Prevention of neural tube defects by folic acid - awareness among women of childbearing age in Slovakia.

BACKGROUND: Folic acid deficiency plays a central role in the aetiology of many congenital anomalies including neural tube defects. Protective effect of folic acid on embryo may be acquired only if taken periconceptionally. OBJECTIVES: The aim of the study was to investigate the awareness about folic acid among women of childbearing age in Bratislava, Slovakia. METHODS: There were 130 respondents involved in the research (106 pregnant women, 24 female students of medical faculty). Using questionnaire we acquired following data: pregnancy details, interest in diet before and during pregnancy, recommendations regarding nutrition and supplementation pre- and post-conception, knowledge about folic and other acid in 2004 and 2009. RESULTS: More than half of the respondents knew the sources of folic acid. The interest in the nutrition facts of the food dropped from 91 % to 58.5 %. The number of pregnant women advised about correct nutrition and folic acid supplementation before and during pregnancy increased from 16 % to 37 %. Planning the next gravidity with folic acid supplementation became greater than 21 % (38 % in 2009). Nevertheless, only 46 % of these women believed that proper food content with folic acid may prevent congenital anomalies. In a group of students planning to take folic acid periconceptionally the number raised up to 62.5 %. CONCLUSION: The results revealed low knowledge about the effect of folic acid on developing embryo among women of childbearing age. Effective intervention programs are needed with the aim to improve periconceptional intake of folic acid in 2004 and 2009. The results in both periods show low knowledge about this essential vitamin (Tab. 1, Fig. 8, Ref. 31).

Valsartan and atenolol in patients with severe essential hypertension.

The aim of this study was to evaluate the efficacy and tolerability of valsartan, a new angiotensin II receptor antagonist, versus atenolol in the treatment of severe primary hypertension. A total of 103 adult out-patients were randomised to receive either valsartan 160 mg or atenolol 100 mg once daily for 6 weeks. If necessary, additional blood pressure (BP) control could be provided as add-on therapy. Both valsartan and atenolol decreased mean sitting diastolic BP (DBP) and mean sitting systolic BP (SBP): least squares mean change from baseline in DBP; valsartan, -20.0 mm Hg; atenolol, -20.4 mm Hg: in SBP; valsartan, -30.0 mm Hg; atenolol, -25.5 mm Hg. There was no statistically significant difference between the treatment groups. Add-on hydrochlorothiazide (HCTZ) 25 mg was required by 97.2% of patients receiving atenolol and 83.6% of patients receiving valsartan; additional verapamil SR 240 mg was also required by 58.3% of patients receiving atenolol and 64.2% receiving valsartan. Valsartan was well tolerated, with a comparable incidence of treatment-related adverse experiences in both groups. In conclusion valsartan 160 mg is as well tolerated and effective as atenolol 100 mg in lowering BP in severely hypertensive patients.

[Changes in platelet function in patients with arterial hypertension]. / Zmeny destickových funkcí u nemocných s arteriální hypertenzí.

The authors examined some indicators of platelet activity in patients with hypertension stage II (according to WHO). They revealed an increased platelet activity which was manifested by an increased concentration of platelet factor 4 (50.2 +/- 28.2 ng/ml) and thromboxane B2 (49.9 +/- 20.1 pg/ml) in plasma. The increase of indicators of platelet activation associated with hypertension is a molecular marker of activation of haemostasis and according to data in the literature it is an indicator of vascular complications in hypertension. It is not clear whether the increased platelet functions in hypertension is primary or an induced change.

[Rheumatoid arthritis developing into systemic lupus erythematosus during long-term treatment with penicillamine and sulfasalazine]. / Prechod revmatoidní artritidy v systémový lupus erythematosus pri dlouhodobé lécbé penicilaminem a sulfasalazinem.

A female patient with IgM RF seropositive rheumatoid arthritis according to criteria of the American Rheumatism Association was treated for 133 months with Penicillamine and for 17 months also with Sulfasalazine. Both types of treatment were discontinued because the patient developed symptoms meeting diagnostic criteria of systemic lupus erythematosus, as defined by the same society. Early recognition of this diagnosis was made possible by regular follow up of clinical and laboratory data (ANA, anti DNP, anti dsDNA, C3, C4 and others). Marked improvement, incl. improvement of the nephropathy, was recorded after pulsed treatment with methylprednisolone.

Bopindolol: Czechoslovak experience with a new beta blocker in the treatment of hypertension.

Bopindolol is a nonselective beta blocker with mild intrinsic sympathomimetic activity. One of the drug's main benefits is its prolonged effect, lasting for 24 hours, which makes it possible to administer bopindolol in a single daily dose, a fact that may improve patient adherence to therapy. A double-blind study was performed in two centers, comparing bopindolol with metoprolol in 86 hypertensive patients. Baseline diastolic blood pressure (BP) was 100 to 120 mm Hg. The effects of bopindolol or metoprolol on BP and heart rate were similar: return to normal values was achieved in 70% of patients with either drug. A 6-month study at another center found that bopindolol did not affect the levels of total cholesterol, low-density and high-density lipoprotein cholesterol or triglycerides. Another 12-month study documented a decrease in total cholesterol, apolipoprotein (apo) A1 and apo B. The apo A/B ratio rose, thus improving the atherosclerotic index. No deterioration of glucose tolerance or immunoreactive insulin response to glucose was seen after 6 months of bopindolol administration. Bopindolol satisfactorily modifies not only resting but also exercise BP during isometric and isotonic load, thus reducing BP fluctuation during physical activities of the hypertensive patient. The drug exerts no effect on renal and liver function, electrolyte balance and hematologic parameters. Bopindolol is a very useful drug of first choice in mild and moderate hypertension. Bopindolol's main advantages include its prolonged action, good tolerance and a beneficial effect on risk factors of atherosclerosis (lipid and carbohydrate metabolism).

The effect of bopindolol on lipids and platelet aggregation.

An open ambulatory study was performed to assess the effect of bopindolol in 19 hypertensive patients (W.H.O. stage I-II). A statistically significant decrease in systolic and diastolic pressure as well as heart rate (never below 60 beats per minute) was demonstrated. No undesirable subjective side-effects of the drug were reported. Compared with the serum concentrations after placebo, a decrease in all low-density fractions was observed after 12 months. The total cholesterol/HDL cholesterol ratio did not deteriorate and the apolipoprotein A/apolipoprotein B ratio increased. The values of triacylglycerols during 8 months of therapy did not exceed initial serum concentrations following placebo administration. Patients treated with bopindolol exhibited decreased platelet aggregation due to collagen.