Dita Protopopova | Charles University, Prague (original) (raw)

Papers by Dita Protopopova

Research paper thumbnail of Effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics

Neuro endocrinology letters, 2019

OBJECTIVES Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated w... more OBJECTIVES Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics (MARTA). METHODS We measured serum 25-hydroxyvitamin D [25(OH)D] levels and body mass index (BMI) in patients with (≥1 months) and without long-term exposure to MARTA to evaluate the role of 25(OH)D deficiency on BMI. RESULTS The BMI was significantly higher after long-term MARTA exposure in 25(OH)D-deficient patients than in non-deficient patients. No significant difference was found in antipsychotic exposure between the long-term MARTA exposure groups. The BMI was significantly higher in long-term MARTA exposure 25(OH)D-deficient patients than in 25(OH)D-deficient patients without long-term exposure. CONCLUSION Vitamin D deficiency could be a risk factor for MARTA-induced weight gain. Further studies are necessary to replicate this finding.

Research paper thumbnail of Peripheral endothelial dysfunction as a marker of cardiovascular risk in physically healthy patients with schizophrenia and related psychoses: a matched case control study

Neuro endocrinology letters, 2014

OBJECTIVES Our aim was to assess endothelial function in physically healthy patients with schizop... more OBJECTIVES Our aim was to assess endothelial function in physically healthy patients with schizophrenia and related psychoses and to compare the results with healthy controls. Endothelial dysfunction was shown to predict future cardiovascular events in general population so we assumed to find a higher prevalence of endothelial dysfunction in patients with psychosis, as their cardiovascular morbidity is markedly higher than in general population, and to confirm the referred correlation with the traditional cardiovascular (CV) risk factors. DESIGN We assessed the traditional CV risk factors and endothelial function using non-invasive peripheral arterial tonometry (EndoPAT2000) in 50 stabilized and medicated schizophrenic patients (aged between 18 and 50 years) without any history of cardiovascular diseases and compared the results with 50 age-matched healthy controls. SETTING Psychiatric Clinic, University Hospital, Hradec Kralove and 2nd Department of Internal Medicine, General Unive...

Research paper thumbnail of Peripheral endothelial dysfunction as a marker of cardiovascular risk in physically healthy patients with schizophrenia and related psychoses: A matched case control study

Neuro Endocrinology Letters, Nov 2, 2014

Our aim was to assess endothelial function in physically healthy patients with schizophrenia and ... more Our aim was to assess endothelial function in physically healthy patients with schizophrenia and related psychoses and to compare the results with healthy controls. Endothelial dysfunction was shown to predict future cardiovascular events in general population so we assumed to find a higher prevalence of endothelial dysfunction in patients with psychosis, as their cardiovascular morbidity is markedly higher than in general population, and to confirm the referred correlation with the traditional cardiovascular (CV) risk factors. We assessed the traditional CV risk factors and endothelial function using non-invasive peripheral arterial tonometry (EndoPAT2000) in 50 stabilized and medicated schizophrenic patients (aged between 18 and 50 years) without any history of cardiovascular diseases and compared the results with 50 age-matched healthy controls. Psychiatric Clinic, University Hospital, Hradec Kralove and 2nd Department of Internal Medicine, General University Hospital, Prague, Czech Republic There was no difference in relative hyperaemia index as an endothelial function measure between patients and controls (2.19±0.68 vs. 1.98±0.57, p=NS) and there were also no correlations between reactive hyperaemia index and the traditional CV risk factors, illness duration or psychotic symptoms. On the other hand, the two study groups differed significantly in almost all traditional CV risk factors.

Research paper thumbnail of The use of antipsychotic drugs in patients with dementia

Ceska a Slovenska Neurologie a Neurochirurgie

ABSTRACT

Research paper thumbnail of The prevalence of cardiometabolic risk factors and the ten-year risk of fatal cardiovascular events in patients with schizophrenia and related psychotic disorders

Psychiatria Danubina, 2012

People suffering from schizophrenia have a significantly shorter lifespan compared to the general... more People suffering from schizophrenia have a significantly shorter lifespan compared to the general population. The majority of deaths are caused by physical diseases, including cardiovascular events. The aim of this cross-sectional study was to predict the risk of premature cardiovascular mortality and assess the prevalence of cardiometabolic risk factors in a sample of Czech patients with schizophrenia and related psychoses. We reviewed data from 129 subjects treated in an outpatient clinic that specialised in psychoses. The main collected variables included basic physical parameters (height, weight, waist circumference, blood pressure), smoking habits, laboratory data (glucose level, serum lipid level) and an electrocardiograph (ECG). We calculated the ten-year risk of fatal cardiovascular events using the Systematic Coronary Risk Evaluation (SCORE) chart. The most prevalent risk factors were being overweight (70% of patients had a BMI over 25), dyslipidaemia (70% of patients) and ...

