OBJECTIVE: Establishing the incidence and types of complications following surgical intervention for ARM, primarily after reconstruction. Patient- and treatment-related risk factors were also determined. BACKGROUND: Postoperative complications of ARM surgery vary widely, with data predominantly derived from single-center retrospective studies with limited number of patients. Whether factors such as ARM type, associated congenital anomalies, prior enterostomy, or type of reconstructive surgery affect complication incidence remains unclear. METHODS: This multicenter cohort study was performed using the ARM-Net registry with prospectively collected data. Enterostomy-related and post-reconstructive complications in patients who underwent reconstructive surgery before the age of five years were recorded. Patients with more than 25 % missing data, unknown sex, ARM type, or reconstruction date, or without (information on) reconstruction or complications, were excluded. Multivariable analyses identified independent risk factors for the development of complications. RESULTS: A total of 2,043 patients were eligible for analysis. Complications after enterostomy formation and closure occurred in 25 % and 12 % of patients, respectively. Post-reconstructive complications occurred in 25 % of patients, with wound complications comprising half of the complications. In a multivariable analysis, recto-bladder neck fistula, any associated anomaly, and the LAARP procedure were identified as independent risk factors for post-reconstructive complications. In contrast, anoplasty and mini-PSARP reduce the risk of complications. CONCLUSIONS: Post-reconstructive complications in ARM patients are common, and certain patient- and treatment-related characteristics affect postoperative outcomes. These results aid counselling and clinical decision-making, and may guide the operative planning of ARM types that are amenable to several different surgical approaches.

• MeSH
• anální kanál * chirurgie   abnormality   MeSH
• anorektální malformace * chirurgie   MeSH
• enterostomie škodlivé účinky   MeSH
• incidence MeSH
• kohortové studie MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• pooperační komplikace * epidemiologie   etiologie   MeSH
• předškolní dítě MeSH
• registrace MeSH
• rektum * chirurgie   abnormality   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• zákroky plastické chirurgie * metody   škodlivé účinky   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

Ein Universitätslehrbuch, das sich auf die Anatomie des Arms konzentriert.

• MeSH
• anatomie MeSH
• paže MeSH

• Konspekt
• Učební osnovy. Vyučovací předměty. Učebnice
• Anatomie člověka a srovnávací anatomie
• NLK Obory
• anatomie
• NLK Publikační typ
• učebnice vysokých škol

Práca podáva informácie o klinickom obraze, diagnostike a diferenciálnej diagnostike zriedkavejšie sa vyskytujúcich fenotypov ochorenia motoneurónu – flail arm a flail leg syndrómu. Ide o varianty MND, ktoré sa líšia od klasickej ALS charakterom iniciálnych príznakov, priebehom aj prognózou. Predkladáme kazuistiku pacienta s klinickým a elektrofyziologickým obrazom charakteristickým pre flail arm syndróm, u ktorého bola vzhľadom na pozitivitu antigangliozidových protilátok ako terapeutický test aplikovaná kúra intravenóznym ľudským imunoglobulínom, avšak bez želaného efektu a pri follow-up sledovaní choroba nezadržateľne progreduje.

The paper provides information about clinical symptoms, diagnostics and differential diagnostics of rare phenotypes of motoneuron disease – flail arm and flail leg syndrome. This syndrome is a variant of MND and differs from typical ALS in the initial symptoms, course and outcome of the disease. We present a case report of a patient with clinical and electrophysiological findings typical for the flail arm syndrome. Due to positivity for anti-ganglioside antibodies, we used intravenous administration of human immunoglobulin as a therapeutic test, however without desired result. The follow-ups showed that patient’s condition was deteriorating and the progress of the disease was inexorably proceeding.

