Biomedical subjects

J Payer

Publications and source records attributed to J Payer.

At least 19 recordsLinked to original sources

PubMed2001

[Effect of hormone replacement therapy on the cardiovascular system].

Hormonal replacement therapy becomes frequently used in peri- and postmenopausal women. It causally affects the climacteric syndrome, positively stimulates psychics, improves quality of the skin, decreases dryness of mucous membranes and frequency of recurrent inflammations of eyes and vagina. The positive influence on the bone metabolism and therefore on the incidence of osteoporosis highly dominates among its long-term effects. Long lasting hormonal replacement reduces also the incidence of Alzheimer disease, colorectal carcinoma and it has particularly favourable effect on the cardiovascular system. Estrogens positive affect the lipid spectrum, however, more than 50% of their beneficial influence comes from their direct vasodilatory effect. Estrogene replacement becomes in many countries indicated for the primary prevention of the ischemic heart disease. The question of its application for the secondary prevention remains still open.

Blood Vessels↗

PubMed2000

[Prevention and non-hormone therapy of osteoporosis].

Osteoporosis is an important age-related disease, constituting a major risk of fracture in the elderly, and in postmenopausal women in particular. The main aim of any therapy for osteoporosis is to prevent fractures. Primary prevention attempts to increase peak bone mass by diet and exercise. Secondary prevention aims to prevent bone loss after the menopause by the use of drugs (HRT, calcitonin, bisphosphonates, etc) and is more efficient strategy.

Aged↗

PubMed2000

Autoimmune thyroiditis with severe hypothyroidism resistant to the treatment with high peroral doses of thyroxine: case report.

Female patient (42 yr) suffered from autoimmune thyroiditis resulting in severe hypothyroidism. She was treated for several years by district physician with the dose of 150 microg L-thyroxine daily. Since the level of TSH was repeatedly very high and no improvement of clinical signs has been observed, she was referred to the Medical Faculty Hospital. Thyroid ultrasound showed remarkable diffuse hypoechogenicity, thyroid scintigraphy showed enlarged thyroid with low 99mTc uptake, TRH test was normal, thin needle biopsy supported autoimmune thyroiditis. X-ray examination showed normal sella turcica and no changes in the pituitary were observed with computer tomography. In spite of increasing the dose of peroral L-thyroxine to 300 microg/d and later to 500 microg/d the clinical status and TSH level did not improve. The patient was originally suspected from malabsorption of thyroxine. However, the test with a large single peroral dose (1000 microg) of L-thyroxine showed a rapid decrease of TSH level (from 126 to 75 mU/l) and increase of total T4 level (from 18 to 64 nmol/l) within 4 hr. Later the patient has been treated with intravenous L-thyroxine (500 microg every 3-4 days for 4 weeks) which resulted in the decrease of TSH level to 10 mU/l and increase of T4 level to 80-100 nmol/l. After that it was concluded that the problem is a poor compliance of the patient who apparently does not actually take the medication, although she always claimed that she is doing so. Referring to some similar cases described in the literature the case was classified as thyroxine pseudomalabsorption. In spite that this problem has been explained to her and her relatives, she refused to take any medication and is consistently neglecting all invitations to further examinations.

Administration, Oral↗

PubMed2000

[Effect of pancreatic substitutes on fecal and serum elastase and on pain in patients with chronic pancreatitis].

Views on the existence of a negative feedback between pancreatic secretion and intraduodenal of proteases in humans are controversial. The objective of the study was to find out whether enzyme substitution will have an impact on pancreatic enzyme secretion and pain in chronic pancreatitis. The preparation Panzytrate 2500 (2 x 3 capsules/day containing 1250 units of proteases per capsule) was administered for a 4-week period. In 18 patients with chronic pancreatitis (7 with the severe and 11 with the medium severe and mild form of pancreatitis) the faecal and serum pancreatic elastase was assessed one day before and one day after enzyme substitution therapy. A significant reduction of the faecal elastase concentration (p = 0.03) and serum elastase (p = 0.00375) was recorded in patients with mild and medium severe CP. The values of faecal and serum pancreatic elastase 1 were insignificantly reduced also in patients with severe chronic pancreatitis. Pain relief was statistically significant already after two weeks' administration of enzyme substitution therapy (p = 0.0233) and after four weeks' treatment (p = 0.00766). The results support the importance of the negative feedback on regulation of pancreatic secretion and the positive effect of substitution therapy on pain in chronic pancreatitis.