Research paper thumbnail of Peripheral endothelial dysfunction as a marker of cardiovascular risk in physically healthy patients with schizophrenia and related psychoses: a matched case control study

Neuro endocrinology letters, 2014

Our aim was to assess endothelial function in physically healthy patients with schizophrenia and ... more Our aim was to assess endothelial function in physically healthy patients with schizophrenia and related psychoses and to compare the results with healthy controls. Endothelial dysfunction was shown to predict future cardiovascular events in general population so we assumed to find a higher prevalence of endothelial dysfunction in patients with psychosis, as their cardiovascular morbidity is markedly higher than in general population, and to confirm the referred correlation with the traditional cardiovascular (CV) risk factors. We assessed the traditional CV risk factors and endothelial function using non-invasive peripheral arterial tonometry (EndoPAT2000) in 50 stabilized and medicated schizophrenic patients (aged between 18 and 50 years) without any history of cardiovascular diseases and compared the results with 50 age-matched healthy controls. Psychiatric Clinic, University Hospital, Hradec Kralove and 2nd Department of Internal Medicine, General University Hospital, Prague, Cz...

Research paper thumbnail of Comparison between gadolinium and iodine contrast for percutaneous intervention in atherosclerotic renal artery stenosis: clinical outcomes

Nephrol Dialysis Transplant, 2007

Background. Percutaneous angiography with iodinated contrast in patients with chronic kidney dise... more Background. Percutaneous angiography with iodinated contrast in patients with chronic kidney disease carries a risk of contrast nephropathy, which is independently associated with renal disease progression and increased mortality. Gadolinium contrast is a potential alternative to iodinated contrast for percutaneous transluminal renal angioplasty (PTRA), and appears to be safe and well tolerated. The aim of this study was to assess the results of gadolinium use to facilitate PTRA in patients with chronic kidney disease. Methods. Clinical outcomes were compared between patients with serum creatinine (Cr) ≥ 176 µmol/L (2 mg/dL), who had either gadolinium (n = 57; gadoteridol or gadodiamide), iodinated (n = 68; iohexol or iodixanol) or a combination of gadolinium and iodinated-contrast-enhanced (n = 38) PTRA. Results. Despite similar degrees of pre-procedural renal insufficiency, the incidence of immediate contrast nephropathy [defined as an increase in serum Cr of 44 µmol/L (0.5 mg/dL) within 7 days without other identifiable causes] was lowest in the gadolinium group (3/57, 5.3%) compared to those receiving a combination of modest iodinated contrast in addition to gadolinium (4/38, 10.5%) or solely iodinated contrast (14/68, 20.6%). This was associated with a reduction in the 30-day progression to need for renal replacement therapy (RRT) (P < 0.005). Yet, over a mean follow-up of 40 ± 22 months, renal function outcomes or all-cause mortality were not different between the contrast groups. The type of contrast used had no effect on technical success and both short-and long-term blood pressure outcomes were comparable between the groups. Two patients developed pathology-proven nephrogenic fibrosing dermopathy, a serious skin condition that has been seen in patients with kidney disease following administration of gadolinium.

Research paper thumbnail of Body weight and self-esteem in patients with schizophrenia evaluated with Β-WISE®

Schizophrenia Research, 2006

Background: Metabolic abnormalities and weight gain are an important problem in patients with sch... more Background: Metabolic abnormalities and weight gain are an important problem in patients with schizophrenia. An instrument to evaluate body image and self-esteem related to weight has recently been developed (B-WISE®). The first objective was to evaluate whether the findings of the original validation study could be confirmed in a European sample. The second objective was to explore the association of B-WISE® scores with the metabolic syndrome and glucose abnormalities. Methods: A Dutch translation of B-WISE® was tested in a large sample of patients with schizophrenia (n = 300) who underwent an extensive metabolic screening. Results: The original findings with B-WISE® were confirmed in an independent sample. Scores on B-WISE® differed significantly as a function of BMI. Scores on B-WISE® also differentiated patients with and without the metabolic syndrome and glucose abnormalities. Patients experiencing a recent weight gain had lower self-esteem and poorer psychosocial adaptation. Conclusion: B-WISE® could be a useful instrument to evaluate the subjective psychosocial consequences associated with current weight and weight gain in patients with schizophrenia.

Research paper thumbnail of Prolactin as a factor for increased platelet aggregation

Neuro Endocrinology Letters, Sep 1, 2007

Administration of antipsychotics appears to be related to increased risk of venous thromboembolis... more Administration of antipsychotics appears to be related to increased risk of venous thromboembolism and cerebrovascular side effects. The biological mechanism responsible for this possible adverse drug reaction is unknown, but there is a growing number of elucidating hypotheses. Treatment with antipsychotics is associated with elevation of prolactin level. Prolactin has recently been recognized as potent platelet aggregation co-activator, and have therefore been postulated as an additional risk factor for both arterial and venous thrombosis. We briefly review the arguments for the role of hyperprolactinemia in pathogenesis of platelet aggregation.

