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M Andĕl

Publications and source records attributed to M Andĕl.

At least 19 recordsLinked to original sources
PubMed2004

[Ferritin, oxidative stress and coronary atherosclerosis].

BACKGROUND AND AIM: In the recent years several studies showed the association between body iron stores, represented by serum ferritin, and atherosclerosis. It was proposed that iron bound to ferritin catalyzes the formation of highly reactive forms of oxygen free radicals which subsequently cause the oxidative modification of atherogenic lipoproteins. Aim of our study was to compare serum ferritin concentrations and certain markers of oxidative stress in patients with and without coronarographically assessed coronary vascular disease. METHODS AND RESULTS: Measurements were performed in 216 subjects at the age of 35-60 years. The patient group included 76 patients with coronarographically assessed coronary vascular disease (CVD) (mean age 51.16 +/- 5.713 years) and 140 healthy controls (mean age 50.21 +/- 5.331 years). The plasma concentration of ferritin was higher in patients (169.04 +/- 63.899 micrograms/l) than controls (87.70 +/- 41.394 micrograms/l), p < 0.001. The group of patients revealed significantly lower plasma concentrations of anti-oxLDL antibodies, nitrites/nitrates, tocopherol and high density lipoprotein cholesterol (HDL-cholesterol) than controls; on the contrary patients had significantly higher concentrations of hemoglobin, thrombocytes and triacylglycerols. In the whole cohort of investigated subjects, ferritin correlated positively with retinol, body mass index (BMI), total-cholesterol, triacylglycerols, low density lipoprotein cholesterol (LDL-cholesterol), blood glucose, creatinine, uric acid, alaninaminotransferase (ALT), aspartateaminotransferase (AST), hematocrite, erythrocytes, with occurrence of CVD and with sex. Inverse correlation was observed between ferritin and HDL-cholesterol. CONCLUSIONS: Our observations are consistent with the hypothesis that high stored iron levels, measured by serum ferritin concentrations, may contribute to the oxidative stress and thus elevate the risk for development of CVD.

Adult↗
PubMed2004

[Genetic risk factors in autoimmune diabetes mellitus, their significance and function].

Autoimmune diabetes mellitus is characterized by selective destruction of beta pancreatic cells and by cellular infiltration with T- (particularly Th1) and B-lymphocytes. The marker of autoimmunity is the presence of autoantibodies (ICA, IAA, GADab, IA2ab). Etiology of the autoimmune process is still unknown. It is suggested that the pathogenesis is activated by genetic and environmental factors. Individual predisposition can influence also the onset and progression of the disease. The most important genetic risk factors of autoimmune diabetes mellitus are the HLA class II alleles (DQB1*0302, 0201; DRB1*0301, 0401; DQA1*0301, 0501) and the risk alleles of INS-VNTR of the promoter region. Recent studies have shown various genetic risk factors for the autoimmune diabetes mellitus. Individual predispositions belong to the genetic polymorphisms in cytokine genes (IL-10, IL-12, IL-18) and the microsatellite polymorphism of MHC class I chain-related gene A (MIC-A).

Autoimmunity↗
PubMed2004

[The Budd-Chiari syndrome in a patient with primary thrombocythemia treated with interferon alfa and transjugular portosystemic shunt].

The case report of a young female patient with personal history of primary thrombocythaemia, treated with interferon alpha, admitted to our medical department for severe abdominal pain, hepatomegaly, ascites and alteration of hepatic function is presented. Magnetic resonance imaging showed the picture typical for Budd-Chiari syndrome caused by external obstruction of the intrahepatal portion of inferior vena cava. The cause of the syndrome remains uncertain, possibility of the haematogenic infiltration of the liver or venal thrombosis within primary or secondary (interferon-induced) antiphospholipid syndrome is discussed. Liver biopsy could elucidate the exact cause, but it was not performed for technical problems.

Adult↗
PubMed2004

[Signs of active infection with Chlamydia pneumoniae in patients with coronary heart disease].

