Nemocnice Břeclav

Nemocnost je jednm z dleitch faktor demografickch proces. Tak v epidemiologickch studich jsou asto sledovny demografick faktory a socioekonomick vlivy. Z tohoto dvodu bylo pro hodnocen nemocnosti vybrno celkem 19 determinant, kter odpovdaj pti hlavnm oblastem pouvanm Evropskou komis v evaluaci zdravotnch ukazatel (nadje doit, index st, struktura mrtnosti, poet lka a ordinac, index tlesn hmotnosti aj.). Clem pspvku je zhodnotit ukazatele nemocnosti a jejich regionln diferenciace na rovni okres Jihomoravskho kraje v obdob let 2006-2015. Vvoj ukazatel nemocnosti v okresech je srovnvn pomoc koeficient rstu a vsledky pro strukturu mrtnosti jsou vizualizovny (program ArcGIS). Nstrojem pro hodnocen determinant zdrav bylo dotaznkov eten (255 respondent), jeho vsledky byly peneseny do polygonov vrstvy v geografickch informanch technologich a tak vizualizovny. Vsledky ukzaly regionln diferenciace ve vvoji ukazatel nemocnosti. Nejlpe hodnocenmi se staly okresy Brno-msto a Brno-venkov, naopak nejhor vsledky nap hodnocenmi oblastmi

Here we report the catching of a single specimen of a rare native fish species, the cactus roach Rutilus virgo (Heckel), by rod and line on 31 January 2016 at Břeclav (r.km 25.6), on the main channel of the River Dyje (right tributary of the River Morava, Danube basin). This report comes 62-years after the last confirmed record in the Czech Republic, the species having been reported as extinct in the country since then. The morphometric and genetic characteristics of the specimen are presented and evaluated in light of the previous report.

A retrospective study was undertaken to define the efficacy of both mini gastric bypass or one anastomosis gastric bypass (MGB/OAGB) and sleeve gastrectomy (SG) in type 2 diabetes mellitus (T2DM) remission in morbidly obese patients (pts). Eight European centers were involved in this survey. T2DM was preoperatively diagnosed in 313/3252 pts (9.62%). In 175/313 patients, 55.9% underwent MGB/OAGB, while in 138/313 patients, 44.1% received SG between January 2006 and December 2014. Two hundred six out of 313 (63.7 %) pts reached 1 year of follow-up. The mean body mass index (BMI) for MGB/OAGB pts was 33.1 ± 6.6, and the mean BMI for SG pts was 35.9 ± 5.9 (p < 0.001). Eighty-two out of 96 (85.4%) MGB/OAGB pts vs. 67/110 (60.9%) SG pts are in remission (p < 0.001). No correlation was found in the % change vs. baseline values for hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) in relation to BMI reduction, for both MGB/OAGB or SG (ΔFPG 0.7 and ΔHbA1c 0.4 for MGB/OAGB; ΔFPG 0.7 and ΔHbA1c 0.1 for SG). At multivariate analysis, high baseline HbA1c [odds ratio (OR) = 0.623, 95% confidence interval (CI) 0.419-0.925, p = 0.01], preoperative consumption of insulin or oral antidiabetic agents (OR = 0.256, 95% CI 0.137-0.478, p = <0.001), and T2DM duration >10 years (OR = 0.752, 95% CI 0.512-0.976, p = 0.01) were negative predictors whereas MGB/OAGB resulted as a positive predictor (OR = 3.888, 95% CI 1.654-9.143, p = 0.002) of diabetes remission. A significant BMI decrease and T2DM remission unrelated from weight loss were recorded for both procedures if compared to baseline values. At univariate and multivariate analyses, MGB/OAGB seems to outperform significantly SG. Four independent variables able to influence T2DM remission at 12 months have been identified.

The mid-term results of valgus osteotomy performed by the technique described by Coventry et al. testify to the lasting success of this method. Satisfaction with its outcome can be expected in about 90% of the patients in a 5-year post-operative period. To achieve this, it is necessary to strictly observe the indication criteria, operative technique and thorough arthroscopic treatment of the joint. Also, the necessity of slight over-correction to 8 degrees of valgus is emphasised.

The aim of the study was to evaluate the group of patients treated for varus arthritic knee by the method of high tibial osteotomy from the lateral approach and to assess its role in the present-day orthopaedic surgery which also offers other options such as distraction osteotomy from the medial approach, autologous chondrocyte transplantation or alloplasty. The study included 101 patients, 41 women and 60 men, undergoing lateral valgus high tibial osteotomy at our department between 2003 and 2007. The age of patients at the time of surgery ranged from 34 to 61 years, with an average of 54 years. The follow-up period was in the range of 2 to 7 years, with an average of 5.2 years. Moderate varus gonarthrosis was the most frequent indication for osteotomy. Each procedure was preceded by arthroscopy with treatment of the pathologies found; these most frequently included a torn medial meniscus, synovitis or medial compartment chondropathy. The outcomes were evaluated using a system of clinical and radiographic assessment (A) and the Lysholm score (B) before and after surgery. The A system evaluation showed excellent, good and poor results in 42, 47 and 12 patients, respectively. The average Lysholm score was 51 points before surgery and 73 points at the final follow-up examination; the average improvement was by 22 points. The average mechanical axis was 2 degrees of varus before and 6 degrees of valgus after surgery. The minimal correction of the axis was 4 degrees and the maximal correction was 18 degrees. The average change of the axis was 8 degrees. Complications were recorded in 21% of the patients. None of the patients had delayed healing, pseudoarthrosis, fracture of the tibial plateau or peroneal nerve palsy. Long-term excellent and good outcomes were found more often in the patients with a greater resulting valgus angle. After surgery the average anatomical axis was 7.4 degrees of valgus for good and excellent results, and 4.3 degrees of valgus for poor results. This is in agreement with the common recommendation that osteotomy should produce mild overcorrection. The 95% osteotomy survival rate in this study is in accordance with the results reported by Coventry et al. and Sprenger et al. With strict adherence to the indication criteria, we did not find any clear relationship between the severity of knee injury before surgery and the subjective evaluation of post-operative clinical outcome. The patient's body mass index (BMI) had no effect on the outcome, but the majority of our patients had a BMI below 30 (average, 28.2). The range of motion after surgery was not significantly limited. Both the occurrence of complications and alignment maintenance are comparable with the results of distraction osteotomy. The mid-term results of valgus osteotomy performed by the technique described by Coventry et al. testify to the lasting success of this method. Satisfaction with its outcome can be expected in about 90% of the patients in a 5-year post-operative period. To achieve this, it is necessary to strictly observe the indication criteria, operative technique and thorough arthroscopic treatment of the joint. Also, the necessity of slight over-correction to 8 degrees of valgus is emphasised.