Retrospective study assessing efficacy and safety of left atrial appendage occlusion.

OBJECTIVE: To describe the initial experience with Amplatzer Amulet in left atrial appendage occlusion in Slovakia. To evaluate procedural efficacy and safety. BACKGROUND: Atrial fibrillation increases the risk of stroke. While anticoagulation therapy can reduce the risk of stroke, it is associated with bleeding risk and often unsatisfactory prescribed. Most thrombi form in the left atrium appendage, hence left atrium appendage occlusion may be a suitable therapeutic alternative for these patients. METHODS: This is an observational, retrospective, single-centre, case-series study including 30 patients with atrial fibrillation at a high risk of stroke, undergoing left atrial appendage occlusion from June 2015 to December 2018. RESULTS: The left atrial appendage was successfully closed in 29 (96.7 %) patients. Three months after the procedure, 4 patients had small leaks (< 2 mm). No complications were reported so far. Prior to the procedure, patients mostly received low molecular weight heparin (53.3 %). Three months after the procedure, patients mostly received acetylsalicylic acid (60.7 %) and clopidogrel (32.1 %). CONCLUSION: Left atrial appendage occlusion was shown to be an effective and safe alternative to anticoagulation therapy in patients with atrial fibrillation, at a high risk of stroke and bleeding. The procedure is safe, when performed carefully even by less experienced cardiologists (Tab. 6, Fig. 4, Ref. 29). Text in PDF www.elis.sk Keywords: atrial fibrillation, stroke, haemorrhage, left atrial appendage occlusion, Amplatzer Amulet.

[Pharmacoeconomics in the therapy of peptic ulcer]. / Farmakoekonomika v terapii peptických vredov.

The great prevalence and chronic nature of peptic ulcers traditionally represent a great economic load for the system of health care. The exponentially growing therapeutic and diagnostic possibilities of the treatment of peptic diseases are under a strong economic pressure from health-insurance companies. The use of an economic model for the management of peptic diseases aims to maximize health benefit from limited sources of the health services. It can be said already now that the detection of the Helicobacter pylori infection ranks among the most important discoveries of the 20th century. Elimination of the Helicobacter pylori infection can produce a dramatic reduction in relapses of peptic ulcers, which is reflected not only in the improved quality of life but also in a subsequent economic contribution. The present authors paid attention to the financial costs of the combined therapy for eradication of the Helicobacter pylori infection in the course of the years 1998-2001.

[Effect of pancreatic substitutes on fecal and serum elastase and on pain in patients with chronic pancreatitis]. / Vplyu pankreatickej substitúcie na fekálnu a sérovú elastázu a na bolest' u pacientov s chronickou pankreatitídou.

Views on the existence of a negative feedback between pancreatic secretion and intraduodenal of proteases in humans are controversial. The objective of the study was to find out whether enzyme substitution will have an impact on pancreatic enzyme secretion and pain in chronic pancreatitis. The preparation Panzytrate 2500 (2 x 3 capsules/day containing 1250 units of proteases per capsule) was administered for a 4-week period. In 18 patients with chronic pancreatitis (7 with the severe and 11 with the medium severe and mild form of pancreatitis) the faecal and serum pancreatic elastase was assessed one day before and one day after enzyme substitution therapy. A significant reduction of the faecal elastase concentration (p = 0.03) and serum elastase (p = 0.00375) was recorded in patients with mild and medium severe CP. The values of faecal and serum pancreatic elastase 1 were insignificantly reduced also in patients with severe chronic pancreatitis. Pain relief was statistically significant already after two weeks' administration of enzyme substitution therapy (p = 0.0233) and after four weeks' treatment (p = 0.00766). The results support the importance of the negative feedback on regulation of pancreatic secretion and the positive effect of substitution therapy on pain in chronic pancreatitis.

[Pharmacotherapy of ischemic heart disease in ambulatory practice]. / Farmakoterapia pri liecbe ischemickej choroby srdca v ambulantnej praxi.

The analysis of medical prescriptions has revealed that 96% of mass-produced pharmaceutical preparations are prescribed for chronic ischaemic heart disease, mainly by physicians in the field of general medicine. The assortment of prescribed drugs in the ATC classification is represented by 73% of drugs for the cardiovascular system with the dominant position of nitrates, above all the preparation Nitro-Mack retard 2.5 mg cps. The dependence of the consumption of drugs for the treatment of the ischaemic heart disease on the age has a parabolic course in both sexes, while in the productive age area males show higher consumption per one person.