OBJECTIVES:The first aim of this cross-sectional study was to reveal the prevalence of overweight and obesity among Czech military personnel (CMP). The second aim was to compare accuracy of the body mass index (BMI) classification with the body fat percentage (BF%), waist circumference (WC), and visceral fat area (VFA). BMI is a commonly used method to assess obesity, but its accuracy in reflecting body composition, especially in physically fit individuals, has been questioned. METHODS:Data were collected from six military units in the Czech Republic. Soldiers underwent anthropometric assessments including height, weight, WC, BF%, and VFA using the bioelectrical impedance method (BIA). RESULTS:The study group consisted of 446 soldiers (337 males, 109 females). The prevalence of obesity in Czech soldiers regardless of gender was 18%-20% according to BF% and 13%-16% according to WC. There were almost one fifth of obese males and more than 5% of females with BMI ≥ 30. The risk level of VFA was observed in 24% of male a 34% of female soldiers. In male soldiers there was a high rate (43%) of false positives according to BMI (BMI ≥ 25, BF% < 20), on the other hand, a certain part (18%) of female soldiers was classified as false negative according to BMI (BMI < 25, BF% ≥ 28). When overweight and obesity were assessed by WC and BMI, significant false positives (56%) were found in male soldiers (BMI ≥ 25, WC < 94). When obesity was evaluated using VFA and BMI, a certain rate of false negatives (30%) was found in female soldiers (BMI < 25, VFA ≥ 100). CONCLUSION:Through an analysis we explored the limitations of BMI, and we propose an alternative method (measurement of BF%, VFA using BIA) for a more accurate assessment of body composition in this specific population.

Zvyšující se prevalence obezity a komorbidity s ní spojené vedou k nutnosti intenzivní prevence a léčby tohoto závažného onemocnění již lékaři prvního kontaktu. Základem léčby obezity jsou úpravy životního stylu, založené na pohybové aktivitě a dietních opatřeních. Tato opatření budou účinná pouze při plné spolupráci motivovaného pacienta. Text podává přehled o současných možnostech dietních opatření a možnostech pohybové aktivity u obézních pacientů v ordinaci praktických lékařů. Zvláštní pozornost věnuje možnostem spolupráce praktických lékařů s nutričními terapeuty.

OBJECTIVE:The article deals with occupational health protection and identification of health risks in the work environment of the Ministry of Defence (MoD) of the Czech Republic (CR). It focuses on the assessment of the incidence of occupational diseases (OD) in high-risk and risk-free occupational categories in the years 2010-2019 and compares them with data from the civilian sector. It identifies the differences between military staff and civilian employees of the MoD. METHODS:From the records of OD at the Department of Occupational Diseases of the Central Military Hospital in Prague, the data on acknowledged OD from the years 2010 to 2019 were obtained and then a retrospective analysis focusing on the classification of work at risk was performed. The obtained data were compared with the data from the Czech National Registry of Occupational Diseases (NROD), which are published annually by the National Institute of Public Health. RESULTS:In the years under review, 191 OD were confirmed at the area of MoD, 26% of all OD occurred in employees classified in the occupational risk category. Compared with the data in the NROD, where 50% of OD were found to have been caused by high-risk work, the incidence of OD caused by high-risk work in professional soldiers is lower. Only 1.6% of all OD occurred in professional soldiers whose work was classified as high-risk one. In civilian employees of MoD 24.6% of all OD were connected with high-risk work. On the contrary, the proportion of OD occurring in professional soldiers working in risk-free categories was 57.6%, in civilian employees of MoD was the ratio much lower - 16.2%. CONCLUSION:Work at the Ministry of Defence was not adequately categorized, therefore, in 2020 a new categorization of work was introduced, which together with preventive measures could contribute to reducing the incidence of OD at the Ministry of Defence.

Článek se zabývá ochranou zdraví při práci a zjišťováním zdravotních rizik pracovního prostředí. Dále popisuje systém kategorizace prací v České republice, přístup k profesionálním onemocněním se zaměřením na nemoci z povolání a řeší odpovědnost za škodu způsobenou těmito onemocněními a její náhradu. Přehledově shrnuje výskyt nemocí z povolání vzniklých při rizikových a nerizikových pracích, které jsou určeny zaměstnavatelem a krajskou hygienickou stanicí (KHS) a jejich vývoj v letech 2010-2019.

