[An association between microalbuminuria and obesity in healthy adolescents - preliminary results from the "Respect for Health" study]. / Vztah mikroalbuminúrie a obezity u zdravých mladistvých - predbezné výsledky stúdie "Respekt pre zdravie"

BACKGROUND: Microalbuminuria is a marker of present/future cardiovascular and/or renal disease. The roots of these diseases extend back into childhood. Data on renal excretion of albumin (albumin/creatinine ratio - ACR) and the prevalence of microalbuminuria in apparently healthy adolescents are scares. METHODS AND RESULTS: We determined ACR and the prevalence of microalbuminuria in 15-to-19-years-old adolescents (n = 846, 482 boys), in association with markers of obesity. ACR (0.43; 0.29-0.67 mg albumin/mmol creatinine vs 0.35; 0.25-0.51 mg albumin/mmol creatinine, p < 0.001), and the prevalence of microalbuminuria (3.6 % vs 1.2 %, χ2: p = 0.024) were higher in girls than in boys. In underweight subjects, particularly boys, ACR was significantly higher if compared with the overweight//obese subjects. ACR correlated inversely with the markers of peripheral and central obesity. CONCLUSIONS: Prevalence of microalbuminuria in general population of adolescents was relatively low. Paradoxically, in the boys ACR showed an inverse relationship to markers of nutritional status. Our data suggest the need of specific interpretation of data on ACR in the adolescents, and the need of further analysis of this (in the adults risk) marker in population of adolescents with regard to other important determinants of ACR, such as actual blood pressure, insulin sensitivity, etc.

Risk factors of cardiovascular diseases.

BACKGROUND: Cardiovascular diseases are the leading cause of premature mortality of women and men in Slovak republic. THE AIM: The occurrence and mean values of major CVD risk factors were assessed in a population of 2480 Bratislava citizens (2/3 of them were women) interested in health promotion and primary CVD prevention activities in Community Health Promotion Center. METHODS: Major CVD risk factors were assessed, using standard methods, and criteria, in accordance with the guidelines of European and national medical societies. MAIN RESULTS: The greatest proportion of visitors, both women and men, were in their forties. 73% of all women and 70% of all men were aged 30-59 yrs. The most frequent risk factors, were overweight and obesity, present in 64% of men and 59% of women. Of them, central type obesity was found in 30% of men, 15% of women. In 52% of men and 32% of women elevated casual blood pressure was assessed at the first visit. Of the total, in 27% of men and 21% of women, the BP elevation was within the range of borderline hypertension. In 25% of men and 11% women the BP values were within the mild to severe hypertension range. Elevated blood cholesterol was assessed in 53% of men and 54% of women, lowered HDL cholesterol in 55% of men and 43% of women. Elevated TC/HDL-C ratio was found in 60% of men and in 35% of women. Triglyceride level elevation was assessed in 24% of men and in 17% of women, with TGL/HDL-C ratio raised in 66% of these men and in 40% of these women. CONCLUSIONS: In assessment of CVD risk factors clustering, our results are different from the results of CINDI SR screening from 1992. In our study, only 13% persons were free of any CVD risk factors. One risk factor was found in 21.1%, two of them in 29.9%, three in 29.8% and four in 6.2% of the population screened. Evaluation of the effect of complex individual intervention in our center will be the subject of our next study. (Fig. 5, Tab. 5, Ref. 11.)

The distribution of ciprofloxacin and its metabolites in human plasma, pulmonary and bronchial tissues.

The disposition of ciprofloxacin and its pharmacologically active metabolites (sulfociprofloxacin, oxociprofloxacin, and desethylenciprofloxacin) in plasma, lung and bronchial tissues was studied in 24 patients undergoing a partial or total resection of the lung. The patients were divided into four groups, a control group and groups in which ciprofloxacin (200 mg) was given i.v. 1, 2 and 3 h before surgery. The concentrations of ciprofloxacin and its metabolites were determined by high performance liquid chromatography (HPLC). Ciprofloxacin concentrations in lung tissue were four times and in bronchial tissue twice those in plasma (p less than 0.01). The individual tissue concentrations of ciprofloxacin correlated with the individual plasma concentrations (r = 0.95 for lung; r = 0.94 for bronchi; p less than 0.001). Metabolite concentrations in both tissues and plasma were 10- to 100-fold lower than the concentrations of ciprofloxacin. These data suggest that the concentrations of the parent compound are essential for the therapeutic efficacy of ciprofloxacin.

[Beta-aescin in the treatment of chronic venous insufficiency]. / Beta-aescin v liecbe chronickej zilovej insuficiencie.

In 15 patients with primary or secondary chronic venous insufficiency (CHVI) the authors evaluated the action of three weeks' treatment with beta-aescin (Yellon caps). The regression of clinical symptoms of CHVI (sensation of "heavy" and "tired" legs, swollen ankles, nocturnal cramps was complete in five patients, partial or slight in seven patients, and none in three patients (with secondary venous insufficiency associated with thrombosis of the deep venous system). Undesirable effects of the agent were not revealed by common screening tests. No change of the basic parameters of haemostasis occurred. The haemodynamic action on the venous and capillary circulation of the lower extremities was evaluated by the method of venous occlusion plethysmography. Already after the first week of treatment a significant drop of capillary filtration to 74% of the original mean value before treatment occurred (0.265 +/- 0.084 ml/100 ml tissue). After the second and third week of treatment the values of capillary filtration decreased on average to 66% of the original mean value. The venous capacity (before treatment on average 3.5 +/- 0.9 ml/100 ml tissue) and venous drainage (before treatment on average 24.5 +/- 13.5 ml min/100 ml) did not change significantly during treatment.

Protective effect of rioprostil on indomethacin-induced lesions of gastric and duodenal mucosa in healthy volunteers.

