Biomedical subjects

K Urbánek

Publications and source records attributed to K Urbánek.

At least 19 recordsLinked to original sources

PubMed2005

Cognitive performance in people with Parkinson's disease and mild or moderate depression: effects of dopamine agonists in an add-on to L-dopa therapy.

In a randomized prospective multi-centre study, we evaluated the cognitive performances of a group of 41 non-demented patients, all with advanced Parkinson's disease (PD) and a current depressive episode, in whom the effects of pramipexole (PPX) and pergolide (PRG) in an add-on to l-dopa therapy were also studied and published with regard to motor symptoms of PD, motor complications and depression. The Trail Making Test, the Stroop test and four subtests (arithmetic, picture completion, digit symbols and similarities) of the Wechsler Adult Intelligence Scale-Revised were performed prior to and 8 months after the administration of either PPX or PRG. We found no statistically significant difference between the two tested drugs or between the first and the last visit in any of the above-listed neuropsychological tests. All patients' motor outcomes significantly improved and we conclusively demonstrated the anti-depressive effect of PPX. The dissociation of dopaminomimetic effects on the different tested domains indicates that there are different pathological mechanisms of cognitive, motor and affective disturbances in advanced PD patients. In our non-demented group of fluctuating depressed PD subjects, both PPX and PRG administration in combination with l-dopa were safe in terms of the effect on cognitive performance.

Aged↗

PubMed2004

Comparison of ultrasonography, CT angiography, and digital subtraction angiography in severe carotid stenoses.

Digital subtraction angiography (DSA) is considered to be the 'gold standard' for confirmation of severe (70-99%) stenoses of internal carotid arteries (ICAs). However, it is associated with a risk of complications. The aim of this study was to assess the accuracy of ultrasonography (US), computed tomographic angiography (CTA), and their combined use for the detection and quantification of severe carotid stenoses, when compared with DSA. Severe ICA stenoses were diagnosed by US in a set of 29 patients. All patients also underwent CTA and DSA. Sensitivity, specificity, positive (PPV), negative predictive values (NPV), and Pearson's correlation coefficient were used in the evaluation of the percentage of stenosis results. Homogeneity chi2 test was applied when assessing statistical significance. Severe stenosis was diagnosed in 34 ICAs. Two ICAs with uninterpretable CTA finding were excluded. The number of ICAs with stenoses 70-99%/<70%- US 32/0; CTA 29/3; US + CTA 29/3; DSA 24/8. Pearson's correlation coefficient - US 0.601; CTA 0.725; US + CTA 0.773. Sensitivity/specificity/PPV/NPV - US 1.0/0.75/0.75/xxx; CTA 1.0/0.844/0.828/1.0; US + CTA 1.0/0.844/0.828/1.0. Homogeneity chi2 test results - US, P = 0.002; CTA, P = 0.098; US + CTAG, P = 0.098. US in combination with CTA can be used for relatively secure diagnostics of severe ICA stenoses. Thus, invasive DSA can be avoided in a substantial number of patients.

Angiography, Digital Subtraction↗

PubMed2003

Facilities for acute stroke patients care in the Czech Republic: nationwide epidemiological study.

BACKGROUND AND PURPOSE: Stroke is the third most common cause of death in the Czech Republic (CR). Specialized in-patient stroke unit care improves the outcome of stroke patients. The aim of the study was to chart and improve the current facilities. METHODS: Neurological in-patient departments exist in 75% of the districts in the CR, and in the capital Prague. Questionnaires were sent to all 79 neurological in-patient departments. A chi2 test was used for the evaluation of statistical significance. RESULTS: There is better access to intensive/intermediary care beds (statistically not significant) and to angiography (statistically significant) in the districts with a population density of over 151 inhabitants per km2 than in districts with a lower population density (p = 0.09 and p = 0.008). Stroke patients have access within 1 hour to computed tomography of the brain in all but one, and to laboratory tests in all districts with a neurological in-patient department(s). There is no statistically significant difference in the availability of ultrasound examination of extracranial brain arteries between the sparse, and more populated districts (p = 0.715). CONCLUSIONS: Facilities for the establishment of stroke units are quite good in the majority of highly populated areas; however, they are worse in some of the larger towns. The results of the study must be used to further improve the development of stroke care in the CR.

Catchment Area, Health↗

PubMed2003

Pramipexole and pergolide in the treatment of depression in Parkinson's disease: a national multicentre prospective randomized study.