BACKGROUND: Possible relationship between Chlamydia pneumoniae (CPN) infection and atherosclerosis has been documented in many seroepidemiological, histological and biological studies. The objectives of the present study were to find out whether serological signs of active CPN infection in patients with coronary heart disease (CHD) are associated with the presence of bacterial DNA in peripheral blood and to correlate with clinical symptoms and to study the dynamics of the markers of CPN infection within a six-month follow-up. METHODS AND RESULTS: Seventy-one patients with acute CHD were enrolled in the study. They underwent clinical and biochemical tests and were screened for the presence of genus- and type-specific IgG, IgA and IgM antibodies against CPN at admission and then in 3- and 6-month intervals. CPN DNA was detected in peripheral blood using nested PCR. Serological markers of active CPN infection were found in 36 patients (51.4%) while bacterial DNA was detected in two patients only. Laboratory signs of active CPN infection did not correlate with either clinical symptoms or levels of biochemical markers. In most of the patients, titers of anti-CPN antibodies were stable throughout the follow-up. Increase in antibody titers was observed in 23% of patients and was associated with more frequent signs of unstable angina pectoris (p=0.06) but not with higher risk of myocardial infarction within 6 months after the acute episode of CHD. CONCLUSIONS: In patients with CHD, serological markers of active infection persist for a long time. Nevertheless, their association with the course of CHD or relapse risk was not proved. Bacterial DNA was rarely detected in peripheral blood of the patients. None of the currently available laboratory tests proved adequately effective for detection of ongoing or chronic CPN infection. This project was sponsored by grant IGA MZ CR NI/6811-3 and research plan of Natl. Inst.Publ.Health

Antibodies, Bacterial↗
PubMed2003

Serological markers of Chlamydia pneumoniae, cytomegalovirus and Helicobacter pylori infection in diabetic and non-diabetic patients with unstable angina pectoris.

The possible role of inflammation in coronary artery disease (CAD) is being recognised, while markers of inflammation (e.g., CRP) and infection with Chlamydia pneumoniae (C. pneumoniae), cytomegalovirus (CMV) and Helicobacter pylori (H. pylori) have been proposed as risk factors for CAD. However, these associations require further evaluation. It is a known fact that diabetic patients suffer from impaired immune response to some pathogens and a high incidence of atherosclerosis. In this case-control study we investigated serological markers of infection with C. pneumoniae, CMV, and H. pylori in a group of 140 patients with unstable angina pectoris (UA), 52 of them having type 2 diabetes mellitus, and in a matched control group. Anamnestic (IgG) and acute infection (IgA) antibodies against the above agents were tested using ELISA or indirect immunofluorescence tests. In patients with UA we found a significantly higher seroprevalence and titres of IgG antibodies against C. pneumoniae (p = 0.04) and increased titres of IgG antibodies against CMV (p = 0.007). No differences were found in IgA antibody response to these pathogens. Antibody response to H. pylori was similar in both groups tested. In diabetic patients with UA, the frequency of group-common IgG antibodies against C. pneumoniae was higher than in the non-diabetic UA patients. The other serological markers studied were comparable in the patients with or without diabetes mellitus. Our findings confirmed association of C. pneumoniae and CMV with cardiovascular heart disease. Moreover, diabetes mellitus may predispose the patients to C. pneumoniae infection. However, serological markers observed do not indicate that destabilisation of angina pectoris is associated with acute C. pneumoniae or CMV infection. No relationship was found between UA and H. pylori infection.

Adult↗
PubMed2003

[Calculation of the costs of drugs, medical materials, certain medical procedures and social services for patients with diabetic foot syndrome].