Research paper thumbnail of Pharmacological treatment of severe dyslipidaemia in patients with schizophrenia

International Clinical Psychopharmacology

Mortality rates in patients with schizophrenia are double compared with the general population, w... more Mortality rates in patients with schizophrenia are double compared with the general population, with cardiovascular disease causing 50% of the excess. Lowering low-density lipoprotein cholesterol is recognized as a primary target for the prevention of cardiovascular mortality. The effects of lipid-lowering treatment were evaluated in patients with schizophrenia. Forty-six patients with schizophrenia and with severe dyslipidaemia were identified. All were treated with antipsychotics. Patients were screened for cardiovascular risk factors and examined at baseline when statin therapy was initiated. The effects of lipid-lowering medication on lipid profile, glucose homeostasis and components of metabolic syndrome were evaluated at 3 months follow-up. After 3 months of statin therapy, a significant decrease in triglycerides, total cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and, in associated ratios, low-density lipoprotein/high-density lipoprotein, cholesterol/high-density lipoprotein was observed. No significant changes occurred in high-density lipoprotein cholesterol, body mass index, waist circumference or glucose homeostasis. The only component of metabolic syndrome affected by statin therapy has been the serum triglyceride level. Statins proved effective in the management of dyslipidaemia in patients with schizophrenia treated with antipsychotics. More complex treatment may be required for associated metabolic disturbances.

Research paper thumbnail of Pharmacological treatment of severe dyslipidaemia in patients with schizophrenia

International clinical psychopharmacology, 2007

Mortality rates in patients with schizophrenia are double compared with the general population, w... more Mortality rates in patients with schizophrenia are double compared with the general population, with cardiovascular disease causing 50% of the excess. Lowering low-density lipoprotein cholesterol is recognized as a primary target for the prevention of cardiovascular mortality. The effects of lipid-lowering treatment were evaluated in patients with schizophrenia. Forty-six patients with schizophrenia and with severe dyslipidaemia were identified. All were treated with antipsychotics. Patients were screened for cardiovascular risk factors and examined at baseline when statin therapy was initiated. The effects of lipid-lowering medication on lipid profile, glucose homeostasis and components of metabolic syndrome were evaluated at 3 months follow-up. After 3 months of statin therapy, a significant decrease in triglycerides, total cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and, in associated ratios, low-density lipoprotein/high-density lip...

Research paper thumbnail of Gadolinium-based versus iodine-based contrast for percutaneous renal artery angioplasty

Aim: There is increasing evidence that primary aldosteronism (PA) may be common in patients defin... more Aim: There is increasing evidence that primary aldosteronism (PA) may be common in patients defined as "essential" hypertensive. Aim of this study was to evaluate the incidence of primary aldosteronism in a primary-care hypertensive population.

Research paper thumbnail of Body weight and self-esteem in patients with schizophrenia evaluated with B-WISE®

Schizophrenia Research, 2006

Background: Metabolic abnormalities and weight gain are an important problem in patients with sch... more Background: Metabolic abnormalities and weight gain are an important problem in patients with schizophrenia. An instrument to evaluate body image and self-esteem related to weight has recently been developed (B-WISE®). The first objective was to evaluate whether the findings of the original validation study could be confirmed in a European sample. The second objective was to explore the association of B-WISE® scores with the metabolic syndrome and glucose abnormalities. Methods: A Dutch translation of B-WISE® was tested in a large sample of patients with schizophrenia (n = 300) who underwent an extensive metabolic screening. Results: The original findings with B-WISE® were confirmed in an independent sample. Scores on B-WISE® differed significantly as a function of BMI. Scores on B-WISE® also differentiated patients with and without the metabolic syndrome and glucose abnormalities. Patients experiencing a recent weight gain had lower self-esteem and poorer psychosocial adaptation. Conclusion: B-WISE® could be a useful instrument to evaluate the subjective psychosocial consequences associated with current weight and weight gain in patients with schizophrenia.

Research paper thumbnail of Comparison between gadolinium and iodine contrast for percutaneous intervention in atherosclerotic renal artery stenosis: clinical outcomes

Nephrology Dialysis Transplantation, 2007

Background. Percutaneous angiography with iodinated contrast in patients with chronic kidney dise... more Background. Percutaneous angiography with iodinated contrast in patients with chronic kidney disease carries a risk of contrast nephropathy, which is independently associated with renal disease progression and increased mortality. Gadolinium contrast is a potential alternative to iodinated contrast for percutaneous transluminal renal angioplasty (PTRA), and appears to be safe and well tolerated. The aim of this study was to assess the results of gadolinium use to facilitate PTRA in patients with chronic kidney disease. Methods. Clinical outcomes were compared between patients with serum creatinine (Cr) ≥ 176 µmol/L (2 mg/dL), who had either gadolinium (n = 57; gadoteridol or gadodiamide), iodinated (n = 68; iohexol or iodixanol) or a combination of gadolinium and iodinated-contrast-enhanced (n = 38) PTRA. Results. Despite similar degrees of pre-procedural renal insufficiency, the incidence of immediate contrast nephropathy [defined as an increase in serum Cr of 44 µmol/L (0.5 mg/dL) within 7 days without other identifiable causes] was lowest in the gadolinium group (3/57, 5.3%) compared to those receiving a combination of modest iodinated contrast in addition to gadolinium (4/38, 10.5%) or solely iodinated contrast (14/68, 20.6%). This was associated with a reduction in the 30-day progression to need for renal replacement therapy (RRT) (P < 0.005). Yet, over a mean follow-up of 40 ± 22 months, renal function outcomes or all-cause mortality were not different between the contrast groups. The type of contrast used had no effect on technical success and both short-and long-term blood pressure outcomes were comparable between the groups. Two patients developed pathology-proven nephrogenic fibrosing dermopathy, a serious skin condition that has been seen in patients with kidney disease following administration of gadolinium.

