Plaque imaging of the internal carotid artery - correlation of B-flow imaging with histopathology.

BACKGROUND AND PURPOSE: The noninvasive identification of plaque types prone to cause symptomatic disease is of great interest to improve the effectiveness of surgical or interventional management. The purpose of the present prospective pilot study was to evaluate the association between the results of imaging-the novel sonography technique B-flow imaging (BFI), B-mode, and color Doppler imaging (CDI)-and histopathologic examination in the characterization of internal carotid artery (ICA) plaques. METHODS: Twenty-eight consecutive patients with high-grade internal carotid artery stenosis scheduled for carotid endarterectomy were included. BFI, B-mode, and CDI images were used to classify the plaques applying the standardized scores of Beletsky et al and the American Heart Association (AHA), to calculate the gray-scale median (GSM) and to detect potential ulcerations; histopathologic examination results of explanted plaques served as the "gold standard." RESULTS: Based on the classification of Beletsky et al, BFI and histopathologic examination results agreed in 21 (75%, kappa = 0.61, P < .001) patients, and the corresponding results for B-mode were 19 (68%, kappa = 0.52, P < .001) patients, respectively. Corresponding results for the AHA classification revealed inferior agreements for BFI (19 patients/68%, kappa = 0.38, P = .003) and B-mode (17 patients/61%, kappa = 0.25, P = .045). The median GSM for BFI and B-mode correlated significantly (r = 0.95, P < .001). The sensitivity of BFI for the detection of ulcerated plaques was 100% and the specificity was 95.8%; corresponding values for CDI were 100% and 92.7%, respectively. CONCLUSION: BFI and the combination of B-mode and CDI exhibit comparable results in the assessment of ICA plaque components and plaque ulceration as well as in the determination of GSM levels.

[Vaginal bacteriology in women with use of sanitary towels and tampons during menstruation]. / Bakteriologie pochvy u uzivatelek menstruacních vlozek a tamponu.

PURPOSE OF STUDY: Clinical study of peri-menstrual changes of vaginal environment in healthy fertile women after long-term use of sanitary towels (group A) or vaginal tampons (group B). TYPE OF STUDY: Prospective study. SEAT OF SITE: Centre of Outpatient Gynaecology Brno, Dept. of Obstetrics and Gynaecology, Masaryk Univesrity Brno. MATERIALS AND METHODS: The group consisted of 100 females with regular menstrual cycle without clinical and microbiological signs of vaginal inflammation or dysmicrobia for three months. In the perimenstrual period samples were taken three times from the ventral vaginal arch and sent for culture examination. A selected group of the females was also subject to culture examination of samples taken from the vulva 0.5 cm under the posterior comisure. RESULTS: Occurrence of ten most common bacteria and yeasts before beginning of menstruation was comparable in both groups. In the course of menstrual bleeding reproduction of bacteria in group B was lower and the vaginal environment return to normal after menstruation end was quicker in the same group. Significant differences between the two groups also included a higher occurrence of peptostreptococci, E. coli and enterococci during and after menstruation in group A women. CONCLUSION: Regular use of vaginal tampons during menstruation does not represent increased risk of disruption of the vaginal environment, effusions or recurring sexually transmitted infections.

Skin cholesterol: test performance, evaluation of potential determinants and correlation analysis with cardiovascular risk factors and circulating markers of inflammation.

BACKGROUND: Skin cholesterol (SkC) has been suggested to be an additional risk predictor, so we evaluated the test performance, potential determinants of this marker as well as a potential correlation of SkC with markers of inflammation and the history of cardiovascular events. PATIENTS AND METHODS: SkC, determined by the non-invasive PREVU POC Skin Sterol test, as well as serum lipids, the body fat status, high-sensitive CRP (hs-CRP) and serum amyloid A (SAA) were evaluated in consecutive patients with and without documented atherosclerotic disease. RESULTS: SkC was assessed in 201 patients. The within-day precision (CV) was 3.8%, the day-to-day CV of the right hand was 8.6% and 4.3% for the left hand, respectively. Neither univariate analysis nor multiple regressions identified a significant influence of age, sex, serum lipids, body fat status, smoking or diabetes mellitus on SkC, corresponding results were observed in a further analysis including 174 of these patients concerning hs-CRP and SAA (all p > 0.05). T-test analyses detected no significant differences between patients with and without a history of coronary, peripheral vascular and cerebrovascular events (all p > 0.05). CONCLUSIONS: The PREVU POC Skin Sterol test for the assessment of SkC proved an acceptable test performance. SkC is independent from serum lipids, traditional cardiovascular risk factors, two sensitive markers of systemic inflammation as well as the history of cardiovascular events indicating that the perception of this parameter as an established marker of vascular disease is premature.

