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Biomedical subjects

C Pirich

Publications and source records attributed to C Pirich.

45 records · Page 3Linked to original sources
PubMed1993

[Antihypertensive effectiveness of enalapril and hydrochlorothiazide as a combination drug].

1062 patients with moderate to severe hypertension were enrolled in an open-label multicenter trial investigating the antihypertensive efficacy and safety of the preconstituted formulation enalapril (20 mg) and hydrochlorothiazide (12.5 mg) over a treatment period of 12 weeks. According to the inclusion criteria of the study protocol 489 patients had to be excluded from statistical evaluation of efficacy. Results were calculated from 573 patients (339 females, 234 males, mean age 59.1 +/- 12.3 years) of whom 89% (n = 510) received the standard dosage of 1 tablet daily. They revealed a significant reduction (p < 0.001) of both diastolic and systolic blood pressure (BP) from a mean of 108.2 +/- 7.8 mm Hg (182.2 +/- 17.6 mm Hg) before treatment to a mean of 88.4 +/- 6.7 mm Hg (152.6 +/- 10.8 respectively) after 12 weeks of treatment. 81% responded to therapy defined as a lowering of diastolic BP < 90 mm Hg. Heart frequency dropped significantly (from a mean of 77.8 +/- 10.6 to a mean of 71.7 +/- 8.0, p < 0.01), too. Adverse effects leading to discontinuation were seen in 2.8% (n = 30) of all participating patients. Cough and gastrointestinal discomfort were the most frequent side effects. None of the safety parameters i.e. serum potassium and creatinine changed during the period of investigation. In conclusion, the preconstituted formulation enalapril (20 mg) and hydrochlorothiazide (12.5 mg) was shown to be an effective and well tolerated treatment not only for patients with newly diagnosed moderate to severe hypertension, but also for nonresponders to previous antihypertensive therapy.

Adult↗
PubMed1993

Coffee, lipoproteins and cardiovascular disease.

Morbidity and mortality of cardiovascular diseases are related to life-style (in particular diet, exercise and smoking). Many epidemiological studies have demonstrated that nutrition significantly affects cholesterol (C) and lipoprotein levels i.e. LDL-c and HDL-c, whereby an increase in LDL-c and a decrease in HDL-c represent independent primary risk factors for atherogenesis. For many years studies have been performed to discover other risk factors, one of the most important being the influence of coffee consumption. Epidemiological analysis of a single dietary factor produces many methodological difficulties, which may explain the inconsistent study findings regarding the effects of coffee. Thus, these studies have to be performed with large numbers of participants over many years, during which time dietary and drinking habits have to be stabilized in order to detect possible associations. Coffee contains a number of biochemically active substances, one of the most important being caffeine, a xanthine derivative. Recent studies have concentrated on the methods of preparation of coffee, which vary from country to country. A lipid fraction of boiled coffee, which is widely consumed in Northern European countries has been shown to significantly raise C and LDL-c in a dose-dependent manner. Filtered coffee, however, does not contain this lipid elevating fraction. Thus, recommendations concerning the consumption of coffee have to take into account the particular method of preparation, the amount consumed and predisposing risk factors that could interact with coffee consumption such as hypertension, hyperlipidaemia, cardiac arrhythmia.

Cardiovascular Diseases↗
PubMed1993

[Radiosynovectomy with dysprosium-165 iron hydroxide].

Treatment of chronic rheumatoid synovitis (RS) is directed to control the inflammatory process causing pain and disability. Radiation synovectomy is suggested to be an alternative to surgical treatment, but its clinical use has been restricted because of significant leakage (> 10%) associated with the use of the standard radionuclide 90-Yttrium (used as 90-Yttrium silicate colloid) and because of its long physical half-life of 64 hours prolonging the patients' stay in the hospital. 165-Dysprosium possesses promising nuclear properties for the treatment of patients suffering from RS. The maximum soft tissue penetration of its beta-particles is 5.7 mm which is the range being necessary to penetrate the inflamed synovia. Using as carrier ferric hydroxide macroaggregates (DFH) 165-Dy is expected to minimize the cumulative radiation dose to non-target organs by its very low leakage. Animal studies were performed in 13 rats and 6 rabbits to obtain the rationale and safety data for its clinical evaluation. These studies revealed that 98.2 +/- 0.6% of the injected dose remained in the joint with a nontarget organ uptake of less than 0.1%. Clinical results were obtained from 8 patients with rheumatoid arthritis. 24 hours after injection scintigraphy was performed over the treated joint and the liver region revealing no detectable leakage of the injected activity from the joint. Blood pool activity was also assessed revealing a leakage of 0.02% of the dose injected in the knee 24 hours after injection.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Concomitant aspirin treatment abolishes the antiatherosclerotic effects of the calcium channel blocker isradipine mediated by PGI2.

