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Biomedical subjects

R Gass

Publications and source records attributed to R Gass.

At least 19 recordsLinked to original sources
PubMed2005

[Mortality from malignant melanoma: epidemiological trends in Switzerland].

The skin doesn't forget damage by sun exposure (sunburn, ultraviolet radiation). Indeed, melanoma mortality increases quite linearly with rising age. For Swiss nationals the sex ratio of mortality rates is 1.7, i.e. risks for male foreigners and Swiss females are of similar size. However, in younger Swiss men (35 to 44 years) mortality rates between 1979/83 and 1997/2001 diminished by 66% (p < 0.02). Analyses of mortality by occupational groups revealed that indoor working males like graduates and employees with commercial or technical education have an increased risk. The results support the association between melanoma risk and intermittent sun exposure, outdoor workers with chronic sunlight exposure being slightly protected. Further declines in mortality may be expected with skin cancer prevention campaigns improving sun exposure behaviour.

Adult↗
PubMed2002

Benign prostatic hyperplasia: the opposite effects of alcohol and coffee intake.

OBJECTIVE: To assess several lifestyle factors influencing benign prostatic enlargement and therefore the severity of benign prostatic hyperplasia (BPH). SUBJECTS AND METHODS: In age-stratified cohorts from population-based random samples of 882 men (aged 65, 70, 75 and 80 years) each participant completed a standardized questionnaire, including weight, height, socio-economic status, use of cigarettes, alcohol and coffee consumption. The questionnaire also elicited detailed information on the medical history of prostatic and (over the past month) lower urinary tract symptoms, applying all questions from the American Urology Association instrument. The lifestyle variables were evaluated for confounding by multiple logistic regression, controlling for age, relative weight and professional education, with those classified as having BPH analysed as the dependent variable. RESULTS: The prevalence of surgery for BPH increased with age from 15% at 65 years to 41% at 80 years. There was a strong inverse association between alcohol intake and men treated surgically for BPH or in 'watchful waiting' for surgical intervention, but a positive correlation with coffee consumption, and although not significantly, with the number of cigarettes smoked. Nevertheless, those who had never smoked have a slightly greater risk of BPH than current smokers. The body mass index and professional education were not associated with the risk of BPH. CONCLUSIONS: Given the opposite effects of coffee and moderate alcohol consumption, together with the increased risk for clinical BPH in men with coronary heart disease, coffee constituents, which increase the serum concentration of low-density lipoprotein cholesterol, may be involved in the pathophysiology of BPH. Further epidemiological studies are needed to evaluate whether avoiding coffee intake reduces the risk of BPH.

Aged↗
PubMed2001

The early preclinical diagnosis of osteoporosis measuring the pure trabecular bone density.

The major skeletal determinants of fracture risk are bone mass and postmenopausal bone loss with gradual destruction of trabecular bone architecture. Therefore, the management of osteoporosis is to prevent bone loss after menopause in women below 60 years of age. We need a screening test of bone mineral density (BMD) with the ability to identify correctly individuals with accelerated bone loss; unnecessary treatment has to be avoided. But without measurable extraskeletal factors, no technique assessing BMD as single test has the reasonable high sensitivity and specificity for the diagnosis of fast bone losers. It is on principle the repeated volumetric bone measurement--within 12 months--in the pure trabecular bone, especially at distal radius of the non-dominant arm with the peripheral quantitative computed tomography (pQCT), being able to detect accurately the individuals as fast bone losers with trabecular bone loss > 8 mg/cm3 or > 3.5% per year (prevalence about 35%). Only women with very high trabecular BMD (in highest quintile) have no risk for osteoporosis.

Bone Density↗
PubMed1999

[Benign prostatic hyperplasia--dos the frequency of operations depend on insurance status?].

