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Biomedical subjects

C Marti

Publications and source records attributed to C Marti.

15 recordsLinked to original sources
PubMed2006

[Social inequalities and access to health care: consequences of the revision of the Swiss insurance law (art 64A)].

The revision of the Swiss health insurance law (article 64A) excludes an increasing portion of the Swiss population from access to health care, and specifically to medications. From May to August 2006, 84 patients were referred to the University Hospital's primary care outpatient clinic to receive medications. These patients had a low socio-economic position, suffered from chronic diseases (88%) and had a high prevalence of psychiatric diseases (59%). This change in the Swiss insurance law mainly has an impact on the more fragile members of society and threatens the concept of equal access of the whole population to the national health care system.

Health Services Accessibility↗
PubMed1999

[Cartilage oligomeric matrix protein (COMP): the role of a non-collagen cartilage matrix protein as a marker of disease activity and joint destruction in patients with rheumatoid arthritis and osteoarthritis].

UNLABELLED: Today, we can assess criteria to predict the tissue destruction and progression of Rheumatoid Arthritis (RA) and Osteoarthritis (OA) only in a late stage of the disease. It would be an advantage to have biochemical markers of disease activity and joint destruction to optimize therapy. PATIENTS AND METHODS: In this cross-sectional study with 37 RA and 20 OA patients (disease duration 119 +/- 130 months for RA and 41 +/- 73 months for OA), ESR, CRP, disease activity score (DAS), the functional status of RA (American College of Rheumatology), and the radiological scoring systems of Larsen and Kellgren/Lawrence, respectively, were used as parameters for disease activity and joint destruction. Cartilage oligomeric matrix protein (COMP) was measured with an enzyme-linked immunosorbent assay (ELISA) in serum and synovial fluid, COMP fragments with immunoblot in the synovial fluid. RESULTS: The mean COMP value in synovial fluid was 38 ug/ml (RA) and 46 ug/ml (OA); 6.5 ug/ml (RA) and 3.4 ug/ml (OA) in serum. RA patients had a higher amount of small COMP fragments in synovial fluid than OA patients. In RA patients, there was a significant positive correlation between disease activity (DAS) and COMP in synovial fluid and serum, a negative correlation between functional status of RA and serum COMP and between radiologic joint destruction of the knee and serum COMP. In OA patients, there was a significant correlation of joint space width and synovial fluid COMP. DISCUSSION: A high clinical disease activity (DAS) correlated with high COMP values in serum and synovial fluid and with increasing proteolytic activity (higher amount of small COMP fragments especially in RA). An increased turnover of cartilage matrix in joint inflammation might explain this correlation. The correlation of decreased COMP with decreased functional status in RA and increased joint destruction is compatible with a loss of cartilage and less turnover. The correlation between joint space width and increased COMP in OA patients with short disease duration might be explained with a higher turnover of the cartilage matrix in the early stage of the disease.

Adult↗
PubMed1998

[From chondrocyte culture to joint cartilage replacement. Development of de novo cartilage in vitro].

Local repair of acute or chronic cartilage lesions has not been successful so far. An attempt has been made to use synthetic materials to improve the quality of the repair tissue, but no method has achieved reliable regrowth of normal hyaline cartilage with adequate biomechanical properties and bonding to surrounding tissue. After publication of the first short-term results of chondrocyte transplantation in patients with localized cartilage lesions of the knee joints by a Swedish group in 1994 [1], the situation seems to have changed. Even though the advantages of this method of chondrocyte transplantation is a matter of controversy, the interest in the so-called "Carticel" approach has grown steadily. Indeed, the technique was recently approved by the FDA, on condition of a randomized, "placebo"-controlled trial. In view of this rapid development, we feel that independent experimental studies are urgently needed. In this article we present our own results in synthesizing de novo cartilage from cultured and phenotypically stable chondrocytes in a truly three-dimensional cartilage-like polyanionic matrix. With the experience gained in animals, we expect to set the stage for future experimental therapy in young human patients with early cartilage lesions.

Animals↗
PubMed1997

Metallic versus bioabsorbable interference screw for fixation of bone-patellar tendon-bone autograft in arthroscopic anterior cruciate ligament reconstruction. A preliminary report.

We retrospectively compared the clinical outcome and the radiographic incorporation of the bone blocks between two groups of patients undergoing anterior cruciate ligament reconstruction using either metallic or bioabsorbable interference screws for fixation of the bone-patellar tendon-bone autograft. Sixty-nine patients (44 male and 25 female) were available for follow-up. There were 31 patients with a mean age of 33 years (range 16-59 years) in group I (bioabsorbable interference screw fixation) and 38 patients with a mean age of 32 years (range 18-58) in group II (metallic screw fixation). The mean follow-up was 9.6 months after surgery in group I (range 6-17 months) and 20.5 months in group II (range 6-32 months). At follow-up, the IKDC scores were comparable between the two groups, and there was no statistically significant difference for the Lysholm (P = 0.925) and Tegner (P = 0.197) scores. The KT-2000 tests showed a statistically insignificant mean side-to-side difference of 2.0 mm (+2.2 mm SD) in group I and 2.2 mm (+2.4 mm SD) in group II (P = 0.741). At follow-up, all patients showed osseous incorporation of the bone block autografts within the femoral and tibial bone tunnels with no osteolytic changes.

