Movement is an inseparable part of one's life, and has been a basic everyday activity through the history of mankind. However, a lack of physical activity and availability of food have resulted in a variety of serious health impairments. The 20th century has witnessed a steep rise of mortality from cardiovascular disease, increase in the prevalence of type-2 diabetes mellitus, malignant diseases, and dramatic increase in body weight initially in industrialized nations followed, in the last two decades of the last century, by the populations of third-world countries with all inherent consequences of this phenomenon. Preventive programmes involving physical activity have also been on the list of top priorities of various materials issued by the World Health Organization. Physical activity is one of the simplest non-pharmacological tools in the prevention of a plethora of diseases. The simplest physical activity, even for therapeutic purposes, is walking. We can walk any time, virtually anywhere, so walking is also the least expensive therapeutic option.

• Klíčová slova
• exercise, physical activity, prevention, transplantation,
• MeSH
• cvičení fyziologie   MeSH
• dospělí MeSH
• kardiovaskulární nemoci prevence a kontrola   MeSH
• lidé MeSH
• obnova funkce MeSH
• primární prevence * MeSH
• rizikové faktory MeSH
• transplantace ledvin * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• Klíčová slova
• ACCIDENTS, INDUSTRIAL/prevention and control *, MINING *,
• MeSH
• hornictví * MeSH
• lidé MeSH
• pracovní nehody prevence a kontrola   MeSH
• prevence úrazů * MeSH
• úrazy a nehody * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND AND OBJECTIVE: Recommendations for preventing cardiovascular (CV) disease are currently separated into primary and secondary prevention. We hypothesize that relative effects of interventions for CV prevention are not different across primary and secondary prevention cohorts. Our aim was to test for differences in relative effects on CV events in common preventive CV interventions across primary and secondary prevention cohorts. METHODS AND RESULTS: A systematic search was performed to identify individual patient data (IPD) meta-analyses that included both primary and secondary prevention populations. Eligibility assessment, data extraction, and risk of bias assessment were conducted independently and in duplicate. We extracted relative risks (RR) with 95% confidence intervals (95% CI) of the interventions over patient-important outcomes and estimated the ratio of RR for primary and secondary prevention populations. We identified five eligible IPDs representing 524,570 participants. Quality assessment resulted in overall low-to-moderate methodological quality. We found no subgroup effect across prevention categories in any of the outcomes assessed. CONCLUSION: In the absence of significant treatment-subgroup interactions between primary and secondary CV prevention cohorts for common preventive interventions, clinical practice guidelines could offer recommendations tailored to individual estimates of CV risk without regard to membership to primary and secondary prevention cohorts. This would require the development of reliable ASCVD risk estimators that apply across both cohorts.

• Klíčová slova
• Cardiovascular prevention, Prevention, Primary, Secondary prevention, Subgroup analysis, Systematic review,
• MeSH
• kardiovaskulární nemoci prevence a kontrola   MeSH
• lidé MeSH
• primární prevence metody   normy   MeSH
• sekundární prevence metody   normy   MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

With increasing knowledge of coronary heart disease (CHD) epidemiology, it has become apparent that preventive treatment of high-risk individuals--the high-risk strategy--will reduce individual risk but is insufficient by itself to reduce the burden of CHD in the population as a whole because more than half of the future victims of CHD have risk factor levels below the high range, leaving these persons unprotected. Since the relationship between risk factors and clinical CHD risk is continuous in most instances, without a sharp dividing line between high and low risk, the aim of optimal preventive action must be to shift the entire risk factor distribution curves to the left, in order to reduce the number of persons in the upper end of the distribution on the right. The strategy designed to effect this shift is the community strategy which requires that the whole population adopts preventive measures, i.e. makes changes in lifestyles, especially as regards diet, smoking habits, daily exercise and patterns of stress which favour unhealthy habits or may be harmful in themselves. The two strategies are not alternatives but complementary and, for optimal effectiveness, must be carried out simultaneously in the community. It can be shown that the combined strategy is more effective than either strategy alone. Each of the strategies has on comparison its own particular strengths, adding up to create a community climate favourable for prevention. The practicing physician is primarily concerned with the high-risk strategy but also plays an essential role in providing active support for the community strategy through giving preventive advice on health-promoting living habits to all of his patients and their families.

