Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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Foam sclerotization of varicose veins may cause paradoxical embolization through patent foramen ovale (PFO). The aim of our study was to: 1) select an optimal screening method for the detection of PFO; 2) determine the prevalence of PFO in a non-selected population; and 3) test the risk of paradoxical embolization of venous bubbles in patients with PFO. ⋯ PFO prevalence with significant R-L shunt was 14% in the non-selected population of Czech divers. Simulated dives indicate that PFO represents a risk factor for paradoxical embolization of gas bubbles. TCD is a suitable screening method for the detection of PFO and the evaluation of R-L shunt significance. These results are indicative of a possible high risk of paradoxical embolization of gas bubbles and the trombogenic substance in patients with a larger PFO and significant R-L shunt undergoing foam sclerotization of varicose veins.
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Interspinous spacers are supposed to reduce the segmental extension with a decrease in the expansion of yellow ligaments into the spinal canal, thus avoiding the dynamic narrowing of the spinal canal and compression of nerve roots. The aim of this study was to evaluate clinical outcomes and post-operative complications during one year in patients mostly having suffered from spinal stenosis and treated by In-Space interspinous spacer (Synthes, USA). ⋯ 1. Percutaneous, minimally invasive insertion of an In-Space interspinous spacer is an effective and safe method of dynamic stabilization not accompanied by any serious complications. 2. ODI improved by 63% 6 months after surgery with a decrease in this effect 12 months after surgery. VAS for axial and radicular pain, as reported by patients, improved on average by 55.4% 6 months and by 57.8% 12 months after surgery. 3. In all cases, the lordotic sagittal angle remained after surgery and the extent of segmental motion from flexion to extension was minimally changed.
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The increasing prevalence of obesity and type 2 diabetes mellitus (T2DM) worldwide may nowadays be regarded as a "twin" metabolic pandemic, causing the number of patients with the metabolic syndrome (MS) to rise rapidly. MS is a combination of several interrelated medical disorders such as obesity, T2DM, hypertension, dyslipidaemia etc. These conditions very frequently result in atherosclerosis, ischaemic heart disease, liver steatosis or even steatofibrosis. MS usually causes a significant worsening of the quality of life, often also leading to shortened life span. Bariatric, also referred to as metabolic (B-M), surgery currently represents a very powerful method for the treatment of morbid obesity and the metabolic syndrome. ⋯ Treatment options for the metabolic syndrome include bariatric-metabolic surgery, preferably using the mini-invasive laparoscopic method. These procedures are indicated primarily in morbidly obese patients with BMI > 40 kg/m2 after conservative therapy failure, or patients with severe obesity (BMI > 35 kg/m2) associated with serious circulatory, metabolic or mobility complications. Moreover, surgical treatment of T2DM has been proven to be possible in the last decade.