Research paper thumbnail of P03-267 - Assessment of microalbuminuria and ankle-brachial index in outpatients with schizophrenia treated with antipsychotics - a possible predictors of cardiovascular disease

European Psychiatry, 2011

and related psychoses are associated with excess morbidity and mortality from cardiovascular (CV)... more and related psychoses are associated with excess morbidity and mortality from cardiovascular (CV) disease. Microalbuminuria (MA) is associated with an increased risk of CV disease and mortality. This association is independent of other known CV risk factors such as hypertension, dyslipidemia, obesity, smoking, and impaired renal function. The ankle brachial index (ABI), which is the ratio of systolic pressure at the ankle to that in the arm, is quick and easy to measure and has been used to confirm the diagnosis and assess the severity of peripheral artery disease. Low ABI has been related to an increased incidence of total and CV mortality and CV events.The objective of prospective pilot study was to determine MA and ABI as well as the prevalence of CV risk factors (glucose tolerance status, lipids levels, obesity, hypertension, smoking) and assessment of Framingham risk score in patients with schizophrenia treated with antipsychotic drugs. The study included thirty-three outpatient subjects (female, n= 16), aged 21-66 years. The exclusion criteria included urinary infection and presence of diabetes mellitus.Three patients (7,7 %) has abnormal (>26 mg/d) levels of MA, non of ABI.In conclusion, stratification by MA can help identify a high-risk subset of nondiabetic patients with schizophrenia in risk of CV events.

Research paper thumbnail of P03-266 - Innovation and modification of criteria for prevention of venous thromboembolism in psychiatric patients

European Psychiatry, 2011

Research paper thumbnail of Treatment with Rosuvastatin for Severe Dyslipidaemia in Patients with Schizophrenia and Schizoaffective Disorder

Drug Safety, 2006

Mortality rates in patients with schizophrenia are double compared to those in the general popula... more Mortality rates in patients with schizophrenia are double compared to those in the general population, with cardiovascular disease causing 50% of the excess. Lowering low-density lipoprotein (LDL) cholesterol is recognized as a primary target for the prevention of cardiovascular mortality according to the National Cholesterol Education Program-Adult Treatment Panel III. Use of lipid-lowering drugs such as statins is recommended when lifestyle changes are not sufficient to reach the LDL goal. The efficacy and safety of rosuvastatin treatment were evaluated in schizophrenic patients. 100 schizophrenic patients with severe dyslipidemia were identified. All were treated with antipsychotics. Fifty-two patients were treated with rosuvastatin and compared with 48 who did not receive statin treatment. All patients were screened for cardiovascular risk factors and examined at baseline. The effects of lipid-lowering medication on lipid profile, glucose homeostasis, and components of metabolic syndrome were evaluated at 3-month follow-up. The study began in 2003, and all data available until December 2005 are reported. After 3 months of statin therapy, a significant decrease in triglycerides, total cholesterol, LDL cholesterol, and non-high-density lipoprotein (non-HDL) cholesterol and in associated ratios (LDL/HDL, total cholesterol/HDL) was observed. The difference was highly significant compared to patients not receiving statin treatment. No significant changes occurred in HDL cholesterol, body mass index and waist circumference, or glucose homeostasis. The only component of metabolic syndrome affected by statin therapy was the serum triglyceride level. Rosuvastatin proved effective in the management of dyslipidemia in patients with schizophrenia treated with antipsychotics. More complex treatment may be required for associated metabolic disturbances.

Research paper thumbnail of Cognitive changes in spinocerebellar ataxia type 2

Neuro Endocrinology Letters, 2011

OBJECTIVES: Cognitive disorders and dementia occur in 19 to 42% of patients with spinocerebellar ... more OBJECTIVES: Cognitive disorders and dementia occur in 19 to 42% of patients with spinocerebellar ataxia type 2 (SCA2). Neuropsychological tests can reveal executive dysfunction, impaired visual and verbal memory, tongue and speech impairment, attention disorders and impaired verbal fluency.METHODS: We performed psychiatric and neuropsychological examinations in 12 patients diagnosed with genetically confirmed SCA2 and 12 healthy volunteers matching the patients in age, gender, and length of education. The level of motor impairment was determined using the brief ataxia rating scale (BARS). The neuropsychological examination focused on testing executive functions, short-term visual and verbal memory, attention, psychomotor tempo, visual motor coordination, learning ability and comprehension ability. The tests were divided into two subgroups according to the difficulty of motor tasks. The cognitive abilities composite score (CACS) was determined by calculating the arithmetic mean of T scores of the respective tests.RESULTS: Patients with SCA2 had significantly lower CACSs (p=0.00005) compared to the healthy volunteers. Patients exhibited impaired performance in both difficult and simple motor tests. The severity of cognitive impairment was related to the age at the onset of the disease (p=0.002) but not to the duration or to the overall BARS score.CONCLUSIONS: Compared to healthy volunteers, patients with SCA2 exhibited significantly worse cognitive performance in all areas tested, including the tests of simple motor tasks. Moreover, the cognitive performance of patients worsened as the difficulty of the motor tasks increased.

