Arterial stiffness is a marker of vascular damage. Although adiposity increases cardiovascular risk, the relationship between paediatric overweight and arterial stiffness is unclear. The study aimed to evaluate the simultaneous effect of hypertension and overweight on arterial stiffness using cardio-ankle vascular index (CAVI) and related novel, theoretically blood pressure (BP)-independent, index CAVI0. CAVI and CAVI0 were measured in 140 adolescent boys (16.0 ± 1.9 years) divided into age-matched groups: normal-weight normotensives, overweight normotensives, overweight white-coat hypertensives, and overweight essential hypertensives. Overweight normotensives had significantly lower CAVI and CAVI0 compared to normal-weight normotensives (4.81 ± 0.64 vs. 5.33 ± 0.66, p < .01; 7.10 ± 0.99 vs. 7.81 ± 1.00, p < .01, respectively). CAVI and CAVI0 in overweight essential hypertensives showed no significant difference compared to normal-weight normotensives and were significantly higher compared to overweight normotensives (5.32 ± 0.77 vs. 4.81 ± 0.64, p < .01; 7.77 ± 1.19 vs. 7.10 ± 0.99, p < .01, respectively). CAVI, but not CAVI0, was associated positively with diastolic pressure (0.022 mmHg-1, p = .002) and negatively with pulse pressure (-0.022 mmHg-1, p = .001), and it was significantly higher in overweight white-coat hypertensives compared to overweight normotensives (5.20 ± 0.63 vs. 4.81 ± 0.64, p < .05). The lowering effect of overweight on arterial stiffness indexed by CAVI and CAVI0 in hypertensive adolescents seems to counterbalance the early arteriosclerotic effect of essential hypertension. The increase in CAVI, but not CAVI0, in overweight white-coat hypertensives could be attributable to residual BP dependence of CAVI, which is not present in CAVI0. Under certain conditions, CAVI0 may offer a clinically relevant improved assessment of arterial stiffness superior to CAVI.

• Klíčová slova
• Vascular stiffness, adolescent, atherosclerosis, blood pressure, hypertension, obesity, overweight, pulse wave analysis, white coat hypertension,
• MeSH
• analýza pulzové vlny MeSH
• arterioskleróza diagnóza   MeSH
• hypertenze diagnóza   MeSH
• kotník krevní zásobení   MeSH
• krevní tlak MeSH
• lidé MeSH
• mladiství MeSH
• nadváha patologie   patofyziologie   MeSH
• rizikové faktory MeSH
• tuhost cévní stěny MeSH
• zlepšení kvality MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Schimke immuno-osseous dysplasia (SIOD) is a rare multisystem disorder with early mortality and steroid-resistant nephrotic syndrome (SRNS) progressing to end-stage kidney disease. We hypothesized that next-generation gene panel sequencing may unsurface oligosymptomatic cases of SIOD with potentially milder disease courses. We analyzed the renal and extrarenal phenotypic spectrum and genotype-phenotype associations in 34 patients from 28 families, the largest SMARCAL1-associated nephropathy cohort to date. In 11 patients the diagnosis was made unsuspectedly through SRNS gene panel testing. Renal disease first manifested at median age 4.5 yrs, with focal segmental glmerulosclerosis or minimal change nephropathy on biopsy and rapid progression to end-stage kidney disease (ESKD) at median age 8.7 yrs. Whereas patients diagnosed by phenotype more frequently developed severe extrarenal complications (cerebral ischemic events, septicemia) and were more likely to die before age 10 years than patients identified by SRNS-gene panel screening (88 vs. 40%), the subgroups did not differ with respect to age at proteinuria onset and progression to ESKD. Also, 10 of 11 children diagnosed unsuspectedly by Next Generation Sequencing were small at diagnosis and all showed progressive growth failure. Severe phenotypes were usually associated with biallelic truncating mutations and milder phenotypes with biallelic missense mutations. However, no genotype-phenotype correlation was observed for the renal disease course. In conclusion, while short stature is a reliable clue to SIOD in children with SRNS, other systemic features are highly variable. Our findings support routine SMARCAL1 testing also in non-syndromic SRNS.

