Sbornik lekarsky最新文献

{"title":"[Ventilatory support in neurologic diseases].","authors":"J Fiksa,&nbsp;J Bauer,&nbsp;K Sonka,&nbsp;J Böhm,&nbsp;P Vymĕtalová","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many neurological diseases cause permanent ventilatory insufficiency. In the ambulatory care we consider regular observation of these patients as a very important. The detection of the early clinical symptoms initialises early ventilatory support. We prefer non-invasive mechanical ventilatory methods to invasive ones. Invasive home care ventilation is very difficult and needs adequate social, medical and economical conditions. We present one case.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 1","pages":"99-105"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22127341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender, obesity and health.","authors":"Berit Lilienthal Heitmann","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 4","pages":"465-70"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22333591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Obesity--a risk factor].","authors":"P Hlúbik,&nbsp;L Opltová,&nbsp;J Chaloupka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The nutritional status of a selected population--859 male members of the Fire Rescue Service from 12 districts in the Czech Republic--was assessed in 1997 and 1998. The study provides extensive information on selected anthropometrical and biochemical parameters, especially on those, which are generally used as risk indices for the origin and development of cardiovascular disease (CVD): body mass index (BMI), body fat percentage (b. fat), waist circumference (waist), serum concentrations of total cholesterol (Tchol), HDL- and LDL-cholesterol (HDL-chol, LDL-chol), triacylglyceroles (TAG) and the atherogenic index (AI). As far as lipid parameters were concerned, increased serum levels were estimated in 30.4% (TAG), 54% (Tchol) and 60.9% (LDL-chol) of volunteers. Decreased serum levels of HDL-chol were found in 38.2% of volunteers. An AI higher than 3.5 a.u. was calculated for 79.9% of all subjects in study while an AI higher than 5.0 a.u. was calculated for 45.3% of all subjects. An AI higher than 3.5 a.u. was found in 62% of males with normal weight, in 85% of overweight males and in 92% of obese males. The results of the study proved the considerable prevalence of the overweightness and obesity in the male population group that was followed: according to the calculated BMI, 49.5% of volunteers were estimated to be overweight and 16.3% to be obese. The study concept made it possible to reveal the relationships among the anthropometrical and biochemical parameters followed. The correlation matrix documents a statistically significant dependence among the BMI or waist values and the serum concentrations of Tchol, LDL-chol, TAG and AI. A significant negative correlation was found between the HDL-chol serum concentration and the BMI or waist values. The variance analysis results (the estimated lipid parameter values were divided into groups according to BMI and waist categories) document a statistically significant increase in serum Tchol, LDL-chol, TAG and AI in age categories over 35 years in comparison with the category of men under 25 years of age. For Tchol and LDL-chol a statistically significant increase had already been found in the 25-35 year age category. In comparison with the normal weight category, Tchol serum levels and AI values were statistically significantly higher in both the overweight and obese categories. Statistically significant increase was proven for the TAG and LDL-chol serum levels in both the overweight II. gr. and obese categories. A statistically significant decrease in comparison with the normal weight category was found in the HDL-chol serum levels of both the overweight and obesity categories. In the same way, an increase in Tchol and LDL-chol, TAG serum concentrations and AI values in higher and high risk CVD categories (according to the waist circumference value) was found in comparison with the low CVD risk category.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 4","pages":"499-509"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22333596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-pump coronary artery bypass grafting. The 1st Medical Faculty of Charles University study.","authors":"M Semrád,&nbsp;P Bodlák,&nbsp;M Stríteský,&nbsp;J Kristof,&nbsp;J Lindner,&nbsp;T Urban,&nbsp;V Vondrácek,&nbsp;I Vanĕk","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the surgical technique, anaesthesiological management, immediate and mid-term results, graft patency and effectiveness of less invasive coronary artery bypass grafting through a median sternotomy.</p><p><strong>Methods: </strong>From January 1998 through December 1999, 144 patients had coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB) done by one surgeon through a median sternotomy. The cohort of 107 men and 37 women averaged 60.8 years, mean ejection fraction (EF) was 51.8%. An average of 2.7 (range 1 to 5) grafts/patients was achieved. Results are compared with a CPB subgroup of patients operated on through a median sternotomy in the same time (N = 234). In a random subgroup of 100 patients (50 per group) an angiographic control of graft patency was done.