An 8-month multicentre prospective randomized study aimed at comparing the effects of dopamine receptor agonists pramipexole (PPX; Mirapexin) and pergolide (PRG; Permax) as add-on to L-dopa therapy on depression [Montgomery and Asberg Depression Rating Scale (MADRS)] in 41 non-demented patients (25 men, 16 women) suffering from both mild or moderate depression and advanced Parkinson's disease (PD). The assessment was performed by a blinded independent observer. Motor symptoms (UPDRS III), motor complications (UPDRS IV), activities of daily living (UPDRS II and VI) and depressive symptoms as measured by Self - Rating Depression Scale by Zung were evaluated in an open-label design. The average value of Zung scores decreased significantly in both groups with no statistical difference between both groups. A significant decrease in the average value of MADRS scores was present only in the PPX group. The average UPDRS scores decreased significantly with no statistical difference between both groups at the comparable average total daily dose of both preparations. In both cases, the total daily dose of L-dopa decreased significantly but the decrease was statistically more pronounced in the PRG group. Our results demonstrate the antidepressant effect of PPX in patients with PD while we can't make any conclusions with regard to antidepressant effect of PRG.

Activities of Daily Living↗

PubMed2001

Pharmacokinetic study of iodine-labeled silibinins in rat.

The very low bioavailability of silibinin (silybin, SB), the main antioxidant flavonolignan of silymarin from Silybum marianum L. (Asteraceae), requires sensitive methods to study the modulation of silibinin bioavailability. To evaluate the potential for use of radiolabeled silibinin, two silibinin derivatives, separated by HPLC after iodination ((125)I-SB(1) and (125)I-SB(2)) and their complexes 1 : 1 with phosphatidylcholine ((125)I-SPC(1) and (125)I-SPC(2)) were administered concurrently with a single intragastric dose of 5.0 mg or 50 mg of unlabeled silibinin (alone or as a constituent of the complex) per kg of body weight in a comparative study of bioavailability in the rat. Pharmacokinetic parameters as well as organ uptake of (125)I-SB(1)-derived radioactivity showed a dose-response pattern. The parameters of bioavailability after (125)I-SPC(1) intake were not influenced by unlabeled silibinin (complexed with phosphatidylcholine), since maximal levels were achieved by the lower dose of unlabeled compound. The superior bioavailability of (125)I-SPC(1) was obvious at the lower dose of unlabeled compound as elevated AUC and RA(max) (maximal percentage of administered radioactivity), and increased radioactivity in liver, kidney, spleen and heart. An absence of these characteristics with (125)I-SB(2) and (125)I-SPC(2) suggests the use of(125)I-SB(1) for studies of modulation of its bioavailability in vivo in rat.

Animals↗

PubMed2001

Antibiotic selective pressure and development of bacterial resistance.

This study evaluates the development of resistance in Gram-negative rods to cefotaxime and ceftazidime, ofloxacin and ciprofloxacin, gentamicin and amikacin, meropenem and ampicillin/sulbactam over a five year period of use (1994-1998) at the University Hospital in Olomouc, Czech Republic. The development of bacterial resistance was linked with antibiotic use and hence selective pressure which was specific for the type of antibiotic and the bacterial species. Statistically significant correlations were found for the use of ofloxacin and resistance in Escherichia coli, Proteus vulgaris and Providencia rettgeri; cefotaxime and Enterobacter cloacae; ceftazidime and Acinetobacter spp., Enterobacter agglomerans and Proteus vulgaris; and gentamicin and Proteus mirabilis.

Aminoglycosides↗

PubMed1997

[A modeling analysis of possible generic substitutions in an inpatient facility].

The paper presents an example of a sectional analysis of drug consumption in a large in-patient health-service facility which is to be used as a foundation for making decisions about the measures to decrease the costs of drugs. Consumption of industrially produced pharmaceutical preparations at a selected facility for a period of four months was analyzed. The authors evaluated possible substitution of administered important preparations by cheaper equivalents and by means of model analysis they calculated expected savings when using the cheapest available mass-produced pharmaceutical preparations. In the preparations under study, possible savings of costs in the extent of 2.2% of the spent sum were found. On the basis of the results of the analysis, the hospital formulary authors consider the positive list with a quality system of objective monitoring of drug consumption to be the most suitable way of introduction of more rational prescription of industrially produced drugs in an in-patient facility.

Cost Savings↗

PubMed1993

Incoordination of the phonation start in individuals with balbuties.

We studied the effect occurring in close proximity before the phonation start and give an account of the microdramas taking place upon the glottis immediately before the phonation start in a group of individuals suffering from balbuties (60 children and adolescents from 9 to 14 years of age) and an equally large control group suffering from no such speech defect. In the group of children and adolescents with balbuties only less than 4% of the cases showed undisturbed regular phonation starts, whereas in the control group it was almost as much as 90%.

Adolescent↗

PubMed1993

Proliferation of reticuloendothelial system (RES) in rats with altered vision or smell (to the hypothetic neural regulation of the RES).