• MeSH
• arterioskleróza diagnóza   genetika   patologie   MeSH
• dítě MeSH
• DNA-helikasy genetika   MeSH
• dospělí MeSH
• fenotyp MeSH
• genetické testování MeSH
• genotyp MeSH
• kohortové studie MeSH
• kojenec MeSH
• ledviny patologie   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mutace MeSH
• nefrotický syndrom diagnóza   genetika   patologie   MeSH
• osteochondrodysplazie diagnóza   genetika   patologie   MeSH
• plicní embolie diagnóza   genetika   patologie   MeSH
• předškolní dítě MeSH
• primární imunodeficience MeSH
• syndromy imunologické nedostatečnosti diagnóza   genetika   patologie   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• DNA-helikasy MeSH
• SMARCAL1 protein, human MeSH Prohlížeč

Elevated C-reactive protein concentration, measured by an ultrasensitive method (hsCRP), has been proved to be a risk factor for atherosclerosis progression and its complications (myocardial infarction and stroke) in otherwise healthy men and women. In patients with already diagnosed atherosclerotic disease elevated concentration of hsCRP predicts prognosis. There are multiple causes of elevated hsCRP concentration: metabolic changes (e.g. as a part of metabolic syndrome), genetic background and chronic infections. Proinflammatory effect of adipose tissue in obese individuals seems to play an important role, hsCRP levels correlate with markers of abdominal obesity. Elevated hsCRP concentrations can be lowered both pharmacologically and by a lifestyle change. This review covers current knowledge of pathophysiology of elevated hsCRP concentration and possible use of this method in clinical medicine.

• MeSH
• arterioskleróza diagnóza   MeSH
• biologické markery krev   MeSH
• C-reaktivní protein analýza   fyziologie   MeSH
• imunoanalýza metody   MeSH
• kardiovaskulární nemoci diagnóza   prevence a kontrola   MeSH
• lidé MeSH
• metabolický syndrom diagnóza   MeSH
• nefelometrie a turbidimetrie MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• biologické markery MeSH
• C-reaktivní protein MeSH

The role of adhesive selectin molecules in the process of atherogenesis is an open question. These molecules are known as markers of atherosclerosis activity, however, only some biological mechanisms are known up to now. In this study we examined the levels of soluble forms of E-, P-selectin and monocyte chemotactic protein (MCP-1) in the process of extracorporeal cholesterol elimination by LDL-apheresis. We measured the levels of sE-, sP-selectin and MCP-1 in the plasma before and after LDL-apheresis and in the washout solution from immunoabsorption columns Lipopak. Eighty measurements were performed repeatedly in 6 patients with severe familial hypercholesterolemia (FH) on long-term LDL-apheresis treatment. Before the procedure P-selectin levels were 204+/-179 ng/ml, E-selectin 32.1+/-33.7 ng/ml, MCP-1 323.8+/-121 pg/l, whereas after the procedure we found P-selectin levels 131.6+/-34 ng/ml, E-selectin 33.1+/-51 ng/ml, and MCP-1 200.4+/-15 pg/l. Levels of P-selectin were increased in the blood of patients with FH in spite of long-term intensive extracorporeal LDL-elimination, documenting thus the activity of atherosclerosis. The levels of P-selectin and MCP-1 decreased significantly after the hypolidemic procedure and could be used as another marker showing the effectivity of the extracorporeal LDL-cholesterol elimination (immediately after the procedure), and, after further verification, may serve as a marker for controlling the therapy efficacy.