Research paper thumbnail of Effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics

Neuro endocrinology letters, 2019

OBJECTIVES Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated w... more OBJECTIVES Our aim was to examine the effect of vitamin D deficiency on BMI in patients treated with Multi-acting Receptor Target Antipsychotics (MARTA). METHODS We measured serum 25-hydroxyvitamin D [25(OH)D] levels and body mass index (BMI) in patients with (≥1 months) and without long-term exposure to MARTA to evaluate the role of 25(OH)D deficiency on BMI. RESULTS The BMI was significantly higher after long-term MARTA exposure in 25(OH)D-deficient patients than in non-deficient patients. No significant difference was found in antipsychotic exposure between the long-term MARTA exposure groups. The BMI was significantly higher in long-term MARTA exposure 25(OH)D-deficient patients than in 25(OH)D-deficient patients without long-term exposure. CONCLUSION Vitamin D deficiency could be a risk factor for MARTA-induced weight gain. Further studies are necessary to replicate this finding.

Research paper thumbnail of Peripheral endothelial dysfunction as a marker of cardiovascular risk in physically healthy patients with schizophrenia and related psychoses: a matched case control study

Neuro endocrinology letters, 2014

OBJECTIVES Our aim was to assess endothelial function in physically healthy patients with schizop... more OBJECTIVES Our aim was to assess endothelial function in physically healthy patients with schizophrenia and related psychoses and to compare the results with healthy controls. Endothelial dysfunction was shown to predict future cardiovascular events in general population so we assumed to find a higher prevalence of endothelial dysfunction in patients with psychosis, as their cardiovascular morbidity is markedly higher than in general population, and to confirm the referred correlation with the traditional cardiovascular (CV) risk factors. DESIGN We assessed the traditional CV risk factors and endothelial function using non-invasive peripheral arterial tonometry (EndoPAT2000) in 50 stabilized and medicated schizophrenic patients (aged between 18 and 50 years) without any history of cardiovascular diseases and compared the results with 50 age-matched healthy controls. SETTING Psychiatric Clinic, University Hospital, Hradec Kralove and 2nd Department of Internal Medicine, General Unive...

Research paper thumbnail of Peripheral endothelial dysfunction as a marker of cardiovascular risk in physically healthy patients with schizophrenia and related psychoses: A matched case control study

Neuro Endocrinology Letters, Nov 2, 2014

Our aim was to assess endothelial function in physically healthy patients with schizophrenia and ... more Our aim was to assess endothelial function in physically healthy patients with schizophrenia and related psychoses and to compare the results with healthy controls. Endothelial dysfunction was shown to predict future cardiovascular events in general population so we assumed to find a higher prevalence of endothelial dysfunction in patients with psychosis, as their cardiovascular morbidity is markedly higher than in general population, and to confirm the referred correlation with the traditional cardiovascular (CV) risk factors. We assessed the traditional CV risk factors and endothelial function using non-invasive peripheral arterial tonometry (EndoPAT2000) in 50 stabilized and medicated schizophrenic patients (aged between 18 and 50 years) without any history of cardiovascular diseases and compared the results with 50 age-matched healthy controls. Psychiatric Clinic, University Hospital, Hradec Kralove and 2nd Department of Internal Medicine, General University Hospital, Prague, Czech Republic There was no difference in relative hyperaemia index as an endothelial function measure between patients and controls (2.19±0.68 vs. 1.98±0.57, p=NS) and there were also no correlations between reactive hyperaemia index and the traditional CV risk factors, illness duration or psychotic symptoms. On the other hand, the two study groups differed significantly in almost all traditional CV risk factors.

Research paper thumbnail of The use of antipsychotic drugs in patients with dementia

Ceska a Slovenska Neurologie a Neurochirurgie

ABSTRACT

Research paper thumbnail of The prevalence of cardiometabolic risk factors and the ten-year risk of fatal cardiovascular events in patients with schizophrenia and related psychotic disorders

Psychiatria Danubina, 2012

People suffering from schizophrenia have a significantly shorter lifespan compared to the general... more People suffering from schizophrenia have a significantly shorter lifespan compared to the general population. The majority of deaths are caused by physical diseases, including cardiovascular events. The aim of this cross-sectional study was to predict the risk of premature cardiovascular mortality and assess the prevalence of cardiometabolic risk factors in a sample of Czech patients with schizophrenia and related psychoses. We reviewed data from 129 subjects treated in an outpatient clinic that specialised in psychoses. The main collected variables included basic physical parameters (height, weight, waist circumference, blood pressure), smoking habits, laboratory data (glucose level, serum lipid level) and an electrocardiograph (ECG). We calculated the ten-year risk of fatal cardiovascular events using the Systematic Coronary Risk Evaluation (SCORE) chart. The most prevalent risk factors were being overweight (70% of patients had a BMI over 25), dyslipidaemia (70% of patients) and ...