Adolescent↗
PubMed1993

Elevated high density lipoprotein concentrations in heart transplant recipients are related to impaired plasma cholesteryl ester transfer and hepatic lipase activity.

Accelerated atherosclerosis is a major complication of heart transplantation, and is frequently associated with a dyslipoproteinemia characterized by a paradoxical increase in HDL-cholesterol concentration. To define this abnormality, the lipoprotein profiles of 25 heart transplant recipients (HTR) were analyzed and compared with those of 26 control subjects. HDL, as separated on the basis of density in 3 subfractions, were increased in concentration: HDL2: +51%, HDL3a: +29%, HDL3b: +32%. HDL2 and HDL3a displayed an enrichment in surface components, phospholipids, unesterified cholesterol and apo E, leading to an increased size compared with subfractions of similar density in the controls. The major steps of plasma HDL metabolism were investigated: cholesterol esterification (LCAT activity), cholesteryl ester transfer to apo B-containing lipoproteins (CETP) and the hepatic hydrolysis of HDL components (HL activity). We demonstrated a partial deficiency in CETP (-28%) and hepatic lipase (-36%) activities with normal LCAT activity. Correlations in total study population (HTR plus controls) evidenced negative associations between CETP activity and HDL3a concentrations and between HL activity and HDL2-cholesterol as a percent of total HDL-cholesterol. Therapeutic agents used in post transplantation treatment such as glucocorticoids and/or cyclosporine may be speculated thus to affect both CETP and HL activities and, by arresting the HDL cycle in a CE-saturated state, do decrease the efficiency of reverse cholesterol extraction at the site of the graft.

Apolipoproteins↗
PubMed1992

Effect of a moderate alcohol intake on the lipoproteins of normotriglyceridemic obese subjects compared with normoponderal controls.

Moderate alcohol intake is frequently associated with an elevated concentration of high-density lipoprotein (HDL), which is one of the potential causes for the relative decrease in cardiovascular risk reported in moderate drinkers. Conversely, low HDL concentrations, particularly HDL2, in obese subjects may be a risk factor. The effect of 30 g alcohol daily (wine) during 14 days following a period of abstinence was studied in seven normolipidemic obese subjects (body mass index [BMI], 30 +/- 1.7 kg/m2) compared with seven normoponderal controls (BMI, 22 +/- 1.2 kg/m2). Alcohol caused apolipoprotein (apo) AI and apo AII concentrations to increase in all controls by 12% and 16% (P less than .05), but not in obese subjects. Lipoprotein (Lp) AI HDL particles (without AII) were initially in the same proportions in the two groups. Their increase in controls only (P less than .03) was not matched by an increase in HDL2 in all subjects. In obese subjects, neither Lp AI nor HDL2 were increased by alcohol, but their HDL-triglyceride (TG) contents, initially elevated, were normalized. Cholesterol ester (CE) transfer activity was not different in controls and obese subjects during abstinence (105.7 +/- 40.8 v 104.8 +/- 34.5 mmol/mg protein/h). It was notably depressed by alcohol in controls (74.2 +/- 27.4, P less than .002), but not in obese subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Autoimmune hemolysis after Catergen ([+]-cyanidanol-3)].

Clinical and serological data in 5 cases of autoimmune hemolysis following therapy with Catergen are reported and compared to the data in similar literature reports. The main argument in favour of Catergen as causative agent in our 5 cases was rapid remission of hemolysis within 2 1/2 to 10 weeks of withdrawing Catergen treatment. Besides causing hemolysis mediated by drug dependent antibodies, long term treatment with Catergen may induce formation of IgG autoantibodies against red blood cells with or without overt hemolysis.

Adult↗
PubMed1986

Growth hormone response to thyrotropin-releasing hormone in children and adolescents: a reappraisal.