Influence of HMG-CoA-reductase inhibitors on the body fat status.

BACKGROUND: While the literature has conclusively shown a significant decrease of plasma lipids after intake of HMG-CoA reductase inhibitors, there is no detailed information provided about their effects on the body fat status. PATIENTS AND METHODS: We performed a retrospective analysis of a prospective randomized controlled trial including consecutive patients with suspected arterial occlusive disease. Normolipidemic patients served as the control group and hyperlipidemic patients were randomized to either 20 mg atorvastatin or to 40 mg simvastatin. At baseline, after 6 weeks and after 6 months we assessed the relative body fat, the waist circumference and the body mass index (BMI) as well as plasma total cholesterol (chol), low-densitiy lipoprotein cholesterol (LDL) and triglycerides (TG). RESULTS: In total we included 129 patients in our analysis. The body fat status remained unchanged in the control group as well as in the atorvastatin group (all p > 0.05) for the whole study period, while simvastatin treatment led to a slight, but significant increase of the relative body fat (+ 4.2%) between the 6 weeks and 6 months assessment (p = 0.013). CONCLUSIONS: Long-term intake of statins seems to have no positive influence on parameters of the body fat status and therefore misses one important goal in the cardiovascular risk prevention.

[Three-dimensional digital rotation angiography for embolization therapy of uterine leiomyomas: first results]. / Dreidimensionale digitale Rotationsangiographie in der Embolisationstherapie von Uterusmyomen: Erste Erfahrungen.

PURPOSE: To evaluate three-dimensional rotational digital subtraction angiography (3D-RDSA) in the embolization of the uterine artery in the treatment of symptomatic uterine leiomyomas (fibroids). MATERIALS AND METHODS: Eight women with complex pelvic vessel anatomy caused by large fibroids were embolized using 3D-RDSA. The raw data were sent to an external workstation, and video files with a resolution of one image/3 degrees and a scan range of 180 degrees in a surface-shaded display mode were produced. The primary goal was to assess an image intensifier angulation for the optimal visualization of the origin of the uterine artery. In addition, the intervention parameters were compared with those of 48 patients with standard angiography. RESULTS: The analysis revealed no single angulation that can be recommended for standard angiography. No statistical differences were found between both groups concerning fluoroscopy time, dosage area product and amount of administered contrast medium (p > 0.05). CONCLUSION: It can be stated that 3D-RDSA is a feasible method that facilitates the catheterization of the uterine artery even in patients with complex pelvic vessel anatomy, with the potential to reduce the radiation exposure and the amount of administered contrast medium in future embolization therapy of symptomatic uterine fibroids.

[Extended field-of-view sonography in Achilles tendon disease: a comparison with MR imaging]. / Panorama-Ultraschall in der Abklärung symptomatischer Achillessehnenerkrankungen: ein Vergleich zur MRT.

PURPOSE: To evaluate the role of real-time extended field-of-view sonography (EFOVS) in symptomatic Achilles tendon disease in comparison with MR imaging (MRI). MATERIALS AND METHODS: Twenty-three symptomatic tendons were examined by conventional grayscale sonography, EFOVS and MRI, which served as the gold standard. RESULTS: The median tendon thickness in MRI was 7.8 mm (IQR 3.1) and correlated significantly to the results of EFOVS (7.0 mm, IQR 2; r = 0.74, P < 0.01). In total, MRI detected 24 lesions in 18 tendons and EFOVS 21 hypoechoic lesions in 15 tendons, corresponding to a sensitivity of 87.5 % and specificity of 100 %. The additional usage of conventional grayscale sonography improved sensitivity to 95.8 %. The median distance of the largest lesion to the calcaneal tuberosity was 10.4 mm (IQR 3.4) in MRI and 8.5 mm (IQR 5.1) in EFOVS (r = 0.64; P < 0.05). The sensitivity and specificity of EFOVS for the detection of a peritendinitis were 63.6 % and 66.7 %, respectively. Corresponding values for the detection of a bursitis were 68.8 % and 28.6 %. The additional usage of conventional grayscale sonography improved the specificity to 85.7 %. CONCLUSION: The combination of EFOVS and grayscale sonography has the potential to challenge MRI as the preferred imaging method in diagnosing symptomatic Achilles tendon disease, especially with respect to saving time and cost and the absence of any contraindications.

