|
|
The influence of menopause on risk factors for atherosclerosis
Lejsková, Magdalena ; Alušík, Štefan (advisor) ; Žák, Aleš (referee) ; Kvapil, Milan (referee)
Introduction: While low in women of childbearing age, cardiovascular risk rises quickly after menopause. It is a well known fact that cholesterolemia increases in the absence of ovarian estrogen secretion, and a number of studies have demonstrated an increasing incidence of metabolic syndrome (MS) following menopause. Despite this, conclusive evidence for most of the MS components is unavailable, and an increase in insulin resistance due to menopause has likewise not been documented. The aim of our study was to determine the effect of menopause on selected cardiovascular risk factors in Czech women. Methods: A total of 909 women, as a random 5% sample of female residents of Prague 4 aged 45-55 years, were enrolled. Fasting blood samples were obtained, a thorough history was taken, necessary anthropometric measurements and ultrasound examinations of arteries were performed. Results: In multivariate regression analysis, postmenopausal status, not age, was the only predictor of combined markers, i.e., MS as defined by NCEP-ATPIII (p = 0.03) and atherogenic lipid indexes (total cholesterol/HDL-C, p = 0.002; LDL-C/HDL-C, p = 0.004; apolipoprotein B/apolipoprotein A-I, p = 0.004). While age was the strongest predictor of individual components of MS, menopausal status was only associated with waist circumference...
|
|
|
Evaluation of rationality and risks of pharmacotherapyin older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
|
|
|
Evaluation of rationality and risks of pharmacotherapy in older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
|
|
|
Aspirin in the secondary prevention of ischemic stroke
Adámek, Tomáš ; Alušík, Štefan (advisor) ; Kalvach, Pavel (referee) ; Souček, Miroslav (referee)
Introduction: The recurrence of the cerebral ischemic stroke after a history of TIA or ischemic stroke is 3-4% per year. One way of reducing the risk of reccurence is using antiplatelet therapy. The aim of our study was to investigate the effect of aspirin. Even though, newer antiplatelet drugs were developed, their risk/benefit profile has not been proved to be better than aspirin. Reasons for using aspirin in secondary prevention are: the longest experience, clearly proven effect in many studies and low price. On the other hand, aspirin prevents only 25% of strokes, thus there is wide space for searching for causes of failed therapy and alternative therapeutic ways. Noncompliance of aspirin use and embolic events are usually indicated as the most common causes of an ineffective therapy. The goal of our study was to find the antiplatelet therapy effectivity in patients with history of stroke treated with aspirin in daily dose of 100mg. We assured 100% compliance among these patients and as much as possible minimalized a likelihood of embolic causes of strokes. What is more, we tried to find out whether an insuffient suppression of 11-dehydrotromboxane B2 correlates with comorbidities, other used medication or laboratory parameters. Furthermore, whether by administrating an increased dose of...
|
|
|
Anti-platelet effects of citalopram
Richter, Tomáš ; Alušík, Štefan (advisor) ; Jirák, Roman (referee) ; Matějovská Kubešová, Hana (referee)
Introduction Citalopram is a preferred medication used for the treatment of depression and belongs to a group known as selective serotonin reuptake inhibitors (SSRI). When used on a long-term basis, it leads to a significant decrease of serotonin in thrombocytes. Citalopram-treated patients often display haemorrhagia that is explained by its anti-platelet effect, which is also - more or less - the case for other medications from the SSRI group. Aim of the Thesis The aim of the thesis was to find out: a) Whether citalopram treatment (2 weeks) has influence on the plasma concentration of thromboxane B2; b) Whether there is a relation between the expected decrease of thromboxane B2 levels and the plasma concentration of citalopram. Methods and Patient Population We carried out clinical and laboratory tests on a study population consisting of elderly and polymorbid patients who underwent a 14-day citalopram treatment with daily doses of 20mg. Among other tests, we observed the plasma concentration of thromboxane and citalopram. Out of 160 patients examined, 78 patients were assessed. Results Our study has proved that even a short-term citalopram treatment results to a significant increase in the plasma concentration of thromboxane B2 and the suppression rate of thromboxane B2 correlates with the higher...
|
|
|
Evaluation of rationality and risks of pharmacotherapyin older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
|
|
|
Relationship between prothrombogenic factors and hearing loss with tinnitus.