PURPOSE OF THE STUDY: The annual number of spinal fusion procedures has been increasing and is well documented worldwide. The O-arm is slowly becoming the standard for transpedicular screw insertion. The accuracy and safety of this method have been confirmed by many studies. Therefore, the learning curve of this method and its use by younger surgeons is the focus of our investigation. Longer operative time and radiation exposure to the patient are its only disadvantages. Our aim was to evaluate the learning curve of neurosurgical residents receiving specialist training and to demonstrate the safety and accuracy compared to the conventional C-arm-guided screw insertion used in the surgical management of spondylolisthesis. MATERIAL AND METHODS: Two groups of patients were evaluated - a retrospective cohort composed of patients with degenerative lumbar spinal instability indicated for C-arm-guided posterior transpedicular screw fixation and a prospective group of patients with the same diagnosis and surgical indication for O-arm-navigated screw insertion. In the retrospective group, the surgeons were largely experienced certified spine surgeons and neurosurgeons, whereas in the prospective group there were mainly neurosurgical residents receiving specialist training under the supervision of a certified physician. Both groups underwent a postoperative CT scan to evaluate the pedicle screw malposition using the Grade system and the anatomical plane of malposition. The operative times for both groups were recorded and for the O-arm navigated group a learning curve from the introduction of the method was generated. The values obtained were statistically analysed. RESULTS: A relatively favourable learning curve of the O-arm-navigation was obtained, with operative times approximating the Carm-guided group at two years after the introduction of the method. Safety of the O-arm navigation applied by less experienced surgeons was confirmed through statistically significantly higher accuracy achieved in the O-arm group at the expense of longer operative times. Also, a significantly lower number of significant Grade 2 and 3 malposition was reported in the O-arm group. DISCUSSION: The higher accuracy of transpedicular screw insertion in the navigation method has been confirmed multiple times. In our study, even in the group of less experienced surgeons. The favourable learning curve of neurological residents receiving specialist training is less documented. Time efficiency of the method and its safety when applied by younger surgeons could help make O-arm navigation the new gold standard in spine surgery. The longer operative time, the purchase price of the device, and a relatively higher radiation exposure to the patient continue to be its disadvantages. CONCLUSIONS: Based on the data obtained, a conclusion can be drawn that the O-arm navigation in spine surgery represents a safer and more accurate method for transpedicular fixation compared to the conventional C-arm technique, even when used by less experienced surgeons. In future, we should focus on increasing its time-efficiency. We are convinced that the navigationassisted spinal instrumentation will soon become a necessity for spine surgery centres. KEY WORDS: O-arm, transpedicular fixation, spondylolisthesis, fusion, navigation, learning curve.

• MeSH
• bederní obratle * chirurgie   MeSH
• chirurgie s pomocí počítače metody   přístrojové vybavení   MeSH
• délka operace MeSH
• fúze páteře přístrojové vybavení   metody   výchova   MeSH
• kostní šrouby MeSH
• křivka učení * MeSH
• kurzy a stáže v nemocnici MeSH
• lidé středního věku MeSH
• lidé MeSH
• prospektivní studie MeSH
• retrospektivní studie MeSH
• spondylolistéza * chirurgie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• srovnávací studie MeSH

• MeSH
• fixace fraktury metody   MeSH
• fraktury humeru chirurgie   MeSH
• poranění paže MeSH
• Publikační typ
• kazuistiky MeSH

• MeSH
• cévy MeSH
• horní končetina patofyziologie   MeSH
• nervový systém MeSH
• vibrace MeSH
• Publikační typ
• kongresy MeSH
• sborníky MeSH

• Konspekt
• Lékařské vědy. Lékařství
• NLK Obory
• pracovní lékařství
• environmentální vědy

• MeSH
• plastická chirurgie MeSH
• poranění paže chirurgie   MeSH

• MeSH
• antropometrie MeSH
• dospělí MeSH
• ergometrie metody   přístrojové vybavení   MeSH
• lidé MeSH
• paraplegie MeSH
• paže MeSH
• sporty MeSH
• tělesná námaha MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• přehledy MeSH
• srovnávací studie MeSH

In breaststroke races, the dolphin kick could finish before, at the same time, or during the arm pull-out, but it is unclear how swimmers perform this technique. The aim of this study was to investigate whether swimmers glide between the dolphin kick and arm pull-out, favour continuity or even overlap those two phases, as it would impact the active underwater sequence. Fourteen international and national male swimmers performed 100-m breaststroke with all-out effort in a pre-calibrated 25 m swimming pool. A multi-camera system tracked the head of the swimmers. Key points of the active underwater sequence were obtained from notational analysis. A hierarchical cluster analysis identified three coordination profiles. All swimmers started their dolphin kick before the arm pull-out. However, one swimmer started the arm pull-out before the end of the dolphin kick, seven swimmers started the arm pull-out after the end of the dolphin kick, and four swimmers synchronised the beginning of the arm pull-out and the end of the dolphin kick, while two other swimmers mixed two coordination profiles among the start and the three turns. Those different profiles allow achieving similar performance outcome, suggesting individual training regarding the underwater phase.

• MeSH
• bérec MeSH
• biomechanika MeSH
• lidé MeSH
• paže * MeSH
• plavání * MeSH
• shluková analýza MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• amputace psychologie   MeSH
• dítě MeSH
• dospělí MeSH
• hygiena MeSH
• lékařská elektronika MeSH
• lidé MeSH
• paže chirurgie   MeSH
• protetické prostředky MeSH
• protézy - design MeSH
• rehabilitace metody   přístrojové vybavení   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• Publikační typ
• přehledy MeSH