Colour and power Doppler sonography in symptomatic Achilles tendon disease.

The present trial focused on the exact role of colour and power Doppler sonography in Achilles tendinopathy and correlated these techniques with the clinical severity of the disease and with findings on grey-scale sonography. Twenty patients with in total 28 symptomatic Achilles tendons were included in this prospective trial. Additionally included were the asymptomatic tendons (n = 12) of patients and both tendons (n = 30) of fifteen controls. The pain score of Robinson - which ranges from 0 (strong severe pain) to 100 (asymptomatic) - was used to assess clinical severity of the disease. Both tendons of patients and controls were examined by a GE LOGIQ 9 trade mark scanner with a small-parts 14 MHz transducer. Grey-scale sonography detected in total 31 focal hypoechoic areas in 19 (68 %) of the 28 symptomatic tendons. Colour as well as power Doppler sonography detected blood flow in 14 (74 %) of the 19 tendons with focal hypoechoic areas. No blood flow was detected in the remaining symptomatic tendons (n = 14) and in the asymptomatic tendons of patients or in both tendons of controls. Colour and power Doppler sonography resulted in a specificity of 100 % and a sensitivity of 50 % for symptomatic Achilles tendinopathy. Patients with blood flow within the tendon had a significantly lower score according to Robinson than symptomatic patients without flow (P = 0.009). It is concluded that colour and/or power Doppler sonography are useful as an adjunct to grey-scale sonography in the examination of Achilles tendinosis, especially because the presence of blood flow is associated with stronger pain, discomfort and physical restriction.

Prostanoids for intermittent claudication.

BACKGROUND: Peripheral arterial occlusive disease (PAOD) is a common cause of morbidity in the general population. While numerous studies have established the efficacy of prostanoids in PAOD stages III and IV the question of the role of prostanoids as an alternative or additive treatment in patients suffering from claudicatio intermittens (PAOD II) has not yet been clearly answered. OBJECTIVES: The aim of this review was to evaluate effects of prostanoids in patients with intermittent claudication. SEARCH STRATEGY: Computerised searches of the Cochrane Peripheral Vascular Diseases Specialised Register (last searched April 2003), The Cochrane Central Register of Controlled Trials (CENTRAL) (last searched Issue 1, 2003), MEDLINE and EMBASE were undertaken. In addition relevant journals were hand-searched. SELECTION CRITERIA: Randomized clinical trials describing the effects of prostanoids in the treatment of patients suffering from intermittent claudication have been considered for inclusion. DATA COLLECTION AND ANALYSIS: All reviewers assessed the quality of studies and extracted data unblinded. Statistical analysis including tests for heterogeneity and overall effect were performed by using MetaView of Review Manager 4.2. All numeric values are expressed as mean +/- Standard deviation (SD). MAIN RESULTS: Eighteen studies were included for analysis. A significant heterogeneity between the included studies was detected in most of the subgroup analysis. Five studies compared the effects of prostaglandin E1 (PGE1) versus placebo, and reported in their individual results significant increases in walking distances after the administration of PGE1. The attained increase in walking distances appears to be not merely a short-term effect because several studies reported that walking capacity remained increased even after termination of treatment. On the other hand, oral or intravenous prostacyclin did not increase the walking distances significantly. At least one adverse reaction was reported from 23.6% of the patients treated with prostacyclin (PGI2), and its analogues and from 13.7% of the patients treated with PGE1. REVIEWER'S CONCLUSIONS: Because of the heterogeneity between most of the included studies, we did not pool relevant parts of the data by meta-analysis. Based on the individual results of the published literature, patients with intermittent claudication seem to benefit from administration (intravenous or intra-arterial) of PGE1 by a significant improvement of their walking capacity. Further well-conducted randomized, double blinded trials, with a sufficient number of patients to provide statistical powerful information, should be performed to confirm the results of this review.

