Stárnutí populace je považováno na celém světě za hlavní faktor, který je v pozadí růstu nákladů na zdravotní péči. V odborné literatuře se však poslední dobou množí důkazy, které naznačují, že stárnutí populace má jen malý vliv na růst těchto nákladů. Autoři textu předkládají rešerši literatury, analyzují náklady na zdravotnictví v České republice a upozorňují na oblasti zdravotní péče, které mají největší vliv na růst výdajů na zdravotnictví v ČR. V závěru konstatují, že v ČR je vliv stárnutí obyvatelstva na výdaje ve zdravotnictví relativně malý a podobá se situaci popsané v zahraniční literatuře. Vyslovují názor, že by centrálním mechanismem způsobujícím rychlý růst výdajů v ČR mohla být nabídkou indukovaná poptávka., Population aging is purported to be a major factor behind the rise of the health care cost worldwide. The increasing body of evidence available in the literature on the subject of aging population and its influence on health care cost suggests that demographic changes play a relatively minor role in driving up the health care bill. First, we review some available evidence. Second, we analyze the situation in the Czech Republic using financial and utilization data and demographic projections. Third, we point out main areas of health care responsible for health care expenditures growth in the Czech Republic, Ludwig Dittrich, Dana Stará, and Lit.: 12
The Purpose of the study: define the indications and contraindications to sphincterpreserving operation in lowerampullar cancer of rectum. The Materials and methods: In coloproctological branch of National Oncological Scientific centre (NOSC) in 20052009 years 142 patients were performed radical operations, 64 (45,1%) patients were performed sphincterpreserving operations abdominoanal resection of rectum (AARR), medium age of patients 59,8 years, beside 78 (54,9%) patients were performed abdomeno perineal extirpation of rectum (APER), medium age 54,2 years. The Results: Studied results of the morphological research of removed preparation by histological structure of tumors and by form of the growing, depending on locations of the tumors on toothed line. The remote postoperative results studied beside 51 (79,7%) patient with AARR and beside 63 (80,1%) patients with APER. The Findings: sphincterpreserving operations (SPO) of the rectum can be the operation of the choice in treatment of high differentiated adenocarcinoma (HDA) and medium differentiated adenocarcinoma (MDA) in stages T23 in localization of the lower pole of tumors, not below 1 centimeter of toothed line (TL) and carries combined character, in location of the lower edge of tumors on toothed line in patients with HDA MDA in 4% and 2,2% cases are shown that completing intrasphincternal resections of rectum, in connection with particular aggressiveness LDA question about choice of the method of the treatment under their localizations directly on TL must be solved in favour of complete APER, in exophytic tumor located onto and above TL is indication for sphincterpreserving operation in type of AARR, indices recurrencefree and not metastatic period, oneyear deathrate, threeyear survivability after SPO at inferior ampular cancer of rectum has not an essential distinction from results after APER., A. M. Hakimov, H. B. Bobokulov, and Literatura