• MeSH
• koronární nemoc prevence a kontrola   MeSH
• lidé MeSH
• primární prevence * MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: The subcutaneous implantable defibrillator (S-ICD) provides an alternative to the transvenous ICD for the prevention of sudden cardiac death, but has not been well studied in the most commonly treated transvenous ICD patient population, namely, primary prevention (PP) patients with left ventricular dysfunction. OBJECTIVE: The analyses in the present study were designed to compare clinical outcomes for PP patients with and without a reduced ejection fraction (EF) and secondary prevention (SP) patients implanted with the S-ICD. METHODS: All patients 18 years and older from the S-ICD IDE study and the EFFORTLESS Registry with available data as of November 18, 2013, were included (n = 856; mean follow-up duration 644 days). Outcomes were evaluated in 2 analyses: (1) comparing all PP patients (n = 603, 70.4%) with all SP patients (n = 253, 29.6%) and (2) comparing all PP patients with an EF ≤35% (n = 379) with those with an EF >35% (n = 149, 17.4%). RESULTS: No differences were observed in mortality, complications, inappropriate therapy, or ability to convert ventricular tachyarrhythmias between SP and PP patients. However, SP patients had a higher incidence of appropriate therapy than did PP patients (11.9% vs 5.0%; P = .0004). In the PP subanalysis, the cohort with an EF ≤35% had significantly older patients with more comorbidities and higher mortality (3.0% annually vs 0.0%). Despite these differences, device-related complications, conversion efficacy, and incidence of inappropriate shock therapies were not significantly different between PP subgroups. CONCLUSION: The S-ICD performs well in protecting patients with either PP or SP implant indications from sudden cardiac death. Within PP patients, device performance was independent of EF.

• Klíčová slova
• Appropriate shock, Ejection fraction, Primary prevention, Secondary prevention, Subcutaneous ICD,
• MeSH
• defibrilátory implantabilní * MeSH
• dospělí MeSH
• dysfunkce levé srdeční komory * diagnóza   patofyziologie   MeSH
• elektrická defibrilace * škodlivé účinky   přístrojové vybavení   metody   MeSH
• Kaplanův-Meierův odhad MeSH
• komorová tachykardie * mortalita   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhlá srdeční smrt prevence a kontrola   MeSH
• primární prevence metody   statistika a číselné údaje   MeSH
• protetické vybavení MeSH
• registrace MeSH
• sekundární prevence metody   statistika a číselné údaje   MeSH
• senioři MeSH
• tepový objem MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

OBJECTIVE: A new 'normal' in global affairs may be erupting from large global powers to that of non-state actors and proxies committing violence through scaled conflict in a post-Westphalian world generating significant global health policy challenges. Health security of populations are multifactorial and indirectly proportional to war, conflict and disaster. Preventing conflict and avoiding the health vacuum that occurs in war and violence may be best practices for policy makers. This paper considers an approach of applying clinical primary prevention principles to global health policy. METHODS: Brief policy review of current standards and practices in health security in fragile and failed states and prevention; and definitions discussion. A short case study series are presented with best practices, with risk and outcome review. RESULTS: The global balance of power and order may be shifting through geopolitical transference and inadequate action by major global power brokers. Health security in at risk nation-states may be decreasing as a result. CONCLUSION: Small scale conflict with large-scale violence threatens health security and may experience increased incidence and prevalence in fragile and failed states. Preventative policy to resuscitate fragile and failed states and prevent further external and internal shocks may support health and promote a positive feedback loop of further state stability and increased health security. Public health policy shift to mitigate state failure and public health crisis in war and conflict through the basis of primary prevention may provide best practices and maximize health security for at risk populations.

• Klíčová slova
• evidenced based policy, fragile and failed states, health security, infectious disease, non-communicable disease, primary prevention,
• MeSH
• celosvětové zdraví * MeSH
• lidé MeSH
• mezinárodní spolupráce * MeSH
• primární prevence metody   MeSH
• veřejné zdravotnictví metody   MeSH
• zdravotní politika * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Sýrie MeSH
• Ukrajina MeSH

• Klíčová slova
• Attempted suicide, National program, Prevention and control, Secondary prevention, Suicidal ideation, Suicide,
• MeSH
• lékařská praxe založená na důkazech MeSH
• lidé MeSH
• prevence sebevražd * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• konsensus - konference MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

• Klíčová slova
• ACCIDENT PREVENTION *, ACCIDENTS, INDUSTRIAL *,
• MeSH
• lidé MeSH
• pracovní nehody * MeSH
• prevence úrazů * MeSH
• průmysl * MeSH
• úrazy a nehody * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