Adult↗

PubMed2000

[Effect of alendronate therapy on bone turnover--results of a multicenter study].

Sodium alendronate is a bisphosphonate of the IInd generation with a strong antiresorptive effect. Its favourable effect on reduction of the incidence of vertebral and non-vertebral fractures was repeatedly confirmed. The objective of the multicentre study was to evaluate the effect of administration of 10 mg of sodium alendronate combined with 1000 mg of elemental calcium administered in the course of three months on the N-terminal telopeptide(NTx) a sensitive marker of bone resorption. The group comprised 275 postmenopausal women with densitometrically confirmed osteoporosis. After three months treatment a 53% decline of NTx values occurred as compared with baseline values. This finding confirms the favourable effect of sodium alendronate on bone remodelling. A decline of the concentration of bone markers is one of the good predictors of the effectiveness of treatment focused on reduction of atraumatic osteoporotic fractures.

Adult↗

PubMed1999

Laparoscopic adjustable gastric band: first experience in Slovakia.

BACKGROUND: Until recently, surgery for obesity was not done in Slovakia. After preparation in workshops, the authors began to perform laparoscopic adjustable gastric banding. Their laparoscopic work is based on a 7-year experience in laparoscopy. METHODS: From December 1997 to May 1998, 14 procedures were done. The laparoscopic adjustable gastric band was used in all procedures. The group consisted of 8 women and 6 men. Their ages ranged from 30 to 53 years (mean 43), the body mass index was 37-56 (average 46.2), the hospital stay was 3-7 days (4.8), and the operating time was 75-285 minutes (145.3). A five-trocar technique was used. RESULTS: Weight loss in the first month ranged from 9 to 15 kg. In follow-up, the weight loss averaged 3-4 kg monthly. Up to the time of writing, no band had been adjusted. Intraoperative hemorrhage occurred in two patients. No conversion was done. One patient underwent reoperation and removal of the band because of obstruction of the stoma caused by profuse vomiting after enormous intake of food. CONCLUSIONS: Despite a small early series, the procedure seems to be safe and well tolerated by patients, with sufficient early weight loss.

Adult↗

PubMed1999

[Bone turnover and bone density in type 1 diabetics in the initial stages of diabetic nephropathy].

OBJECTIVE: To compare the bone turnover and bone mineral density in type 1 diabetic patients with normoalbuminuria and type 1 diabetic patients with diabetic nephropathy with microalbuminuria or mild proteinuria. METHODS: We studied 18 type 1 diabetic patients (Group A) with normoalbuminuria (UAE < 10 micrograms/min) and 8 type 1 diabetic patients (Group B) with UAE 100-1000 micrograms/min and serum creatinine below 150 mumol/l. Markers of bone formation (bone alkaline phosphatase--ALP-B, serum osteocalcin) and bone resorption (serum tartrate-resistant acid phosphatase--ACP-TR, urinary hydroxyproline) were determined. Bone mineral density (BMD) was measured at lumbar spine and right femoral neck. RESULTS: Serum ALP-B was higher in group B [median (95% CI), 518 (405-1070) nkat/l] compared with group A [380 (355-510) nkat/l] (p < 0.05). Urinary hydroxyproline excretion was higher in group B [U-Hxp/U-creat 46.7 (22.9-80) mumol/mmol] compared with group A [18.3 (8.9-22.7) mumol/mmol] (p < 0.001). No difference was found in serum osteocalcin and ACP-TR and in BMD at L2-L4 and femoral neck. CONCLUSIONS: We conclude that bone turnover was increased in type 1 diabetic patients with incipient stage of diabetic nephropathy but there was no difference in BMD as compared with type 1 diabetic patients without nephropathy. This finding might indicate that biochemical markers unlike densitometry reflect initial changes in bone metabolism in preclinical diabetic nephropathy earlier. (Tab. 2, Ref. 17.)