</p><p><strong>Results: </strong>A non-CPB group showed less postoperative acute myocardial infarction (0.7% vs. 3.8%, p < 0.05) and atrial fibrillation (14.6% vs. 26%, p < 0.05), lower incidence of renal (2.8% vs. 5.1%, p < 0.05) and respiratory complications (2.0% vs. 3.8%, NS). We observed lower operative mortality (0.7% vs. 3.4%, p < 0.05), as well as the occurrence of low cardiac output syndrome (0.7% vs. 5.6%, p < 0.05) in the off-pump group. The follow-up is 36 +/- 12 months and the number of patients with recurrent angina, late AMI and late death is acceptable. We did not find an inordinate number of vein grafts occlusions (0.7% vs. 1.8%, NS) and stenoses (6.6% vs. 6.7%, NS) at anastomotic sites. None of the arterial grafts in both groups were occluded.</p><p><strong>Conclusions: </strong>There was little known about the efficacy of the less invasive coronary artery bypass grafting at the beginning of our study. Starting with pioneering the operative technique, we have discovered and proposed three types of a heart verticalization and a reusable stabilizing device. We detected lower incidence of postoperative complications and decreased operative mortality in a non-CPB group. Angiographic assessment displayed an excellent run-off in both groups of patients. Off-pump coronary bypass grafting is associated with sufficient short-term graft patency and mid-term clinical outcomes.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 3","pages":"297-304"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The International Prognostic Scoring System for primary myelodysplastic syndrome].","authors":"M Sisková,&nbsp;A Dohnalová,&nbsp;R Neuwirtová,&nbsp;J Pĕnicková,&nbsp;J Karban,&nbsp;E Cmunt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A number of prognostic scoring systems for patients with myelodysplastic syndrome (MDS) have been introduced since FAB classification of the MDS in 1982. Recently, the International Prognostic Scoring System (IPSS), published in 1997 by Greenberg et al. [9] is based on the percentage of bone marrow (BM) blasts, cytogenetic abnormalities and number of cytopenias. We applied criteria of the IPSS on 205 patients (pts) with primary MDS (RA = 82, RARS = 49, RAEB = 42, RAEB-t = 8, CMML = 24 pts). IPSS discriminated within each of the FAB-subgroups: RA pts were present in low risk and intermediate (Int) I and II risk subgroups, RARS pts were separated into low and Int I, RAEB were distributed predominantly between Int I and Int II risk groups, RAEB-t in high-risk group, and CMML pts were distributed in all groups. In contrary to Greenberg's group of the MDS patients there are only three risk-groups in our study: low risk (score 0-0.5), intermediate (1-2) and high risk (> 2); the median survival and the risk of the evolution to the acute leukemia (p = 0.0001) are significantly different.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 3","pages":"333-8"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Laparoscopic fundoplication in the treatment of Barrett esophagus].","authors":"Z Krska,&nbsp;P Urbánek,&nbsp;T Krechler,&nbsp;M Pesková,&nbsp;J Sváb,&nbsp;R Demes,&nbsp;J Petrtýl,&nbsp;K Lukás,&nbsp;M Lukás,&nbsp;R Brůha","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>Barrett's esophagus (BE) the serious complication of gastroesophageal reflux disease (GERD) is discussed. BE has been defined as the complete intestinal metaplasia of distal esophagus. The most serious complication of BE is esophageal adenocarcinoma. We present our results with the group of patients with GERD from the years 1998-2000. We prospectively followed 67 patients with GERD (group A) and 8 patients with GERD/BE (group B). All patients underwent laparoscopic fundoplication. The average length of the Barrett's segment was 4.3 cm. Average time of the surgery was 75 min. Nissen fundoplication was used in seven cases in group B, in one case we used Rossetti laparoscopic fundoplication. The postoperative endoscopic controls were performed at two months after surgery and then every one-year.</p><p><strong>Results: </strong>In one case we observed the complete reepithelization with the mixed spinocelullar and columnar components. We didn't observe any one case of histological deterioration. There was on any difference between two groups regarding the subjective complains. Six patients form group B reported complete disappearing of pyrosis. Two patients reported significant improvement, with very rare pyrosis or dysphagia. Our experience (together with the literature) proved the surgical antireflux therapy is very safe, very effective and with very long lasting effect. The effectivity of surgical therapy is increased by the laparoscopy. Described laparoscopic approaches can lead to the reepithelization of Barrett's metaplasia or, at least, they can diminish the symptoms without any long-term medication. Surveillance endoscopy and biopsy are strictly recommended in all patients with BE and also in the patients with BE after antireflux surgery. The intervals depend on the grade of dysplasia in metaplastic epithelium.