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Biomedical subjects

M Andĕl

Publications and source records attributed to M Andĕl.

At least 37 records · Page 2Linked to original sources
PubMed1999

The relationship between central serotonergic activity and insulin sensitivity in healthy volunteers.

In order to determine whether central serotonin (5-HT) activity is related to sensitivity of insulin receptors, 19 healthy volunteers with normal basal glycemia and HbAlc were studied. The relationship between prolactin response to D-fenfluramine (delta PRL) in a challenge test and metabolic clearance rates (MCR) of glucose during the hyperinsulinemic-euglycemic clamp technique was evaluated. delta PRL had been chosen as a correlate of central 5-HT activity. Two levels of insulin concentration of approximately 70 mU/l (MCRsubmax) and 2000 mU/l (MCRmax) were used in a clamp, each for a duration of 120 min. A negative correlation was found between delta PRL and MCRsubmax (r = -0.55, P < 0.02) and between delta PRL and MCRmax (r = -0.51, P < 0.03). We did not find any correlation between the prolactin response to D-fenfluramine and body weight, body mass index (BMI) or waist and hip circumference (WHR). The data support the hypothesis of a close connection between 5-HT activity in the brain and peripheral sensitivity to insulin. The possible physiological mechanisms of this connection are discussed.

Adult↗
PubMed1999

[Sonographic measurement of intimal thickness of the common carotid artery in diabetics].

Incidence of atherosclerotic cardiovascular diseases in diabetics is known to be 2-4 times higher than in nondiabetic subjects. Intima-media-thickness of common carotid artery (IMT ACC) measured by B-mode sonography positively correlates with the severity of atherosclerotic changes in coronary arteries. This study compares sonographically assessed IMT ACC in patients with type 2 diabetes mellitus (27 patients, mean age 66.57 +/- 6.06 years) vs. 66 nondiabetic subjects (mean age 63.58 +/- 9.09 years). Intima-media thickness in diabetics was significantly higher when compared with the control group (0.826 +/- 0.29 mm vs. 0.647 +/- 0.26 mm). In the whole cohort of investigated subjects IMT ACC positively correlates with age. When adjusted for age, the mean IMT ACC level was significantly higher in men than in women.

Aged↗
PubMed1998

[Trans-fatty acids in the diet and their possible health risks].

Trans fatty acids are unsaturated fatty acids which have at least one double bond in the trans configuration. Their dietary source are some foods of animal origin, but in particular hardened fats and products which contain them. Increased attention is paid to these substances in particular because they are suspected to act as risk factors for ischaemic heart disease. The authors discuss in the submitted review the chemistry, dietary sources, estimated intake and effects of trans fatty acids in the organism.

Coronary Disease↗
PubMed1998

Fasting plasma insulin levels in an unselected Prague suburban population.

OBJECTIVE: The aim of the study was to determine the levels of fasting plasma insulin in an unselected population of a Prague suburban community and correlate the levels of insulin with other metabolic and anthropometric parameters which could be directly or indirectly associated with insulin levels. RESEARCH DESIGN AND METHODS: A total of 835 adult inhabitants, the Prague suburban community, were examined. Mean age of examined people was 44.9 +/- 16.9 years, the group included 370 men and 465 women, 189 of the latter were in the menopause. The parameters examined included the fasting plasma levels of insulin, glycaemia, total cholesterol, HDL cholesterol and triacylglycerols; LDL cholesterol and, using the basic anthropometric data, the body mass index (BMI) and the waist/hip ratio (WHR) were calculated. RESULTS: The levels of all parameters were divided in ten-year groups of men and women. The average levels of fasting plasma insulin in all ten-year groups of men and women were normal. We found in the men small but constant rise of fasting insulinaemia in the decades. This was not observed in women, where the insulin levels were similar up to the time after menopause, then the level of average plasma insulin rose significantly. We found the positive correlation of plasma insulin levels with triacylglycerol levels (p < or = 0.001), BMI (p < or = 0.001) and WHR (p < or = 0.001) and a negative correlation with plasma HDL cholesterol (p < or = 0.001) in the whole group of probands. No significant correlation was demonstrated between fasting insulinaemia and total or LDL cholesterol. When dividing the group by age and sex, the strongest positive correlations were seen between insulin and triacylglycerols, glycaemia, BMI, and WHR, and negative correlations between insulin and HDL cholesterol. CONCLUSION: Fasting plasma insulin levels in an unselected population were within the normal range, but follow a continuous and steady upward course in men while did not change until after the menopause when they bounce in women; compared to insulin levels in younger women, insulinaemia does not increase up to 55 years of age. The strongest positive correlations were demonstrated between plasma insulin and triacylglycerols, and between insulin and BMI and WHR in men and postmenopausal but not premenopausal women whereas a negative correlation was observed between fasting plasma insulin and HDL cholesterol.

Adolescent↗
PubMed1998

Indicators of risk of ischaemic heart disease in patients with acute myocardial infarction under 65 years and their relatives.

The incidence of risk factors for atherosclerosis was investigated in a group of 846 patients under 65 years of age, hospitalized with acute myocardial infarction (AIM) in coronary hospital units in 21 districts of the Czech Republic in 1996. The group of patients comprises 649 men and 197 women. The incidence of risk factors in patients was compared with the incidence of risk factors in the population of the Czech Republic: the mean values of the investigated indicators are in patients with AIM higher in both sexes (total serum cholesterol, triacylglycerols, BMI, WHR). As to anamnestic data, in the majority low or irregular physical activity predominates, a high percentage of patients reported that they "do not restrict" or "rather do not restrict" their total food intake nor the intake of animal fats. Among the patients 52.6% males and 42.1% females were smokers. The results indicate that patients with AIM have a higher incidence of risk factors for atherosclerosis, a higher percentage of patients have cumulated risks and a higher percentage of patients has a higher risk score than the general population. The incidence of AIM is markedly higher in subjects with lower education.

Adult↗
PubMed1998

[Tryptophan, its metabolism and function in the human body (with emphasis on metabolic diseases and depressive syndromes)].

There is shown a brief review of essential amino acid tryptophan. The tryptophan is known as the most precious essential amino acid. There is also presented review about synthesis, degradation and metabolism of tryptophan, about effects of tryptophan and degradation products of tryptophan. There are described diseases from pathologic metabolism and intake of tryptophan.

Depressive Disorder↗
PubMed1998

[Type 1 diabetes mellitus in the aged].

Diabetes mellitus type I was till recently considered a disease affecting children and young adults. Research in the past several years provided evidence that this type of diabetes is found in all age groups and that the majority develops after the age of 35 years. Diagnostic possibilities of type I diabetes were markedly extended due to the introduction of radioimmunoassay of antibodies against glutamate decarboxylase. This examination has a 82% sensitivity and 100% specificity in diabetes. Diabetes mellitus in advanced age is manifested much less dramatically than in child age. It is found in non-obese subjects and usually its clinical manifestation is gradual. At first the patients are as a rule treated by diet. After several months usually sulphonylurea derivatives are started and only later insulin. If the diagnosis of diabetes mellitus type I is beyond doubt due to autoimmune disease, assessed preferably by antiGAD antibodies, immediate substitution therúpy with insulin is fully indicated. The latter can protect the residual function of B cells of the islets of Langerhans of the pancreas and contribute thus to the prevention of microvascular complications of diabetes mellitus.

Age Factors↗
PubMed1996

[Autoimmunity and glutamate decarboxylase antibodies in the pathogenesis of type I diabetes mellitus in experimental and clinical practice].

Diabetes mellitus type 1 (DM type 1) is a chronic, organ specific autoimmune disease. Autoantibodies against the islets of Langerhans (ICA) are found in 71%, against insulin (IA) in 65% against glutamate decarboxylase (GAD) in 67-77% of children with DM type 1; in their close relatives and in patients with a more prolonged persistence of DM type 1 these antibodies and manifestations of cell-mediated autoreactivity are found less frequently also as a sign of the autoimmune character of DM type 1. In the pathogenesis of DM type 1 with the help of experimental mammalian models an idea on the genesis of the disease was obtained--activation of autoimmunity on the background of genetic sensitivity and environmental factors, the development of lymphocytic infiltration of the pancreatic islets (insulitis) destruction of pancreatic B-cells due to the cytotoxicity of T lymphocytes and the manifestation of DM type 1. According to this idea among the series of antigens of B-cells of the islets of Langerhans the dominant antigen is the isoform GAD65--under experimental conditions the specific response of T lymphocytes against GAD65 is found first, then follows extension of the reactivity also against other antigens of the islets. Understanding of the immune pathogenesis of DM type 1 makes it possible to apply the immunomodulating approach to the treatment of this condition which gave the first positive results in experimental work as well as in clinical practice.

Animals↗
PubMed1994

[Endothelial dysfunction in diabetes mellitus].