Chrbolka, Pavel ; Alušík, Štefan (advisor) ; Hahn, Aleš (referee) ; Čoček, Aleš (referee)
(AJ) Tinnitus is not seen as a separate disease, but in terms of symptoms accompanying various diseases. The emergence of tinnitus is involved in a variety of risk factors. Relationship between tinnitus and blood flow of the ear is described in a relation to impaired microcirculation, which plays a key role in the proper function of the inner ear and therefore we evaluated the relationship prothrombogenic factors for tinnitus. From the original group of 853 patients we excluded patients with organic cause problems. We excluded patients with hearing impairment, cardiovascular and other comorbidities and also patients taking ototoxic drugs or patients with laboratory abnormalities. Then we have a homogenous group of 40 patients without the evidence of an organic cause of tinnitus and without associated diseases and the effect of ototoxic medications. On this basis there has been created a control group matched by the age and sex. In our group as the main marker of protrombogenic state was used a level of 11- dehydrotromboxan B2. Patients with tinnitus have significantly higher values of 11- dehydrotromboxane-B2. The average concentration in tinnitus patients was 2.02±1.81 ng/ml compared to 1.32±1.33 ng/ml in the control group. At the same time we evaluated other coagulation parameters. We checked...
|
|
|
Evaluation of rationality and risks of pharmacotherapy in older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
|
|
|
Aspirin in the secondary prevention of ischemic stroke
Adámek, Tomáš ; Alušík, Štefan (advisor) ; Kalvach, Pavel (referee) ; Souček, Miroslav (referee)
Introduction: The recurrence of the cerebral ischemic stroke after a history of TIA or ischemic stroke is 3-4% per year. One way of reducing the risk of reccurence is using antiplatelet therapy. The aim of our study was to investigate the effect of aspirin. Even though, newer antiplatelet drugs were developed, their risk/benefit profile has not been proved to be better than aspirin. Reasons for using aspirin in secondary prevention are: the longest experience, clearly proven effect in many studies and low price. On the other hand, aspirin prevents only 25% of strokes, thus there is wide space for searching for causes of failed therapy and alternative therapeutic ways. Noncompliance of aspirin use and embolic events are usually indicated as the most common causes of an ineffective therapy. The goal of our study was to find the antiplatelet therapy effectivity in patients with history of stroke treated with aspirin in daily dose of 100mg. We assured 100% compliance among these patients and as much as possible minimalized a likelihood of embolic causes of strokes. What is more, we tried to find out whether an insuffient suppression of 11-dehydrotromboxane B2 correlates with comorbidities, other used medication or laboratory parameters. Furthermore, whether by administrating an increased dose of...
|
|
|
Anti-platelet effects of citalopram
Richter, Tomáš ; Alušík, Štefan (advisor) ; Jirák, Roman (referee) ; Matějovská Kubešová, Hana (referee)
Introduction Citalopram is a preferred medication used for the treatment of depression and belongs to a group known as selective serotonin reuptake inhibitors (SSRI). When used on a long-term basis, it leads to a significant decrease of serotonin in thrombocytes. Citalopram-treated patients often display haemorrhagia that is explained by its anti-platelet effect, which is also - more or less - the case for other medications from the SSRI group. Aim of the Thesis The aim of the thesis was to find out: a) Whether citalopram treatment (2 weeks) has influence on the plasma concentration of thromboxane B2; b) Whether there is a relation between the expected decrease of thromboxane B2 levels and the plasma concentration of citalopram. Methods and Patient Population We carried out clinical and laboratory tests on a study population consisting of elderly and polymorbid patients who underwent a 14-day citalopram treatment with daily doses of 20mg. Among other tests, we observed the plasma concentration of thromboxane and citalopram. Out of 160 patients examined, 78 patients were assessed. Results Our study has proved that even a short-term citalopram treatment results to a significant increase in the plasma concentration of thromboxane B2 and the suppression rate of thromboxane B2 correlates with the higher...
|
guest ::