Adult↗

PubMed1999

Vitamin 1,25-(OH)2 D3 concentrations in patients hospitalized long-term.

Vitamin D deficiency may be one reason for the onset and development of osteoporosis. The aim of the present study was to determine the occurrence rates of hypovitaminosis D in an unselected group of individuals presenting with common medical conditions and hospitalized for long periods. Concentrations of 1,25-(OH)2 D3 were measured in 89 patients (38 males and 51 females). Mean age was 70 years. Thirty-eight patients were tested in the spring and the remaining 51 patients in the autumn. Vitamin D3 levels were significantly reduced in patients tested in the autumn (p < 0.001). The reason for this surprising observation may have been the small number of sunny days and the long hospital stays during the study period, differences in the composition of both groups and the fact that 1,25-(OH)2 D3 reflects the actual vitamin D3 levels rather than those of its reserve in the human body. The results obtained suggesting hypovitaminosis D in an unselected group of elderly patients hospitalized with common diseases, even after the summer season, suggest the need for general supplementation of this vitamin throughout the year, regardless of the risk factors.

Aged↗

PubMed1999

[Vitamin D deficiency in hospitalized patients].

Vitamin D deficiency is one of the important risk factors for the development of osteoporosis and fractures. The high prevalence of hypovitaminosis in elderly people in old age pnesioners homes was proved in several investigations, similarly as the favourable effect of vitamin D (800 IU/day) and calcium supplementation on a decline of fracture risk. Risk factors of hypovitaminosis such as an inadequately varied diet; low exposure to sunlight, chronic liver and kidney disease and treatment affecting the metabolism and clearance of vitamin D are very frequent in elderly patients hospitalized in medical departments. In the submitted trial the authors assessed in a group of 38 patients, mean age 70 years, hospitalized at the medical department at the end of the winter period the vitamin D3 serum level. They found a significant reduction of the concentration of 1.25 hydroxyvitamin D3 (p < 0.01) in the investigated group. The results of the trial, along with data in the literature on the high prevalence of hypovitaminosis D in the European population, indicate the need to introduce this simple cheap and safe therapeutic modality into routine practice.

Aged↗

PubMed1999

[Salmon calcitonin in the treatment of osteoporosis].

Salmon calcitonin is frequently used in the treatment of osteoporosis. Via specific receptors on osteoclasts it reduces bone absorption and has also an osteogenic effect. Treatment with calcitonin leads to an increase in bone density, drop of markers of bone turnover and reduction of risk fractures. In the submitted trial the authors investigated the influence of nasal calcitonin administered in amounts of 100 IU in three-month intervals, on bone density. The group comprised 59 patients, mean age 64 years. The mean period of treatment was 2.5 years. Treatment led to a significant increase of bone density in the region of the lumbar spine and neck of the femur. Treatment was well tolerated and the authors did not record new manifest fractures or side-effects of treatment.

Administration, Intranasal↗

PubMed1998

[Bone changes in gastrointestinal diseases].

BACKGROUND: Gastrointestinal (GIT) diseases are a common cause of metabolic bone changes. The aim of the study was to indicate GIT diseases (lactose intolerance, non-lactose intolerance, Crohn's disease, ulcerative colitis, pancreatic insufficiency, states after gastric resection, chronic diseases of the liver, and coeliac disease) by means of literature data and the authors' own results coinciding with the detected low bone density and thus increased risk of fracture. Bone changes coinciding with GIT diseases are frequent and are commonly asymptomatic for a long period. CONCLUSION: In coincidence with GIT diseases the authors indicate the necessity of being aware of the risk of bone changes development and to investigate them actively. An early diagnosis aids to introduce preventive and therapeutical measures and to halt or at least slow down the origin of bone changes. (Ref. 21.)

Bone Diseases, Metabolic↗

PubMed1998

[Autoimmune thyroid disease in patients with type 1 diabetes mellitus].