The aim of this study was to analyse the direct costs of some components of primary, secondary and tertiary prevention of the diabetic foot syndrome (cost of illness study). Information considering the costs of prevention and therapy of the diabetic foot and costs following after amputation in diabetic patients is available from international economical trials but is almost missing in the Czech Republic. The economical assessment of the most important mean of primary prevention/which is regular dispensarisation and preventive care for diabetic patients in risk of diabetic foot syndrome/is very problematic. The costs of primary prevention were calculated as the intervention costs of risk factors of diabetic foot syndrome according to the recommended daily doses and prices of the medicaments in AISLP database. Costs of hospitalisation in secondary and tertiary prevention were calculated by using bills for health insurance company in the programme Steiner-UNIS, costs for out-patient care according to ordinations (medication, aids, codes for heath insurance companies and means of diagnostic process). Costs of tertiary prevention were based on information gained from the Regional Social Authority. There were 20 patients (12 men, 8 women, age 65 +/- 12 years, 3 patients with 1. type diabetes, 17 with 2. type diabetes), involved in secondary in-patient care, 30 (20 men, 10 women, age 69 +/- 12.4 years, 2 patients with type 1. diabetes, 28 with type 2 diabetes) in out-patient care and 20 (12 men, 8 women, age 70 +/- 9.4 years, 1 patient with type 1 diabetes, 19 with type 2 diabetes) in tertiary prevention. This study proved high costs of the intervention of hyperglycaemia in type 1. diabetics, hypertension with ACE inhibitors, critical ischaemia, neuropathy. Costs of out-patient care for ulcers for eight months were 7,500.- +/- 4,400.-CK, antimicrobial treatment 1,900.-CK, in-patient care for ulcers 22,500.- +/- 6,400.-CK and amputation 22,000.- +/- 9,900.-CK. The highest costs were calculated for tertiary prevention--the first year after amputation 400,000.- CK. The study shows very high costs of tertiary prevention and suggests discussion on this topic.

Aged↗
PubMed2003

[Infectious and inflammatory factors in the etiology and pathogenesis of atherosclerosis].

Although the metabolic syndrome together with insulin resistance and their consequences are probably basic factors in pathogenesis of atherosclerosis, inflammatory and infectious aspects of this process are unquestionable only in some of the patients. Endothelial dysfunction was identified both in the experiment and in patients after herpes virus simplex 1 infection, cytomegaloviral infection, Chlamydia pneumoniae infection, or Helicobacter pylori infection. However, it is not clear whether it is always caused by direct specific activity of a given pathogen or whether it is a result of inflammatory cytokines activity, heat shock protein activity, or CRP activity. In recent years secondary antibiotic prevention in patients after myocardial infarction has been discussed. Lower mortality rate from acute myocardial infarction and cerebral vascular accidents were found in several observations of patients vaccinated against influenza. In patients with non-stable angina pectoris we have found significantly more frequent occurrence of IgG antibodies against Chlamydia pneumoniae. This occurrence was more frequent in diabetics compared to non-diabetics. Endothelia exposed to cyto-megaloviral infection exprimed adhesive molecules on their surfaces. After an increase of the concentration of glucose in medium to 11.0 mmol/l and 16.5 mmol/l the expression of adhesive molecules after cyto-megaloviral infection increased. Relationship of infection, inflammation, and atherosclerosis has been a subject of intensive investigation in recent years. Discussion of possible consequences of these findings, especially from viewpoint of atherosclerosis prevention and its organ complications, is of the same intensity. Hypothesis about participation of infection and inflammation in pathogenesis of atherosclerosis seems to be very attractive. In spite of the fact that findings supporting this hypothesis cumulate final conclusion can't be made yet.

Arteriosclerosis↗
PubMed2002

[Association of HLA molecules with autoimmune diseases].

The etiology of autoimmunity diseases includes an immunological reaction against various autoantigens. The HLA molecules play an important role in the antigen presentation process to the immune system. The HLA genes were found as the most significant genetic predisposition factor. The strongest association described in the literature is the association of HLA-B27 with ankylosing spondylitis. Associations were since usually observed with HLA-DR and DQ genes. We are also focused on Diabetes mellitus 1. type. Diabetes is an organ specific autoimmune disease characterised by destruction of beta-cells of Langerhansen pancreatic islets. The cause of the destruction process is not known yet, but it seems to be triggered by repeated presentation of self-antigen hGAD65 to the immune system. This review presents the most interesting solutions and hypotheses of the unanswered question about HLA association mechanism.

Autoimmune Diseases↗
PubMed2002

[Methods for identification of HLA antigen polymorphisms].

