hodnota-glykemie\" \/><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Aktu\u00e1ln\u00ed hodnota kreatininu<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"aktualni-hodnota-kreatininu\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"aktualni-hodnota-kreatininu\" \/><\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"rowex fourth\">\n<div class=\"item\">\n      <span class=\"labelex\">Diabetes<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"diabetes\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"diabetes\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"diabetes\" value=\"Ne\" \/><span class=\"wpcf7-list-item-label\">Ne<\/span><\/label><\/span><\/span><\/span><\/p>\n<div data-id=\"group-555\" data-orig_data_id=\"group-555\" data-clear_on_hide class=\"\" data-class=\"wpcf7cf_group\"><span class=\"wpcf7-form-control-wrap\" data-name=\"diabetes-info\"><span class=\"wpcf7-form-control wpcf7-radio mt8\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"diabetes-info\" value=\"pouze dieta\" \/><span class=\"wpcf7-list-item-label\">pouze dieta<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"diabetes-info\" value=\"PAD\" \/><span class=\"wpcf7-list-item-label\">PAD<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"radio\" name=\"diabetes-info\" value=\"INZ\" \/><span class=\"wpcf7-list-item-label\">INZ<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"diabetes-info\" value=\"INZ-PAD\" \/><span class=\"wpcf7-list-item-label\">INZ-PAD<\/span><\/label><\/span><\/span><\/span><\/div>\n<\/p><\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Ren\u00e1ln\u00ed insuficience<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"renalni-insuficience\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"renalni-insuficience\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"renalni-insuficience\" value=\"Ne\" \/><span class=\"wpcf7-list-item-label\">Ne<\/span><\/label><\/span><\/span><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">T\u011bhotenstv\u00ed<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"tehotenstvi\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"tehotenstvi\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"tehotenstvi\" value=\"Ne\" \/><span class=\"wpcf7-list-item-label\">Ne<\/span><\/label><\/span><\/span><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Kojen\u00ed<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"kojeni\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"kojeni\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"kojeni\" value=\"Ne\" \/><span class=\"wpcf7-list-item-label\">Ne<\/span><\/label><\/span><\/span><\/span>\n    <\/div>\n<\/p><\/div>\n<div class=\"rowex fourth\">\n<div class=\"item\">\n      <span class=\"labelex\">Vy\u0161et\u0159en\u00ed