Impairment of the vascular endothelium and its functions is a common sign of several serious diseases (atherosclerosis, hypertension, vascular spasms, thromboses) and is the initial stage of vascular affection in diabetes mellitus. The endothelium plays an important role in the transformation of some substances with a cardiovascular action and it secretes itself vasoactive substances. Vascular affections in diabetes are characterized by impaired homeostasis of vasoactive substances of endothelial origin--raised levels of vasoconstrictor factors (endothelins, thromboxanes) and reduction of vasodilatating factors (prostacyclin, EDRF--endothelin derived relaxing factor) as well as disorders of their interrelations. Vasoactive agents lead at the same time also to alteration of the growth and proliferation potential of smooth muscle cells of the vascular wall and thus to remodelling of the vascular structure in diabetes. At present possible ways how to influence these processes in a favourable way are intensely studied and discussed.

Diabetes Complications↗
PubMed1994

[Does the diabetic patient need special diabetic food?].

At present the diet recommended by the Czech Diabetological Society does not fundamentally differ from the diet recommended to the population of the Czech Republic as a whole. The diet must contain high-fibre foods, provide 55% of the energy as carbohydrates, 30% of the energy should be derived from fats and the protein content should be less than 1 g of protein per kg body weight. The cholesterol intake should not exceed 300 mg/day. The system of intensified insulin therapy made a flexible schedule time, of food intake for type I diabetics possible. For diabetics type II the basic provision is a low energy diet which leads to body weight reduction, as the great majority of these patients is overweight. Products described as "dia" or products where on the wrapping it is maintained that they are suitable for diabetics can be divided into two groups, depending on the sweetener used. Products containing non-caloric sweeteners (saccharin, aspartam, acesulfam or so far not permitted cyclamate) have a markedly reduced energy content and are thus suitable in particular for type II diabetics. Products sweetened with fructose, xylitol, sorbitol have as a rule the same or a similar energy values as sucrose containing products and are of no advantage for diabetics type II who are frequently obese. This is why it will be useful to abandon labelling such as "dia-product" or "product suitable for diabetics". This description should not be permitted and the term "low-energy food" should be used. It will be necessary to define precise criteria for these foodstuffs.

Diabetes Mellitus↗
PubMed1994

[Hyperinsulinemia--the common denominator in type II diabetes mellitus,obesity, hypertension, hypertriglyceridemia and atherosclerosis].

During the last twenty years we witnessed a remarkable increase in knowledge of the mechanism as regards insulin action, the central hormone of metabolic regulations. Interest in cellular and molecular mechanisms of action was conditioned by a high prevalence of insulin resistance and the fact that insulin resistance holds a key position in the pathogenesis of many diseases, in particular atherosclerosis, obesity, hypertension, diabetes mellitus type II, ovarian hyperandrogenism and others. The syndrome of hyperinsulinaemia/insulin resistance is the basic component of the so-called X syndrome defined in 1988 by Reaven. It is encountered in subjects with a normal glucose tolerance but a predisposition for diabetes type II. If this disposition, probably genetic by nature, is potentiated by the central type of obesity and a sedentary lifestyle it can influence the development of hypertension and dyslipidemia. The sum of these factors promotes acceleration of atherosclerosis and frequently its premature manifestations: myocardial infarction and other cardiovascular diseases which hold the first place as regards causes of death on a world wide scale. It is important to identify but also to treat this complex not only metabolic risk factors for macrovascular diseases. It is a paradox that some drugs used as antihypertensives can cause deterioration of insulin resistance, subsequently influence in an adverse manner dyslipidemia and thus increase the metabolic risk of cardiovascular diseases. In the submitted paper the authors tried to summarize hitherto expressed views on the syndrome of hyperinsulinaemia and insulin resistance, using as a basic the results of their own work.

Arteriosclerosis↗
PubMed1993

Do preoperative branched-chain amino acids have a beneficial effect on the heart after cardiac surgery?

To verify the hypothesis, formulated on the basis of data emerging from animal experiments, that branched-chain amino acids (BCAA) exert a protective effect on the heart during ischaemia, eight patients immediately before aortocoronary reconstruction were provided 400 ml of a 3% BCAA solution. A control group comprised another eight patients. Per- and postoperative myocardial status and myocardial enzyme levels were assessed. Myocardial biopsy was performed during surgery to determine glycogen levels. Creatine kinase (CK) levels were invariably higher in the BCAA group, with statistically significant differences in samples obtained immediately after surgery (10.6 +/- 3.35 mu kat/l vs. 4.07 +/- 0.59, p < 0.0004), in the evening after surgery (14.2 +/- 5.92 vs. 5.91 +/- 2.21, p < 0.06) and in the morning of the first postoperative day (18.0 +/- 10.1 vs. 7.5 +/- 4.76, p < 0.025) when aspartate aminotransferase (AST) levels were likewise higher (1.35 +/- 0.28 vs. 1.00 +/- 0.26, p < 0.035). There were no differences between the groups in the number of defibrillations after ischaemia, myocardial glycogen content, peroperative ischaemia, incidence of arrhythmia and catecholamine support. We conclude that BCAA at the above indicated doses did not raise myocardial glycogen content or improve myocardial status after cardiac surgery. Their administration resulted in a rise in CK and AST in the postoperative period.