108 male rabbits, aged 6 months, with experimental hypercholesterolemia and experimental abdominal aortic lesioning received different regimen of antiatherosclerotic treatment; 36 of them were treated with isradipine, a dihydropyridine calcium antagonist (0.3 mg/kg/daily), 36 with isradipine in combination with aspirin whereas 36 animals received placebo. The entry of 125I-radiolabelled LDL into the aorta was demonstrated to be significantly diminished in isradipine-treated rabbits as well as positive Sudan-III-staining and aortic cholesterol content were in comparison to placebo. This benefit was almost completely abolished by concomitant aspirin-treatment. The notable increase in vascular prostacyclin (PGI2) is supposed to mediate the strong antiatherosclerotic effect of isradipine resulting in an inhibition of LDL-entry and vascular cholesterol accumulation. Aspirin almost totally blocked the raise in PGI2-synthesis by the inhibition of cyclooxygenase detected in isradipine-treated animals. It can be concluded, that aspirin-treatment may minimize the antiatherosclerotic actions of calcium antagonists which are mediated by the PG-system.

Animals↗
PubMed1992

[Lowering cholesterol with Anticholest--a high fiber guar-apple pectin drink].

In order to determine the efficacy of Anticholest, an apple-pectin-guar soft-drink in reducing elevated cholesterol (c) levels, 33 participants (aged from 8 to 73 years) were divided into three groups of comparable age, body-mass index, total c, LDL-c, HDL-c, and triglycerides. They received this combined fiber product either (group 1) at dosages of 1 cup (17 g) every second day, or (group 2) of 1 cup a day or (group 3) of 2 cups a day. Anticholest significantly reduced total c, LDL-c and the total c/HDL-c ratio. In group 3 HDL-c was increased significantly (p less than 0.01). The average percentage decrease in total c was 10.0% for group 1, 10.7% for group 2, and 15.7% for group 3. LDL-c was lowered 14.4% in group 1, 13.8% in group 2 and 19.1% in group 3. The highest individual reduction amounted to more than 30% for total-c and LDL-c. A significant decrease was also detected in the triglycerides (tg) in group 3 (p less than 0.05). 7 patients were non-responders. Anticholest appears to be an appropriate treatment for patients at risk of coronary heart disease with insufficient or inadequate response to dietary measures, but where long-term pharmacotherapy is not yet indicated. The lack of side effects and its form of administration as a viscous drink are important determinants for long-term compliance, which is essential in the management of a chronic progressive disease such as atherosclerosis.

Adolescent↗
PubMed1992

[Economic aspects of therapy for lipid metabolism disorders].

The primary and secondary prevention of cardiovascular diseases and, therefore, the therapy of hyperlipidemia is essential in strategies to lower morbidity and mortality from coronary heart disease (CHD), the most relevant atherosclerosis-associated disease. These programs imply not only a medical but also an economic challenge to our health system. That is why all therapeutic measures have to be evaluated regarding their cost-effectiveness. A cost-effectiveness profile was calculated for all the therapies of hyperlipidemia (nutritional therapy, dietetic nutritionals, drugs and LDL-apheresis) with respect to the following parameters: total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides. The daily costs of all interventional measures are compared to the success rate, whereby an index of daily therapy costs and 1% change per lipid parameter was calculated. Nutritional therapy is by far the cheapest, and LDL-apheresis the most expensive but also the most effective and reliable therapeutic measure. It has to be considered, however, that dietary intervention can be very successful in overnutrition while in rare cases of severe homozygous familial hypercholesterolemia there is no therapeutic alternative to LDL-apheresis. Life-style modifications, such as changing nutritional habits, may contribute towards reducing or removing one or more risk factor(s) (e.g. malnutrition is associated with overweight, hyperlipoproteinemia (HLP), hyperinsulinemia (syndrome X), hyperfibrinogenemia and hypertension). But neither health politicians nor the population seem to be conscious of the fact that life-style changes help to reduce medical expenditure. Considering the fact that nearly every medical service is getting more and more expensive, the need to introduce financial regulations is evident.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholesterol↗