sp\u011bch\u00e1<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"vysetreni-specha\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"vysetreni-specha\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"vysetreni-specha\" value=\"Ne\" \/><span class=\"wpcf7-list-item-label\">Ne<\/span><\/label><\/span><\/span><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Imobilita<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"imobilita\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"imobilita\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"imobilita\" value=\"Ne\" \/><span class=\"wpcf7-list-item-label\">Ne<\/span><\/label><\/span><\/span><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Vy\u0161et\u0159en\u00ed v anest\u00e9zii<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"vysterni-v-anestezii\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"vysterni-v-anestezii\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"vysterni-v-anestezii\" value=\"Ne\" \/><span class=\"wpcf7-list-item-label\">Ne<\/span><\/label><\/span><\/span><\/span>\n    <\/div>\n<div class=\"item\">\n      <span class=\"labelex\">Pot\u0159ebuje pacient kysl\u00edk?<\/span><br \/>\n      <span class=\"wpcf7-form-control-wrap\" data-name=\"potreba-kyslik\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"potreba-kyslik\" value=\"Ano\" \/><span class=\"wpcf7-list-item-label\">Ano<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"potreba-kyslik\" value=\"Ne\" \/><span class=\"wpcf7-list-item-label\">Ne<\/span><\/label><\/span><\/span><\/span>\n    <\/div>\n<\/p><\/div>\n<\/div>\n<div class=\"rowex__section subsection\">\n<h3 class=\"rowex__section__subtitle\">Pou\u010den\u00ed pro l\u00e9ka\u0159e<\/h3>\n<div class=\"uacf7_conditional podminka_priprava_fdg\">\n<ul>\n<li>PET\/CT vy\u0161et\u0159en\u00ed by m\u011blo b\u00fdt provedeno minim\u00e1ln\u011b <strong>10 dn\u00ed od chemoterapie a 3 m\u011bs\u00ed\u010dn\u00edm odstupem od radioterapie<\/strong>, pokud jde o vyhodnocen\u00ed oz\u00e1\u0159en\u00e9 oblasti. \u010c\u00edm del\u0161\u00ed jsou \u010dasov\u00e9 odstupy, t\u00edm v\u011bt\u0161\u00ed je spolehlivost PET.<\/li>\n<\/ul>\n<\/div>\n<div class=\"uacf7_conditional podminka_priprava_fpsma\">\n<ul>\n<li>CAVE: prob\u00edhaj\u00edc\u00ed terapie zam\u011b\u0159en\u00e1 na androgenn\u00ed dr\u00e1hu m\u016f\u017ee zp\u016fsobovat zm\u011bny v akumulaci PSMA a t\u00edm fale\u0161n\u011b ovlivnit n\u00e1lez na PSMA PET\/CT vy\u0161.<\/li>\n<\/ul>\n<\/div>\n<ul>\n<li>J\u00f3d obsa\u017een\u00fd v&nbsp;kontrastn\u00ed l\u00e1tce znemo\u017en\u00ed proveden\u00ed scintigrafie \u0161t\u00edtn\u00e9 \u017el\u00e1zy \u010di l\u00e9\u010dbu pomoc\u00ed radioj\u00f3du v p\u0159\u00ed\u0161t\u00edch 2 m\u011bs\u00edc\u00edch.<\/li>\n<li>Je nutn\u00e9, aby pacient spolupracoval a byl schopen b\u011bhem vy\u0161et\u0159en\u00ed setrvat v naprost\u00e9m klidu.