The protective effect of rioprostil against gastroduodenal mucosal lesions induced by indomethacin is investigated in a double-blind controlled trial on 36 healthy adult volunteers, divided into three groups. All the volunteers are treated with indomethacin, 50 mg t.d.s. during a period of 5 days. The first group is treated with placebo, the second with rioprostil, 300 micrograms, and the third with rioprostil, 600 micrograms. Endoscopies are performed before and after treatment. Blood samples for high performance liquid chromatography determination of indomethacin plasma concentrations are taken on the 6th day, before the last dose of indomethacin is administered, and 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 10, 12 and 24 h after the last dose of indomethacin. It is found that in both doses rioprostil exerts a protective effect against indomethacin-induced lesions, reducing the appearance rate of erosions from 67% to 17% statistically significant in the 600 micrograms group. The bioavailability of indomethacin in the three groups does not differ significantly.

Comparison of the antihypertensive effects of celiprolol and acebutolol.

The antihypertensive effects of the new cardioselective beta-blocker celiprolol and acebutolol have been compared. Thirty patients with arterial hypertension WHO Grade I-II were treated in a double-blind fashion with celiprolol or acebutolol. Before starting the treatment and on Days 15 and 29, before the morning dose, blood samples were taken for measurement of the plasma level of celiprolol. At the same times physical examinations, and clinical and urine chemistry analyses were performed. At the 99% probability level both drugs had significantly lowered the systolic and diastolic blood pressures to normal values at the end of the second and fourth weeks. There was no significant difference between their antihypertensive efficacy. The decrease in diastolic blood pressure at the end of the second week was significantly correlated with the reciprocal of the plasma celiprolol concentration at steady-state at the end of the dosage interval.

[Pharmacokinetics of the cephalosporin antibiotic cefotiam following its intravenous administration to patients after cholecystectomy]. / Farmakokinetika na tsefalosporinoviia antibiotik tsefotiam sled intravenozno vuzvezhdane na bolni sled kholetsistektomiia.

The pharmacokinetic behaviour of cephalosporin antibiotic, second generation after intravenous administration to patients during the early post-operative period was characterized as well as after cholecystectomy. The data suggest a two-compartment distribution with elimination from the central compartment, realized on account of the renal way of clearance. In one of the patients, with one-compartment distribution of the drug, the presence of the theoretical determining factors in "the collapse" of one two-compartment open model to one-compartment is shown, associated with clinical characteristics of that patient.

Pharmacokinetics and quantitative characterization of cefotiam excretion after intravenous administration to patients after cholecystectomy.

Six patients, aged 52 to 71 years, with T-tube drainage of the common bile duct and a urinary catheter after cholecystectomy, were studied in order to evaluate the urinary and biliary excretion and pharmacokinetics of cefotiam in the early postoperative period. Each patient received cefotiam 1 g i.v. as a bolus injection. Cefotiam in plasma, urine, and bile were determined by HPLC. A 2-compartment open model with elimination from the central compartment satisfactorily fitted the plasma levels of the drug. The renal clearance of cefotiam (CLR = 133 ml/min) was an order of magnitude greater than its biliary clearance (CLB = 11.8 ml/min). Glomerular filtration was the main mechanism for elimination of cefotiam. The values of CLR and CLB in relation to the total plasma clearance (CL = 138. ml/min) demonstrated the negligible role of metabolism in elimination of cefotiam in these patients.

[Characterization of the pathways of cefotiam elimination by clearance approaches in patients following cholecystectomy]. / Okharakterizirane na putishtata za eliminirane na tsefotiam pri bolni sled kholetsistektomiia posredstvom klirunsovi podkhodi.

The clearance approach was used in the evaluation of the role of renal and biliary excretion in the total elimination of cephothiam from organism of patients after cholecystectomy. Six patients with inserted T-like drain into the choledochus duct and urinary catheter after gall bladder operation received I g cephothiam by stream intravenously during the early postoperative period. The value of renal clearance (= 132.86 +/- 27.35 ml/min) was with one order higher than that of biliary clearance (= 11.54 +/- 9.67 ml/min) and revealed glomerular filtration as the basic mechanism for elimination of cephothiam from the organism of those patients. The value for the sum Clr + Clb = 144.40 ml/min. kre + keb + 1.51 h1-resp. corresponded to the value of the clearance from the central (plasma) compartment, that for kle resp. suggesting that the kidneys and liver were part of that compartment. The high degree of positive correlation between the biliary clearance and biliary flow (r = 0.94, p less than or equal to 0.02) as well as the positive dependence of the biliary excretory rates, biliary excretory rate constants resp X 80, (r = 0.81, r = 0.83 resp) from the biliary flow revealed that the elimination of the drug from the live depends on the volume of the biliary flow. The negative correlation (r = -0.87, p less than 0.05) between the half-life for biliary excretion and the volume of the biliary flow support that presumption.

Plasma tryptophan level in chronic renal failure.

Total (Trp), free (fTrp) and bound (bTrp) tryptophan concentrations were measured in the plasma of hemodialyzed (HD), peritoneally dialyzed (CAPD) and conservatively treated (ND) patients in chronic renal failure (CRF). 1) A marked decrease of Trp and bTrp was found in all three groups of patients. 2) fTrp concentration was unaltered in the HD and CAPD groups but decreased in the ND patients. 3) No relationship between a fall of bTrp and plasma albumin and transferrin levels was found. 4) Decreased body weight was not reflected in changes in Trp, bTrp and fTrp. 5) An inverse correlation between the serum creatinine and the bTrp/albumin ratio was found. Two alterations of Trp metabolism in CRF may be outlined: Trp deficiency and an alteration of Trp binding to plasma albumin. They affect Trp availability and seem to correlate with the degree of kidney function impairment.