Naše kazuistika popisuje případ nemocného s hypersenzitivní reakcí vznikající pravidelně během prvních minut po zahájení hemodialýzy. Tato reakce provázená pletorickým zabarvením v obličeji, bronchospazmem, hypertenzí, úzkostí a následně poklesem saturace hemoglobinu kyslíkem měřené pulzním oxymetrem a obrazem centrální cyanózy přicházela pravidelně bez ohledu na použitý typ dialyzátoru, premedikaci či předchozí laváž systému izotonickým roztokem chloridu sodného. Pokles počtu krevních destiček a klidný průběh dialýzy provedené bez heparinu upozornily na skutečnou podstatu problému, jehož řešením bylo v našem případě užití techniky regionální antikoagulace 4% citronanem sodným v průběhu intermitentní hemodialýzy., Our report describes the case of patient with hypersensitive reaction regularly arising early after initiation of haemodialysis. This characteristic reaction with pletoric face coloration, bronchospasm, increase of blood pressure, anxiety and decrease of blood oxygen saturation at the consequence and central cyanosis was regularly present without dependence on type of dialysis membrane, drug premedication or prophylactic flushing haemodialysis system by isotonic natrium chloride solution. Low platelet value and trouble-free haemodialysis realized without heparin showed real cause of patients problem. Resolution of this state was regional citrate anticoagulation during intermitent haemodialysis., and Jan Masopust, Jiří Charvát, Dana Mokrá, Ondřej Hloch, Jan Háša
Hyperhomocysteinemia has been suggested to induce hypertension due to its role in endothelial dysfunction. However, it remains controversial whether homocysteine and hypertension are truly causally related or merely loosely associated. To test the hypothesis that hyperhomocysteinemia occurs in spontaneously hypertensive rats (SHR) we measured plasma levels of homocysteine in 10 male adult SHR and in 10 normotensive controls using ion exchange chromatography. In addition, plasma concentrations of the 22 most common amino acids were measured to explore the relation of homocysteine with amino acid metabolism. Plasma levels of homocysteine were significantly lower in SHR (4.1±0.1 μmol/l) than in controls (7.2±0.3 μmol/l) (p<0.00001). The amounts of aminobutyric acid, alanine, citrulline and valine were also decreased, whereas we found increased levels of aspartate, glutamate, glutamine, histidine and ornithine. Thus, contrary to our hypothesis, hypertension in SHR occurs despite low plasma levels of homocysteine. We provide a new hypothesis whereby reduced conversion of arginine to citrulline is related to increased ornithine levels, but decreased bioavailability of nitric oxide, resulting in impaired blood vessel relaxation and hypertension. In conclusion, our findings do not necessarily exclude that homocysteine and hypertension might be pathophysiologically connected, but corroborate the notion that hypertension can arise due to mechanisms independent of high homocysteine levels., D. Kondziella, H. Zetterberg, E. Haugen, M. Fu., and Obsahuje bibliografii a bibliografické odkazy
Hypertenze bílého pláště (white-coat hypertension – WCH) je velmi častý jev; vyskytuje se asi u jedné třetiny osob s patologickým krevním tlakem (TK) měřeným v ordinaci, a to typicky u žen, ve vyšším věku a nekuřáků. Prognostická data nejsou zcela spolehlivá, protože velká část jedinců s tímto typem TK je léčena na podkladě vysokého TK v ordinaci; existují práce s dlouhodobým sledováním ukazující, že kardiovaskulární (KV) riziko je zvýšené oproti jedincům s normálním TK. Opačný jev je maskovaná hypertenze (MH). V populačních studiích byl zjištěn její výskyt v 13 %. Je častá u mužů, zejména ve věku 30–50 let, kuřáků s nepříznivým rizikovým profilem, a také u diabetiků. Riziko budoucího výskytu kardiovaskulárních příhod se blíží trvalé hypertenzi. Důležité je její vyhledávání, a proto bychom měli doporučovat domácí měření TK i těm jedincům, kteří mají normální TK v ordinaci. Neexistují prospektivní studie léčby WCH ani MH. U obou typů hypertenze lze zvolit jen nefarmakologická opatření, pokud je KV riziko nízké; u těch jedinců, kteří mají zároveň další KV rizikové faktory nebo orgánové komplikace hypertenze, je nutno zvážit léčbu, při níž však můžeme postupovat pouze empiricky., White-coat hypertension (WCH) is very common: it is present in about one third of subjects with high office blood pressure (BP). A typical patient is a non-smoking female at higher age. Prognostic data are not very reliable because most patients are treated on the basis of elevated office BP; some long-term studies have shown that cardiovascular (CV) risk is