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Biomedical subjects

R Ceska

Publications and source records attributed to R Ceska.

At least 19 recordsLinked to original sources
PubMed1995

[Silent myocardial ischemia in outpatients being treated for hyperlipoproteinemia].

BACKGROUND: Hyperlipoproteinaemias, in particular those associated with hypercholesterolaemia, are in a causal relationship with the development and acceleration of atherogenesis. One of the serious forms of coronary heart disease is silent myocardial ischaemia--an asymptomatic objectively confirmed ischaemic episode. The objective of the present study was to 1. assess the prevalence of this disease in subjects with hyperlipoproteinaemia and 2. to assess the optimal diagnostic procedure to detect it. METHODS AND RESULTS: The group comprises 57 subjects selected at random (23 men and 34 women) from the out-patient department for genetics and treatment of hyperlipoproteinaemias. In all subjects an ergometric loading test was made and 24-hour ambulatory ECG monitoring. Suspected silent myocardial ischaemia (i.e. positive results of the two examinations) was confirmed by load scintigraphy of the heart muscle. Silent myocardial ischaemia was proved in 3 of 23 examined men (13%) and in 4 of 34 women (11.8%). CONCLUSIONS: Prevalence of silent myocardial ischaemia is significantly higher in high risk subjects--with hyperlipoproteinaemia than in the general asymptomatic population. The best screening test for its detection is a loading test and ambulatory ECG monitoring, supplemented by loading scintigraphy of the heart muscle.

Adult↗
PubMed1995

[Decrease in common carotid artery intimal thickness after hypolipemic therapy].

BACKGROUND: In recent years evidence was provided that it is possible to assess sonographically the thickness of the intima of the common carotid artery, whereby an increase of the thickness of the intima is considered an early stage of atherosclerosis. In the submitted work the authors tried to assess whether it is possible to influence the thickness of the intima by therapy. METHOD AND RESULTS: In 32 patients with familial hyperlipoproteinaemia sonographic control examinations of the common carotid artery were performed after 27 months of comprehensive treatment. In 21 subjects with familial hypercholesterolaemia the thickness of the intima decreased from 0.83 mm to 0.68 mm (p < 0.01), in 8 subjects with familial combined hyperlipoproteinaemia from 0.77 mm to 0.74 mm (a decline was recorded in half the subjects). In the whole group the greatest decrease was recorded in subjects treated with statins and a smaller decrease in those treated with fibrates. CONCLUSIONS: The authors assume that the decrease of the thickness of the intima of the common carotid artery recorded in hyperlipoproteinaemic patients after hypolipidaemic treatment is a manifestation of regression of atherosclerosis.

Adult↗
PubMed1995

[Simvastatin in the treatment of familial hypercholesterolemia].

BACKGROUND: The association between hypercholesterolemia and premature atherosclerosis is almost universally accepted. Treatment of hyperlipoproteinemias represents a reasonable approach in preventive cardiology. The aim of the study was to prove a hypolipidemic effect of simvastatin, Zocor tablets à 10 mg, produced by MSD, U:S.A. in patients with familial hypercholesterolemia. METHODS AND RESULTS: 29 familial hypercholesterolemia heterozygotes have been treated with increasing dose of simvastatin (10 and 20 mg/day with the evening meal) for three months. All patients have been on AHA step I diet. The basic parameters of lipid and lipoprotein metabolism have been measured, as well the concentrations of apolipoproteins A-I and B, and the level of lipoprotein(a). Concentration of total cholesterol decreased after treatment with 10 and 20 mg of simvastatin by 20%, resp. 26%. The hypolipidemic effect was even more pronounced in LDL-cholesterol level, which was reduced by 24% respectively 34%. On the other hand therapy with simvastatin did not influence HDL-cholesterol at all. Also triglycerides concentration did not changed very significantly after administration of simvastatin (triglycerides levels were reduced by 7% respectively by 18%). Decline of LDL-cholesterol has been accompanied by decrease of apolipoprotein B concentration by 24%, resp. 26%. The concentration of lipoprotein (a) has not been statistically significantly influenced, even its level increased slightly. The body weight of the patients did not changed during the study. Simvastatin treatment has been well tolerated by the patients. CONCLUSIONS: Simvastatin, Zocor, seems to be powerful hypolipidemic drug, which is to be used even in the treatment of familial hypercholesterolemia heterozygotes, who are usually very resistant to the therapy. The dose of 10 mg of simvastatin is usually sufficient to influence plasma lipids and lipoproteins. A double dose intensifies the hypolipidemic effect but this additional effect is not so expressive. Zocor is tolerated well by the patients and in safety laboratory we did not notice any important undesirable result.