In this epidemiologic study, conducted in a representative age-stratified cohort of the town of Zurich, 1221 men aged 65, 70, 75, 80 and 85 years (accidentally at least 200 men in each of the five age groups) returned the correctly completed questionnaire containing standardized questions on those symptoms, which can be caused by BPH, also on digital rectal examination of the prostate gland, done by urologist or family doctor, and therefore, if the BPH has been diagnosed and, for that reason, if surgical or nonsurgical treatment. Calculating the age-specific prevalence of BPH and the prostate symptom score (international PSS), this study evaluates the relation between prostatectomy (results of surgery) and the health-insurance status. The logistic regression as multivariate analysis, the effects of age and professional education adjusted in the first step, reveals that the insurance status does not reflect the indication for surgery. The means of PSS are very low in men, BPH being never diagnosed, moderate in men with prostatectomy and higher in men with diagnosed BPH but without need for surgery, highest in men with subjective and objective indication for surgical intervention: the means of PSS by insurance status are in each of these four groups homogeneous. On the other hand, persons with only basic health-insurance seem much more to omit the digital examination of the prostate gland. Nevertheless, the complaints or symptoms caused by BPH, as stated by the patients in a quantitative manner of increasing severity, take care that the patient himself, not waiting too long, decides to visit a doctor. The quality of life, examined by classes of PSS, depends clearly from the persisting symptoms; the insurance status cannot show statistically any evident influence.

Age Factors↗
PubMed1996

International comparison of hip fracture rates in 1988-89.

A comparison of hip fracture rates among nine countries (Canada, Chile, Finland, Hong Kong, Scotland, Sweden, Switzerland, the United States and Venezuela) was made using national hospital discharge data for the same time interval. The rates increased by age and were higher for females than males in all nine countries. When based on overall discharge rates, the incidence of hip fracture appeared high in three European countries (Finland, Scotland and Sweden) relative to the other countries. However, when transfer cases were removed and adjustments made for differences in case definition, the risk of hip fracture for both men and women was much similar among the four European and two North American countries, but higher than in Hong Kong. Rates of fracture were lowest in Venezuela and Chile, varying from three to 11 times less than for residents of the other seven countries. Although there are limitations in using hospital discharge data as a measure of incidence, the wide variation in the risk of hip fracture across the nine countries appears real but differences between North American and north European countries may not be as great as previously reported. Such cross-national comparisons may help clarify different etiologic hypotheses.

Age Factors↗
PubMed1996

Donor-to-host transmission of Mycoplasma hominis in lung allograft recipients.

Mycoplasma hominis is a significant pathogen in immunocompromised hosts, particularly organ transplant recipients. We describe two recipients of lung allografts from the same donor who had M. hominis pleuropulmonary infection during the immediate postoperative period. The most likely source of infection in these cases was the donor's respiratory tract. The slow-growing pinpoint colonies formed by M. hominis on routine bacterial culture medium may be easily overlooked and should be subcultured to mycoplasmal medium for definitive identification. The recommended management of this infection consists of drainage and antimicrobial therapy with tetracycline, clindamycin, or a fluoroquinolone. This report highlights the potential for M. hominis to be transmitted from donor to recipient during organ transplantation.

Adult↗
PubMed1995

[Prevention of postmenopausal osteoporosis: how effective is transdermal hormone substitution? (Continuous estradiol plus sequential oral norethisterone acetate)].

