University Karlova v Praze

Prague, Czech Republic

University Karlova v Praze

Prague, Czech Republic

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Lindhardt M.,Steno Diabetes Center | Persson F.,Steno Diabetes Center | Currie G.,University of Glasgow | Pontillo C.,Mosaiques Diagnostics | And 13 more authors.
BMJ Open | Year: 2016

Introduction: Diabetes mellitus affects 9% of the European population and accounts for 15% of healthcare expenditure, in particular, due to excess costs related to complications. Clinical trials aiming for earlier prevention of diabetic nephropathy by renin angiotensin system blocking treatment in normoalbumuric patients have given mixed results. This might reflect that the large fraction of normoalbuminuric patients are not at risk of progression, thereby reducing power in previous studies. A specific risk classifier based on urinary proteomics (chronic kidney disease (CKD)273) has been shown to identify normoalbuminuric diabetic patients who later progressed to overt kidney disease, and may hold the potential for selection of high-risk patients for early intervention. Combining the ability of CKD273 to identify patients at highest risk of progression with prescription of preventive aldosterone blockade only to this high-risk population will increase power. We aim to confirm performance of CKD273 in a prospective multicentre clinical trial and test the ability of spironolactone to delay progression of early diabetic nephropathy. Methods and analysis: Investigator-initiated, prospective multicentre clinical trial, with randomised double-masked placebo-controlled intervention and a prospective observational study. We aim to include 3280 type 2 diabetic participants with normoalbuminuria. The CKD273 classifier will be assessed in all participants. Participants with high-risk pattern are randomised to treatment with spironolactone 25 mg once daily, or placebo, whereas, those with low-risk pattern will be observed without intervention other than standard of care. Treatment or observational period is 3 years. The primary endpoint is development of confirmed microalbuminuria in 2 of 3 first morning voids urine samples. Ethics and dissemination: The study will be conducted under International Conference on Harmonisation - Good clinical practice (ICH-GCP) requirements, ethical principles of Declaration of Helsinki and national laws. This first new biomarker-directed intervention trial aiming at primary prevention of diabetic nephropathy may pave the way for personalised medicine approaches in treatment of diabetes complications. Trial registration number: NCT02040441; Preresults.


Human biomonitoring is a tool that has been used more frequently in recent years to determine population exposure to environmental chemicals, to monitor time trends, to assess health risks and to confirm the efficacy of preventive measures. Biomonitoring is defined as a measurement of chemicals, their metabolites or other pathophysiological changes related to exposure (generally called biomarkers) in human body fluids and tissues of the general population. Reference values (95% percentile of measured values) indicate the upper margin of background exposure in a given population. Health-based limit values have been defined for certain biomarkers; when these levels are exceeded there are potential health risks for the population. In the Czech Republic, human biomonitoring has been carried out since 1994 within the framework of the Environmental Health Monitoring System. It includes the monitoring of selected heavy metals (Pb, Cd, Hg) in blood, urine and hair, and persistent chlorinated organic compounds (like DDT, PCBs) in lipids of human milk or blood serum. This article discusses the requirements for sampling body fluids and analysis of biomarkers, as well as interpretation of results. Human biomonitoring procedures in European countries will be harmonized through the COPHES project within the European Union 7th Framework Program.


PubMed | Martin Luther University of Halle Wittenberg, University of Macedonia, Steno Diabetes Center, Novo Nordisk AS and 8 more.
Type: Journal Article | Journal: BMJ open | Year: 2016

Diabetes mellitus affects 9% of the European population and accounts for 15% of healthcare expenditure, in particular, due to excess costs related to complications. Clinical trials aiming for earlier prevention of diabetic nephropathy by renin angiotensin system blocking treatment in normoalbumuric patients have given mixed results. This might reflect that the large fraction of normoalbuminuric patients are not at risk of progression, thereby reducing power in previous studies. A specific risk classifier based on urinary proteomics (chronic kidney disease (CKD)273) has been shown to identify normoalbuminuric diabetic patients who later progressed to overt kidney disease, and may hold the potential for selection of high-risk patients for early intervention. Combining the ability of CKD273 to identify patients at highest risk of progression with prescription of preventive aldosterone blockade only to this high-risk population will increase power. We aim to confirm performance of CKD273 in a prospective multicentre clinical trial and test the ability of spironolactone to delay progression of early diabetic nephropathy.Investigator-initiated, prospective multicentre clinical trial, with randomised double-masked placebo-controlled intervention and a prospective observational study. We aim to include 3280 type 2 diabetic participants with normoalbuminuria. The CKD273 classifier will be assessed in all participants. Participants with high-risk pattern are randomised to treatment with spironolactone 25 mg once daily, or placebo, whereas, those with low-risk pattern will be observed without intervention other than standard of care. Treatment or observational period is 3 years.The primary endpoint is development of confirmed microalbuminuria in 2 of 3 first morning voids urine samples.The study will be conducted under International Conference on Harmonisation - Good clinical practice (ICH-GCP) requirements, ethical principles of Declaration of Helsinki and national laws. This first new biomarker-directed intervention trial aiming at primary prevention of diabetic nephropathy may pave the way for personalised medicine approaches in treatment of diabetes complications.NCT02040441; Pre-results.


Kubatova A.,Charles University | Kubatova A.,University Karlova v Praze
Czech Journal of Food Sciences | Year: 2010

A unique project exists in the Czech Republic, namely the Czech National Programme of Protection of Genetic Resources of Economically Significant Microorganisms and Tiny Animals (NPPGR), which includes nineteen Czech collections of microorganisms (bacteria, fungi), viruses, and tiny animals. It is fully financed by the Ministry of Agriculture of the Czech Republic. Under this Programme, the Culture Collection of Fungi (CCF) in Prague maintains 293 fungal strains, 225 of which are food and feed relevant fungi (e.g. toxigenic Aspergillus flavus, Pénicillium verrucosum, and Fusarium sporotrichioides). The main aims of the Programme are to provide adequate protection of the microbial genetic resources that are of importance to the agriculture and food industries, to provide strains (free of charge) for the research and educational purposes, and to support the cooperation between Czech and foreign institutions. A database of all microorganisms is accessible online.


Kasparova M.,University Karlova v Praze | Siatka T.,University Karlova v Praze | Klimesova V.,University Karlova v Praze | Dusek J.,University Karlova v Praze
Chemicke Listy | Year: 2012

The role of 2-[(2-fluoro-6-nitrobenzyl)sulfanyl]pyridine- 4-carbothioamide as a potential elicitor of biosynthesis of flavonoids and isoflavonoids in the red clover suspension cultures was investigated. The maximum content of flavonoids and isoflavonoids increased by 438 % and 180 %, compared with control, on 48-h application of the tested substance at concentrations 10 μmol 1 -l and 1 μmol 1 -l, respectively.


Tobacco dependence is a disease that causes dozens of illnesses and premature deaths. Effective treatment exists and should be available to all smokers in frame of the local health care service. The Czech Republic is not the only country missing the full availability. A worldwide project "Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment" is trying to improve the situation. As we can see from the website globalbridges.org, the project focuses on different geographical regions of the world - even if comparisons between countries are difficult due to the different health care systems including their financing. The European Globalbridges group met in June 2012 in Birmingham at the occasion of the UK National Smoking Cessation Conference. The entire interconnected system of thousands of people involved in smoking cessation in UK, including research support, is truly impressive and may be an example to other countries not only in Europe.


PubMed | University Karlova v Praze
Type: Journal Article | Journal: Casopis lekaru ceskych | Year: 2011

The number of notified tuberculosis cases in the Czech Republic in 2009 was lower than in 2008. 710 new tuberculosis cases and relapses were reported.598 cases were pulmonary tuberculosis and from them 439 were proved pulmonary tuberculosis cases. In 2009 235 smear-positive cases of pulmonary tuberculosis were diagnosed.The incidence of tuberculosis was 6.8/100000 inhabitants in 2009. The percentage of tuberculosis cases diagnosed in foreign-born persons living in the Czech Republic increased from 14.2% in 2003 to 19.2% in 2009.Next targets of tuberculosis control in the Czech Republic must be an active case-finding in the high-risk groups and monitoring of latent tuberculosis infection.


PubMed | University Karlova v Praze
Type: Journal Article | Journal: Casopis lekaru ceskych | Year: 2012

Tobacco dependence is a disease that causes dozens of illnesses and premature deaths. Effective treatment exists and should be available to all smokers in frame of the local health care service. The Czech Republic is not the only country missing the full availability. A worldwide project Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment is trying to improve the situation. As we can see from the website globalbridges.org, the project focuses on different geographical regions of the world - even if comparisons between countries are difficult due to the different health care systems including their financing. The European Globalbridges group met in June 2012 in Birmingham at the occasion of the UK National Smoking Cessation Conference. The entire interconnected system of thousands of people involved in smoking cessation in UK, including research support, is truly impressive and may be an example to other countries not only in Europe.

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