The HLA complex is the most polymorphic genetic system in man yet known. The variability of the HLA antigens is given by the presence of many alleles of the HLA genes. Requirements for compatibility of HLA antigens in organ and bone marrow transplantations, and also in the determination of genetic risk factors in autoimmune diseases evoke strong pressure on progress in HLA typing methods, mainly for increasing their sensitivity and resolution. For typing of the HLA antigens there are used cellular, serological, biochemical and DNA methods. For HLA class I typing there following tests are used: cytotoxic test (serological), CML (cellular), 1D--IEF (biochemical), RFLP, SSO, SSP--PCR, and SBT (DNA methods). For HLA class II typing, cytotoxic test (cellular), MLC (serological), RFLP, SSO, SSP--PCR, and SBT (DNA methods) are used. DNA methods represent the modern trend in the area of HLA typing and it will probably replace larger part of other HLA typing techniques. In our article, we describe the principles of methods that are used for HLA typing.

HLA Antigens↗
PubMed2002

Insulin lispro improves postprandial glucose control in patients with diabetes mellitus.

Insulin lispro was compared with regular human insulin with respect to glycaemic control in patients with diabetes mellitus on intensive insulin treatment. Sixty-two patients (55 type 1; 7 type 2) from eight study centres in the Czech Republic, Slovenia and the Slovak Republic participated in a 4-month, open-label, randomized, crossover study. Patients administered insulin lispro immediately before meals or regular human insulin 30 min before meals. A test meal (220-400 kcal), based on local and individual dietary habits and consistent for each patient throughout the study was given at baseline and at the end of each treatment. At each test meal visit HbA1c, fasting blood glucose, 1-hour and 2-hour postprandial blood glucose levels were measured. The level of HbA1c (7.6% +/- 1.5% versus 7.4% +/- 1.5%), incidence of hypoglycaemia (41-66% of patients--versus 39-63%) and daily insulin dose (0.67 +/- 0.11 U/kg versus 0.65 +/- 0.11 U/kg) did not differ between treatment groups at endpoint (insulin lispro versus regular human insulin, respectively). Mean 2-hour postprandial blood glucose excursion for the insulin lispro group (0.0 +/- 3.7 mmol/L) was significantly lower (p = 0.035) when compared with the regular human insulin group (1.3 +/- 3.7 mmol/L) at endpoint. Therapy with insulin lispro was therefore associated with a significant improvement in postprandial blood glucose excursion control when compared with regular human insulin, without an increase in rate of hypoglycaemia.

Adult↗
PubMed2002

[Parenteral glutamine does not improve the nutritional status in patients during high-dose chemotherapy and autologous peripheral stem cell transplantation].

BACKGROUND AND AIM: High-dose chemotherapy is aggressive treatment modality adversely affecting both energy/protein demands and oral intake/resorption of nutrients. Aminoacid glutamine is known for its' proteoanabolic effect and as an energy source for enterocytes and immune system. Nutritional parameters have been studied in a controlled, randomised, double-blinded trial of parenteral glutamine supplementation of autologous stem cell transplant patients. METHODS: Forty consecutive patients with haematological and solid cancer and multiple sclerosis were treated from 1999 to 2001 by high-dose chemotherapy with autologous stem cell transplantation. Patients were randomly assigned either for parenteral administration of 30 g of alanyl-glutamine dipeptide (Dipeptiven, Fresenius-Kabi) or isonitrogenous glutamine-free amino acid solution from day +1 to day +14 or to discharge from hospital. Patients were closely monitored from admission to day +100. Nutritional parameters included: oral dietary intake, body weight, body composition, energy expenditure, concentration of serum proteins and nitrogen balance. Parenteral nutrition in dose of 26.5 kcal/kg and 1 g of aminoacid/kg was given to patients who did not reach adequate oral intake for 5 days and withheld after three consecutive days of adequate intake. RESULTS: Nutritional assessment on admission differed according to the method used but no parameter of nutrition predicted the clinical course of treatment. Inadequate oral intake period lasted (mean +/- SD) 6.8 +/- 5.9 days, average length of stay being 17.5 +/- 3.9 days. Patients were unable to use sipping of enteral feed. Resting energy expenditure neither on admission nor in critical period differed from predicted value. Serum protein concentrations significantly decreased on discharge with normalisation as soon as to day +28, correlating inversely with changes in extracellular water content. Nitrogen urine loss was 10-16 g/day. Only 42.5% of patients were treated with parenteral nutrition. Cumulative nitrogen balance at day +9 was -30.7 +/- 24.1 g N. Body weight at day +28 significantly decreased (-2.94 +/- 4.4 kg), mostly consisting of loss of pure body cell mass. Glutamine supplementation did not improve any of the listed nutritional parameters. CONCLUSIONS: High-dose chemotherapy with autologous stem cell transplantation causes proteocatabolism of medium severity. Nutritional status of patients cannot be improved by the mode and dosage of parenteral glutamine used in our study. Optimal nutritional monitoring and treatment for this group of patients is suggested.