<\/li>\n<\/ul>\n<div class=\"uacf7_conditional podminka_priprava_fdg\">\n<ul>\n<li>Vy\u0161et\u0159en\u00ed d\u011bt\u00ed je mo\u017en\u00e9 dle jejich schopnost\u00ed spolupr\u00e1ce (v klidu le\u017eet cca 20 minut b\u011bhem samotn\u00e9ho sn\u00edm\u00e1n\u00ed).<\/li>\n<li>U hospitalizovan\u00e9ho pacienta s inf\u00fazn\u00ed terapi\u00ed by m\u011bla b\u00fdt p\u0159eru\u0161ena parenter\u00e1ln\u00ed v\u00fd\u017eiva min. 4 hodiny p\u0159ed vy\u0161et\u0159en\u00edm, je vhodn\u00e9 pokra\u010dovat v hydrataci pacienta krystalick\u00fdmi roztoky, av\u0161ak bez gluk\u00f3zy a inzul\u00ednu.<\/li>\n<li>Relativn\u00ed kontraindikac\u00ed PET\/CT vy\u0161et\u0159en\u00ed je t\u011bhotenstv\u00ed.<\/li>\n<\/ul><\/div>\n<ul>\n<li>Imobiln\u00edm pacient\u016fm je nutn\u00e9 zajistit na PET\/CT doprovod, kter\u00fd z\u016fstane s vy\u0161et\u0159ovan\u00fdm po celou dobu pobytu na ONM.<\/li>\n<li>P\u0159i p\u0159evozu pacienta sanitn\u00edm vozem je nutn\u00e9 vystavit pacientovi \u017e\u00e1danku na p\u0159evoz i pro zp\u00e1te\u010dn\u00ed cestu. V p\u0159\u00edpad\u011b nestabiln\u00edho pacienta je nutn\u00e9 zajistit zdravotnick\u00fd doprovod, kter\u00fd u pacienta z\u016fstane po celou dobu pobytu na ONM.<\/li>\n<\/ul>\n<div class=\"uacf7_conditional podminka_priprava_fes\">\n<ul>\n<li>FES PET je vhodn\u00e9 prov\u00e9st p\u0159ed nasazen\u00edm hormon\u00e1ln\u00ed l\u00e9\u010dby. <strong>V p\u0159\u00edpad\u011b ji\u017e prob\u00edhaj\u00edc\u00ed hormon\u00e1ln\u00ed l\u00e9\u010dby je nutn\u00e9 vysadit antiestrogenn\u00ed l\u00e9ky typu Tamoxifen, Fulvestrant na min. 6 t\u00fddn\u016f. Inhibitory aromat\u00e1zy vy\u0161et\u0159en\u00ed nevad\u00ed a vysazovat je nen\u00ed pot\u0159eba.<\/strong><\/li>\n<\/ul>\n<\/div>\n<\/div>\n<div class=\"rowex__section subsection\">\n<h3 class=\"rowex__section__subtitle\">Pou\u010den\u00ed pro pacienta<\/h3>\n<ul>\n<li>Pacient se dostav\u00ed na vy\u0161et\u0159en\u00ed PET\/CT do Protonov\u00e9ho centra, kter\u00e9 se nach\u00e1z\u00ed v are\u00e1lu Fakultn\u00ed nemocnice Bulovka, adresa: Bud\u00ednova 1a, Praha 8.<\/li>\n<li>Pacient mus\u00ed m\u00edt zapnut\u00fd telefon, aby ho bylo mo\u017eno kontaktovat v p\u0159\u00edpad\u011b provozn\u00edch probl\u00e9m\u016f<\/li>\n<li>Pacient se <strong>dostav\u00ed na vy\u0161et\u0159en\u00ed v\u010das<\/strong> a po dodr\u017een\u00ed po\u017eadovan\u00e9 p\u0159\u00edpravy p\u0159ed vy\u0161et\u0159en\u00edm. Ohledn\u011b vy\u0161et\u0159en\u00ed bude ka\u017ed\u00e9ho pacienta p\u0159edem kontaktovat n\u00e1\u0161 person\u00e1l.<\/li>\n<li>Pacient s sebou do PTC k vy\u0161et\u0159en\u00ed p\u0159inese doklad toto\u017enosti s fotografi\u00ed (OP, cestovn\u00ed pas, \u0158P) a origin\u00e1l \u017e\u00e1danky s raz\u00edtkem a podpisem indikuj\u00edc\u00edho l\u00e9ka\u0159e a kv\u016fli aplikaci jodov\u00e9 kontrastn\u00ed l\u00e1tky i v\u00fdsledky ren\u00e1ln\u00edch funkc\u00ed ne star\u0161\u00ed ne\u017e 1 m\u011bs\u00edc<\/li>\n<li>Z d\u016fvodu radia\u010dn\u00ed ochrany by pacienti 24 hodin po aplikaci radiofarmaka m\u011bli v nejv\u011bt\u0161\u00ed mo\u017en\u00e9 m\u00ed\u0159e omezit bl\u00edzk\u00fd kontakt s d\u011btmi a t\u011bhotn\u00fdmi \u017eenami. Ze stejn\u00e9ho d\u016fvodu tak\u00e9 \u017e\u00e1d\u00e1me pacienty, aby d\u011bti a t\u011bhotn\u00e9 \u017eeny nep\u0159iv\u00e1d\u011bli jako doprovod na vy\u0161et\u0159en\u00ed.