Insulin dependent diabetes mellitus type I. (IDDM) is often connected with other autoimmune diseases. The most frequently concomitant disease is autoimmune thyroiditis. The authors present the results of the observation of 33 patients. The age of patients at the beginning of the study was 39.5 (24-65) years (median + confidential intervals). In all these patients, there were performed the assessment of thyroid stimulating hormone (TSH), free thyroxine (fT4), thyroid peroxidase antibodies (AbTPO) and TSH receptor antibodies (TRAK). An ultrasound examination and percutaneous aspiratory biopsy were performed in all patients. The control examination was realised 5 years later. In 1991, primary hypothyroidism due to lymphoid thyroiditis in 12.1% and autoimmune hyperthyroidism in 3% of all patients were found. During the observation period 2 patients died. In 1996 the diagnosis of primary hypothyroidism in 9.6% and M. Graves-Basedow in 3% of all patients were confirmed. Thyroid peroxidase antibodies have been positive in 33.4% of all patients with primary hypothyroidism and they correlated with ultrasound and cytology findings. (Tab. 3, Ref. 13.)

Adult↗

PubMed1998

[Etiology and pathogenesis of acute pancreatitis].

The theory of pancreatic gland autodigestion by pancreatic enzymes assumed by Chiari 1886 as the crucial moment in the pathogenesis of acute pancreatitis (AP) remains accepted so far. The appearance of mutations of cationic trypsinogen gene on the 7th chromosome in several families with hereditary AP, supports the significance of trypsin in the initiation of AP. The generally recognized etiologic factors of AP include the biliary tract disease and alcohol. Opie in his "Common Channel theory" assumed that the impacted gallstone in the ampulla of Vater could cause a permanent obstruction and subsequently AP. Later clinical studies have confirmed that a short-term block of the common pancreatic duct caused by migrating gallstones is associated with onset of AP. Chronic consumption of alcohol evokes subclinical pancreatic disturbances already prior to the onset of AP. PAP (pancreatic associated protein) being the marker of pancreatic inflammation was significantly increased in chronic alcoholism without signs of AP. Many pathophysiological concepts and effective therapeutic procedures which were successful in the animal studies have not turned out to be appropriate in man. The destruction of both cellular structure and cellular connections is an early event in the development of experimental AP. There is much evidence that free oxygen radicals and the disturbances of microcirculation determine the severeness of AP. The roles of NO (nitric oxide) and kinins remain to be clarified cytokins a interleukin 2 (IL2) and interleukin 10 (IL10) had a protective effect in experimental AP. In humans the antagonist of PAF (platelet activating factor) had reduced the occurrence of organ failure. There is hope, that this knowledge, will lead to new therapeutic possibilities.

Acute Disease↗

PubMed1998

[Therapy of acute pancreatitis].

The mortality rate in acute pancreatitis (AP) is significantly lower in patients hospitalized directly at the intensive care unit than in patients admitted to hospital in 2 weeks after the assessment of diagnosis, prophylactic administration of low-molecular protease inhibitor reduces the occurrence of post ERCP pancreatitis a well a coincident complications. Despite rational considerations concerning the significance of pryphylactic administration of antibodies (ATB) in severe AP, there still not enough convincing data which could be recommended a standard therapy. One of the concepts of causal therapy of AP. Suggest that inhibition of exocrine pancreatic enzymatic secretion reduces autodigestion of the gland (setting the gland at rest). The reports on success of secretin-inhibiting substances a glucagon, calcitonin, atropine and somatostatin require confirmation in randomized or accurately defined comparable groups. The initial studies on the therapeutic significance of lexipanphate-antagonist of platelet activating factor (PAF) in acute pancreatitis is promising. A long-term lavage had reduced the mortality.

Acute Disease↗

PubMed1997

[Bone changes in ulcerative colitis].

One of the complications of ulcerative colitis with frequent relapses is mineral deficiency (potassium, calcium, magnesium and phosphorus). The objective of the present work is to examine the bone density and laboratory parameters of bone metabolism in 25 patients with a medium severe and severe form of ulcerative colitis. In patients with ulcerative colitis a significantly reduced bone density was found in the era of neck of the femur (p < 0.05), a a non-significantly reduction of the bone density in the era of the lumbar vertebrae and an elevated level of osteocalcin (p < 0.05). These findings indicate a higher prevalence of bone changes in patients with ulcerative colitis. Early detection of bone changes makes adequate prevention and treatment of bone complications possible.