Adult↗
PubMed1995

[DNA analysis in heterozygotes in familial hypercholesterolemia].

BACKGROUND: Accuracy of clinical diagnosis of heterozygotes with familial hypercholesterolemia (FH) is limited. The aim of our study was to demonstrate possibilities of progressive diagnostic approach, DNA analysis, LDL receptor gene (LDLR) and apolipoprotein B (ApoB) in case of our study, and compare our results with the data obtained in other populations. METHODS AND RESULTS: The low density lipoprotein receptor (LDLR) gene RFLP frequencies for restriction endonucleases AvaII, HincII, NcoI, PvuII and StuI were determined in the sample of 52 FH patients and in the group of 37 healthy individuals. Using PCR, the LDLR gene was then tested for Pro664-Leu and Val408-Met point mutations. The first DNA diagnosis of familial defective apolipoprotein B-100 (FDB) using point mutation PCR analysis of 26. exon of ApoB gene in Czech Republic was performed. LDLR gene RFLP frequencies for restriction endonucleases AvaII, HincII, NcoI, PvuII and StuI in he sample of 52 FH patients were 0.48, 0.52, 0.73, 0.31 and 0.93 respectively. LDLR gene RFLP frequencies for enzymes AvaII, HincII, NcoI, PvuII and StuI in the group of 37 healthy individuals were 0.39, 0.50, 0.70, 0.22 and 0.99 respectively. In the group of FH patients no point mutations Pro664-Leu and Val408-Met were detected. However, there was found 110bp insertion in the 9th exon of LDLR gene in two FH patients during studies of Val408-Leu mutation. Two FDB probands in the FH group and another 7 FDB individuals in probands families were detected. FDB frequency in the sample of FH patients was 3.8%. CONCLUSIONS: LDLR gene RFLP frequencies and FDB frequency in our group of FH patients did not differ from that of FH patients in other Caucasian populations. DNA analysis is advantageous complementary method for diagnosis of FH and is irreplaceable for the detection of FDB.

Adult↗
PubMed1995

[Pharmacotherapy of hyperlipoproteinemia in view of the newest European and American recommendations].

UNLABELLED: Hyperlipoproteinaemias, in particular types associated with elevated levels of total and LDL-cholesterol and partly triacylglycerols (in particular in combination with reduced HDL-cholesterol), are one of the most serious risk factors of early manifestation of IHD and atherosclerosis at other sites. Their effective treatment is considered a rational procedure in preventive cardiology. Who should be treated, when and how? When deciding we have to combine two basic approaches. Every patient must be considered individually, on the other hand, it is necessary to respect some general recommendations. The most comprehensive view of the given problem will be found in the innovated recommendations of the EAS of 1992 and NCEP of 1993. They contain not only values of parameters of the lipid and lipoprotein metabolism where dietetic and pharmacological intervention should be provided but also target values which should be aimed for in these patients. Treatment of hyperlipoproteinaemias is comprehensive and comprises dietary and lifestyle provisions. In indicated cases increasingly pharmacotherapy is emphasized to which most of the presented paper is devoted. Pharmacotherapy of hyperlipoproteinaemias. Hypolipidaemic agents can be divided into several groups. 1) Drugs which affect above all cholesterol; 2) Drugs which affect cholesterol and triacylglycerols (HDL-CH); 3) Drugs used only on a small scale; 4) Dietetic preparations; 5) Oestrogens? and 6) a combination of two or more hypolipidaemic agents!!! CONCLUSION: The author discusses the basic indications of different hypolipidaemic agents from the aspect of their effect, safety and tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1994

[Monitoring plasma levels of vitamin D metabolites in simvastatin (Zocor) therapy in patients with familial hypercholesterolemia].

