[The 115th Internal Medicine Seminar--the XVI. Vanysek Seminar--Lipids 2000 presented by the Czech and Slovak Internal Medicine Society, the Society of Czech Physicians in Brno and the Czech Atherosclerosis Society on the anniversary of the birth of Dr. Rudolf Vanysek, founder of the Brno School of Internal Medicine. 10 March 2000, Brno].

Vnitr Lek 2000, 46(9):493-568

[Dr. Rudolf Vanysek, DrSc. (1876-1957)].

P Svacina

Vnitr Lek 2000, 46(9):496-497

[Should we treat the symptom or the disease? Treat the patient].

M Anděl

Vnitr Lek 2000, 46(9):498-500

[Longitudinal trends of total and HDL cholesterol in a representative population sample in the Czech Republic].

R Cífková, Z Skodová, V Lánská, R Poledne, V Adámková, E Novozámská, M Jozífová, Z Petrzílková, G Hauserová, A Dusková, Z Hejl, P Stávek, J Skibová

Vnitr Lek 2000, 46(9):501-505

Cardiovascular diseases are the main cause of death in the Czech Republic. Since 1984 there is a decline of the total and cardiovascular mortality in the CR which is due to a decline of the mortality from IHD and cerebrovascular disease. Within the framework of the MONICA project in 1985, 1988 and 1992 in six districts of the CR screening examinations of cardiovascular disease risk factors were made. For examination always 1% of the population aged 25-64 years (random sampling) was invited. In 1997 and 1998 a similar cross-sectional surmy was made in nine districts of the CR. A total of 3,209 subjects were examined. In 1985-1997/98 in the representative...

[Pathophysiologic aspects of hyperlipoproteinemias].

V Soska

Vnitr Lek 2000, 46(9):506-509

Elevated LDL-cholesterol levels and reduced HDL-cholesterol levels are independent risk factors for the development of ischaemic heart disease. Atherosclerosis is promoted also by some particles rich in triacylglycerols, in particular intermediate density lipoproteins (IDL), partly also very low density lipoproteins (VLDL). The risk of IHD is enhanced also by subfractions of LDLIII and protracted postprandial lipaemia, characterized by an increased concentration of remnants of chylomicrons. An independent risk factor is also an increased concentration of lipoprotein(a). When evaluating the cardiovascular risk of an actual patient it is always necessary...

[Nutritional aspects of hyperlipoproteinemias].

Z Zadák, V Bláha, R Hyspler, P Zďánský

Vnitr Lek 2000, 46(9):510-514

The article deals with contemporary views on the impact of different nutritional substrates important for the construction of diets for patients with primary and secondary hyperlipoproteinaemia, explanation of different provisions and instructions according to which the physician or dietitian can prepare individual diets for normosthenic and obese patients, incl. calculation of the energy value of the diet. The author emphasizes also some new aspects of nutritional pharmacology useful not only for the treatment of hyperlipoproteinaemia but also for prevention of thrombogenic complications and adverse vasomotor reactions in patients with affections...

[Lipids and chronic heart failure].

J Spinar, L Spinarová, J Vítovec

Vnitr Lek 2000, 46(9):515-519

The causes of chronic heart failure at the end of the 20th century are quite different from those 30 or 50 years ago. The last data from the Framingham study indicate that ischaemic heart disease and/or hypertension are the main cause in as many as 90% patients. The prevalence of chronic heart failure in European countries, 0.4-2%, implies 40-200,000 patients in the Czech Republic. Pharmacological treatment during the last 15 years revealed clearly that the drugs of choice which prolong life are inhibitors of the angiotensin converting enzyme (ACE-I) which are combined with other drugs as needed by the patient. A combination of five drug groups (ACE-I,...

[Lipids and acute coronary syndromes].

M Stejfa

Vnitr Lek 2000, 46(9):520-525

Eccentric atherogenic plaques which cause only insignificant narrowing of the diameter of coronary arteries are the cause of 60-80% of all acute coronary syndromes. The plaque becomes unstable (vulnerable) due to cytokines released by macrophages in the lipid rich core. Weakening of the fibrous capsule of the core then leads to rupture of the plaque and subsequently to intracoronary thrombosis with a wide spectrum of ischaemia or even necrosis of the myocardium. Secondary preventive studies (4S, LIPID, CARE), morphological non-mortality studies (e.g. AVERT, REGRESS, LCAS) and primary preventive studies (WOSCOPS, AFCAPS/TexCAPS) revealed that statins...

[Lipids and heart valve defects].

R Cerbák

Vnitr Lek 2000, 46(9):526-528

[Lipids and atherosclerosis of the peripheral vessels].

I Hofírek, V Krejcí

Vnitr Lek 2000, 46(9):529-531

The authors present a review of information on the incidence éf obliterations of peripheral vessels, incl. their own experience, with a group of diabetic patients. Attention is paid to the pathophysiology of affections of peripheral vessels. In the final part data on the relationship of lipids or their fractions and the development of obliteration of peripheral vessels are presented.

[Dyslipoproteinemia and diabetes mellitus].

