Casopís lékar̆ů c̆eských
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Polymorphisms in drug metabolizing enzymes are considered as a major factor influencing the incidence of adverse drug reactions or failure of pharmacotherapy. Our aim was to compare the distribution of functional polymorphisms in the genes CYP2D6 and CYP2C19 between healthy control group and of patients reffered to our department due to adverse drug reactions or insufficient efficacy of a treatment. ⋯ Clinically apparent alteration of drug effects are often caused by partial or complete deficit of CYP2D6 activity. Our results confirm the importance of CYP2D6 polymorphisms on the efficycy and safety of pharmacotherapy.
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Casopís lékar̆ů c̆eských · Jan 2007
[Effect of surgical treatment of atrial fibrillation on the attainment and maintenance of sinus rhythm in patients undergoing concomitant cardiac surgery--short-term results].
Atrial fibrillation is the most frequent sustained arrhythmia. It is associated with higher morbidity and mortality of patients. Cryoablation was introduced to the current practise in cardiac surgery as a non-pharmacological method of therapy of atrial fibrillation. The aim of the study was to assess the effect of surgical ablation of atrial fibrillation on the attainment and maintenance of sinus rhythm in patients undergoing concomitant cardiac surgery. ⋯ Perioperative ablation of atrial fibrillation using cryoenergy is effective therapeutic method for restoring and maintenance of sinus rhythm in relatively high proportion of patients. The most significant predictors of late recurrence are preoperative atrial size and duration of atrial fibrillation. This non-pharmacological method should be routinely used in patients undergoing concomitant cardiac surgery.
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Casopís lékar̆ů c̆eských · Jan 2007
Review[Thrombotic complications of sepsis and their pharmacological prophylaxis].
Patients with severe sepsis are at increased risk for developing thrombembolic phenomena. This article aims to clarify the association between systemic inflammation activation and coagulation, pathogenesis of coagulation abnormalities during severe sepsis. The article reviews incidence and deep venous thrombosis risk factors among these patients and summarizes recent evidence-based guidelines for deep venous thrombosis prophylaxis.
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Casopís lékar̆ů c̆eských · Jan 2007
Review[Obesity based on mutation of genes involved in energy balance].
Within the last decade an intensive research led to an identification of several genes which are involved in a regulation of energy balance. In most cases, carriers of these gene mutations do not exhibit further characteristic phenotypic features except for a severe obesity. Obesity based on mutation of one gene product is called monogenic obesity. ⋯ Mutations of the other genes involved in energy homeostasis are very rare. Although these mutations are sporadic we assume that further research of monogenic forms of obesity might lead to our understanding of physiology and pathophysiology of regulation of the energy homeostasis and eating behaviour. Additionally, they may open new approach to the management of eating behaviour and to the treatment of obesity.
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Sepsis represents an important infectious process with systemic manifestation. The incidence of sepsis is continuously increasing. This epidemiologic trend reflects the aging population, increasing number of chronically ill patients and invasiveness of the modern medicine. ⋯ As an example is a failure of clinical study with monoclonal antibody against TNF-a. Thus, the search for new clinically effective therapeutic agents is aimed at pathogenetic mechanisms activated in longer time frame after the primary insult. Currently, out of drugs modulating the already known immunopathophysiological mechanisms of sepsis corticosteroids and activated protein C are used.