BACKGROUND: Simvastatin is a hypolipidaemic agent, a statin which inhibits cellular cholesterol synthesis by blocking 3HMG CoA reductase. The authors present a report on levels of plasma metabolites of vitamin D after treatment with 10 and 20 mg simvastatin daily in 13 patients, heterozygotes with hypercholesterolaemia during a five-week period. METHODS AND RESULTS: During simvastatin treatment in all patients plasma levels, of the sum of hydroxylated vitamin D metabolites and 1,25-dihydroxyvitamin D after five weeks of treatment with 10 and 20 mg hypolipidaemic drug were examined. For assessment of vitamin D metabolites radioassay was used which assesses the sum of hydroxylated vitamin D metabolites, and radioimmunoanalysis for assessing the 1,25-dihydroxyvitamin D plasma level. For statistical evaluation the non-parametric Friedman test and simultaneous testing was used. CONCLUSIONS: Simvastatin raises the plasma levels of the sum of hydroxylated vitamin D metabolites and 1,25-dihydroxyvitamin D in a dose-dependent ratio. The authors recommend to monitor the plasma levels of vitamin D metabolites over a longer time period.

Adult↗
PubMed1994

[Familial apolipoprotein B-100 defect, a newly discovered lipid metabolism disorder].

Familial defective apolipoprotein B-100 is a newly revealed genetic disorder which leads to a rise of atherogenic LDL lipoproteins. It is probably due to the replacement of a single amino acid in the huge apoliprotein B-100 molecule, i.e. substitution of glutamine by arginine in position 3,500. Thus altered LDL-lipoproteins are unable to bind with the LDL-receptor. As a result of the mentioned metabolic disorder a slightly or markedly elevated plasma cholesterol develops which very probably leads to premature manifestation of atherosclerosis. The disease is transmitted by autosomal dominant inheritance and its incidence in the population is estimated to amount to 1:500, i.e. a similar rate as familial hypercholesterolaemia. In the submitted paper some historical facts are presented which led to the detection of the disease, methods which are used for its detection, and the author presents also results of the first, so still limited clinical investigations.

Apolipoprotein B-100↗
PubMed1993

[Therapy with fibrates and vitamin D metabolism].

The authors investigated in 29 patients with familial hyperlipoproteinaemia the effect of fibrate treatment (Duolip forte, Merckle, and Lipanthyl, Richter) on vitamin D metabolism. In 10 patients treated for 6 months with daily oral doses of 500 mg Duolip forte they did not prove changes of plasma levels of 25-hydroxyvitamin D, however, they recorded a rise of the 1,25-dihydroxyvitamin D3 plasma level. In 19 patients who were given for 6 months 300 mg Lipanthyl per day by the oral route they proved a significant decline of the 25-hydroxyvitamin D plasma levels and a rise of 1,25-dihydroxyvitamin D3 plasma levels. The authors maintain that fibrates influence plasma concentrations of vitamin D metabolites either directly or indirectly by reducing cholesterol plasma levels.

Adult↗
PubMed1993

[Carotid artery and femoral artery disease in asymptomatic patients with various types of hyperlipoproteinemias and in healthy persons].

The authors examined by means of the sonograph Siemens Quantum 2000 the carotid and femoral arteries of 21 controls and 91 asymptomatic subjects with different types of hyperlipoproteinaemia (HLP). 46 patients suffered from familial hypercholesterolaemia, another 19 patients with hypercholesterolaemia suffered from ischaemic heart disease, 21 patients had familial combined hyperlipoproteinaemia and 5 patients had familial dysbetalipoproteinaemia. In the controls no plaques or stenoses were detected. In the different groups with HLP plaques and stenoses on the carotid artery were found in 15-36%, on the femoral artery in 24-63%. In patients with HLP on the common carotid artery in different groups a detectable intima was found more frequently, a statistically highly significantly wider intima (0.73 +/- 0.17 mm to 0.84 +/- 0.31 mm) and a lower maximum rate (79 +/- 18 cm/s to 98 +/- 24 cm/s) than in controls (0.41 +/- 0.14 mm and 121 +/- 30 cm/s resp.). On the common carotid the authors found a significant direct correlation between age and the cholesterol level and between age and the width of the intima and an indirect correlation between age and the maximal rate. The differences in the width of the intima and maximum rate were preserved even when the groups were adjusted for age. Changes of the femoral artery were less marked.