Adult↗

PubMed1997

[Endogenous levels of somatostatin, C-peptide and insulin in acute pancreatitis].

The authors compared in seven patients with acute pancreatitis the levels of endogenous somatostatin, insulin and C-peptide to assess their mutual correlation and relation to the development of the disease and serum amalyse levels. The results were compared with values recorded in 11 healthy volunteers. The levels of endogenous somatostatin were in patients with acute pancreatitis significantly higher (p < 0.05) than in the control group. The authors found an inverse relationship between the somatostatin and amylase level (correlation coefficient 0.75). They did not observe a significant correlation between somatostatin and insulin levels nor between somatostatin and C-peptide levels. The elevated somatostatin level may be due to the counteregulatory reaction during secretion, stimulated by endogenous or exogenous factors (cholecystokinin, alcohol, food).

Acute Disease↗

PubMed1996

Effects of Ca and H2O2 added to RPMI on the fretting corrosion of Ti6Al4V.

Titanium and its alloys have demonstrated considerable success in various surgical procedures including orthopedic, dental, and cardiovascular surgery. However, particulate debris from corrosion and wear is present in a considerable quantity in tissue local to the implant. This study evaluated the effect of Ca, since it is present in both serum and bone, and H2O2, since it is produced through local inflammation, on the amount of titanium release. Four sets of Ti6Al4V plates and Ti6Al4V screws were used. Each set was designated to one of four solutions: RPMI (cell culture growth media), RPMI with CaCl2, RPMI with CaCO3, and RPMI with H2O2. A fretter was used to cause corrosion by creating micromotion between two screws and a two-hole plate of Ti6Al4V. After fretting for 72 h, weight loss of the plate and screws and the amount of Ti and vanadium (V) in solution was used to assess the amount of fretting corrosion which had occurred. Results of weight loss and Ti in solution indicated that the presence of H2O2 increased the amount of particulate debris produced in RPMI as compared with RPMI alone. The addition of CaCl2 to RPMI also increased both weight loss and Ti in solution compared with RPMI alone. The addition of CaCO2, however, did not give values significantly different from RPMI alone. Comparison of weight loss and Ti in solution indicated that the increase in fretting corrosion was not different between RPMI with CaCl2 and RPMI with H2O2. The particulate wear debris from the four solutions was black in color and the size of the particulate produced was compared using a Coulter Multisizer. The results indicated that particles produced in the four solutions were not different, with mean values between 1.324 and 1.100 microns, and they were similar in size to the particulate found in tissues surrounding failed total hip replacements. In order to better understand the role of Ca in the fretting corrosion of Ti6Al4V, energy dispersive x-ray analysis (EDXA) using SEM was used to determine elemental composition of one countersink surface of a plate which had been run four times in RPMI with CaCl2. The presence of Ca in the bulk was not significant (% composition < 0.5%). However, Ca was present in two surface particles which were examined at a magnification of 55,000, with a Ca% composition of 63.2% and 19.2%. While results from this study indicate that both soluble Ca(CaCl2) and H2O2 increase the fretting corrosion of Ti6Al4V, the insoluble form of Ca, which would be found in bone and hydroxyapatite, has no effect. These data indicate that it is important to specify the media used in corrosion, dissolution, and elution experiments.

Alloys↗

PubMed1996

[The circadian cycle of endothelin-1 in healthy persons].

The possible circadian rhythmicity of endothelin-1 was investigated. Radioimmunoassay method was used in 5 clinically healthy male subjects aged 24-32 years. Blood samples were collected at 4-hour intervals over a period of 24 hours. Data for ET-1 were fitted to a 24-hour cosine curve. Statistically significant curves were found in two subjects (maximum at 4 p.m. and minimum at 10 p.m.), one did not yield a statistically significant curve and in two subjects despite the fact that the curves were not presented. Nevertheless, the circadian rhythmicity in our study was not confirmed according to our results it could not be excluded. (Fig. 2, Tab. 2, Ref. 23.)

Adult↗