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Biomedical subjects

D Sailer

Publications and source records attributed to D Sailer.

At least 19 recordsLinked to original sources
PubMed2001

[Drug interactions--their impact on safe drug therapy in the example of the new thiazolidinedione group (glitazone)].

Troglitazone (CAS 97322-87-7), rosiglitazone (CAS 155141-29-0) and pioglitazone (CAS 111025-46-8) represent novel agents for the treatment of diabetes mellitus. Very often such patients receive several drugs at the same time and consequently their interaction potential needs to be known, especially as troglitazone was recently withdrawn from the market partly because it inhibited and induced drug metabolism.

Drug Interactions↗
PubMed2000

[Weight reduction, statins or fibrates? How to reach lipid goal values in diabetic patients].

Diabetics have a greatly increased risk for cardiovascular disease. At the center of the pathogenesis is the elevated blood sugar, insulin resistance and hyperinsulinemia. Treatment must therefore be aimed at controlling glucose metabolism (HBA1c < 7.0%) and lipid metabolism (LDL conc < 100 mg/dL, triglycerides < 150 mg/dL). Blood pressure should not exceed 130/85 mmHg. In addition to changes in lifestyle--low-fat, calorie-controlled diet and increased physical activity--lipid-lowering medication can rarely be done without. On the basis of the results of large interventional studies, the CSE inhibitors are particularly to be recommended. While the domain of the fibrates is the lowering of triglycerides, no comparative data on the usefulness of this group of substances are currently available.

Anticholesteremic Agents↗
PubMed1999

Immunoradiometric assay for intact human osteocalcin(1-49) without cross-reactivity to breakdown products.

BACKGROUND: Osteocalcin (Oc), a serum marker of bone turnover, circulates in several forms. We developed an assay for intact human Oc and investigated its clinical features. METHODS: We generated goat antibodies and N- and C-terminal Oc. The former was used on solid phase (polystyrene beads), and the latter was used as the tracer in an IRMA. RESULTS: The assay was linear with no cross-reactivity to Oc(1-43), total imprecision (CV) of <10%, and recovery of 100% +/- 10%. Assay values for intact Oc in EDTA plasma samples were unchanged at 18-25 degrees C for 6 h. Values for intact Oc in serum, EDTA plasma, and heparin plasma samples did not change after storage on ice for 8 h. Serum samples from patients with various conditions were stored at -70 or -135 degrees C for up to 5 years and yielded z-scores comparable to an Oc(1-43) IRMA for all conditions except for renal failure. In renal failure, the Oc(1-43) assay values were increased, whereas the intact assay values were in the reference interval. CONCLUSION: Decreases in Oc assay values are inhibited by calcium chelation, and slowed by reduced temperatures. The described assay for intact Oc allows improved specificity for bone compared with an assay for Oc(1-43).

Adolescent↗
PubMed1998

Obstructive sleep apnoea and diabetes mellitus: the role of cardiovascular autonomic neuropathy.

Knowledge of conditions associated with an increased prevalence of obstructive sleep apnoea (OSA) may help to identify patients with OSA and might give some insight into the pathogenesis of OSA and its sequelae. A number of earlier, smaller studies hinted at an association between diabetic cardiovascular autonomic neuropathy (AN) and OSA. The present study was, therefore, conducted with the aim of establishing the prevalence of OSA in diabetics with AN and of determining whether OSA is more prevalent in diabetics with AN, than in those without. We studied two groups of diabetic patients: 23 with and 25 without AN. All patients were evaluated for possible OSA (apnoea/hypopnoea index > or = 10) using initial ambulatory screening followed by polysomnography. Six patients with AN (26%) were found to have OSA, but none of the patients without AN met the diagnostic criteria (p<0.01). When the patients with OSA were compared to those without, no differences were found in terms of age, sex, body mass index or diabetes type or duration. In conclusion, about one in four diabetic patients with autonomic neuropathy suffers from OSA. Thus, obstructive sleep apnoea is more prevalent in diabetic patients with autonomic neuropathy, than in those without.

Autonomic Nervous System Diseases↗
PubMed1998

[Obesity: entrance port to multimorbidity].

Obesity is an essential risk factor for hypertension, coronary heart disease and stroke as well as for metabolic disturbances, especially for type 2 diabetes, hyper- and dyslipidemia, and it is responsible for the metabolic syndrome with insulin resistance and hyperinsulinemia. Disturbances in the lung function are also induced by obesity, as a higher risk for arthrosis on the lower extremities. Some oncological diseases like breast-, endometrial-, and prostatic cancer are associated with obesity. It is evident, that the fat distribution plays an important role in the development of obesity associated diseases: the accumulation of visceral fat has a higher risk as the peripheral fat, probably due to the different metabolism.

Body Composition↗
PubMed1996

[Type II diabetic patients in general practice. A regional questionnaire survey--analysis and consequences].