Adult↗
PubMed1993

[Familial hypercholesterolemia from the aspect of DNA analysis].

The authors summarize their first experiences with DNA analysis of defective low density lipoprotein receptor (LDLR) gene of the familial hypercholesterolemia heterozygotes that were selected from the III. Medical Clinic of the 1st Medical Faculty in Prague patients group. First genotype studies of unrelated FH individuals were performed by restriction fragment length polymorphism (RFLP) method. Relative allele frequencies of PvuII (0.69) and StuI (0.91) restriction enzymes agree with the world literature datas, in the ApaLI (0.69) case the higher value may be caused by, for the present, small number of analyzed patients. Possibilities of DNA analysis for pedigree FH diagnosis were demonstrated on the PvuII restriction enzyme case. By the use of polymerase chain reaction (PCR) DNA diagnosis of the familial defective apolipoprotein (Apo) B-100 (exon 26) was performed. 43 unrelated FH individuals were screened and none defective ApoB-100 gene was recorded.

Apolipoprotein B-100↗
PubMed1992

[Diseases of civilization from the aspect of evolution of the human diet].

The authors discuss contemporary views regarding the causes of diseases of civilization which developed on an epidemic scale in industrial societies during the last 60-70 years. They are due to the immense changes of lifestyle adopted by these societies. On the whole this lifestyle is a marked deviation from optimal conditions for humans. The genetic equipment of man which determines the evolutional advantages and function of different metabolic processes which ensure the homeostasis of the healthy organism is conservative and is entirely adapted to the human genome which developed in the course of hundreds of thousands of years. The aim of preventive medicine is to analyze, point out and enforce diminution of the effect of risk factors, as an important way towards improvement of the general health status of the population.

Diet↗
PubMed1992

[Combined therapy of hyperlipoproteinemia. Colestipol and gemfibrozil in the treatment of heterozygous familial hypercholesterolemia].

Combined concurrent treatment with two or more hypolipidaemic agents is a modern trend in the pharmacotherapy of hyperlipoproteinaemias. Aggressive treatment of hyperlipoproteinaemias can lead not only to the arrest of progression but also to regression of the atherosclerotic process. The authors submit experience assembled with the treatment of 14 heterozygotes with familial hypercholesterolaemia by a combination of colestipol (Colestid Upjohn, Belgium) with gemfibrosil (Loped Parke-Davis, USA), 15 g and 1200 mg resp. per day. One month of administration of this combination of hypolipidaemic agents led to a drop of total cholesterol by 21% and of LDL-cholesterol by 30%. At the same time the authors recorded a marked and statistically significant increase of HDL-cholesterol by 23%. Favourable changes were observed also as regards apolipoprotein concentrations. The apolipoprotein A-1 level increased by 32%, while the level of the atherogenic apolipoprotein B declined by 30%. The triglyceride level declined also. It did not prove possible even by combined treatment to reduce the level of apolipoprotein(a). Combined treatment with colestipol and gemfibrosil was well tolerated by the patients and in none of the patients treatment had to be discontinued because of undesirable side-effects.

Adult↗
PubMed1992

[Colestipol in the treatment of heterozygous familial hypercholesterolemia].

