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Biomedical subjects

M Häcki

Publications and source records attributed to M Häcki.

9 recordsLinked to original sources
PubMed2000

Effect of one year treatment with inhaled fluticasone propionate or beclomethasone dipropionate on bone density and bone metabolism: a randomised parallel group study in adult asthmatic subjects.

BACKGROUND: There is some concern that prolonged treatment with high doses of inhaled corticosteroids may have a detrimental effect on bone mass. The aim of this one year study was to investigate the effects of low and high doses of fluticasone propionate (FP) (400 microg/day and 750 microg/day) and beclomethasone dipropionate (BDP) (800 microg/day and 1500 microg/day) on bone mass and metabolism. METHODS: This was a multicentre, double blind, parallel group study involving 69 mild to moderate asthmatic subjects who were randomised to treatment as follows: 22 to FP400, 21 to BDP800, 13 to FP750, and 13 to BDP1500. Their mean age was 39 years, 67% were men, and all the women were premenopausal. RESULTS: The results of peripheral quantitative computed tomographic (pQCT) measurements (primary variable) showed that, compared with baseline values, there was no loss of trabecular or integral (cortical and trabecular) bone in the distal radius or tibia in any of the patients over the 12 month study period. No consistent pattern emerged from the analysis of changes from baseline in markers of bone formation and resorption after six and 12 months of treatment. CONCLUSION: The results of this study provide reassuring prospective one year data showing that inhaled corticosteroids, in the range of doses used, had no adverse effects on bone mass and metabolism in this group of asthmatic patients.

Administration, Inhalation↗
PubMed1993

Are asthmatics salt-sensitive? A preliminary controlled study.

OBJECTIVE: Epidemiologic evidence suggests that high levels of salt consumption are associated with "spastic" disorders of smooth muscles, ie, essential hypertension and bronchial asthma. Experimentally, it has been shown that high intake of salt leads to increased bronchial hyperreactivity in asthmatics, ie, enhanced contractility of bronchial muscle to spasmogenic stimuli. On the basis of these observations, the following questions were asked: (1) Does salt loading worsen the clinical and functional findings in asthmatics? (2) Is it the sodium or the chloride in salt that is important? METHODS: To answer these questions, the effect of salt restriction (= 5 to 6 g NaCl/d = 86 to 103 mmol Na), salt loading (+ 6.1 +/- 2.8 g NaCl/d = + 105 +/- 48 mmol Na), and loading with sodium citrate in nearly equimolar concentrations (+ 140 +/- 40 ml Shohl's solution, = + 120 +/- 30 mmol Na) was investigated in 14 asthmatics in a controlled crossover study. The total sodium load during the high salt diet was 191 to 209 mmol of sodium per day and during the sodium-citrate phase, 206 to 223 mmol of sodium per day. RESULTS: Statistical analysis showed that salt loading worsened symptoms (p = 0.06) and increased the use of inhaled steroids (p < 0.05). The effect on lung function was less equivocal: salt loading worsened the forced expiratory volume in 1 s (p < 0.01) and the peak expiratory flow rate (p < 0.05). This effect was presumably mediated by sodium, not chloride, as is demonstrated by loading with sodium citrate. CONCLUSION: Patients with bronchial asthma seems to be salt-sensitive, the responsible ion being presumably sodium. A low-salt diet appears to have a favorable effect in patients with asthma and to reduce the need for anti-asthma drugs.

Adult↗
PubMed1986

[Amnesic episodes following administration of the hypnotic drug Midazolam, effect or side-effect?].

Five patients are reported who experienced amnestic episodes a short time after oral intake of the recommended dose (7.5-15 mg) of the new benzodiazepine hypnotic midazolam. Patients were able to perform complex activities or to talk freely with other persons, and seemed to be awake and attentive. However, next morning they had complete andero-grade amnesia from intake of the drug. No other psychotropic medication or alcohol was involved. This type of drug-induced amnesia seems to be more frequent than so far reported, since all these episodes were observed in fewer than 30 cases in which the drug was prescribed. This means a considerable risk for patients and for others, and serious questions arise which should be carefully investigated.

Adult↗
PubMed1985

[Which is the best drug combination for the short-term therapy of tuberculosis? A prospective randomized study with 190 patients].

190 patients with positive cultures for M. tuberculosis were treated in the initial phase as inpatients for 2-3 months at random with either pyrazinamide (Z) or ethambutol (E) in combination with isoniazid (H) and rifampicin (R). In the continuation phase as out-patients they were treated by their family doctor for a further seven months with a new randomization using either R or E combined with H. Regular controls of drug intake using urine test strips were 97% positive. The patients treated with Z showed a tendency to more rapid conversion to negative cultures despite the significantly shorter duration of initial-phase treatment. During the average observation period of 33 months after commencing therapy there were five relapses (without development of drug resistance). The distribution over the four patient groups did not allow statistical conclusions to be drawn. All of the relapses occurred during the first year after the treatment ended. All relapsing patients showed an unusually long delay (108 days) before the tuberculosis cultures proved negative, in comparison with only 48 days in all patients. The relapse rate of 3.6% equals comparable controlled studies in the literature of the last four years, in which patients were initially hospitalized for two months or received medication under direct supervision as out-patients. The family doctors treated their patients on average for ten months instead of the nine months recommended in the treatment scheme ("doctor's compliance"). This seems to be a direct consequence of the earlier recommendations in favour of a longer duration of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

[Wild silk: a strong inhalation allergen (author's transl)].

In the course of 18 months, allergic bronchial asthma due to wild silk was diagnosed in 26 patients (19 women, 7 men) of the relatively high mean age at onset of 34 years. In 25 patients the allergy started 1-36 months after acquiring a so-called wild-silk rug, which contains wild-silk waste; one patient fell ill after occupational contact with the waste of wild silk. In all patients the scratch test with wild-silk waste was strongly positive. Elimination of the rug or the occupational exposure made all the symptoms disappear. Wild-silk waste, product of wild-growing oak silkworms, is thus a relatively strong inhalation allergen. Exposure to wild-silk rugs should routinely be considered in the diagnostic work-up of allergies.

Adolescent↗