In the offices of 26 general practitioners in Upper Franconia, Germany, a complete survey of all type II diabetics was carried out. A total of 2,180 type II diabetics were analyzed in terms of age, sex and treatment with diet alone, tablets, or insulin. On average, each office is looking after 7.8% such diabetics, whose median age was 70 years, with 79% being older than 60. The considerable difference in the distribution of diabetics treated with diet alone, tablets or insulin among the various doctor's offices are discussed. The significance of inter-physician differences with respect to decision-making, e.g. when to start the patient on insulin, is examined. The data point up a need for the auditing of general practitioners.

Adult↗
PubMed1994

Dose-response of simvastatin in primary hypercholesterolemia.

In an 8-week, placebo-controlled multicenter study, the efficacy of dose levels of simvastatin 2.5, 5, 10, 20, and 40 mg was evaluated in 166 patients with hypercholesterolemia, of whom 163 completed the trial. The entry criteria were serum total cholesterol (TCHOL) between 6.2 and 7.8 mM and low-density lipoprotein (LDL) cholesterol between 4.3 and 50 mM on a standard diet and after the 2-week run-in period of placebo treatment. Mean percentage changes in serum lipids in each simvastatin-treated group from baseline were statistically significant. Of treated patients, 0% (placebo), 11% (2.5 mg), 7% (5 mg), 33% (10 mg), 42% (20 mg) and 55% (40 mg) had at least 40% reduction from baseline LDL cholesterol value. After 8 weeks of treatment, 0% (placebo), 11% (2.5 mg), 25% (5 mg), 26% (10 mg), 31% (20 mg), and 55% (40 mg) of patients treated reached a TCHOL level of < or = 5.2 mM. There was a significant linear dose response with regard to the decrease in LDL cholesterol, TCHOL, and triglycerides (TG) and the increase in high-density lipoprotein (HDL) cholesterol after 8 weeks of therapy. No serious clinical or laboratory adverse events related to simvastatin were observed even at higher doses. At each dose level, simvastatin reduced TCHOL and LDL cholesterol. Doses of simvastatin > or = 5 mg moderately increased HDL cholesterol and reduced serum TG. Simvastatin therapy resulted in major improvement in serum lipoprotein profile, particularly at higher doses.

Anticholesteremic Agents↗
PubMed1993

[Total parenteral nutrition in the home of 498 patients with tumor diseases].

Results of home parenteral nutrition in cancer patients were evaluated by analyzing files from 498 individuals. The predominant malignancies were cancer of the stomach (44% in men, 29% in women), the colon or the ovaries, respectively. Most patients (71%) admitted to home parenteral nutrition were severely malnourished, based on a Broca-Index of 0.8 or less. The majority (78%) of these subjects gained weight while on home parenteral nutrition. The remainder 22% continued to loose weight. Median survival was 64 (one to 720) days.

Adolescent↗
PubMed1993

The influence of supportive nutritional therapy via percutaneous endoscopically guided gastrostomy on the quality of life of cancer patients.

Between April 1987 and May 1990 a total of 212 consecutive patients with tumours in the head and neck region were admitted to a prospective study comparing planned prospective enteral nutrition via percutaneous endoscopically guided gastrostomy (PEG; n = 47) and oral nutrition (n = 134). The nutritional status (anthropometric and laboratory chemical parameters) and the quality-of-life index according to Padilla et al. [Res Nurs Health 6:117-126 (1983)] were determined prior to radiotherapy, 2, 4, 6 weeks later during radiotherapy and 6, 12 and 18 weeks after completion of radiotherapy. The quality-of-life score of the orally nourished patients decreased quickly during radiotherapy and improved only slowly afterwards. Although PEG patients had a worse starting score, their quality-of-life index did not deteriorate during therapy (statistically significant difference between the two groups). The same applies to the nutritional status. These results show that an early and constant enteral nutrition by PEG can stabilize the nutritional state and the quality of life of patients with tumours of the head and neck area during radiotherapy.

Adult↗
PubMed1992

[Effect of acarbose on injection-eating interval in type I diabetes. Preliminary contribution].

In a pilot study, 7 patients with Type I diabetes received three daily doses of 100 mg acarbose for three days within the framework of intensified insulin therapy. At the same time, the 30 minute interval normally observed between injection and eating was abandoned. The blood glucose levels measured one hour post-prandial in diabetics taking acarbose and not observing the injection-eating interval were lower than those measured prior to acarbose and while observing the interval. Large-scale controlled studies are needed to investigated the theory that in insulin-dependent diabetics taking acarbose, observation of the injection-eating interval can be abandoned.

Acarbose↗
PubMed1991

Percutaneous endoscopically guided gastrostomy in patients with head and neck cancer.

In 212 patients with tumors in the head and neck region the nutritional status prior to, during, and following radiotherapy, was determined by body measurements and biochemical and immunological parameters. In 165 orally fed patients the nutritional parameters deteriorated rapidly under radiation and afterwards recovered only slowly and incompletely, 31 patients requiring PEG during radiotherapy. By contrast, 47 patients with a poor initial status who had a prospectively performed percutaneous endoscopically guided gastrostomy (PEG) experienced an amelioration of their nutritional status even before radiotherapy ended. The subjective status of the patients was assessed using the Padilla quality of life index. Here, too, the PEG patients had significantly worse initial values than the orally fed patients. As with the objective indicators of nutritional status a significant deterioration was seen in the orally fed patients during radiotherapy, while the scores of the PEG patients remained constant. We consider early institution of a carefully monitored enteral feeding by PEG useful for stabilizing the nutritional status of patients with tumors in the head and neck region, and therefore recommend, when aggressive multimodal therapy is planned-and particularly if primary malnutrition is already obvious-prophylactic performance of PEG prior to the start of therapy.

Adult↗
PubMed1991

T cell activation by mycobacterial antigens in inflammatory synovitis.

To define which mycobacterial antigens were responsible for the activation of synovial fluid T lymphocytes, acetone-precipitated Mycobacterium tuberculosis (AP-MT) antigens were separated into five fractions following polyacrylamide gel electrophoresis and added to the mononuclear cell cultures of patients with inflammatory synovitis. Fractions 2 (50 to 70 kDa) and 5 (less than 28 kDa) resulted in significantly more proliferation than that of fractions 1, 3, and 4. The response to a purified mycobacterial 65-kDa heat shock protein (hsp), which migrated in fraction 2, was highly correlated (r = 0.89, P less than 0.001) with the response to the crude AP-MT. The proliferative response to a different hsp. the Escherichia coli DnaK, by synovial fluid lymphocytes was marginal. Analysis of the synovial fluid T cell response to mycobacterial culture filtrates by T cell Western blotting revealed dominant responses to antigen(s) in the range of 31 to 21 kDa in each responding patient, although no other consistent pattern of T cell activation was noted. Three lines of evidence suggested that the response to the low molecular weight fractions was directed against degradation fragments of the 65-kDa protein. These observations suggest that the activation of T lymphocytes obtained from inflammatory synovial fluids by crude mycobacterial antigens was due in large part to recognition of the 65-kDa mycobacterial hsp.

Antigens, Bacterial↗
PubMed1990

[Scientific approach in nutrition medicine and the example of diet fads].

The dietetics, seen from the historic point of view, have been more of an empirical science, yet in the past few decades they have developed a more rational, scientific basis. Unfortunately, this view is not shared by all, especially by those responsible for research policies of universities. Therefore it is not surprising that so-called "fad-diets" have gained in popularity despite the fact that these diets have not been scientifically proven as valuable. The most well known of these diets are the Schroth-, and F. X. Mayr-cure, the Evers-, Hay's, Atkins-, and Point-diet. Almost every day new diets are introduced to the public via uncritical mass media. These types of diets have nothing to do with modern throphotherapy.

Diet Fads↗
PubMed1990

[Does sugar play a role in the development of gastroenterologic diseases (Crohn disease, gallstones, cancer)?].

The consumption of cane- and beet-sugars per person has today reached a level of 100 g per day. In a discussion of the role of sugar in gastrointestinal diseases there must be a differentiation between a direct effect directly related to high sugar-consumption, and an indirect effect where sugar displaces other nutritive substances in the diet. Not only epidemiological, but also experimental data support that sugar has no direct, toxicological, carcinogenic or disease-inducing disposition for gastroenterological diseases. Investigating several diseases (e.g. M. Crohn) a final determination could not be made, but there is strong indication that an overconsumption of easily reabsorbable carbohydrates is not responsible for the development of diseases. An indirect, shared responsibility of high sugar consumption and reduced consumption of dietary fiber seems to be likely. Further investigations, for example by dietary tests with constant sugar content at variable consumptions of non-participating substances is necessary before a final judgment can be made. There are no useful data in humans at present, of whether food additives, such as hydrocolloids in confections play a casual role.

Cholelithiasis↗
PubMed1990

[Postoperative parenteral nutrition following segmental liver resection--are fat emulsions a risk?].

Thirty-two patients with segmental liver resection were fed 3 different parenteral infusion programs postoperatively. These differed in carbohydrate and lipid content, with the latter representing up to 40% of the total caloric content. Laboratory parameters, including nitrogen balance, acute phase proteins and liver function tests, were found to have a postoperative course similar to that seen following other major abdominal procedures. A transient rise of bilirubin observed may be related to the temporary decrease in the excretory function of the liver. The rise in acute phase proteins, beginning a few days postoperatively, was attributed to the ability of the remaining liver parenchyma to synthesize protein. There was no significant difference observed between the 3 parenteral solutions. Finally, we conclude that in the early postoperative period lipid solutions can be used as an important source of energy.

Alanine Transaminase↗