In the specialized clinic for disorders of the lipid metabolism 27 patients, 8 men and 19 women, heterozygotes with familial hypercholesterolaemia were treated for 8 weeks with Colestid (colestipol bags a 5 g, Upjohn, Belgium). The administered dose was 15 g colestipol per day. After colestipol treatment the authors recorded a statistically significant decline of total cholesterol by 18% and of LDL-cholesterol by as much as 27%. The apolipoprotein B concentration declined during treatment by 9% and concurrently there was a favourable rise of apolipoprotein A-1 by 20%. The authors recorded also a slight rise of the HDL-cholesterol concentration which, however, was not statistically significant. The serum triglyceride level increased slightly after colestipol treatment. It did not prove possible to influence the lipoprotein(a) level by colestipol administration. As compared with other hypolipidaemic agents from the group of ion exchange resins, the patients tolerated Colestid surprisingly well. Only one female patient discontinued treatment because of dyspeptic complaints, severe constipation.

Adolescent↗
PubMed1991

Influence of testosterone isobutyrate on serum lipoproteins during replacement therapy of hypogonadal men.

Replacement therapy of hypogonadal men with testosterone isobutyrate, 100 mg by the i.m. route every two weeks, does not lead to a permanent significant change of the lipoprotein spectrum and to an increased risk of stereogenesis. The expected changes in the liver lipase activity and in the lipoprotein spectrum under the influence of the administered androgens are obviously suppressed by the antagonistic action of estrogens formed by conversion from androgens.

Adult↗
PubMed1990

[Bezalip in the treatment of hyperlipoproteinemia].

In a specialized clinic for hyperlipoproteinaemias 15 patients with different types of hyperlipoproteinaemias were treated with bezafibrate (Bezalip R tablets a 200 mg of Boehringer Co.) for a period of four weeks 3 X 1 tablet per day. The administration of Bezalip led to a significant drop of cholesterol (-20%), triglycerides by 40% and LDL-cholesterol (-17%), while the HDL cholesterol level did not change significantly. During treatment a drop of the apolipoprotein B level by 17% occurred, the concentration of apolipoprotein A-I increased by 12%. The drug was well tolerated by the patients, there were no undesirable effects calling for discontinuation of treatment. The results are discussed along with those of other authors who had the opportunity to administer the drug for a prolonged period. The authors mention also briefly the results obtained during treatment of patients with hyperlipoproteinaemias, using other hypolipidaemic drugs.

Adult↗
PubMed1990

[Etolip and Lipanthyl in the treatment of hyperlipoproteinemia].

Within the framework of clinical tests of Etolip (ethophylline clofibrate cps. 125 mg, Pharmaceutical Research Institute Modra) this preparation was administered to 28 patients with different types of hyperlipoproteinaemia in a specialized clinic for disorders of the lipid metabolism. The period of administration was four weeks, the dose 2 cps. twice a day. The effect of this new hypolipidaemic drug was compared with that of Lipathyl. Treatment with Etolip did not affect significantly the cholesterol and triacylglycerol levels, and the concentrations of apolipoprotein B and LDL-cholesterol did not change significantly. All these parameters were affected favourably and significantly by Lipanthyl. Etolip treatment had the favourable effect of elevating the HDL-cholesterol and apolipoprotein A-I level. Etolip was well tolerated by patients and no undesirable side-effects developed. The effects of Etolip as a hypolipidaemic agent are relatively small and are markedly lower than the effect of other registered hypolipidaemics available in the CSSR.

Clofibrate↗
PubMed1989

[Hyperlipoproteinemia and the genetic epidemiology of diabetes mellitus].

Cardiovascular diseases are the most frequent cause of mortality in the sub-population of type II diabetics (cca 600,000 in the CSSR). Type II diabetics very frequently cumulate several very serious risk factors (hyperlipoproteinaemia, arterial hypertension, obesity, hyperuricaemia, smoking) for the manifestation of cardiovascular disease. Concurrent comprehensive treatment of all revealed risk factors is essential for primary prevention. Systematic application of methods of genetic epidemiology in families of affected diabetics helps to detect in time and to treat other affected members of the family. It is at the same time a rational way of primary prevention of cardiovascular disease in the highest risk sub-populations. The authors submit an algorithm of treatment of hyperlipoproteinaemic type II diabetics.

Aged↗