Research paper thumbnail of Peripheral endothelial dysfunction as a marker of cardiovascular risk in physically healthy patients with schizophrenia and related psychoses: a matched case control study

Neuro endocrinology letters, 2014

Our aim was to assess endothelial function in physically healthy patients with schizophrenia and ... more Our aim was to assess endothelial function in physically healthy patients with schizophrenia and related psychoses and to compare the results with healthy controls. Endothelial dysfunction was shown to predict future cardiovascular events in general population so we assumed to find a higher prevalence of endothelial dysfunction in patients with psychosis, as their cardiovascular morbidity is markedly higher than in general population, and to confirm the referred correlation with the traditional cardiovascular (CV) risk factors. We assessed the traditional CV risk factors and endothelial function using non-invasive peripheral arterial tonometry (EndoPAT2000) in 50 stabilized and medicated schizophrenic patients (aged between 18 and 50 years) without any history of cardiovascular diseases and compared the results with 50 age-matched healthy controls. Psychiatric Clinic, University Hospital, Hradec Kralove and 2nd Department of Internal Medicine, General University Hospital, Prague, Cz...

Research paper thumbnail of Comparison between gadolinium and iodine contrast for percutaneous intervention in atherosclerotic renal artery stenosis: clinical outcomes

Nephrol Dialysis Transplant, 2007

Background. Percutaneous angiography with iodinated contrast in patients with chronic kidney dise... more Background. Percutaneous angiography with iodinated contrast in patients with chronic kidney disease carries a risk of contrast nephropathy, which is independently associated with renal disease progression and increased mortality. Gadolinium contrast is a potential alternative to iodinated contrast for percutaneous transluminal renal angioplasty (PTRA), and appears to be safe and well tolerated. The aim of this study was to assess the results of gadolinium use to facilitate PTRA in patients with chronic kidney disease. Methods. Clinical outcomes were compared between patients with serum creatinine (Cr) ≥ 176 µmol/L (2 mg/dL), who had either gadolinium (n = 57; gadoteridol or gadodiamide), iodinated (n = 68; iohexol or iodixanol) or a combination of gadolinium and iodinated-contrast-enhanced (n = 38) PTRA. Results. Despite similar degrees of pre-procedural renal insufficiency, the incidence of immediate contrast nephropathy [defined as an increase in serum Cr of 44 µmol/L (0.5 mg/dL) within 7 days without other identifiable causes] was lowest in the gadolinium group (3/57, 5.3%) compared to those receiving a combination of modest iodinated contrast in addition to gadolinium (4/38, 10.5%) or solely iodinated contrast (14/68, 20.6%). This was associated with a reduction in the 30-day progression to need for renal replacement therapy (RRT) (P < 0.005). Yet, over a mean follow-up of 40 ± 22 months, renal function outcomes or all-cause mortality were not different between the contrast groups. The type of contrast used had no effect on technical success and both short-and long-term blood pressure outcomes were comparable between the groups. Two patients developed pathology-proven nephrogenic fibrosing dermopathy, a serious skin condition that has been seen in patients with kidney disease following administration of gadolinium.

Research paper thumbnail of Body weight and self-esteem in patients with schizophrenia evaluated with Β-WISE®

Schizophrenia Research, 2006

Background: Metabolic abnormalities and weight gain are an important problem in patients with sch... more Background: Metabolic abnormalities and weight gain are an important problem in patients with schizophrenia. An instrument to evaluate body image and self-esteem related to weight has recently been developed (B-WISE®). The first objective was to evaluate whether the findings of the original validation study could be confirmed in a European sample. The second objective was to explore the association of B-WISE® scores with the metabolic syndrome and glucose abnormalities. Methods: A Dutch translation of B-WISE® was tested in a large sample of patients with schizophrenia (n = 300) who underwent an extensive metabolic screening. Results: The original findings with B-WISE® were confirmed in an independent sample. Scores on B-WISE® differed significantly as a function of BMI. Scores on B-WISE® also differentiated patients with and without the metabolic syndrome and glucose abnormalities. Patients experiencing a recent weight gain had lower self-esteem and poorer psychosocial adaptation. Conclusion: B-WISE® could be a useful instrument to evaluate the subjective psychosocial consequences associated with current weight and weight gain in patients with schizophrenia.

Research paper thumbnail of Prolactin as a factor for increased platelet aggregation

Neuro Endocrinology Letters, Sep 1, 2007

Administration of antipsychotics appears to be related to increased risk of venous thromboembolis... more Administration of antipsychotics appears to be related to increased risk of venous thromboembolism and cerebrovascular side effects. The biological mechanism responsible for this possible adverse drug reaction is unknown, but there is a growing number of elucidating hypotheses. Treatment with antipsychotics is associated with elevation of prolactin level. Prolactin has recently been recognized as potent platelet aggregation co-activator, and have therefore been postulated as an additional risk factor for both arterial and venous thrombosis. We briefly review the arguments for the role of hyperprolactinemia in pathogenesis of platelet aggregation.