H Vaverková

Vnitr Lek 2000, 46(9):532-538

Diabetes mellitus is, as compared with the non-diabetic population, associated with a much higher mortality of ischaemic heart disease and other cardiovascular diseases. In this risk participates in a major way also diabetic dylipidaemia. The latter is characterized in particular by hypertriglyceridemia which reflects the increase of VLDL and IDL lipoproteins. Elevated and prolonged postprandial lipaemia participates in the development of qualitative lipoprotein changes. Highly athergenic "small dense LDL" are formed which are liable to an oxidative modification and are then in an unregulated manner taken up in the vascular wall. Reduction of HDL-cholesterol...

[Dyslipoproteinemia and chronic kidney failure].

J Zahálková, H Vaverková, V Kristof

Vnitr Lek 2000, 46(9):539-546

Lipoprotein abnormalities are a regular part of metabolic changes associated with chronic renal failure. The character of dyslipoproteinaemia changes with the severity of disorders of renal functions, from initial deviations in the composition and distribution of circulating lipoprotein particles (a decline of glomerular filtration to 0.7-0.8 ml/s) to differently expressed changes of plasma lipid concentrations in terminal renal failure. The basis of the pathogenetic mechanism of these lipid abnormalities is the negative effect of the uraemic environment on the formation and catabolism of triglyceride-risk lipoproteins and on the function of the reverse...

[Lipid disorders in liver diseases].

P Studeník

Vnitr Lek 2000, 46(9):547-548

The liver is the main organ of cholesterol, triglyceride metabolism and lipoprotein synthesis. In diffuse parenchymatous diseases which lead to cirrhosis of the liver a decline of VLDL and HDL particles occurs, as well as a decline of apo-B, apo-E lipoprotein (a). In cholestatic diseases the levels of free cholesterol, phospholipids and sometimes also triglyceride levels rise, in the termonal stage they decline again. A specific marker of cholestasis is the presence of abnormal lipoprotein X, which is formed from non-esterified cholesterol and phsopholipids regurgitating from bile. Primary lipid disorders may then cause liver disease--steatosis. The...

[Lipid disorders after organ transplantation].

M Kuman

Vnitr Lek 2000, 46(9):549-550

Transplantations are a routine method of treatment of chronic and acute organ failure. Changes in the therapeutic strategy led to improvement of organ and patient survival immediately after transplantation and during the early post-transplantation period. Medium-term and long-term results of organ survival improved less markedly. Chronic dysfunction and death are the most frequent causes of loss of a transplanted organs one year after transplantation. Chronic dysfunction has immunological and non-immunological causes. An important risk factor is hyperlipidaemia. Therapy must be started as soon as possible. It threatens the patients prognostically more...

[Dyslipoproteinemia in elderly patients].

V Bláha, D Solichová, Z Zadák

Vnitr Lek 2000, 46(9):551-554

Dyslipoproteinaemia as one among classical risk factors of atherosclerotic cardiovascular diseases has been involved also in the aged. The predictive value of total cholesterol, LDL-cholesterol, HDL-cholesterol, triacylglycerols and lipoprotein (a) is preserved. There are several objective data from post-hoc analyses of prospective clinical studies AFCAPS/TexCAPS, 4S, CARE, LIPID a WOSCOPS, which addressed the need of treatment of dyslipoproteinaemia in the aged. The guidelines are not unique, but they stress an individual approach. We usually continue to treat genetic forms of dyslipidaemia. Candidates of treatment are also patients with diagnose...

[Therapeutic goals in hyperlipoproteinemia].

R Ceska

Vnitr Lek 2000, 46(9):555-558

In the treatment of hyperlipoproteinaemias (HLP) our main effort should be treatment of the patient and not achievement of defined biochemical values. The basic goals of HLP treatment can be defined on the basis of results of intervention studies as follows: reduction of general mortality, reduction of morbidity from IHD, reduction of the incidence of CMP, improved course of ischaemia of the lower extremities, better quality of life of patients with cardiovascular disease and reduced necessity of revascularization surgery. Even if we shall assume that the positive effect of treatment with HLP are in the first place optimization of the lipid spectrum,...

[Effect of nonpharmacologic intervention on lowering plasma cholesterol levels].

Z Brázdová, J Fiala

Vnitr Lek 2000, 46(9):559-564

UNLABELLED: Our study focused on the effect of non-pharmacological intervention based on the modification of dietary habits and increasing physical activity on the level of total plasma cholesterol.SAMPLE AND METHODS: Intervented sample was created by 279 highly motivated healthy adults from Brno (168 women and 111 men) of average age 43.5 +/- 10.3 years and average level of total plasma cholesterol 6.1 +/- 0.75 mmol/l and HDL-cholesterol 1.04 +/- 0.14 mmol/l. After medical and life-style history assessment, followed by clinical and biochemical checking and evaluation the risk from the life-style and biochemical and clinical parameters, the participants...

[Pharmacotherapy of hyperlipoproteinemia].

V Soska

Vnitr Lek 2000, 46(9):565-568

Hyperlipoproteinaemia is one of the main risk factors of ischaemic heart disease. The centre of gravity of its pharmacotherapy with hypolipidaemic agents is secondary prevention of ischaemic heart disease. In patients in primary prevention of ischaemic heart disease pharmacotherapy is indicated only in case of high risk, if non-pharmacological treatment does not lead to achievement of target values of blood lipids. Available hypolipidaemic drugs on our market include statins, fibrates and resins. A suitable preparation should be selected with regard to the type of hyperlipidaemia. A constant part of treatment with hypolipidaemic drugs must be also...