<\/li>\n<\/ul>\n<\/div>\n<div class=\"rowex__section subsection dark--subsection\">\n<div class=\"uacf7_conditional podminka_priprava_fdg\">\n<div class=\"darksubsetionitems\">\n<div class=\"darksubsetionitem\">\n<h3 class=\"rowex__section__subtitle\">P\u0159\u00edprava p\u0159ed vy\u0161et\u0159en\u00edm FDG PET<\/h3>\n<p>FLUORODEOXYGLUK\u00d3ZA (FDG)<\/p>\n<ul>\n<li><strong>\u010cEK\u00c1N\u00cd NA POKOJI (PO APLIKACI RF):<\/strong> 60 min<\/li>\n<li><strong>D\u00c9LKA VY\u0160ET\u0158EN\u00cd:<\/strong> 10\u201320 min<\/li>\n<li><strong>CELKOV\u00dd \u010cAS V PTC:<\/strong> 2\u20133 h<\/li>\n<li><strong>RE\u017dIM PIT\u00cd:<\/strong> P\u00edt hodn\u011b neslazen\u00e9 a neperliv\u00e9 vody<\/li>\n<li><strong>RE\u017dIM J\u00cdDLA:<\/strong> Nej\u00edst 6 h p\u0159ed vy\u0161et\u0159en\u00edm<\/li>\n<li><strong>RE\u017dIM L\u00c9K\u016e:<\/strong>\n<p>\u203a Inzul\u00edn u\u017e\u00edt max. 6 h p\u0159ed vy\u0161et\u0159en\u00edm<\/p>\n<p>\u203a Mo\u017en\u00e9 u\u017e\u00edt l\u00e9ky, kter\u00e9 pacient u\u017e\u00edv\u00e1 trvale<\/p>\n<\/li>\n<li><strong>FYZICK\u00c1 N\u00c1MAHA:<\/strong> 2\u20133 dny p\u0159ed vy\u0161et\u0159en\u00edm bez fyzick\u00e9 n\u00e1mahy<\/li>\n<\/ul><\/div>\n<div class=\"darksubsetionitem light\">\n<h3 class=\"rowex__section__subtitle\"><i class=\"fa-solid fa-heart\"><\/i> P\u0159\u00edprava p\u0159ed vy\u0161et\u0159en\u00edm FDG PET se zam\u011b\u0159en\u00edm na srdce<\/h3>\n<p>TATO P\u0158\u00cdPRAVA SE T\u00ddK\u00c1 POUZE PACIENT\u016e, KTE\u0158\u00cd \u010cEKAJ\u00cd FDG PET SE ZAM\u011a\u0158EN\u00cdM NA SRDCE.<\/p>\n<p><strong>24 hodin p\u0159ed vy\u0161et\u0159en\u00edm<\/strong> pouze n\u00edzkosacharidov\u00e1 dieta s vysok\u00fdm obsahem tuk\u016f (maso, ryby, oleje, vaj\u00ed\u010dka, zelenina), proteiny bez omezen\u00ed.<\/p>\n<p><strong>12 hodin p\u0159ed vy\u0161et\u0159en\u00edm la\u010dnit,<\/strong> hodn\u011b hydratovat \u2013 p\u00edt pouze nesycenou a neochucenou \u010distou vodu.<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"uacf7_conditional podminka_priprava_axumin\">\n<div class=\"darksubsetionitem\">\n<h3 class=\"rowex__section__subtitle\">P\u0159\u00edprava p\u0159ed vy\u0161et\u0159en\u00edm<\/h3>\n<p>FLUCICLOVIN (AXUMIN)<\/p>\n<ul>\n<li><strong>\u010cEK\u00c1N\u00cd NA POKOJI (PO APLIKACI RF):<\/strong> ne\u010dek\u00e1 se<\/li>\n<li><strong>D\u00c9LKA VY\u0160ET\u0158EN\u00cd:<\/strong> 10\u201320 min<\/li>\n<li><strong>CELKOV\u00dd \u010cAS V PTC:<\/strong> 1\u20132 