increased compared to normotensives. The opposite disorder is masked hypertension (MH). Its prevalence in population-based studies is 13 %. MH is common in males, typically aged between 30 and 50 years, smokers with unfavorable risk profile, and it is also frequent in diabetics. The risk of future cardiovascular events is close to that of sustained hypertensives. It is important to search for MH actively, therefore, we should recommend home BP measurements also to those subjects whose office BP is normal. We do not have any prospective data about treatment of either WCH or MH. In subjects with low CV risk, only nonpharmacologic treatment may be initiated – in this case, however, the patient must be followed closely including out-of-office BP measurements; in those subjects where other CV risk factors and/or target organ damage are present, drug treatment should be considered, but as we have no evidence, only empirical approach is possible., and Jan Filipovský
Hypertenze je nejčastějším kardiovaskulárním onemocněním, které se v mladém věku častěji vyskytuje u mužů; ve věkové skupině 45–64 let je hypertenze stejně častá u obou pohlaví, u starších osob je hypertenze častější u žen. Krevní tlak se více zvyšuje u žen v období kolem menopauzy. Podávání hormonální substituční léčby není provázeno vzestupem TK, ale vzhledem k vyššímu riziku koronárních, cévních mozkových a tromboembolických příhod není hormonální substituční léčba v prevenci kardiovaskulárních onemocnění (KVO) indikována. Pokles TK v důsledku léčby hypertenze a přínos z léčby hypertenze je podobný u mužů a u žen. Ženy však udávají zhruba dvojnásobné množství nežádoucích účinků. Užívání perorální antikoncepce je spojeno s mírným vzestupem TK u většiny žen a s rozvojem zjevné hypertenze přibližně u 5 % žen. Preeklampsie je spojena se zvýšením rizika rozvoje kardiovaskulárních onemocnění v pozdější fázi života (častější rozvoj hypertenze, infarktu myokardu a cévních mozkových příhod)., Hypertension is the most common cardiovascular disorder affecting more males in younger age groups; in the age group of 45–64, it is equally frequent in both genders, it is more common in elderly females. Blood pressure increases more in females around the menopause. Use of hormonal replacement therapy is not associated with an BP increase but, because of increased risk of coronary events, stroke, and thromboembolic events, HRT is not recommended in CVD prevention. There is a similar decrease in BP by antihypertensive drugs in both genders as well as benefit from antihypertensive treatment. Women report about a double rate of adverse events of antihypertensive drugs. Oral contraception use is associated with a mild BP increase in most women and development of overt hypertension in about 5 %. Pre-eclampsia is associated with increased risk of developing CVD later in life (more frequent development of hypertension, myocardial infarction, and stroke)., and Renata Cífková
Hypertenze je nejčastějším kardiovaskulárním onemocněním, které se v mladém věku častěji vyskytuje u mužů; ve věkové skupině 45–64 let je hypertenze stejně častá u obou pohlaví, u starších osob je hypertenze častější u žen. Krevní tlak se více zvyšuje u žen v období kolem menopauzy. Podávání hormonální substituční léčby není provázeno vzestupem TK, ale vzhledem k vyššímu riziku koronárních, cévních mozkových a tromboembolických příhod není hormonální substituční léčba v prevenci kardiovaskulárních onemocnění (KVO) indikována. Pokles TK v důsledku léčby hypertenze a přínos z léčby hypertenze je podobný u mužů a u žen. Ženy však udávají zhruba dvojnásobné množství nežádoucích účinků. Užívání perorální antikoncepce je spojeno s mírným vzestupem TK u většiny žen a s rozvojem zjevné hypertenze přibližně u 5 % žen. Preeklampsie je spojena se zvýšením rizika rozvoje kardiovaskulárních onemocnění v pozdější fázi života (častější rozvoj hypertenze, infarktu myokardu a cévních mozkových příhod). Klíčová slova: epidemiologie hypertenze – gestační hypertenze – hormonální substituční léčba – hypertenze v těhotenství – perorální antikoncepce – preeklampsie – randomizované klinické studie u hypertenze, Hypertension is the most common cardiovascular disorder affecting more males in younger age groups; in the age group of 45–64, it is equally frequent in both genders, it is more common in elderly females. Blood pressure increases more in females around the menopause. Use of hormonal replacement therapy is not associated with an BP increase but, because of increased risk of coronary events, stroke, and thromboembolic events, HRT is not recommended in CVD prevention. There is a similar decrease in BP by antihypertensive drugs in both genders as well as benefit from antihypertensive treatment. Women report about a double rate of adverse events of antihypertensive drugs. Oral contraception use is associated with a mild BP increase in most women and development of overt hypertension in about 5 %. Pre-eclampsia is associated with increased risk of developing CVD later in life (more frequent development of hypertension, myocardial infarction, and stroke). Key words: epidemiology of hypertension – gestational hypertension – hormonal replacement therapy – hypertension in pregnancy – oral contraception – pre-eclampsia – randomized clinical trials in hypertension, and Renata Cífková