TelemedicĂ­na se rozvĂ­jĂ­ v poslednĂ­ch dekĂĄdĂĄch 20. stoletĂ­ a je zaloĹžena na přenosu zvuku, obrazu a dat stĂĄle AastA›ji za vyuĹžitĂ­ bezdrĂĄtovĂ˝ch technologiĂ­. V obezitologii se objevuje v praxi od konce 20. stoletĂ­, kdy doĹĄlo nejen k rozvoji komunikaAnĂ­ch technologiĂ­ a objevily se prvnĂ­ zĂĄznamy příjmu potravy přes poAĂ­taAovĂ˝ software, ale předevĹĄĂ­m k velkĂSmu nĂĄrĹŻstu poAtu obĂSznĂ­ch pacientĹŻ. V AŒeskĂS republice je v souAasnĂS dobA› vĂ­ce jak 60 % dospA›lĂS populace s diagnĂlzou nadvĂĄhy nebo obezity. TelemedicĂ­na se uplatňuje předevĹĄĂ­m při sbA›ru dat o energetickĂSm příjmu, monitoringu pohybovĂS aktivity, zĂĄznamu hladin glykĂSmiĂ­ a komunikaci mezi terapeutem a pacientem. VyuĹžitĂ­ telemedicĂ­ny zvyĹĄuje compliance i adherenci obĂSznĂ­ch pacientĹŻ k lĂSAbA› a zvyĹĄuje takĂS jejich motivaci. TelemedicĂ­na s moĹžnostĂ­ uchovĂĄvĂĄnĂ­ dat, sdĂ­lenĂ­ dat a jejich analĂ˝zou je tak postupem, jak snĂ­Ĺžit nĂĄklady na diagnostiku a lĂSAbu obezity.

OBJECTIVESThe aim of this work is to compare the current prevalence of selected risk factors in cardiovascular diseases in the Czech general population in a particular region with a selected population of Czech soldiers in a particular military unit.METHODSWithin medical preventive examinations, data from 684 civilians aged between 30-60 years were obtained (405 men and 279 women). Within compulsory medical preventive examinations, data from 659 soldiers from a particular military unit aged between 30-60 years were obtained (576 men and 83 women). Anthropometric parameters such as height and body weight were monitored and then used to calculate the values of Body Mass Index (BMI) and waist circumference. From biochemical parameters the following values were monitored: glycaemia, uric acid, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, ALT, and GGT. As for the demographic data, age and gender were processed. In the cohort of male soldiers a questionnaire was used to find the extent of cigarette smoking, frequency of using alcoholic drinks and performance of regular physical activities such as aerobic exercises.RESULTSAs for cardiovascular risk, assessed anthropometric parameters in monitored female age categories are statistically significantly lower (p < 0.05) in women in the Army of the Czech Republic (ACR) compared to the female civilian population. Most of the biochemical parameters also display values that indicate the female military population is healthier than the civilian in these parameters. On the other hand, assessed anthropometric parameters in monitored male age categories are statistically significantly lower (p < 0.001) in civilian men compared to the male military population. Most of the assessed biochemical parameters show statistically significant health-indicative values in the male civilian population as well.CONCLUSIONThis work revealed differences in anthropometric and biochemical parameters between the examined civilian and military populations. As for cardiovascular risk, the main findings are significantly worse anthropometric and biochemical parameters in the selected male military cohort compared to the male civilian cohort.

Autor popisuje možnosti monitorování výskytu neinfekčních onemocnění hromadného výskytu a realizaci preventivních intervenčních programů formou preventivních lékařských prohlídek, řízené fyzické aktivity a dispenzarizace nemocných osob ve zdravotnických, lázeňských a rehabilitačních zařízeních. Vyzdvihuje výhody provádění primárně preventivních opatření v Armádě České republiky.

Abundant drinking of fluids at any occasion became popular in wealthy society in last decades. It is referred to asserted beneficial health effects, but rationale of these recommendations is disputed in expert environment as hardly traceable and tenable. Authors of the article analyse theoretical issues as well as empiric literary evidence for the current popular recommendation. They find them unfounded and difficult to be defended and the risks of transitive hypo-hydration overestimated. Moreover, they alert true risks of water poisoning we meet not quite rarely in common practice.