AIMS: Prevention guidelines have identified the management of obese patients as an important priority to reduce the burden of incident and recurrent cardiovascular disease. Still, studies have demonstrated that over 80% of patients with coronary heart disease (CHD) fail to achieve their weight target. Here, we describe advice received and actions reported by overweight CHD patients since being discharged from hospital and how weight changes relate to their risk profile. METHODS AND RESULTS: Based on data from 10 507 CHD patients participating in the EUROASPIRE IV and V studies, we analysed weight changes from hospital admission to the time of a study visit ≥6 and <24 months later. At hospitalization, 34.9% were obese and another 46.0% were overweight. Obesity was more frequent in women and associated with more comorbidities. By the time of the study visit, 19.5% of obese patients had lost ≥5% of weight. However, in 16.4% weight had increased ≥5%. Weight gain in those overweight was associated with physical inactivity, non-adherence to dietary recommendations, smoking cessation, raised blood pressure, dyslipidaemia, dysglycaemia, and lower levels of quality of life. Less than half of obese patients was considering weight loss in the coming month. CONCLUSIONS: The management of obesity remains a challenge in the secondary prevention of CHD despite a beneficial effect of weight loss on risk factor prevalences and quality of life. Cardiac rehabilitation programmes should include weight loss interventions as a specific component and the incremental value of telehealth intervention as well as recently described pharmacological interventions need full consideration.

• Klíčová slova
• Coronary heart disease, Obesity, Secondary prevention,
• MeSH
• hmotnostní úbytek MeSH
• koronární nemoc * komplikace   epidemiologie   prevence a kontrola   MeSH
• kvalita života MeSH
• lidé MeSH
• nadváha * MeSH
• obezita komplikace   epidemiologie   terapie   MeSH
• sekundární prevence metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: The authors researched the incidence of suicidal thoughts and related factors in 123 patients of the psychiatric ward of the Hospital of České Budějovice with diagnosed attempted suicide in their medical history for the period from January 2013 – June 2015. METHODS: The research was carried out in two stages. At the beginning of the hospitalization, quantitative data collection was implemented using a semi-structured questionnaire, followed by qualitative research conducted with semi-structured phone conversation, based on previous patient's written consent. The research data were statistically processed to obtain information about the character of relations among individual characteristics. To quantify them, the Bayesian Network (BN) was constructed, and to identify relations among individual characteristics, the Hill-Climbing algorithm was used. Before deriving the network, variables were discretized. The network parameters were set based on a data matrix using the maximal plausibility method. RESULTS: The results of analysed set show that the probability of suicidal thoughts is high, achieving a value of 0.750 (0.781 for women and 0.724 for men). If the patient visits a contact centre for drug-addicted persons, the probability of suicidal thoughts decreases to 0.683. If the patient visits a psychotherapist, the values of 0.736 are achieved. If a daily care centre is visited, the estimated risk rises to 0.832 and the probability of the patient repetitively attempting suicide is 0.606. If the interviewed person regularly consumes alcohol, the probable relapse amounts to 0.616. But if the person consumes alcohol from time to time, the probability rises to 0.701. In case of abstinence, the probable relapse decreases to 0.565. CONCLUSIONS: The incidence of suicidal thoughts in observed patients was high, and the amount of risk was influenced by gender, by visiting follow-up care facilities, psychotherapy, and particularly by the frequency of alcohol consumption. Intermittent alcohol consumption is the highest-risk factor in connection with relapsing suicide. In case of psychiatric patients with attempted suicide in their medical history, all verified preventive and therapeutic procedures that can contribute to prevention of relapses should be used within follow-up professional care. Specific approach of the closest social environment, medical literacy of the population and state safety measures are important.

• Klíčová slova
• suicide, attempted suicide, alcohol, drugs, prevention, suicidal thoughts,
• MeSH
• anamnéza statistika a číselné údaje   MeSH
• dospělí MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pacienti hospitalizovaní psychologie   statistika a číselné údaje   MeSH
• pokus o sebevraždu psychologie   statistika a číselné údaje   MeSH
• prevence sebevražd MeSH
• průzkumy a dotazníky MeSH
• recidiva MeSH
• rizikové faktory MeSH
• sebevražda psychologie   statistika a číselné údaje   MeSH
• sebevražedné myšlenky * MeSH
• sekundární prevence metody   MeSH
• sexuální faktory MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH