Téma: Overview works

Therapeutic dilemmas of insulin resistance syndrome on occasion of the 20th jubilee of its origin – part 2

Juraj Hrnčiar, Mária Hrnčiarová, Jarmila Okapcová, Miroslav Szentiványi, Viera Kiková

The biggest therapeutic dilemmas in treatment of particular phenomenon of insulin resistance syndrome occurred at the end of the 20th century with expansion of pharmacotherapy of obesity by anorectics fenfluramin and fenteramin in the form of serotoninergic valvulopaties and lung hypertension. Other adverse phenomenon of obesity therapy was “chines herbs nefropathy“ and higher occurrence of various malignancies that occurred as the result of unfortunate mistake when two Chinese herbs with similar names (fangchi a fangji) were tetranda. The fist contains aristochol acids , metabolites of which have nephrotoxic and mutagennous effects on oncogen c-H-ras resulting in renal failure with the need of dialysis and transplantation as well as formation of malignancies. Further considerable risks developed by expansion of hormonal replacement and contra conception therapy by sexagens where risks were 5-fold higher than real benefits. Similarly in prevention of transfer of prediabetic dysglycemia into type 2 DM by application of glitazones , risks of congestive heart failure and bone fractures in women seem to be higher than benefits. Dangerous and potentially lethal hyperkaliemic crisis are seen in diabetic patients. After 10 years of disease isolated hyporenin hypoaldosteronism was found in 18% of patients in which after ACEI, sartans, NSA and potassium sparing diuretics and their combinations dangerous and potentially lethal hyperkaliemic crisis occur.

Ročník 2008  Témy časopisu Internal medicine 6 / 2008

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REPRESENTATIVE OF CHAIRMAN
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MEMBERS OF THE EDITORIAL BOARD
doc. MUDr. Viera Fábryová, CSc.
MUDr. Viera Fedelešová, CSc.
prof. MUDr Martin Haluzík, CSc.
prof. MUDr. Štefan Hrušovský, CSc. Dr.SVS.
prof. MUDr. Rudolf Hyrdel, CSc.
doc. MUDr. Oľga Jurkovičová, CSc.
doc. MUDr. Zdenko Killinger, PhD.
doc. MUDr. Soňa Kiňová, PhD.
prof. MUDr. Peter Mitro, PhD.
doc. MUDr. Viliam Mojto, CSc., MHA
prof. MUDr. Karel Pacák, DrSc.
prof. MUDr. Juraj Payer, CSc., FRCP
doc. MUDr. Ján Podoba, CSc.
prof. MUDr. Igor Riečanský, DrSc.
doc. MUDr. Ján Staško, PhD.
doc. MUDr. Mária Szántová, PhD.
prof. MUDr. Ivan Tkáč, PhD.

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1. Shaheen NJ, Crosby NA, Bozymski EM, et al. Is there publication bias in the reporting cancer risk in Barrett ́ esophagus? Gastroenterology 2000; 119: 333-338.
2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285(4): 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
5. Osborne BE. The electrocardiogram of the rat. In: Budden R, Detweiler DK, Zbinden G. The rat electrocardiogram in pharmacology and toxicology. Oxford: Pergamon Press 1981: 15-27.

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c. propionibacterium acnes
d. endothelial growth factor


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