In normal subjects, thyrotropin-releasing hormone (TRH) is not involved in the control of growth hormone secretion. Paradoxical growth hormone (GH) responses to TRH have been described in acromegalic subjects and, recently, in some constitutionally tall children. To confirm this finding, we have examined the GH response to combined LHRH-TRH tests performed to assess the pituitary function of children with GH deficiency, tall stature before and during bromocriptine therapy, precocious or delayed puberty as well as in a group of patients of average height and normal bone age. Unlike prolactin, the GH "response" to TRH, in children followed longitudinally, is particularly heterogeneous with an unpredictable pattern of secretion in repeated tests. Over 90% of children display peaks of GH (greater than or equal to 5 ng/ml), of which 38% occur twice during the test period. Amplitude and frequency of GH peaks appear to be independent of height, chronological age or bromocriptine therapy. Secretory rate estimated by integrated surface area increases in parallel to sex steroids impregnation. The pattern of GH secretory episodes, the increase in mean GH secretion in parallel to the production of gonadal sex steroids and the failure of bromocriptine to affect GH secretion in constitutionally tall children allow to speculate that what is measured after TRH injection is normal spontaneous GH rhythm rather than a direct effect of TRH on GH secretion.

Adolescent↗
PubMed1985

High-dose ifosfamide in advanced osteosarcoma.

In a prospective study, 18 evaluable patients with recurrent osteosarcoma were treated with ifosfamide, 1.8 g/m2 daily for 5 consecutive days. Courses were repeated every 4 weeks. Additional mesna (2-mercaptoethane sulfonate) was given to prevent urotoxicity. All patients had measurable lung deposits and all but one had been pretreated with various cytotoxic agents. Six patients (33%) showed therapeutic response, two complete and four partial, with a median duration of 5.5 months (range, 3-47+). Toxicity included myelosuppression, alopecia, nausea, and vomiting. No severe urotoxicity or central nervous system toxicity was observed. Thus, high-dose ifosfamide in combination with mesna seems to be a safe and effective agent for the chemotherapy of osteosarcoma.

Alopecia↗
PubMed1981

Modification of two essential cysteines in rabbit muscle pyruvate kinase by the guanine nucleotide analogue 5'[p-(fluorosulfonyl) benzoyl] guanosine.

Reaction of rabbit muscle pyruvate kinase with the affinity label 5'-[p-(fluorosulfonyl) benzoyl] guanosine (5'-FSBG), at pH 7.65 and 7.93, leads to a loss in enzyme activity. The inactivation is characterized by a biphasic kinetic profile, with the initial phase accounting for approximately 55% of the reduction in enzymatic activity. For both the rapid and slow phases, at pH 7.93, the inactivation rate constants are linearly proportional to the reagent concentration (from 0.48 to 3.0 mM), yielding second-order rate constants of 195 min-1 M-1 and 19 min-1 m-1, respectively. The effect of ligands was tested on the two phases of inactivation. For both, a decrease in the inactivation rate was produced by Mg2+ alone, but the best protection was provided by Mg2+ plus either ADP or GDP, suggesting that the reaction occurs in the region of the metal-nucleotide binding site. Modified pyruvate kinase is completely reactivated by incubation with 20 mM dithiothreitol, indicating the involvement of cysteine in the inactivation, indicating the involvement of cysteine in the inactivation process. Reaction with [5'=3H]-5'-FSBG leads to the incorporation of up to 1.3 mol of radioactive reagent per mol of enzyme subunit; however, identical radiolabel incorporation is observed before or after dithiothreitol reactivation of modified enzyme. This result implies that the labeled amino acid residue, measured by means of incorporation, is not directly involved in the inactivation process. In contrast, inactivation was found to correlate well with the loss of two free sulfhydryl groups per enzyme subunit and the restoration of activity to correlate with the regeneration of two free sulfhydryls after treatment of modified enzyme with dithiothreitol. It is proposed that inactivation of pyruvate kinase by 5'-FSBG proceeds by formation of thiol sulfonate followed by a rapid displacement of the sulfinic acid moiety by a second cysteine to yield a disulfide. A negative cooperatively in the interaction of pyruvate kinase subunits with 5'-[p-(fluorosulfonyl)-benzoyl] guanosine might best account for the biphasic inactivation kinetics.

Adenosine Diphosphate↗
PubMed1979

[High-dose ifosfamide therapy: systemic use of a mucolytic agent for the reduction of urotoxicity].

Ifosfamid is an alkylating cytostatic agent which appears to differ in its clinical spectrum from the chemically similar cyclophosphamid. So far, however, its pronounced urotoxicity has limited dosage. In spite of prophylactic measures such as forced diuresis and alkalinization of the urine, the treatment has frequently has to be broken off because of macrohematuria and hemorrhagic cystitis. By repeated intravenous administration of sodium-mercapto-ethan-sulfonate (NNI: Mesnum) the urotoxic side effects of ifosfamid can largely be prevented. During 26 cycles of treatment in 18 patients, asymptomatic microhematuria was observed 6 times and macrohematuria only once in a patient with vesico-vaginal fistula. In another case where therapy had had to be discontinued because of hemorrhagic cystitis in spite of conventional prophylaxis, the treatment could be continued without change in the urine sediment under prophylaxis with Mesnum. Mesnum does not affect the antitumoral activity of ifosfamid.

Adult↗