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 2","pages":"181-7"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of pamidronate on bone blood flow and serum levels of IGF-I in sham-operated and oophorectomized female rats].","authors":"J Kapitola,&nbsp;J Zák,&nbsp;V Justová,&nbsp;Z Lacinová","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In our previous work [7] we demonstrated that the bisphosphonate pamidronate lowered the bone blood flow of non-castrated female rats and inhibited the increase in bone blood flow after oophorectomy (OOX). In this paper we present the results of two similar experiments but also with the estimation of IGF-I in blood. The blood flow in the bones of female rats was estimated by means of 85-Sr microsphere technique (NEN, USA), the blood level of IGF-I was ascertained with Rat IGF-I RIA Kit (DSL, USA). Both experiments A and B were performed on female rats according to the same experimental scheme: group I--sham-operated controls, group II--OOX (four weeks before the experiment), group III--pamidronate (Aredia, CIBA-Giegy, 0.6 mg i.p. three days in the week, for four weeks), group IV--OOX + pamidronate. The results of both experiments can be summarized as follows:--it was confirmed again that OOX rises the circulatory indicators in the bones as well as the blood level of IGF-I;--pamidronate suppresses the increase in bone blood flow after OOX;--pamidronate does not unequivocally influence the level of IGF-I in blood. Thus, it is very probable that IGF-I plays a role in the increase of bone blood flow after OOX. However, it is still not clear how the deficiency of estrogens influences the blood level of IGF-I. The mode of action of pamidronate on the bone blood flow--mainly elevated after OOX--is not clear as well.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 4","pages":"455-60"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22333590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cognitive-behavioral therapy in obesity and activities of the STOB (Stop to Obesity) society].","authors":"I Málková","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>STOB Society (STop to OBesity) was founded in the Czech Republic in 1991. It joins together psychologists, medical doctors, instructors of appropriate physical exercises and other professionals whose aim is to help obese people in the struggle with their excess weight. Activities of STOB Society are based on the method of cognitive behavioural psychotherapy, it proceeds from the assumption that inappropriate habits are learnt and so with a help of various techniques they can be also unlearnt. The aim is to induce desirable changes in behaviour, that is in eating and physical activity habits, and at the same time to get rid of the emotions and thoughts that lead to an inappropriate behaviour. The basis of cognitive-behavioural therapy is described. STOB Society popularizes appropriate and healthy way of weight reduction through articles in newspapers and journals, through programmes in radio and television and through brochure, audio and wide tapes, calendar etc. STOB Society organizes national campaigns in which it prompts thousands of obese people in the Czech Republic to appropriate eating and physical activity habits. It organizes \"Weight reduction courses\" in 70 towns in the Czech Republic.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 4","pages":"559-63"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Results of rectal resection procedures at the First Surgical Clinic of the First Medical Faculty of Charles University].","authors":"J Cermák,&nbsp;R Gürlich,&nbsp;J Hubík,&nbsp;O Paul,&nbsp;D Schmidt,&nbsp;J Sváb,&nbsp;M Pesková","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Conventional surgical techniques play an important role in rectal cancer. Dehiscence of the anastomosis after low anterior resection of the rectum is a serious complication. The incidence of dehiscences can be reduced when known principles of preoperative care are respected but in particular by correct surgical technique. In 92 patients operated for rectal cancer at First Surgical Clinic of Charles University we had six patients (6.5%) with dehiscences of anastomosis. The serious character of this surgical complication can be reduced by a primary derivative stomy. Authors recommend implementing a preventive ileostomy in low resection of the rectum in high-risk patients.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 2","pages":"189-92"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevention of thromboembolism in surgery of fractures of the upper end of the femur].","authors":"K Kudrna,&nbsp;Z Krska,&nbsp;J Kvasnicka,&nbsp;J Bríza,&nbsp;S Trca","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Morbidity and mortality after hip fractures is often a result of deep vein thrombosis and pulmonary embolism. Therefore, prophylaxis for venous thrombosis is recommended in patients undergoing osteosynthesis of upper end of lower extremity or arthroplasty of the hip. Study compared efficacy of UFH and LMWH in prevention of thromboembolic disease. The most important part of the study is the prospective trial, which describe group of 81 patients, undergoing operation for hip fracture. These patients suffered fracture of the neck of femur (35) or intertrochanteric fracture (46). For prevention of DVT was used UFH or LMWH. The evaluation was exercised by laboratory tests, Doppler test and by phlebography in cases, where was suspicion of phlebothrombosis. All patients were controlled for two months after operation. Died eleven patients; in every case was PE or cause of death or main complication. Nine of dead was operated for pertrochanteric fracture, another two for fracture of the neck. Prevention drug was UFH in nine dead patients; eight of them suffered pertrochanteric fracture. The most often death sated in fourth and fifth weeks after operation. It means, that the risk of PE continue for a several weeks. It appears, that the prevention use of UFH is not sufficient.</p>","PeriodicalId":76514,"journal":{"name":"Sbornik lekarsky","volume":"103 2","pages":"203-12"},"PeriodicalIF":0.0,"publicationDate":"2002-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22334938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}