Research paper thumbnail of Pharmacological treatment of severe dyslipidaemia in patients with schizophrenia

International Clinical Psychopharmacology

Mortality rates in patients with schizophrenia are double compared with the general population, w... more Mortality rates in patients with schizophrenia are double compared with the general population, with cardiovascular disease causing 50% of the excess. Lowering low-density lipoprotein cholesterol is recognized as a primary target for the prevention of cardiovascular mortality. The effects of lipid-lowering treatment were evaluated in patients with schizophrenia. Forty-six patients with schizophrenia and with severe dyslipidaemia were identified. All were treated with antipsychotics. Patients were screened for cardiovascular risk factors and examined at baseline when statin therapy was initiated. The effects of lipid-lowering medication on lipid profile, glucose homeostasis and components of metabolic syndrome were evaluated at 3 months follow-up. After 3 months of statin therapy, a significant decrease in triglycerides, total cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and, in associated ratios, low-density lipoprotein/high-density lipoprotein, cholesterol/high-density lipoprotein was observed. No significant changes occurred in high-density lipoprotein cholesterol, body mass index, waist circumference or glucose homeostasis. The only component of metabolic syndrome affected by statin therapy has been the serum triglyceride level. Statins proved effective in the management of dyslipidaemia in patients with schizophrenia treated with antipsychotics. More complex treatment may be required for associated metabolic disturbances.

Research paper thumbnail of Pharmacological treatment of severe dyslipidaemia in patients with schizophrenia

International clinical psychopharmacology, 2007

Mortality rates in patients with schizophrenia are double compared with the general population, w... more Mortality rates in patients with schizophrenia are double compared with the general population, with cardiovascular disease causing 50% of the excess. Lowering low-density lipoprotein cholesterol is recognized as a primary target for the prevention of cardiovascular mortality. The effects of lipid-lowering treatment were evaluated in patients with schizophrenia. Forty-six patients with schizophrenia and with severe dyslipidaemia were identified. All were treated with antipsychotics. Patients were screened for cardiovascular risk factors and examined at baseline when statin therapy was initiated. The effects of lipid-lowering medication on lipid profile, glucose homeostasis and components of metabolic syndrome were evaluated at 3 months follow-up. After 3 months of statin therapy, a significant decrease in triglycerides, total cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and, in associated ratios, low-density lipoprotein/high-density lip...

Research paper thumbnail of Gadolinium-based versus iodine-based contrast for percutaneous renal artery angioplasty

Aim: There is increasing evidence that primary aldosteronism (PA) may be common in patients defin... more Aim: There is increasing evidence that primary aldosteronism (PA) may be common in patients defined as "essential" hypertensive. Aim of this study was to evaluate the incidence of primary aldosteronism in a primary-care hypertensive population.

Research paper thumbnail of Body weight and self-esteem in patients with schizophrenia evaluated with B-WISE®

Schizophrenia Research, 2006

Background: Metabolic abnormalities and weight gain are an important problem in patients with sch... more Background: Metabolic abnormalities and weight gain are an important problem in patients with schizophrenia. An instrument to evaluate body image and self-esteem related to weight has recently been developed (B-WISE®). The first objective was to evaluate whether the findings of the original validation study could be confirmed in a European sample. The second objective was to explore the association of B-WISE® scores with the metabolic syndrome and glucose abnormalities. Methods: A Dutch translation of B-WISE® was tested in a large sample of patients with schizophrenia (n = 300) who underwent an extensive metabolic screening. Results: The original findings with B-WISE® were confirmed in an independent sample. Scores on B-WISE® differed significantly as a function of BMI. Scores on B-WISE® also differentiated patients with and without the metabolic syndrome and glucose abnormalities. Patients experiencing a recent weight gain had lower self-esteem and poorer psychosocial adaptation. Conclusion: B-WISE® could be a useful instrument to evaluate the subjective psychosocial consequences associated with current weight and weight gain in patients with schizophrenia.

Research paper thumbnail of Comparison between gadolinium and iodine contrast for percutaneous intervention in atherosclerotic renal artery stenosis: clinical outcomes

Nephrology Dialysis Transplantation, 2007

Background. Percutaneous angiography with iodinated contrast in patients with chronic kidney dise... more Background. Percutaneous angiography with iodinated contrast in patients with chronic kidney disease carries a risk of contrast nephropathy, which is independently associated with renal disease progression and increased mortality. Gadolinium contrast is a potential alternative to iodinated contrast for percutaneous transluminal renal angioplasty (PTRA), and appears to be safe and well tolerated. The aim of this study was to assess the results of gadolinium use to facilitate PTRA in patients with chronic kidney disease. Methods. Clinical outcomes were compared between patients with serum creatinine (Cr) ≥ 176 µmol/L (2 mg/dL), who had either gadolinium (n = 57; gadoteridol or gadodiamide), iodinated (n = 68; iohexol or iodixanol) or a combination of gadolinium and iodinated-contrast-enhanced (n = 38) PTRA. Results. Despite similar degrees of pre-procedural renal insufficiency, the incidence of immediate contrast nephropathy [defined as an increase in serum Cr of 44 µmol/L (0.5 mg/dL) within 7 days without other identifiable causes] was lowest in the gadolinium group (3/57, 5.3%) compared to those receiving a combination of modest iodinated contrast in addition to gadolinium (4/38, 10.5%) or solely iodinated contrast (14/68, 20.6%). This was associated with a reduction in the 30-day progression to need for renal replacement therapy (RRT) (P < 0.005). Yet, over a mean follow-up of 40 ± 22 months, renal function outcomes or all-cause mortality were not different between the contrast groups. The type of contrast used had no effect on technical success and both short-and long-term blood pressure outcomes were comparable between the groups. Two patients developed pathology-proven nephrogenic fibrosing dermopathy, a serious skin condition that has been seen in patients with kidney disease following administration of gadolinium.