Adult↗
PubMed2001

[Diabetology at the threshold of the 21st century].

Scientific advances in the 19th and 20th centuries led to the discovery of insulin, the fundamental therapeutic means for treatment of diabetes mellitus type 1 at the onset of the twenties, to the introduction of sulfonylurea derivatives and biguanides in the fifties and sixties. The discovery of the principle of radioimmunoassay at the end of the fifties made it possible to investigate insulin secretion and to achieve a more accurate understanding of the pathogenesis of type 1 and 2 diabetes. Understanding of insulin resistance made it possible to introduce an euglycaemic hyperinsulin clamp at the end of the seventies. Insulin resistance was presented in context with metabolic syndrome X. Insulin is administered at the break of the millenium in subcutaneous injections, insulin dispensers and insulin pumps, experimentally also by the intraperitoneal and inhalatory route. In the nineties in the practice of diabetes 1 therapy ultrashort-term and finally als long-term insulin analogues were developed. For type 2 diabetes mellitus inhibitors of alpha-amylase were introduced and as a quite new group of oral antidiabetics thiazolidindiones. The possibility of 24-hour monitoring of the blood sugar level by means of a subcutaneous glucose sensor was introduced. The end of the century is characterized also by attempts to administer growth factors in the treatment of non-patent vascular obstructions in the diabetic foot syndrome. In mice and rats transformation of the ductal cell of the exocrine pancreas to the Langerhans islet cell proved successful. Further progress in diabetology will depend, similarly as in the rest of medicine, in particular on advances in cellular and molecular biology and genetics, as well as advances in microelectronics and new materials. Emphasis on the community understanding of this disease and consequential primary prevention of diabetes and secondary prevention of its complications are important.

Diabetes Mellitus↗
PubMed2000

Serum ferritin levels in subjects at high risk of atherosclerosis.

Serum ferritin levels were determined in a group of 148 subjects drawn from a community study who were found to be at high risk of atherosclerosis (evaluated on the basis of the following data: levels of non-HDL cholesterol, arterial pressure, smoking status, cardiovascular or cerebrovascular disease in a subject's history, diabetes mellitus, a positive family predisposition to, or accumulation of the above factors) and compared with the levels obtained in a control group of 148 examined age- and sex-matched subjects from the same community with non-significant risk factors. Mean serum ferritin levels were higher in the whole risk group and in the subgroups of risk men and postmenopausal women than in the corresponding controls (the whole risk group: 263.4 +/- 218.5 micrograms/l vs. 198.3 +/- 179.5 micrograms/l, p < 0.05; the subgroup of men 361.8 +/- 235.7 micrograms/l vs. 286.4 +/- 194.6 micrograms/l, p < 0.05 and the subgroup of postmenopausal women 184.1 +/- 143.1 vs. 126.7 +/- 108.4 micrograms/l, p < 0.05).

Adult↗
PubMed2000

[Fatty acid composition of domestic dietary fats].

Trans fatty acids (TFA) were analyzed by capillary gas chromatography in four groups of edible fats available on the Prague market. In animal fats, 1.9-2.5%, 2.8-5.5% and 11.3-13.5% TFA were found in the lard, butter, and butter enriched by vegetable fat, respectively. In shortenings, TFA content varied between 0.5 and 38%, in margarines from 0.6 to 13% and in table fats from 1.4 to 27%.

Czech Republic↗