[The role of chest X-rays in the diagnosis of thoracic aortic aneurysms]. / Die Rolle des Thoraxröntgens in der Diagnose des thorakalen Aortenaneurysmas.

OBJECTIVE: To evaluate the role of routine chest radiographs in the diagnosis of thoracic aortic aneurysms (TAA). METHODS: An electronic full-text search was performed in our radiological information system for all patients who underwent chest radiograph under standard conditions between 1998 and 2000 and who had suspected widening or aneurysm of the thoracic aorta as a diagnosis. Computed tomography (CT) of the thorax was used as the gold standard and had to be performed within a period of 30 days. Two independent and blinded observers evaluated different morphologic and morphometric parameters in the diagnosis and correlated the results with those of CT. RESULTS: 28 patients were included in the present trial. With almost perfect interobserver correlation (r = 0.95) both investigated morphometric parameters correlated well (r = 0.85 and 0.83) with the diameter of the aorta as evaluated with CT. While a low subjective over-all probability for TAA had a negative predictive value of 100 %, we found that, despite an almost perfect interobserver variability (Kappa > 0.8), none of the investigated morphologic parameters (discrepancy between the ascending and descending aorta, displacement of the trachea to the right and caudal displacement of the left main bronchus) was significantly correlated with the final diagnosis. CONCLUSION: The investigated morphometric parameters help to estimate the diameter of the aorta in the arch and in the descending section, but none of the morphologic criteria can be used for the diagnosis of TAA.

Clinical long-term results of percutaneous transluminal angioplasty in patients with peripheral arterial occlusive disease.

BACKGROUND: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. PATIENTS AND METHODS: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. RESULTS: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0.001), the same results were observed at the end of follow-up (each P < 0.001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0.017) and lower ABI pre-interventional (P = 0.019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. CONCLUSION: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

Prostanoids in the treatment of intermittent claudication--a meta-analysis.

BACKGROUND: Numerous studies have established the efficacy of prostanoids in PAD stages III and IV, but the role of prostanoids as an alternative or additive treatment in patients suffering from PAD II is less clear. To resolve this uncertainty we performed a meta-analysis of all randomised controlled studies analysing effects of prostanoids in patients suffering from intermittent claudication. METHODS: 96 studies have been screened by computerised searches of MEDLINE and EMBASE. Relevant studies were pooled in Cochrane's Review-manager 4.1. RESULTS: 19 studies were included for further analysis. Five studies could not be pooled for analysing walking distances, because standard deviations were not stated. Eight studies compared effects of any prostanoid i.v. vs. placebo. In total 557 patients (281/276) were included for analysis of painfree--walking distance (PFWD) and 519 patients (262/257) for analysis of maximum walking distance (MWD). Prostanoids compared to placebo significantly improved mean PFWD by 28% (7%-49%, P = 0.008) and mean MWD by 30% (11%-50%, P = 0.002). At least one adverse reaction was reported from 39.6% of the patients treated with prostacyclin and its analogues and from 13.7% of the patients treated with prostaglandin E1. CONCLUSION: Patients suffering from intermittent claudication benefit from administration of prostaglandin E1 by a significant improvement of their walking capacity.

Long-term results of systemic thrombolysis therapy in aorto-iliac occlusive disease.

BACKGROUND: Long term results of systemic lysis therapy with ultrahigh-dose urokinase (UHUK) in reopening aorto-iliac occlusive disease have not yet been evaluated. This prospective trial investigates the long-term primary patency rate, the rate of complications and assesses the role of different expected influence parameters on the primary patency rate. PATIENTS AND METHODS: 72 patients with aorto-iliac occlusive disease received daily intravenous infusions of UHUK either until reperfusion or--after at least 3 cycles--no progress in recanalization could be stated on two consecutive days by duplex scanning. RESULTS: Systemic lysis therapy was morphological at least partially successful in 44 patients (61.1%). Concomitant percutaneous transluminal angioplasty was performed in 41 patients (56.9%), surgery in 7 patients (9.7%) and both in further 5 patients (6.9%). In patients without surgery hemodynamical success could be achieved in 39 patients (54.2%) and even more important clinical success in 51 patients (70.8%). Compared to baseline results patients improved significantly in ankle/brachial pressure index and in Fontaine stages (p < 0.001), the same results could be seen after a mean follow-up period of 62 months. Thrombolysis was complicated in 4 patients (5.6%) by macroembolizations but no major bleedings or deaths occurred. Primary patency was 76%, 64%, and 43% after 1, 5 and 10 years. Male sex and distal localization were significantly correlated with lower primary clinical patency. CONCLUSION: Systemic lysis therapy is an alternative to surgical intervention in acute and subacute aorto-iliac occlusive disease, because it offers acceptable long-term results with a low rate of complications.