h<\/li>\n<li><strong>RE\u017dIM PIT\u00cd:<\/strong> 4 h nep\u00edt (zap\u00edt l\u00e9ky mal\u00fdmi dou\u0161ky neperliv\u00e9 vody)<\/li>\n<li><strong>RE\u017dIM J\u00cdDLA:<\/strong> Nej\u00edst 4 h p\u0159ed vy\u0161et\u0159en\u00edm<\/li>\n<li><strong>RE\u017dIM L\u00c9K\u016e:<\/strong> Mo\u017en\u00e9 u\u017e\u00edt l\u00e9ky, kter\u00e9 pacient u\u017e\u00edv\u00e1 trvale<\/li>\n<li><strong>FYZICK\u00c1 N\u00c1MAHA:<\/strong> 1 den p\u0159ed vy\u0161et\u0159en\u00edm bez fyzick\u00e9 n\u00e1mahy<\/li>\n<\/ul><\/div>\n<\/p><\/div>\n<div class=\"uacf7_conditional podminka_priprava_fes\">\n<div class=\"darksubsetionitem\">\n<h3 class=\"rowex__section__subtitle\">P\u0159\u00edprava p\u0159ed vy\u0161et\u0159en\u00edm<\/h3>\n<p>FES<\/p>\n<ul>\n<li><strong>\u010cEK\u00c1N\u00cd NA POKOJI (PO APLIKACI RF):<\/strong> 60 min<\/li>\n<li><strong>D\u00c9LKA VY\u0160ET\u0158EN\u00cd:<\/strong> 10\u201320 min<\/li>\n<li><strong>CELKOV\u00dd \u010cAS V PTC:<\/strong> 2\u20133 h<\/li>\n<li><strong>RE\u017dIM PIT\u00cd:<\/strong> P\u00edt hodn\u011b neslazen\u00e9 a neperliv\u00e9 vody (ide\u00e1ln\u011b kohoutkov\u00e9 \/ oby\u010dejn\u00e9 balen\u00e9 vody)<\/li>\n<li><strong>RE\u017dIM J\u00cdDLA:<\/strong> Bez nutnosti la\u010dn\u011bn\u00ed<\/li>\n<li><strong>RE\u017dIM L\u00c9K\u016e:<\/strong> B\u011b\u017en\u00e9 l\u00e9ky bez omezen\u00ed, minim\u00e1ln\u011b na 6 t\u00fddn\u016f p\u0159ed vy\u0161. mus\u00ed b\u00fdt vysazeny antiestrogenn\u00ed l\u00e9ky typu Tamoxifen, Fulvestrant<\/li>\n<li><strong>FYZICK\u00c1 N\u00c1MAHA:<\/strong> Bez omezen\u00ed<\/li>\n<\/ul><\/div>\n<\/p><\/div>\n<div class=\"uacf7_conditional podminka_priprava_fch\">\n<div class=\"darksubsetionitem\">\n<h3 class=\"rowex__section__subtitle\">P\u0159\u00edprava p\u0159ed vy\u0161et\u0159en\u00edm<\/h3>\n<p>FLUOROCHOLIN (FCH)<\/p>\n<ul>\n<li><strong>\u010cEK\u00c1N\u00cd NA POKOJI (PO APLIKACI RF):<\/strong> 60 min<\/li>\n<li><strong>D\u00c9LKA VY\u0160ET\u0158EN\u00cd:<\/strong> 10\u201320 min<\/li>\n<li><strong>CELKOV\u00dd \u010cAS V PTC:<\/strong> 2-3 h<\/li>\n<li><strong>RE\u017dIM PIT\u00cd:<\/strong> P\u00edt hodn\u011b neslazen\u00e9 a neperliv\u00e9 vody (ide\u00e1ln\u011b kohoutkov\u00e9 \/ oby\u010dejn\u00e9 balen\u00e9 vody)<\/li>\n<li><strong>RE\u017dIM J\u00cdDLA:<\/strong> Bez nutnosti la\u010dn\u011bn\u00ed<\/li>\n<li><strong>RE\u017dIM L\u00c9K\u016e:<\/strong> Mo\u017en\u00e9 u\u017e\u00edt l\u00e9ky, kter\u00e9 pacient u\u017e\u00edv\u00e1 trvale<\/li>\n<li><strong>FYZICK\u00c1 N\u00c1MAHA:<\/strong> Bez omezen\u00ed<\/li>\n<\/ul><\/div>\n<\/p><\/div>\n<div class=\"uacf7_conditional podminka_priprava_fpsma\">\n<div class=\"darksubsetionitem\">\n<h3 class=\"rowex__section__subtitle\">P\u0159\u00edprava p\u0159ed vy\u0161et\u0159en\u00edm<\/h3>\n<p>F-PSMA (Pylclari)<\/p>\n<ul>\n<li><strong>\u010cEK\u00c1N\u00cd NA POKOJI (PO APLIKACI RF):<\/strong> 90 