Vasa nervorum of epicardial nerves and valves of small veins investigated in porcine heart by two types of vascular injections.

The morphology of the vascular supply of peripheral branches of cardiac nerves has not been systematically described until now. The aim of this study was to describe the architectonics of the vasa nervorum of epicardial nerves in porcine hearts by using two injection techniques. Twenty-three hearts from young healthy pigs were used. In 10 hearts India ink solution was injected into the origin of the anterior interventricular branch. In another 10 hearts India ink solution was injected retrogradely through the coronary sinus. The hearts were then analyzed using a magnifying glass and light microscopy. The arterial injection showed the entirety of the rich venous components of the vasa nervorum, which often consisted of paired veins accompanying the epicardial nerves. The thickness of the nerves ranged from 50 to 815 µm. The vasa nervorum drained into larger subepicardial veins. In seven of the hearts prepared with venous injections the vasa nervorum of epicardial nerves were visualized in the same detail as in the arterial preparations and India ink solution filled the right ventricle via the smallest cardiac veins. The histological analysis of these seven hearts showed complete dehiscence and functional insufficiency of small and larger veins valves. In the other three hearts prepared with venous injections the valves were competent, which prevented retrograde filling of larger and smaller veins. The results obtained expand the current knowledge on epicardial nerves vasa nervorum and provide anatomical evidence behind the mechanism of retrograde application of cardioplegic solutions in cardiac surgery.

The Low Prevalence of Overweight and Obesity in Czech Breastfed Infants and Young Children: An Anthropological Survey.

The aim of this study is to evaluate the prevalence of overweight and obesity in a sample of children who were exclusively or predominantly breastfed for at least 6 months compared to Czech references that were constructed based on a representative sample of children, regardless of their mode of feeding. Between 2008 and 2011, a longitudinal study on the growth of breastfed infants was carried out in the Czech Republic. Forty-three GP pediatricians addressed parents at 18-month preventive examinations and collected data on the families' socio-economic conditions and the infants' feeding conditions. The children were measured (length, weight, and head circumference), and anthropometric measurements from 10 previous preventive examinations were obtained from the health records. Out of the collected 1775 questionnaires, 960 children were selected according to the criteria of the WHO Multicentre Growth Reference Study. For the purpose of this study, 799 children who were exclusively or predominantly breastfed for at least 6 months were selected. We found that the proportions of children who were classified as overweight (>90th percentile) or obese (>97th percentile) at 6, 12, and 18-month examinations were far below the proportions of the Czech references. An update of the Czech references and growth charts is highly recommended by GP pediatricians for the valid assessment of growth and nutritional status, including a screening of overweight and obesity in primary preventive health care.

Body parameters of Czech breastfed children compared to the Czech references and WHO growth standards.

BACKGROUND: The study concerns the comparison of percentile curves of Czech breastfed children with Czech national references from 1991 and 2001 and WHO growth standards. Growth charts of breastfed children demonstrate different curve shapes, especially in the first months of life. Incorrect interpretation of the growth curve could lead to premature introduction of complementary foods or infant formula. AIM: The comparison of four body parameters of Czech breastfed children with currently used Czech national references and WHO standards in order to recommend that Czech paediatricians use either Czech references or WHO standards in their practice. SUBJECTS AND METHODS: Nine hundred and sixty breastfed children were included in the study of length-for-age, head circumference-for-age, weight-for-age and weight-for-length parameters. All percentile curves were compared. Values of the 50th percentile expressed in z-scores based on both Czech references and WHO standards were tested. RESULTS: The study confirmed results of previous surveys documenting that growth of breastfed children is specific. Nevertheless, percentile curves of growth parameters of Czech breastfed children are closer to Czech references than WHO standards. CONCLUSIONS: The Czech national references fulfil the needs of Czech paediatricians (with pointing to specifics of breastfed child growth) and WHO standards are suitable, especially for international comparison.

Brachiomedian artery (arteria brachiomediana) revisited: a comprehensive review.

This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis), a very rare variant of the main arterial trunks of the upper limb. It branches either from the axillary artery or the brachial artery, descends superficially in the arm (similar to the course of the superficial brachial artery) and continues across the cubital fossa, runs superficially in the forearm, approaches the median nerve and enters the carpal canal to reach the hand. It usually terminates in the superficial palmar arch. The first drawing was published, in 1830, and the first description was published, in 1844. Altogether, to our knowledge, only 31 cases of a true, superficial brachiomedian artery have been reported (Some cases are incorrectly reported as superficial brachioradiomedian artery or superficial brachioulnomedian artery). Based on a meta-analysis of known, available studies, the incidence is 0.23% in Caucasians and 1.48% in Mongolians. Knowing whether or not this arterial variant is present is important in clinical medicine and relevant for: The catheterization via the radial or ulnar artery; harvesting the vascular pedicle for a forearm flap based on the radial, ulnar or superficial brachiomedian arteries; the possible collateral circulation in cases of the arterial closure; and the surgical management of carpal tunnel syndrome. Its presence can elevate the danger of an injury to the superficially located variant artery or of an accidental injection.