Research paper thumbnail of P03-267 - Assessment of microalbuminuria and ankle-brachial index in outpatients with schizophrenia treated with antipsychotics - a possible predictors of cardiovascular disease

European Psychiatry, 2011

and related psychoses are associated with excess morbidity and mortality from cardiovascular (CV)... more and related psychoses are associated with excess morbidity and mortality from cardiovascular (CV) disease. Microalbuminuria (MA) is associated with an increased risk of CV disease and mortality. This association is independent of other known CV risk factors such as hypertension, dyslipidemia, obesity, smoking, and impaired renal function. The ankle brachial index (ABI), which is the ratio of systolic pressure at the ankle to that in the arm, is quick and easy to measure and has been used to confirm the diagnosis and assess the severity of peripheral artery disease. Low ABI has been related to an increased incidence of total and CV mortality and CV events.The objective of prospective pilot study was to determine MA and ABI as well as the prevalence of CV risk factors (glucose tolerance status, lipids levels, obesity, hypertension, smoking) and assessment of Framingham risk score in patients with schizophrenia treated with antipsychotic drugs. The study included thirty-three outpatient subjects (female, n= 16), aged 21-66 years. The exclusion criteria included urinary infection and presence of diabetes mellitus.Three patients (7,7 %) has abnormal (>26 mg/d) levels of MA, non of ABI.In conclusion, stratification by MA can help identify a high-risk subset of nondiabetic patients with schizophrenia in risk of CV events.

Research paper thumbnail of P03-266 - Innovation and modification of criteria for prevention of venous thromboembolism in psychiatric patients

European Psychiatry, 2011

Research paper thumbnail of Treatment with Rosuvastatin for Severe Dyslipidaemia in Patients with Schizophrenia and Schizoaffective Disorder

Drug Safety, 2006

Mortality rates in patients with schizophrenia are double compared to those in the general popula... more Mortality rates in patients with schizophrenia are double compared to those in the general population, with cardiovascular disease causing 50% of the excess. Lowering low-density lipoprotein (LDL) cholesterol is recognized as a primary target for the prevention of cardiovascular mortality according to the National Cholesterol Education Program-Adult Treatment Panel III. Use of lipid-lowering drugs such as statins is recommended when lifestyle changes are not sufficient to reach the LDL goal. The efficacy and safety of rosuvastatin treatment were evaluated in schizophrenic patients. 100 schizophrenic patients with severe dyslipidemia were identified. All were treated with antipsychotics. Fifty-two patients were treated with rosuvastatin and compared with 48 who did not receive statin treatment. All patients were screened for cardiovascular risk factors and examined at baseline. The effects of lipid-lowering medication on lipid profile, glucose homeostasis, and components of metabolic syndrome were evaluated at 3-month follow-up. The study began in 2003, and all data available until December 2005 are reported. After 3 months of statin therapy, a significant decrease in triglycerides, total cholesterol, LDL cholesterol, and non-high-density lipoprotein (non-HDL) cholesterol and in associated ratios (LDL/HDL, total cholesterol/HDL) was observed. The difference was highly significant compared to patients not receiving statin treatment. No significant changes occurred in HDL cholesterol, body mass index and waist circumference, or glucose homeostasis. The only component of metabolic syndrome affected by statin therapy was the serum triglyceride level. Rosuvastatin proved effective in the management of dyslipidemia in patients with schizophrenia treated with antipsychotics. More complex treatment may be required for associated metabolic disturbances.

Research paper thumbnail of Cognitive changes in spinocerebellar ataxia type 2

Neuro Endocrinology Letters, 2011

OBJECTIVES: Cognitive disorders and dementia occur in 19 to 42% of patients with spinocerebellar ... more OBJECTIVES: Cognitive disorders and dementia occur in 19 to 42% of patients with spinocerebellar ataxia type 2 (SCA2). Neuropsychological tests can reveal executive dysfunction, impaired visual and verbal memory, tongue and speech impairment, attention disorders and impaired verbal fluency.METHODS: We performed psychiatric and neuropsychological examinations in 12 patients diagnosed with genetically confirmed SCA2 and 12 healthy volunteers matching the patients in age, gender, and length of education. The level of motor impairment was determined using the brief ataxia rating scale (BARS). The neuropsychological examination focused on testing executive functions, short-term visual and verbal memory, attention, psychomotor tempo, visual motor coordination, learning ability and comprehension ability. The tests were divided into two subgroups according to the difficulty of motor tasks. The cognitive abilities composite score (CACS) was determined by calculating the arithmetic mean of T scores of the respective tests.RESULTS: Patients with SCA2 had significantly lower CACSs (p=0.00005) compared to the healthy volunteers. Patients exhibited impaired performance in both difficult and simple motor tests. The severity of cognitive impairment was related to the age at the onset of the disease (p=0.002) but not to the duration or to the overall BARS score.CONCLUSIONS: Compared to healthy volunteers, patients with SCA2 exhibited significantly worse cognitive performance in all areas tested, including the tests of simple motor tasks. Moreover, the cognitive performance of patients worsened as the difficulty of the motor tasks increased.