With the increasing prevalence of obesity and especially abdominal obesity, a simple clinical tool is needed that identifies the cardiometabolic risk for cardiovascular disease and type 2 diabetes. The aim of our study was to evaluate a broad spectrum of metabolic variables and IMT in subjects with and without hypertriglyceridemic waist (HTGW) and compare it with the harmonized definition of metabolic syndrome (MS) with both a higher (MS- I) and lower waist circumference (MS -II) for Europids. We enrolled 607 asymptomatic dyslipidemic subjects (295 men and 312 women) into our cross -sectional study. The subjects with HTGW had an atherogenic lipid profile (significantly higher triglycerides, AIP, non -HDL -C, lower HDL -C and ApoA -1, and the women also higher TC and ApoB), increased markers of insulin resistance (insulin, HOMA, C -peptide, proinsulin), inflammation (hsCRP), thrombosis (fibrinogen, PAI -1), SBP and DBP, and lower adiponectin (p<0.05 -0.001 for all). These risk factors were entirely similar in HTGW, MS- I and MS -II. Age -adjusted IMT was significantly higher only in the women with HTGW but this significance disappeared after further adjustment for TC, SBP, and smoking. Our results support the routine use of HTGW as a simple and inexpensive screening tool to detect subjects at increased cardiometabolic risk in clinical practice., H. Vaverková, D. Karásek, D. Novotný, M. Halenka, J. Orság, L. Slavík., and Obsahuje bibliografii
The appearance of variations in the protein profile of Ostertagia ostertagi (Stiles, 1892) infective larvae (L3), which were induced by hypobiosis triggering factors, was evaluated by means of SDS-PAGE and densitometric analysts. Area integration analyses of their protein profiles was carried out between 66 and 77 kDa. Important quantitative variations were identified in the protein levels of the induced larvae, where a 5.25 fold increase compared to the control was observed. Two 75.4 and 70 kDa protein bands were found which exceeded the control profile by 4.5 and 44 fold, respectively. This fact suggests that the changes brought about in the process of hypobiosis induction are restricted. This work demonstrates changes at a molecular level corresponding with biological changes induced by conditions causing O. ostertagi hypobiosis.
Hypoechinorhynchus robustus sp. n. is described from Notolabrus parilus (Richardson) (Labridae) from Pt Peron, Western Australia. It has a proboscis with 30 hooks arranged in ten longitudinal rows: 5 rows of a small apical spine, a large anterior hook and a small posterior spine, 5 rows of a large anterior hook, a middle spine and a posterior spine. The new species is distinguished from other species of the genus by having a set of 5 small apical spines anterior to the large hooks on the proboscis, by having lemnisci that barely exlend beyond the proboscis receptacle and testes which are more adjacent than tandem. II. robustus also has robust trunk spines anteriorly. Re-examination of Hypoechinorhynchus alaeopis Yamaguti, 1939 (type species) revealed trunk spines that had been overlooked previously. The Hypoechinorhynchidae is made a junior synonym of Arhythmacanthidae because there is considerable overlap between the two family diagnoses, particularly in that both families have a proboscis armature that changes abruptly from small basal spines to large apical (or subapical if present) hooks. The genus Hypoechinorhynchus is placed in the subfamily Arhythmacanthinae because it has trunk spines and a spherical proboscis with few hooks (relative to other arhythmacanthid genera). It is also proposed that Ileterosentis magellanicus (Szidat, 1950) be returned to the genus Hypoechinorhynchus since it was transferred to Heterosentis primarily because it had trunk spines. The other hypoechinorhynchid genus contained only Bolborhynchoides exiguus (Achmerov el Dombrowskaja-Achmcrova, 1941) Achmerov, 1959 and is relegated to incertae sedis.