Endovascular brachytherapy for prophylaxis against restenosis after long-segment femoropopliteal placement of stents: initial results.

PURPOSE: To evaluate the feasibility, safety, and effectiveness of endovascular brachytherapy for the prevention of restenosis after long-segment femoropopliteal percutaneous transluminal angioplasty (PTA) and stent implantation. MATERIALS AND METHODS: Thirty-three patients (23 men, 10 women; mean age, 66 years) with femoropopliteal lesions (mean treated length, 17 cm; range, 4-30 cm) underwent PTA and stent implantation followed by brachytherapy with a centering catheter. A dose of 14 Gy was delivered to the adventitia by using an iridium 192 source. Long-term pharmacotherapy with acetylsalicylic acid was combined with clopidogrel for 1 month. Follow-up examinations included measurement of the ankle-brachial index, color-coded duplex ultrasonography, and angiography. RESULTS: The overall 6-month recurrence rate was 30% (10 of 33 arteries). Seven patients developed sudden late thrombotic occlusion of the segment with the stent 3.5-6 months after stent implantation. Considering the overall results after successful local thrombolysis in six of these seven patients, only four (12%) of 33 arteries with a stent had in-stent restenosis caused by neointimal hyperplasia. CONCLUSION: The study results are promising concerning the possibility of reducing in-stent restenosis by means of brachytherapy after long-segment femoropopliteal placement of stents. The high incidence of late thrombotic occlusion requires optimization of the antithrombotic regimen.

Results of a new rapid d-dimer assay (cardiac d-dimer) in the diagnosis of deep vein thrombosis.

The objective was to evaluate the accuracy of a new full blood rapid D-dimer assay in the diagnosis of suspected deep vein thrombosis (DVT). In 100 consecutive patients with suspected DVT, clinical probability was staged according to a pretest score proposed by Wells. For the determination of plasma D-dimer, heparin and citrate blood samples were drawn, and Cardiac D-dimer, STA-LIA, and Tina-quant tests were performed. Final diagnosis was confirmed either by duplex sonography or ascending venography. DVT was diagnosed in 37%, thrombophlebitis in 10%, and no venous thromboembolism was diagnosed in 52%. In 2% pulmonary embolism was detected and one patient was dismissed before final diagnosis. Cardiac D-dimer assay from citrate tubes showed a sensitivity of 88.6%, a specificity of 54%, a positive predictive value of 57.4%, and a negative predictive value of 87.1%. Nearly identical results were observed with heparin tubes. Corresponding results were 88.6%, 48%, 52.5%, and 85.7% for STA-LIA and 88.6%, 46%, 53.4%, and 85.2% for Tina-quant, respectively. In conclusion, we can say that Cardiac D-dimer is a rapid, whole blood assay with a great potential for clinical use. It can help in diagnosing DVT from citrate as well as heparin tubes with comparable sensitivity, specificity, positive and negative predictive values as STA-LIA and Tina-quant tests.

Ultrasound with Levovist in the diagnosis of suspected calf vein thrombosis.

Diagnosing calf vein thrombosis (CVT) by color Doppler ultrasound (US) is often a difficult task because of swelling or obesity. The purpose of this study was to assess if IV infusion of Levovist can improve the accuracy and reduce the rate of indeterminate examinations. A total of 20 patients with suspected CVT underwent color Doppler US without and with Levovist followed by ascending venography as the "gold standard," which detected calf clots in 7 patients (35%). Compared to routine noncontrast sonography, Levovist examination reduced the rate of indeterminate scans from 55% to 20% and improved the specificity for the detection of CVT from 25% to 67% without compromising sensitivity (100% to 86%) notably. Image quality was improved in 13 (65%) of 20 scans. In conclusion, we can say that Levovist improves the quality of duplex examination of the calf veins, especially in cases with difficult conditions due to obesity or swelling.