QUESTION: Can osteoporosis and cardiovascular risk be effectively and simultaneously prevented with transdermal estradiol replacement therapy (in combination with norethisterone acetate 1 mg per day, oral, cyclically for 12 days monthly)? METHODS: A selected, representative group of healthy women with an average age of 52 years, with confirmed natural menopause for 1 to 4 years, randomly allocated to a treatment-group with hormone replacement (n = 42) and a control-group (n = 70), with homogeneous main parameters in the two groups, can be compared, without distortion of the findings, during the period of the two-year intervention study: the purely trabecular bone mass in the distal radius was specifically measured, prospectively, with the highly accurate, three-dimensional, peripheral quantitative computed tomography (thin-und multi-layer technology; Densiscan 1000) and the serum lipid, lipoprotein and apolipoprotein levels were measured (at the end of the gestagen cycle) in the morning fasting state. RESULTS: One-third of the persons of the control-group showed an annual loss of trabecular bone mass of more than 3.5%. These fast-losers, who on the basis of the annual bone-destruction rates are to be classified in the upper tertiles of the two groups, suffered a loss of trabecular bone of 4.2 +/- 0.4% (mean +/- SEM) in the treatment-group, compared with 7.3 +/- 1.0% in the control-group in the first year; in the second year no loss of trabecular bone was observed in the treatment-group, while in the control-group the high rate of trabecular-bone destruction continued unchanged. The slow-losers (belonging to the middle and lower tertiles according to the bone loss rates) showed equally little change in their trabecular bone mass after the menopause, which can be described as physiological, with mean yearly values between -1.1 and +0.4%, both in the treatment-group and in the control-group. Under the transdermal hormone replacement therapy only the triglyceride and total cholesterol levels fell in comparison with the control-group, but without any significant changes in the atherogenic index, either in regard to the LDL/HDL or apolipoproteins B/A-I ratios. CONCLUSIONS: To be able to make valid statements it is necessary to study the effectiveness of a measure or of a preparation for the prevention of osteoporosis in fast-losers, who are to be randomized to the respective study-groups and whose status has been confirmed by tests. Transdermal hormone replacement therapy--low estradiol dose in combination with NETA--stops the pathologically increased loss of trabecular bone only in the second year of the treatment; the antiatherogenic effect, however, is not confirmed. Only an individually adjusted therapy based on test results, with follow-up controls, can constitute an efficient, ethically justifiable postmenopausal prophylaxis of both osteoporosis and coronary heart disease.

Administration, Cutaneous↗
PubMed1995

[Osteoporosis prevention initiated with peripheral quantitative computerized tomography. Thin-layer and multi-layer technique].

In a representative, randomized control group of 70 healthy confirmed postmenopausal women (natural menopause for one to four years) with an average age of 52 years, it was possible to carry out a prospective study over a period of two years, during which the bone mass was investigated regularly by means of peripheral quantitative computed tomography (pQCT, Densiscan type, thin- and multi-layer technology). The distal, purely trabecular and purely compact bone mass of the radius and tibia are measured separately. The epiphyseal trabecular bone masses of the radius and tibia (262 +/- 8 mg/cm3 and 252 +/- 8 mg/cm3, respectively) are initially homogeneous, but over time they show different rates of yearly loss of bone mass: 3.0 +/- 0.4%, compared with 1.5 +/- 0.3% (means +/- SEM). Based on the bimodal frequency distribution of the annual loss rates in the core trabecular volume of the distal radius, fast losers lose more than 3.5% per year, with no significant difference between the first and the second year of observation. Women in the quintile with the highest trabecular bone mass (328 to 458 mg/cm3 at baseline) are slow losers. These women show an absolute loss of 3 mg/cm3 per year, while the women in the lowest quintile (102 to 210 mg/cm3 at baseline), with a proportion of 64% fast losers, lose an average of 10 mg/cm3, irrespective of age, number of fertile years, age at menopause and body-mass index. The bone masses in the metaphyseal compact bone remain constant.2+ a screening program before architectural changes in trabecular bone reach a critical point (i.e. in the reversible stage of osteoporosis), these women can be reliably identified within six months and monitored effectively and economically. With the general risk factors of postmenopausal osteoporosis an individual's risk of rapid bone loss cannot be predicted or determined; therefore, the precise measurement of purely trabecular bone is indispensable.

Aged↗
PubMed1993

[Occupation-specific indicators for strategic prevention in risk groups].