A long-term administration of an azo-dye, trypan blue, induced a reactive proliferation of RES in rats. Reaction of the RES was followed in rats whose optical analyzer was eliminated by enucleation of bulbs after the birth, in rats whose smell analyzer was altered by a repeated long-term exposition to ammoniac and in normal rats. Blind rats showed a striking proliferation of histiocytes of the RES in the liver, while the reaction was weak in the spleen and lymph nodes. In contrary to that, rats with altered smell and also the normal rats exhibited standard reactive changes in the spleen and lymph nodes and distinctly weaker reaction in the liver. The obtained results support an idea that vegetative neural mechanisms play a role in control and coordination of RES reactions.

Ammonia↗

PubMed1992

Luminol-dependent chemiluminescence and the clinical course of multiple sclerosis.

The luminol-dependent chemiluminescence activity before and after the ACTH (Synacthen) treatment was investigated in multiple sclerosis patients and the dependence of the changes of chemiluminescence upon the disease course was evaluated. The tests were performed with granulocytes and monocytes in the presence or in the absence of autologous thrombocytes and, further, the activity of whole blood was tested. All the test were performed both without additional stimuli (spontaneous activity) and with opsonized zymosan. Of the parameters tested, only the spontaneous chemiluminescence activity of whole blood displayed an evidence of dependence on clinical course of the disease. In clinically improved patients a decrease of the whole blood chemiluminescence was found. Similar trend was observed in chemiluminescence of whole blood stimulated by zymosan and in spontaneous granulocyte activity in the presence of autologous thrombocytes. The results show that the whole blood chemiluminescence is decreased in improved patients and suggest that this decrease might be related to the leukocyte-thrombocyte interaction.

Adrenocorticotropic Hormone↗

PubMed1991

[Cerebellar malacias in younger patients].

Based on four observations of cerebellar malacia in patients aged 40-45 years the authors describe the clinical picture of the disease, characterized by acute fierce occipital headache associated with nausea and vomiting. Focal cerebellar and stem symptoms develop frequently after a latency of several hours or days. None of the patients had signs of advanced arteriosclerosis or arterial hypertension:in two during the premorbid period arteriospastic manifestations were present--in one migraine, in the other angina pectoris. In three patients CT revealed bilateral malatic cerebellar affection, in one instance bilateral affection could be assumed from correlation of the clinical and CT finding. One patient died, necropsy revealed extensive malatic foci in both cerebellar hemispheres, while the finding on the entire vascular system was normal. Based on these observations and similar reports in the literature the authors discuss the possibility that arteriospasms are the decisive pathogenetic factor in the development of cerebellar malacia in young and middle age. The authors emphasize the importance of secondary oedematous changes for the prognosis and recommend for therapy a combination of common vasoactive substances with intensive antioedematous treatment and administration of calcium antagonists.

Adult↗

PubMed1991

Luminol-dependent chemiluminiscence of monocytes and granulocytes in multiple sclerosis: the effect of autologous thrombocytes.

The luminol-dependent chemiluminiscence of monocytes and granulocytes and the effect of autologous thrombocytes upon the chemiluminiscence activity were investigated in multiple sclerosis patients, patients with other neurological diseases and healthy controls. The spontaneous monocyte chemiluminiscence was found to be significantly higher in multiple sclerosis patients than in healthy controls. However, no differences were found between multiple sclerosis patients and the group of other neurological diseases. Addition of autologous thrombocytes did not substantially alter both the spontaneous and the zymozan-stimulated monocyte chemiluminiscence. No significant differences in granulocyte spontaneous and stimulated chemiluminiscence were found between the multiple sclerosis patients and both control groups. In all multiple sclerosis patients the addition of autologous thrombocytes markedly depressed the spontaneous and stimulated granulocyte chemiluminiscence and a similar effect was observed in most of the patients with other neurological diseases. In healthy controls, the effect of autologous thrombocytes was rather more heterogenous and both a thrombocyte-dependent increase and a decrease of the granulocyte chemiluminiscence were found. The results suggest that platelets are able to suppress the granulocyte oxidative burst and that this scavenger mechanism can be activated in multiple sclerosis and some other neurological diseases.

Blood Platelets↗

PubMed1990

ACTH and steroids in Kugelberg-Welander disease.

Two brothers with the chronic proximal form of spinal muscular atrophy (Kugelberg-Welander syndrome) were administered with ACTH and prednisone and a repeated remarkable and prompt improvement of the symptoms of this disease could be registered. Since similar experiences has recently been reported by other authors in hereditary sensory and motor neuropathy, a hypothesis is put forward of the possible participation of autoimmune mechanisms in the pathogenesis of some forms of hereditary so-called degenerative diseases of the peripheral motor neuron.

Adrenocorticotropic Hormone↗

PubMed1990