Objectives: The aim of the study is to describe current prevalence of selected risk factors in the Czech general population in a particular region and to compare the data with recently published results in the selected population of Czech soldiers. The work also deals with the advantages and disadvantages of methods determining overweight and obesity. Methods: Within medical preventive examinations the data of 1,051 individuals (482 men, 569 women) were obtained. In this group anthropometric parameters such as height, body weight, Body Mass Index (BMI), and waist circumference were monitored. From biochemical parameters the following values were monitored: glycaemia, uric acid, total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides. Demographic data such as age, gender and achieved education were processed. Results: Average BMI values in men were in the overweight range. Monitored average BMI values in women were up to standards. Monitored anthropometric parameters significantly increased with the age of examined individuals. The highest values of BMI and waist circumference were found in the over-50 age group. Selected biochemical parameters also increased with the age of examined individuals. Education did not have significant influence on the values of selected parameters. A statistically significant positive correlation was found between the values of BMI and waist circumference. The correlation coefficient in men was r = 0.804, p < 0.001, and in women r = 0.858, p < 0.001. Conclusion: The work confirmed differences in anthropometric parameters between the civilian and military Czech male population due to a higher muscle mass percentage in the military population. The work also confirmed the significance of further anthropometric methods in diagnostics of overweight and obesity. The number of individuals with anthropometric and biochemical parameters out of the physiological range is increasing in the over-50 age category.

Práce popisuje systém preventivních lékařských prohlídek v Armádě České republiky (AČR), zavedený v roce 1999, ve srovnání s preventivními programy v civilním sektoru. Podrobný popis obsahu prohlídek, včetně antropometrických měření a novinek z roku 2017, ukazuje výhody a nevýhody zavedeného systému. V diskuzi je rozvedena problematika celkové účasti na prohlídkách a také možných změn v rozsahu prohlídek u vojáků v činné službě v závislosti na poměru finanční náklady-přínos.

V práci je popsán význam pravidelné pohybové aktivity v primární prevenci neinfekčních onemocnění hromadného výskytu ve vojenské populaci. Práce popisuje jednotlivé druhy tělesné přípravy v AČR, sportovní možnosti a druhy sportů na útvarech a typy přezkoušení z tělesné přípravy.

AbstraktPráce popisuje možnosti monitorování výskytu neinfekčních onemocnění hromadného výskytu cestou preventivních lékařských prohlídek, které jsou od roku 1999 nedílnou součástí preventivních programů v Armádě České republiky.Na základě výsledků z rozšířených preventivních prohlídek v roce 2015 práce podává informaci o prevalenci vybraných rizikových faktorů metabolického syndromu profesionálních

Aim: To describe effectiveness of orlistat and phentermine in soldiers of the Armed Forces of the Czech Republic.Methods: In ambulatory patients, some anthropometric and biochemical parameters were compared before administration with 120 mg of orlistat three times a day or 15 mg of phentermine once a day.The same parameters were compared after a three-month therapy.This group included 289 patients (238 males and 51 females) who were administered the same dose of orlistat or phentermine for the entire period of time.Results: Statistically significant weight loss in both genders, on average by 4.6 ± 4.2 kg in males and by 5.3 ± 4.3 kg in females, was observed in patients taking orlistat within three months.Statistically significant weight loss, on average by 6.5 ± 6.0 kg in males and by 5.2 ± 4.3 kg in females, was also observed in patients taking phentermine for the same period of time.As for monitored biochemical parameters, a decrease of total cholesterol, HDL cholesterol and glucose at a statistically significant level (p<0.05) was observed in the group of females, the same statistically significant decrease, but in triglycerides, was proved in the group of males.Then a decrease of total cholesterol and increase of HDL cholesterol at a statistically significant level (p<0.001) was observed in the group of males.Conclusion: We can state that in our patients we have proven a positive effect of orlistat or phentermine substitution on their weight reduction.