• MeSH
• arterioskleróza krev   diagnóza   etiologie   terapie   MeSH
• biologické markery krev   MeSH
• chemokin CCL2 krev   MeSH
• hyperlipoproteinemie typ II krev   komplikace   diagnóza   terapie   MeSH
• LDL-cholesterol izolace a purifikace   MeSH
• lidé MeSH
• reprodukovatelnost výsledků MeSH
• selektiny krev   MeSH
• senzitivita a specificita MeSH
• separace krevních složek metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• biologické markery MeSH
• chemokin CCL2 MeSH
• LDL-cholesterol MeSH
• selektiny MeSH

C-reactive protein (CRP) is one of the positive proteins in an acute phase. It is produced in hepatocytes in response to cytokines activity, especially to IL-6. Its increase is the second biggest after significant bacterial and cardiovascular insults. It reaches its peak between 24 and 48 hours. CRP monitoring makes possible monitoring of the intensity of the pathologic process and to control efficiency of treatment measures according to fluctuation of its level. According to its serum values it can reflect a place of inflammation, e.g. in upper or lower airways, urinary tract etc. It helps to distinguish between bacterial and viral inflammations and to identify size of vascular lesions such as acute myocardial infarction, cerebral infarction, decompensation of atherosclerosis. Because of its easy detection and quick elevation CRP has not only a diagnostic importance but also a prognostic one and is a predictor of a risk of atherosclerosis. Although long lasting renal insufficiency (LLRI), renal failure (RF) and regular dialysis treatment (RDT) are indicated to elevate CRP level, authors present proves that adequately treated patient compensated with an adequate dialysis treatment has normal CRP values for a long time in spite of long lasting comorbidities including atherosclerosis. There has been done a long term monitoring of 10 patients with LLRI and 22 patients with RDT. Their CRP was monitored via a turbidimetric method using sets K-Assay made by company Kamya Bio Comp. Elevated CRP in the samples reflects an acute insult such as infection, cardiovascular disease, diabetes decompensation and last but not least quality of a dialysis treatment.

• MeSH
• arterioskleróza diagnóza   etiologie   MeSH
• biologické markery krev   MeSH
• C-reaktivní protein analýza   MeSH
• chronické selhání ledvin krev   komplikace   terapie   MeSH
• dialýza ledvin MeSH
• dospělí MeSH
• infekce komplikace   diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery MeSH
• C-reaktivní protein MeSH

Primary aortointestinal fistula is a rare reason for gastrointestinal bleeding and mainly caused by a communication between the digestive tract and an aortic aneurysm. The penetrating aortic ulcer has been recently recognized as an independent pathological entity. It may penetrate through the aortic wall, leading to fistula into adjacent organs. We report the case of a 78-year-old woman who was admitted to our department with massive gastrointestinal hemorrhage. Endoscopy did not reveal the cause of hemorrhage. The diagnosis was made by computed tomography showing a primary aortoduodenal fistula without aortic aneurysm. The patient was successfully operated on. During urgent operation we found the penetrating atherosclerotic ulcer as the cause of the aortoduodenal communication. Primary aortoenteric fistula has a fatal outcome unless it is diagnosed accurately and urgently treated by surgical intervention. Contrast-enhanced computed tomography is the primary imaging modality to specify the diagnosis.

• MeSH
• aorta abdominalis patologie   chirurgie   MeSH
• aortografie MeSH
• arterioskleróza diagnóza   chirurgie   MeSH
• cévní píštěle diagnóza   chirurgie   MeSH
• diferenciální diagnóza MeSH
• gastrointestinální krvácení etiologie   chirurgie   MeSH
• lidé MeSH
• nemoci aorty diagnóza   chirurgie   MeSH
• nemoci duodena diagnóza   chirurgie   MeSH
• počítačová rentgenová tomografie MeSH
• senioři MeSH
• střevní píštěle diagnóza   chirurgie   MeSH
• vřed diagnóza   chirurgie   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH

Body surface potential mapping (BSPM) enables to obtain more information about local changes of the heart electrical field then classical electrocardiography makes it possible. We performed this non-invasive diagnostic method in the group of 108 men in the frame of the primary preventive study of the risk factors of atherosclerosis. The findings of BSPM were compared to the selective coronary angiography. The study was started in the years 1976-1979 in the district Prague 2. Out of 2370 invited middle-aged men, 1419 took part in the study. 937 men (66.0%) were affected by one or more risk factors of atherosclerosis. No statistical significance was found in regard to the number and the level of risk factors of atherosclerosis between the groups of patients with different findings on the coronary angiography. Nevertheless, the method of BSPM is a very useful in epidemiological studies of atherosclerosis, namely with coronary localization, in clinical practice, and in the biomedical research too.

• MeSH
• arterioskleróza diagnóza   epidemiologie   MeSH
• epidemiologické studie MeSH
• lidé MeSH
• mapování potenciálů tělesného povrchu * MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

Contemporary methods of assessment of possible cardiovascular disease based on traditional risk factors are not perfect. Therefore new ways are sought. Simple and inexpensive methods include assessment of the blood pressure on the lower extremities above the ankles. The finding of a reduced ratio of the ankle-brachial blood pressure index (ABI) indicates atherosclerosis of the lower extremity arteries. ABI values of 0.9 or less are associated with a significantly increased risk of cardiovascular diseases (in particular myocardial infarction and stroke) that is independent of other risk factors. ABI assessment is a simple clinical examination and should be performed in middle-aged and elderly subjects with a medium and high cardiovascular risk in order to define more accurately their health status. Patients with reduced ABI of 0.9 or less are candidates for secondary preventive treatment for cardiovascular disease.

• MeSH
• arteria brachialis MeSH
• arterioskleróza diagnóza   MeSH
• dospělí MeSH
• kardiovaskulární nemoci diagnóza   MeSH
• kotník krevní zásobení   MeSH
• krevní tlak fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• měření krevního tlaku metody   MeSH
• paže krevní zásobení   MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Contemporary methods of assessment of possible cardiovascular disease based on traditional risk factors are not perfect. Therefore new ways are sought. Simple and cheap methods include assessment of the blood pressure on the lower extremities above the ankles. The finding of a reduced index of ankle pressure (ratio of blood pressure above the ankles and pressure on the arm) indicates affection of the arteries of the lower extremities and a significantly increased risk of cardiovascular diseases (in particular myocardial infarction and stroke), independently on other risk factors. Therefore this simple examination should be made in middle aged and elderly subjects with a medium and high cardiovascular risk in order to define more accurately the health status, and in case of a reduced ankle pressure similar provisions should be made as in patients with secondary preventive care.

• MeSH
• arterioskleróza diagnóza   MeSH
• kotník krevní zásobení   MeSH
• krevní tlak * MeSH
• lidé MeSH
• měření krevního tlaku metody   MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

Chronic mesenteric ischemia often called intestinal angina too, is the clinical syndrome that originates as a result of chronic obstruction of the splanchnic arteries. Intestinal angina is defined by the clinical triad of postprandial abdominal pain, sitophobia (fear of eating) and chronic weight loss. Postprandial abdominal pain is analogous to angina pectoris and calf claudication, two more common manifestations of episodic tissue hypoxia. The authors present the case-history of a 50-year-old woman with intestinal angina due to obliteration of the all three main splanchnic arteries. The authors describe the course of the disease and point out new diagnostic approaches in the diagnosis of chronic mesenteric ischemia (Doppler ultrasound of the splanchnic arteries, helical CT angiography of the splanchnic vasculature). In the discussion they point out the possible atypical clinical manifestation of chronic mesenteric ischemia and existence of gastric ulceration and chronic ischemic gastritis caused by chronic mesenteric ischemia.

• MeSH
• arteriae mesentericae MeSH
• arterioskleróza komplikace   diagnóza   MeSH
• chronická nemoc MeSH
• lidé středního věku MeSH
• lidé MeSH
• mezenteriální cévní okluze diagnóza   etiologie   terapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH