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Biomedical subjects

A Weizel

Publications and source records attributed to A Weizel.

At least 19 recordsLinked to original sources
PubMed2003

Lipid-lowering therapy and cholesterol levels following acute myocardial infarction: a German study of 5361 patients.

BACKGROUND: Current studies on secondary prevention of cardiovascular events (CARE, LIPID, 4S) illustrate the necessity of an effective lipid-lowering therapy. An important part of secondary prevention is the prompt measurement of lipids following an infarct, to be able to start therapy as quickly as possible. AIMS: This study should show the general situation in the prescription of lipid-lowering drugs in patients with acute myocardial infarction (MI) and if there are gender differences in therapy and in the lipid parameters. The second aim was to determine the therapeutical conclusions for secondary prevention made in-hospital in patients with heart attacks. METHODS: Post-infarct lipid parameters (total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG) were examined in 5361 patients within 24 hours following an acute MI. Lipid parameters from 576 patients were measured again after 1 week. RESULTS: 80.1% of men under examination and 81.9% of the women had suffered from their first MI. Only 9% of all patients were already under lipid-lowering therapy before the MI. After the MI TC and LDL-C levels decreased significantly in a time-dependent manner. Around 50% of patients received lipid-lowering drug, or the recommendation of one, during their hospital stay. CONCLUSION: The range of TC values of the patients examined was comparable to those in the CARE and the 4S secondary prevention studies. It can therefore be assumed that the results of these studies are also applicable to Germany. Nevertheless, according to existing data, therapy with lipid-lowering drugs is currently unsatisfactory, even in secondary prevention.

Aged↗
PubMed2001

[Current prescription practice of CSE inhibitors at clinic discharge after acute myocardial infarct].

We investigated the use of statins in clinical practice in patients with acute myocardial infarction in Germany in 17,732 consecutively included patients of the registries MIR-1 and MITRA-1. A clinical follow-up has been performed in the MITRA-1 study after a mean period of 18 months. In total 30% of all patients with acute myocardial infarction received statins at discharge. From 1994 to 1998 the use of statins increased from 6% to 44%; however in 1998 still less than half of the patients with acute myocardial infarction received statins at discharge. In a logistic regression model, concomittant diseases as renal failure (OR 0.7), heart failure (OR 0.7) and diabetes mellitus (OR 0.9) were associated with a lower use of statins. Age > 70 years (OR 0.5) was also associated with a lower use of statins at hospital discharge. Patients with statins at discharge had a lower long-term mortality of 5.8% versus 12.9% in patients without statins. After adjustment to age and comorbidity, use of statins at discharge was associated with a borderline significant reduction of long-term mortality (multivariate OR 0.7, 95% CI 0.4-1.0). In a subgroup analysis of therapeutic benefit, measured by the "number needed to treat" (NNT), the number of patients to treat with statins to save one life, patients with cardiovascular risk factors, as heart failure (NNT 7.5), diabetes mellitus (NNT 7.8) and age > 70 years (NNT 13.8) had a larger therapeutic benefit as patients without these risk factors (NNT 345). However, these high-risk patients received less often statins than patients without risk factors (use of statins 11.8% versus 19.8%).

Aged↗
PubMed1999

[Therapy with CSE inhibitors--more than lipid lowering?].

An elevated plasma cholesterol concentration is an established risk factor for coronary heart disease. Dietary and drug interventions with fibrate, nicotinic acid and colestyramine have resulted in a decreased rate of major coronary events but failed to decrease mortality. Studies using the more potent lipid lowering statins have shown remarkable results in primary (WOSCOPS, AFCAPS, TexCAPS) and secondary prevention (4S, CARE, LIPID). The use of these drugs reduced the risk for coronary events as well as the need for interventions. Furthermore, improvement of angina has been shown in several studies. In high-risk patients coronary heart disease associated mortality and overall mortality was reduced. Lowering of cholesterol was shown to be effective in women, older people and diabetics. Lipid lowering improves prognosis after heart transplant and could be an alternative to PTCA. Furthermore it was also shown that cholesterol lowering reduces the incidence of stroke. New mechanisms are discussed to explain the rapid onset of clinical improvement. Among these are: influences on inflammatory processes in the plaque, on vascular smooth muscle activity, on coagulation and on endothelial dysfunction.

Adult↗
PubMed1997

Drug therapy of severe hypercholesterolemia.

Lowering of plasma cholesterol and particularly of LDL cholesterol has been shown to be an effective way of primary and secondary prophylaxis of coronary heart disease. A broad range of drugs is available (bile acid binding resins, HMG CoA reductase inhibitors, fibrates, nicotinic acid, probucol, beta-sitosterol) for therapy. The choice of the drug is based on the efficacy, possible side effects and proven effects on coronary heart disease.

Adult↗
PubMed1980

Passage of a large bilirubin stone through a narrow papillotomy.

Large stones in the bile are generally considered to be a contraindication for endoscopic papillotomy (EPT). In the case described a large biliary stone passed spontaneously into the lumen of the gut after EPT. It is speculated that pure pigment stones are less "rigid" than cholesterol stones and are therefore able to pass through narrower channels than cholesterol stones.

Aged↗
PubMed1979

Influence of portocaval anastomosis on lipid parameters in patients with alcoholic cirrhosis.

The effect of portocaval shunt operation on lipid metabolism was investigated in 10 patients with alcoholic cirrhosis. Portocaval shunt operation resulted in a significant decrease of concentration of total serum cholesterol, total serum triglycerides, LDL cholesterol, VLDL cholesterol, VLDL triglycerides, and LCAT activity. The concentrations of free cholesterol, esterified cholesterol, phospholipids, LDL triglycerides, HDL cholesterol, and HDL triglycerides were unaffected.

Adult↗
PubMed1979

Acute dietary effects on plasma lipids, lipoproteins and lipolytic enzymes in healthy normal males.

Diurnal plasma lipids and lipoproteins were studied in twelve healthy young males on corn oil and palm oil diets, respectively. The major triglyceridy. Lecithin-cholesterol acyl transferase, lipoprotein lipase and hepatic triglyceride lipase were also measured. diurnal changes of triglycerides and cholesterol were confined to lipoproteins of d less than 1.006 kg/l. There was a diurnal rise of lecithin-cholesterol acyl transferase activity with corn oil but not with palm oil. Fasting and postprandial postheparin lipoprotein lipase and hepatic triglyceride lipase were similar but there was a significant correlation of postprandial hepatic lipase with postprandial plasma triglycerides on palm oil. Marked diurnal changes of triglyceride fatty acids were observed not only in 'very low density lipoprotein' but also in high-density lipoprotein amounting to approximately one third of total high density lipoprotein triglyceride fatty acids.

Adult↗
PubMed1978

Renal excretion of contrast medium after endoscopic retrograde investigations.

Endoscopic retrograde investigations are often performed as diagnostic procedures. The investigation of urine after such procedures in 21 patients has shown that appreciable amounts of contrast medium can be excreted renally. No such excretion could be shown when the contrast medium was injected into the gut lumen. The fact that contrast medium can be absorbed into the liver the pancreas during endoscopic retrograde procedures should influence the decision to perform these studies in patients with known allergies.

Cholangiography↗
PubMed1977

Demonstration of a liver abscess by ERC.

In a patient with septic fever and elevated alkaline phosphatase an ERC was conducted to explore the biliary system. Contrast media could be demonstrated within the hepatic parenchyma, establishing the diagnosis of a liver abscess in communication with the intrahepatic biliary system.

Adult↗
PubMed1977

Secondary hypertriglyceridaemia in patients with parenchymal liver disease.

Hypertriglyceridaemia occurring in patients with liver disease has been studied by measuring hepatic triglyceride lipase (H-TGL) and plasma lipoprotein lipase (LPL) by selective precipitation of H-TGL with specific antibodies. Lipid analysis, determination of lecithin-cholesterol-acyltransferase (LCAT) activity, and liver function tests were performed in parallel in fifty patients with acute hepatitis, twenty patients with chronic active or persistent hepatitis and fifty with cirrhosis of the liver. Total post-heparin lipolytic activity (PHLA) decreased with the severity of liver dysfunction. This decrease was due to low H-TGL and only to some degree to low LPL activity. With improvement over several weeks of hospitalization, hypertriglyceridaemia disappeared with a concomitant increase of H-TGL and LPL. It is concluded that impaired triglyceride metabolism in liver disease is at least partly caused by diminished plasma hepatic TGL activity.

Adolescent↗
PubMed1976

[Incorporation of 4-14C-labeled cholesterol into the cholesterol ester fractions of plasma lipoproteins in patients with cirrhosis of the liver (author's transl)].

In vivo incorporation studies with 4-14C-cholesterol were performed in five patients with cirrhosis of the liver. All patients showed low concentrations of total cholesterol, esterified cholesterol, and a low activity of the lecithin: cholesterol acyltransferase activity (LCAT). The pattern of incorporation corresponded to the results known from hypercholesterolemic, normocholesterolemic and hypertriglyceridemic patients. Low cholesterol ester concentrations and low LCAT activity do not modify the pattern of incorporation into the lipoprotein ester fractions.

Cholesterol↗
PubMed1975

[The effect of acetylsalicylic acid, extremely restricted movement and a cholesterol-rich diet on atheromatosis of the rabbit aorta: comparative investigations (author's transl)].

A multifactorial model for demonstrating the pathogenesis of the diet-induced atheromatosis of the rabbit is described. We examined the effect of various diets (atherogenetic, rich in fibre, mixed, normal) and of extreme restriction of movement, with and without doses of acetylsalicylic acid. The aorta showed uniforms morphological findings; 1. Acetylsalicilic acid no influence on the cholesterol-induced atheromatosis of the rabbit; 2. An atherogenic diet and a diet rich in raw fibre caused different degrees of sclerosis of the aorta; this was related to the cholesterol content of the mixed diet, which was 50% less than the cholesterol content of the atherogenic diet; 3. Macro- and microscopic examination showed that extreme restriction of movement alone has no demonstrable effect on the aorta of the rabbit; 4. The cholesterol-induced atheromatosis showed significantly less involvement of the aorta when there was extreme restriction of movement in addition to the diet; 5. In none of the test groups could we demonstrate any effect of PAT I on platelet adhesiveness; 6. The test conditions did not result in an activation of the contact phase of the haemocoagulation system.

Animals↗