Amino Acids, Branched-Chain↗
PubMed1992

[Long-term home parenteral nutrition using a totally implanted cannulation system].

A 29-year-old patient suffering from stenosis of the rectum and a periproctal fistula due to a severe form of Crohn's disease was completely fed by the parenteral route for 15 months, incl. 13 months at home, via a totally implanted cannula system Implantofix, Braun Co.. The patient felt throughout the period of parenteral nutrition very well, he worked and the secretion from the fistula stopped after four weeks. After 15 months of complete parenteral nutrition and elimination of oral food intake a marked improvement of the local finding in the rectum was observed. All laboratory findings (haemogram, liver tests, urea, creatinine, transferrin, albumin, cholinesterase and pre-albumin, serum levels of sodium, potassium, chlorides, calcium and phosphates) were throughout the observation period within a normal range. The body weight of the patient increased during the 15 months by 1 kg. The described case is the first one where domiciliary parenteral nutrition was used in Czechoslovakia under ambulatory conditions.

Adult↗
PubMed1992

[Actinomycosis of the ovary as a cause of cachexia in a young patient].

The authors describe the case of a 40-year-old female patient treated for prolonged periods unsuccessfully with several antibiotics on account of a febrile condition of obscure aetiology and subsequently repeatedly subjected to laparotomy on account of intra-abdominal abscesses. The cause of the fever, abdominal pain and gradual cachectization was an abdominal form of actinomycosis. After establishment of the diagnosis the patient was successfully treated by long-term penicillin administration and recovered completely. The authors discuss experience reported in the literature and therapeutic possibilities in actinomycosis.

Actinomycosis↗
PubMed1992

[Catabolism after direct myocardial revascularization].

The objective of the investigation was to assemble more knowledge of catabolic processes after cardiosurgery. In 14 patients after 6-hour intervals following an aortocoronary bypass the total production of urea nitrogen, Bistrian's catabolic index and the sodium:potassium ratio in urine was assessed. The urea nitrogen production varied within a range of 5.4-9.5 g per 12 hours. These values when calculated per 24 hours are 94-108 g of protein. The catabolic index was in the range of 5.8-11.2, i.e. within the zone of intense stress. Also the values of the Na/K ratio (1.0-1.9) suggested intense stress. The authors discuss the causes and possibilities to relieve the stress response.

Adult↗
PubMed1991

Prognosis of manpower requirements to ensure specialist diabetological care in the Czech Republic.

The submitted prognosis of need of personnel to ensure specialist diabetological care in the Czech Republic is based on an analysis of the development of the number of diabetic patients and on analysis of activities which must be provided to diabetics in order to maintain the selected standard of health care. The estimate of the future number of diabetics is assessed by the method of demographic projection for one-year age groups, separately for men and women. The analysis of activities in diabetological care was elaborated from the results of an anonymous survey among diabetologists in the South Moravian region. Reflections on different variants of the standard of provided care respect also the analysis of the hitherto recorded trend in the number of health workers in diabetology and their available time. The estimate of needs is objective and can be applied in specialized diabetological services as well as in a different organization of care of diabetics, e.g. by the general practitioner. The contemporary organization of care of diabetics cannot ensure the required standard of care. The prognosis submits several possible ways how to achieve this standard. The prognosis deals in particular with the number of working hours of doctors but does not omit other categories of health workers.

Czechoslovakia↗
PubMed1990

[Outlook on personnel requirements for ensuring professional diabetology care in the Czech Republic].

The submitted prognosis of need of personnel to ensure specialist diabetological care in the Czech Republic is based on an analysis of the development of the number of diabetic patients and an analysis of activities which must be provided to diabetics in order to maintain the selected standard of health care. The estimate of the future number of diabetics is assessed by the method of demographic projection for one-year age groups, separately for men and women. The analysis of activities in diabetological care was elaborated from the results of an anonymous survey among diabetologists in the South Moravian region. Reflections on different variants of the standard of provided care respect also the analysis of the hitherto recorded trend in the number of health workers in diabetology and their available time. The estimate of needs is objective and can be applied in specialized diabetological services as well as in a different organization of care of diabetics, e.g. by the general practitioner. The contemporary organization of care of diabetics cannot ensure the required standard of care. The prognosis submits several possible ways how to achieve this standard. The prognosis deals in particular with the number of working hours of doctors but does not omit other categories of health workers.

Czechoslovakia↗