min<\/li>\n<li><strong>D\u00c9LKA VY\u0160ET\u0158EN\u00cd:<\/strong> 10\u201320 min<\/li>\n<li><strong>CELKOV\u00dd \u010cAS V PTC:<\/strong> 2-3 h<\/li>\n<li><strong>RE\u017dIM PIT\u00cd:<\/strong> Zv\u00fd\u0161en\u00e1 hydratace p\u0159ed vy\u0161et\u0159en\u00edm<\/li>\n<li><strong>RE\u017dIM J\u00cdDLA:<\/strong> Bez omezen\u00ed, vhodn\u00e9 je lehk\u00e9 j\u00eddlo v b\u011b\u017en\u00e9m re\u017eimu<\/li>\n<li><strong>RE\u017dIM L\u00c9K\u016e:<\/strong> B\u011b\u017en\u00e9 l\u00e9ky bez omezen\u00ed, zm\u011bny v akumulaci PSMA m\u016f\u017ee zp\u016fsobovat prob\u00edhaj\u00edc\u00ed terapie zam\u011b\u0159en\u00e1 na androgenn\u00ed dr\u00e1hu<\/li>\n<li><strong>FYZICK\u00c1 N\u00c1MAHA:<\/strong> Bez omezen\u00ed<\/li>\n<\/ul><\/div>\n<\/p><\/div>\n<div class=\"uacf7_conditional podminka_priprava_fmiso\">\n<div class=\"darksubsetionitem\">\n<h3 class=\"rowex__section__subtitle\">P\u0159\u00edprava p\u0159ed vy\u0161et\u0159en\u00edm<\/h3>\n<p>FMISO<\/p>\n<ul>\n<li><strong>\u010cEK\u00c1N\u00cd NA POKOJI (PO APLIKACI RF):<\/strong> 2\u20133 h<\/li>\n<li><strong>D\u00c9LKA VY\u0160ET\u0158EN\u00cd:<\/strong> 10\u201320 min<\/li>\n<li><strong>CELKOV\u00dd \u010cAS V PTC:<\/strong> 3\u20134 h<\/li>\n<li><strong>RE\u017dIM PIT\u00cd:<\/strong> P\u00edt hodn\u011b neslazen\u00e9 a neperliv\u00e9 vody (ide\u00e1ln\u011b kohoutkov\u00e9 \/ oby\u010dejn\u00e9 balen\u00e9 vody)<\/li>\n<li><strong>RE\u017dIM J\u00cdDLA:<\/strong> Bez nutnosti la\u010dn\u011bn\u00ed<\/li>\n<li><strong>RE\u017dIM L\u00c9K\u016e:<\/strong> Mo\u017en\u00e9 u\u017e\u00edt l\u00e9ky, kter\u00e9 pacient u\u017e\u00edv\u00e1 trvale<\/li>\n<li><strong>FYZICK\u00c1 N\u00c1MAHA:<\/strong> Bez omezen\u00ed<\/li>\n<\/ul><\/div>\n<\/p><\/div>\n<\/div>\n<div class=\"rowex__section subsection\">\n<div class=\"rowex twice\">\n<div class=\"item\">\n    <span class=\"labelex\">Odes\u00edlaj\u00edc\u00ed zdravotnick\u00e9 za\u0159\u00edzen\u00ed *<\/span><br \/>\n     <span class=\"wpcf7-form-control-wrap\" data-name=\"zdravotnicke-zarizeni\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zdravotnicke-zarizeni\" \/><\/span>\n   <\/div>\n<div class=\"item\">\n     <span class=\"labelex\">Jm\u00e9no odes\u00edlaj\u00edc\u00edho l\u00e9ka\u0159e *<\/span><br \/>\n     <span class=\"wpcf7-form-control-wrap\" data-name=\"odesilajici-lekar\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"odesilajici-lekar\" \/><\/span>\n   <\/div>\n<\/p><\/div>\n<div class=\"rowex twice\">\n<div class=\"item\">\n    <span class=\"labelex\">I\u010cP za\u0159\u00edzen\u00ed (8-m\u00edstn\u00e9 \u010d\u00edslo vlevo na raz\u00edtku) *<\/span><br \/>\n     <span class=\"wpcf7-form-control-wrap\" data-name=\"icp-zarizeni\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"icp-zarizeni\" \/><\/span>\n   <\/div>\n<div class=\"item\">\n     <span class=\"labelex\">Odbornost *<\/span><br \/>\n     <span