[The Experience of Use Triple Antithrombotic Therapy in Patients With Acute Coronary Syndrome and Atrial Fibrillation].

AIM: In real life to evaluate the effectiveness and safety of apixaban with double antiplatelet therapy for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation and the recent episode of acute coronary syndrome without ST segment elevation. MATERIALS AND METHODS: 8 patients with atrial fibrillation and the recent (8-14 days after the onset of symptoms of ACS) episode of acute coronary syndrome without ST segment elevation were involved into the research. The effectiveness (deaths, stroke and systemic embolism) and the safety (major clinically significant and not significant bleeding) were investigated within 3 months. RESULTS: There were no any strokes, systemic embolism, deaths during observational period. Nasal and mild gingival hemorrhages (not requiring medical intervention) were noted in 2 patients during the first month of treatment and two patients experienced non-permanent petechiae. Major and clinically significant bleeding was not registered. onclusions: the use of oral anticoagulant apixaban 5 mg BID or 2.5 mg BID with double antiplatelet therapy in patients with non-valvular atrial fibrillation and the recent episode of acute coronary syndrome without ST segment elevation is effective and safe for the prevention of stroke and systemic embolism during 3 months of treatment. Future researches are required.

CLINICAL APPLICATION OF RECOMBINANT ERYTHROPOIETIN IN BETA-THALASSAEMIA INTERMEDIA.

Research objective is to study the efficacy of recombinant erythropoietin (epoetin alfa) as alternative method of treatment beta-thalassemia intermedia. Study involved 58 patients with beta-thalassemia intermedia (23 women and 35 men). In all observed patients was defined levels of hemoglobin (Hb), red blood cells (RBC), erythrocyte indexes (MCV, MCH, MCHC), hemoglobin fractions (HbA, HbA2, HbF), serum ferritin, serum erythropoietin before and after administrated rEPO. All patients received rEPO during 6 month at the dose - 10000 IU subcutaneously. The majority of patients - 39 (67%) had a good response to rEPO (increase in hemoglobin level more than 20 g/l); 16 patients (28%) had a mean response (increase in Hb 10 - 20 g/l); in 3 (5%) patients occurred poor response to rEPO therapy (increase in Hb <10 g/l). After rEPO treatment of beta-thalassemia intermedia patients there was a statistically significant change in the number of RBC, levels of HbF and sEPO. The evaluation of interdependence between the indices of the baseline sEPO and increased Hb values in patients after rEPO treatment revealed the presence of the reverse direct relationship (r=-0.67). Based on the results, it can be concluded that the use of rEPO in complex therapy of beta-thalassemia intermedia leads to increased levels of Hb and consequently reducing the need for blood transfusions, and accordingly expected to prevent severe complications of blood transfusion (alloimmunization, hypersplenism, iron overload, contamination transmissible infections) facilitating normal growth and development, and a better quality of life.

Efficiency of recombinant erythropoietin administration in hemoglobinopathy H.

Alpha-thalassemia is widely spread in human population and one of the most common types of α-thalassemia is hemoglobinopathy H which develops with mild microcytic hypochromic anemia, hepatosplenomegaly and jaundice. The basic method of anemia correction is blood transfusion. However this method has crucial deficiencies. As it is known recombinant erythropoetin (rEPO) contributes to erythroid proliferation and could be used for anemia treatment. The aim of the study was to qualify efficiency of administration rEPO in complex therapy of hemaglobinopathy H. Study involved irregularly transfused 14 patients with hemoglobinopathy H (2 males and 12 females). Control group included 30 healthy persons. Recombinant erythropoietin (Eprex) administrated hypodermically 10,000 units 3 times a week during 6 months. Average hemoglobin level before treatment was 62 g/l. Responses to the rEPO treatment varied from 9 to 70 g/l, 9 (64%) of patients had a good response, showed an increase in hemoglobin level more than 20 g/l. In 4 patients (29%) had a moderate response (10-20 g/l), but only in 1 (7%) patient occurred poor response. Changing the parameters of erithrocyte indices, hemoglobin fractions, serum iron and serum ferritin level are not statistically significant. It can be concluded that the use of rEPO in complex therapy of hemaglobinopathy H, leads to increased levels of hemoglobin and consequently reducing the need for blood transfusions.

[The effect of terguride on contractility of rat uterine strips]. / Vliv terguridu na kontraktilitu krysího delozního prouzku.

The effects of terguride on the uterotonic activity of rat's uterine stria were investigated by means of a standardized isometric method of measuring in vitro the contractility of uterine muscles. The uterotonic activity of the given preparation depends on its concentration and on the phase of uterine cycle. The uterotonic activity makes 71.4 U.mg-1 in the range of terguride concentrations from 10(-7) to 10(-5) mg per ml. Used at higher concentrations, the uterotonic activity of terguride is very low. Spontaneous contractions are moderated and the tone of uterus is decreased by terguride administration.

[The effect of propranolol (Obsidan) as well as propranolol and fenoterol (Partusisten) on the motility of the smooth uterus musculature in vitro]. / Die Wirkung von Propranolol (Obsidan) sowie von Propranolol und Fenoterol (Partusisten) auf die Motalität der glatten Uterusmuskulatur in vitro.

Propranolol (1; Obsidan) relaxes in vitro stripes of smooth muscles of non-pregnant rat's uterus in a concentration dependent manner. In contrast, on uterine muscle stripes of pregnant rats 1 causes small contractions. In an combination of 1 and fenoterol (2; Partusisten) (20:1) 1 prevents the relaxing effect of 2, reported to be an inhibitor of uterine muscle activity. This antagonism is most distinct on stripes of pregnant rat's uterus.

[The effect of calcium on the contractility of uterine strips in vitro]. / Vliv vápníku na kontraktilitu delozního prouzku in vitro.

Using a standard isometric method, the authors investigated the effect of some cations and nifedipine on the contractility of isolated strips of the human uterus in vitro. Evidence was provided that the contractility depends on the extracellular surface concentration of the calcium cation. Under the experimental set-up used intracellular calcium does not play any part and the contractions of the uterine strip depend on the state of the calcium channels.

[The effect of certain drugs on the contractility of uterine strips in vitro]. / Regulace kontraktility delozního prouzku nekterými léky in vitro.

The isometric method of assessment of the contractility of uterine strips in vitro makes it possible to follow up systematically the response of smooth uterine musculature to oxytocin and to test the effect of selected preparations on this process. In the submitted work the author investigated the effect of methyloxytocin, magnesium sulphate, seduxene, phenergan, plegomazine and DH-ergotoxin on the uterine contractions of strips of rat and human uteri ted. Based on the results of model experiments in vitro, the author discusses the effect of the mentioned substances on the spasmogenic activity of oxytocin.

[The effect of partusisten, dilatol, papaverine and magnesium sulfate on uterine smooth muscle in vitro]. / Die Wirkungen von Partusisten, Dilatol, Papaverin und Magnesiumsulfat auf die glatte Uterusmuskulatur in vitro.

Inhibitory effects of Partusisten, Dilatol, Papaverin and Magnesium-sulfat on the activity of smooth muscle were tested in vitro on 18 isolated stripes of rats uteri, exhibiting both a high sensitivity against oxytocin and a distinct spontaneous activity. Minimal inhibitory concentrations of all drugs tested were determined, and their influence on the frequency and amplitude of contraction as well as on lag phase between inhibition and onset of spontaneous activity were registered. Basing on these experimental data conclusions were drawn concerning their clinical relevance.