The role of antithrombotic therapy on the patency of peripheral bypasses.

Peripheral bypass surgery is a well-established treatment for symptomatic atherosclerotic disease of the legs. To improve the long-term patency antithrombotic drugs and other adjuvant treatment are applied. In this review we summarize the results of randomized studies concerning antithrombotic treatment for prophylaxis after peripheral bypass surgery. Heparin is used routinely intra- and perioperatively without strong data, and according to few data low molecular weight heparin may be superior in this situation. Aspirin had positive effects in placebo-controlled studies after infrainguinal PTFE-bypasses, furthermore it is recommended due to its general cardiovascular risk reduction. Ticlopidine improved long-term patency in one randomized study after venous bypass surgery. Otherwise there are some data that long-term oral anticoagulation may be preferable in patients after venous bypass surgery.

A severe case of vascular thoracic outlet syndrome.

We report a 21-year-old patient who presented at the outpatient department of angiology with incipient necroses in the fingertips of the right hand. Colour-coded duplex sonography and angiography demonstrated occlusion of the right brachial, ulnar and radial arteries, obviously resulting from an embolism from the subclavian artery narrowed by a cervical rib. After partly successful local thrombolysis this accessory rib was resected. We review angiologic signs and neurological symptoms of the thoracic outlet syndrome (TOS) and analyse the current literature regarding diagnostic procedures and treatment. This complicated and severe case of TOS in a young patient ending with paresis of the right arm and partial finger amputation emphasises the importance of early diagnosis of this condition.

[Noninvasive screening for genital chlamydiosis in adolescents in Brno]. / Neinvazivní screeningové vysetrení genitální chlamydiózy adolescentu mesta Brna.

OBJECTIVE: To run a screening for genital chlamydiosis in adolescents living in the town Brno as the first action of this type in the Czech Republic and to use the results of the screening for the elaboration of recommendations for running similar actions on the national scale. DESIGN: Prospective epidemiological study. SETTING: Veterinary Research Institute, Brno; Institute of Clinical Biochemistry, 1st Faculty of Medicine, Charles University and General Faculty Hospital, Prague; Section of Public Health, Municipal Authorities of Brno; Bioplus Ltd., Brno; Regional Hygienic Services, Brno; Faculty Hospital Brno; with technical assistance of teachers and students of two Medical Assistant Schools in Brno. METHODS: Students (337 females and 15 males) of two Medical Assistant Schools, older than 18 years, were used as probands within the study. Sediments of the first portions of urine collected from the individual probands were tested for the presence of Chlamydia trachomatis using the direct fluorescent test, ELISA, and the ligase chain reaction. RESULTS: Positive reactions in any of the three tests were found in 31 of the 352 probands (8.8%). Positive and doubtful reactions in the direct fluorescent antibody test were obtained in 11 (35.5%) and 3 (9.6%) of the 31 reactors, respectively. The corresponding values for ELISA were 9 (23.0%) and 8 (25.8%), respectively, and those for the ligase chain reaction 3 (16.6%) and 3 (16.6%), respectively. The overall prevalence of 8.8% is higher than the European mean. CONCLUSIONS: The first limited screening for genital Chlamydia infections in the Czech Republic was run in Brno. Urinary samples were collected from 337 females and 15 males aged approximately 18 years. The presence of Chlamydia trachomatis in the urinary sediment was demonstrated by the direct fluorescent test, ELISA, and the ligase chain reaction. The established prevalence of 8.8% exceeded the European mean (3.9%).

Temporary vena cava filters do not always protect from fatal pulmonary embolism.

We describe the case of a young woman who developed fatal pulmonary embolism during thrombolytic therapy of a deep pelvic and leg vein thrombosis, despite the insertion of a temporary vena cava filter. So the opinion that the insertion of inferior vena cava filters always prevents lethal pulmonary embolism caused by thrombi of the deep vein system must be revised.