class=\"wpcf7-form-control-wrap\" data-name=\"odbornost\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"odbornost\" \/><\/span>\n   <\/div>\n<\/p><\/div>\n<div class=\"rowex twice\">\n<div class=\"item\">\n    <span class=\"labelex\">Kontaktn\u00ed telefon *<\/span><br \/>\n     <span class=\"wpcf7-form-control-wrap\" data-name=\"telefon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"+420\" type=\"text\" name=\"telefon\" \/><\/span>\n   <\/div>\n<div class=\"item\">\n     <span class=\"labelex\">E-mail *<\/span><br \/>\n     <span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n   <\/div>\n<\/p><\/div>\n<\/div>\n<div class=\"text-center textinfo\"><strong>\u017d\u00e1danku pros\u00edme ode\u0161lete kliknut\u00edm na pole \u201eOdeslat \u017e\u00e1danku\u201c, n\u00e1sledn\u011b V\u00e1m p\u0159ijde \u017e\u00e1danka v pdf na V\u00e1\u0161 email vypln\u011bn\u00fd v \u017e\u00e1dance. <br \/>Tuto \u017e\u00e1danku z emailu vytiskn\u011bte, oraz\u00edtkujte, opat\u0159ete podpisem a p\u0159edejte pacientovi (nebo ode\u0161lete po\u0161tou do PTC). D\u011bkujeme.<\/strong><\/div>\n<p><input class=\"wpcf7-form-control wpcf7-hidden\" value=\"Zahtjev za PET\/CT pregled &lt;br&gt;(za ispunjavanje online)\" type=\"hidden\" name=\"post-title\" \/><br \/>\n<input class=\"wpcf7-form-control wpcf7-hidden\" value=\"https:\/\/www.ptc.cz\/hr\/moderna-dijagnostika\/pet-ct\/zahtjev-za-pet-ct-pregled-za-ispunjavanje-online\/\" type=\"hidden\" name=\"post-url\" \/><br \/>\n<input class=\"wpcf7-form-control wpcf7-hidden\" value=\"30.4.2026\" type=\"hidden\" name=\"post-date\" \/><br \/>\n<input class=\"wpcf7-form-control wpcf7-hidden\" value=\"_2026_04_30\" type=\"hidden\" name=\"pdf-date\" \/><br \/>\n<input class=\"wpcf7-form-control wpcf7-hidden\" value=\"\" type=\"hidden\" name=\"jmeno-pacienta-convert\" \/><br \/>\n<input class=\"wpcf7-form-control wpcf7-hidden\" value=\"\" type=\"hidden\" name=\"rocnik\" \/><\/p>\n<div class=\"rowex submit rowex__section__submit\">\n   <input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Odeslat \u017e\u00e1danku\" \/>\n <\/div>\n<\/div>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":4739,"parent":4734,"menu_order":136,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-4737","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/pages\/4737","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/comments?post=4737"}],"version-history":[{"count":1,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/pages\/4737\/revisions"}],"predecessor-version":[{"id":4768,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/pages\/4737\/revisions\/4768"}],"up":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/pages\/4734"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/media\/4739"}],"wp:attachment":[{"href":"https:\/\/www.ptc.cz\/hr\/wp-json\/wp\/v2\/media?parent=4737"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}