[Overweight, obesity and underweight prevalence in 7-year-old children in the Czech Republic since 1951]. / Prevalence nadváhy, obezitya podváhy u sedmiletých detí v Ceské republice od roku 1951*

BACKGROUND: Childhood overweight prevalence increases worldwide. The aim of the study was to clarify the change in underweight, overweight and obesity in seven year old Czech children since 1951. METHODS: Data on underweight, overweight and obesity prevalence were obtained using repeated cross-sectional surveys. In 1951-2001 six Czech National Anthropological Surveys were conducted. In years 2008 and 2010 the data were collected as a part of the WHO Europe initiated Childhood Obesity Surveillance Initiative (COSI). The data were evaluated according to WHO references (2007), in 2010 results were assessed also according to the Czech reference standards (1991). RESULTS: From 1951, overweight and obesity prevalence increased in both genders up to 2001. In 2008, a modest decrease in obesity and stable overweight prevalence in girls and in boys a slight increase in obesity and decrease in overweight were found. In 2010, a modest increase in obesity prevalence in girls achieving the levels assessed in 2001 and stable level of overweight were found; in boys the levels remained as in 2008. BMI z score increased significantly between 1951 and 2001. CONCLUSION: These results suggest stabilisation of obesity and overweight prevalence in the Czech Republic in 7 years old children during the last 10 years. Underweight prevalence has remained low.

The prevalence of wasting in Czech infants: a comparison of the WHO child growth standards and the Czech growth references.

The objective of this descriptive study was to evaluate the performance of the international World Health Organization (WHO) child growth standards in the Czech Republic and determine the prevalence of wasting among children using the 1991 Czech growth reference and the WHO growth standards. The study utilized the 2006 WHO Child Growth Standards and the 1991 Czech growth references. The WHO standards were based on a longitudinal study of 882 children aged 0-24 months and on cross-sectional studies of 6669 children aged 18-71 months. The 1991 Czech growth references were based on a cross-sectional survey including 90 910 children aged 0-18 years (34 164 were children aged < 5 years). The prevalence of wasting was significantly higher among Czech children when using the WHO growth standards compared with the Czech references. The prevalence of wasting among 0-5-month-old children was 15.5% among boys and 12.9% among girls compared with the expected 2.3% of the WHO standards. In the length category of 50 cm, 9.0% of boys and 9.9% of girls fell under the WHO wasting cut-off compared with the 3% from the Czech growth reference. The application of the WHO growth standards may results in a significant increase of Czech children classified in the category of wasting, especially among infants aged 0-5 months. The performance and potential impacts of the WHO growth standards should be evaluated further before their adoption in the Czech Republic and other countries with local growth references.

[Relation between dietary and physical activity patterns and obesity in seven year old children--current situation--WHO study]. / Soucasný stav stravování a pohybové aktivity ve vztahu k obezite u sedmiletých detí--studie WHO.

BACKGROUND: Childhood obesity is a global health problem. For monitoring of trends in obesity prevalence and comparison between countries standardized methods are necessary. WHO/Europe launched the "Childhood Obesity Surveillance Initiative" project in 2006 aiming to monitor childhood obesity and associated factors in European countries. This paper provides an overview of the situation in the Czech Republic with focus on diet and physical activity. METHODS AND RESULTS: The cohort included 1704 seven-year olds who were examined by paediatricians in 2008 (essential anthropometric measurements). Questionnaires on children's eating habits, physical activity, family, and school environment were filled in. Statistical methods employed. Multivariate regression with reduction of dimensionality (bi-directional orthogonal projection to the latent structure), one-way ANOVA. Low-fat milk intake frequency was positively correlated with BMI (p = 0.0001), while full-fat milk intake was negatively correlated (p = 0.005). These results probably reflect the change in the diet due to increasing BMI. Number of preventive school programmes aimed on health promotion was negatively associated with BMI (p = 0.026). CONCLUSIONS: Surprisingly, low-fat milk consumption was associated with higher BMI in seven years old children, while full-fat milk consumption was associated with lower BMI. School preventive programmes positively affect children's weight.