Introduction and Aim: Hepatic encephalopathy (HE) is a common complication of transjugular intrahepatic portosystemic shunting (TIPS). It is associated with a reduced quality of life and poor prognosis. The aim of this study was to compare two groups of patients who did and did not develop overt HE after TIPS. We looked for differences between these groups before TIPS.MATERIALS AND METHODS:A study of 895 patients was conducted based on a retrospective analysis of clinical data. Data was analyzed using Fisher's exact test, Chi-square, Mann Whitney test, unpaired t-test and logistic regression. After the initial analyses, we have looked at a regression models for the factors associated with development of HE after TIPS.RESULTS:257 (37.9%) patients developed HE after TIPS. Patients' age, pre-TIPS portal venous pressure, serum creatinine, aspartate transaminase, albumin, presence of diabetes mellitus and etiology of portal hypertension were statistically significantly associated with the occurrence of HE after TIPS (p < 0.01). However, only the age, pre-TIPS portal venous pressure, serum creatinine, presence of diabetes mellitus and etiology of portal hypertension contributed to the regression model. Patients age, serum creatinine, presence of diabetes mellitus and portal vein pressure formed the model describing development of HE after TIPS for a subgroup of patients with refractory ascites.CONCLUSION:we have identified, using a substantial sample, several factors associated with the development of HE after TIPS. This could be helpful in further research.

BACKGROUND: Budd-Chiari Syndrome (BCS) is characterized by obstruction of blood flow in hepatic veins. The aim of the study was to analyze diagnosis, etiology and management of BCS.METHODS: We analyzed 44 patients (32 females, 12 males, the mean age <35y of age) treated with TIPS. Ascites was found in 35 patients as the most frequent symptom. The median of total follow-up was 52 months. Non-covered (bare) or covered stent was inserted to all patients. Diagnosis of myeloproliferative neoplasm (MPN) was based on WHO criteria. Other inherited or acquired thrombophilia were assessed as well. Therapy of BCS was with regard to the etiology.RESULTS: The etiology of BCS was identified in 38 cases. Ph- MPN was found as the most common risk factor (50%, N.=22),especially polycythemia vera. JAK2V617F mutation was detected in the most of 22 MPN cases (82.5%). The second most common etiologic factor was inherited thrombophilia (18%, N.=8). In the non-covered (bare) stent group, a primary patency rates 52.9% in 1 year and 20% in 5 years after TIPS (Portasystemic Shunt, Transjugular Intrahepatic) creation. In the covered stent group the 1-year and 5-year primary patency rates were was 80% and 33.3% respectively. The average 5-year re-intervention rate per patient was 1.65 procedures in the bare stent group and 0.67 in the covered stent group. Re-interventions were more frequent in MPN patients. All patients were anticoagulated with heparin at the beginning, switched to vitamin K antagonist. On top of TIPS, anticoagulant and a vigorous therapy of underlying disorder are necessary.CONCLUSION: BCS is a serious and life-threatening disorder in MPD is a major cause of morbidity and mortality. Therapy requires a multidisciplinary approach. Insertion of TIPS dedicated covered stent is a very effective treatment in cases resistant to conservative approach with lower dysfunction rate and the number of re-interventions.

BACKGROUND Transjugular intrahepatic portosystemic shunts (TIPS) have become a widely accepted tool in the treatment of patients with symptomatic portal hypertension. The aim of our study was to assess glycogen phosphorylase BB (GPBB) concentration in relation to echocardiographic and haemodynamic parameters in patients before and after TIPS insertion. METHODS The study population consisted of 55 patients (38 men and 17 women, age 55.6±8.9 years, range 37-74 years) with liver cirrhosis treated with transjugular portosystemic shunting. GPBB, echocardiographic, and haemodynamic parameters were measured before TIPS insertion and 24 h after the procedure. GPBB concentrations were assessed using the Cardiac Array for Evidence Investigator protein biochip. Correlation between parameters was assessed using the Spearman's coefficient. RESULTS Serum post-procedural GPBB concentrations were increased in comparison with baseline (5.58 vs. 2.67 μg/L, P<0.001). GPBB concentration after TIPS significantly correlated with baseline systemic vascular resistence (r=0.330; P=0.017) and cardiac index (r=0.313; P=0.025). CONCLUSION GPBB concentration measurement may be a useful tool for monitoring myocardial ischemia during a TIPS procedure.