Using graphical representations to compare undistorted information it was attempted to bridge the gap between medicine and concerned risk-groups. Age-standardized mortality rates in 1979-1983 for 55 occupational groups (in 11 categories) of males aged 35 to 74 years were computed and compared to the Swiss national average; simultaneously the quantitative importance and the total mortality without accidents is shown for each occupational group: as an example the figure for lung cancer is reproduced. The elevated total mortality in the upper tertile of occupational groups is significantly explained by an increased risk of dying from circulatory or respiratory diseases, liver cirrhosis or malignancies of the lung, oropharynx, oesophagus or stomach. Foreseeable decrease of high-risk occupational groups will result in a further decline in mortality due to stomach cancer and cerebrovascular diseases in Switzerland.

Adult↗
PubMed1992

[Epidemiology of osteoporosis].

A representative inquiry (n = 4217) in Zürich revealed that 22% of the female population eats a diet poor in calcium. A connection between calcium-deficient nutrition and other unhealthy lifestyles such as lack of exercise, smoking (> 10 cigarettes/day) and regular alcohol intake (several glasses/day) has been shown by multivariate analysis. Therefore one has to suspect, that every third to fourth woman having several risk factors is at risk at entry in menopause. Primary prevention as a population-oriented strategy is therefore sought by general health-education and prevention of accidents in order to lower risks for fractures. Fractures of the collum femoris alone are on the basis of actual life expectancy in Switzerland responsible for 157,000 hospital days in women and 18,000 in men, corresponding to the annual capacity of an acute-cave hospital with 500 beds. With the aid of a risk-group strategy therefore attempts at secondary prevention are necessary. As a cost-effective screening-test every postmenopausal woman should receive a peripheral quantitative computer-tomography. Women with relatively high bone loss-rates and/or low bone density (insufficient stability) could thus be recognized and offered the benefit of an individualized compliance-promoting protective treatment.

Adult↗
PubMed1989

[Evaluation of the dose-effect relationship of perindopril in the treatment of arterial hypertension].

To evaluate the dose-effect relationship of antihypertensive drugs is essential to a rational determination of their effective dosage. Two double-blind and strictly controlled trials have demonstrated the effectiveness of perindopril 4 mg orally in the treatment of mild to moderate arterial hypertension (100 less than DAP less than 120 mmHg). The drug remained effective 24 hours after the last dose. The 2 mg dose proved insufficient to obtain a significant reduction of blood pressure. In case where the 4 mg dose was not sufficiently active, a better antihypertensive effect could be achieved with an 8 mg dose without major untoward reactions. The antihypertensive activity of perindopril was parallel to the percentage of angiotensin-converting enzyme inhibition induced by the compound. This study also illustrates clearly the value of semi-automatic blood pressure recording with the Dinamap system in the determination of dose-effect relationship, compared with the conventional sphygmomanometric method.

Administration, Oral↗
PubMed1989

Evaluation of the dose-effect relationship of perindopril in the treatment of hypertension.

The evaluation of the dose-antihypertensive effect relationship of a drug is essential for the rational determination of the effective dose. The efficacy and safety of the dose of 4 mg of perindopril in the treatment of mild-to-moderate hypertension were demonstrated by means of two double-blind studies conducted according to a rigorous methodology. This efficacy was still present 24 hours after the last dose of perindopril. The dose of 2 mg appeared to be insufficient to exert a significant antihypertensive effect. In the case of inadequate efficacy of the dose of 4 mg of perindopril, the dose of 8 mg is able to exert a greater antihypertensive effect without any major harmful effects. The antihypertensive efficacy is parallel to the percentage of converting enzyme inhibition induced by perindopril. The contribution of the automated method of blood pressure recording using the Dinamap method to establish a dose-effect relationship with reference to the classical sphygmomanometric method is clearly illustrated.

Adolescent↗
PubMed1988

[Cervix smear: study prevalence in city dwellers in the climacteric].

Prevalence of pap smear test has been investigated among a sample of urban women 45 to 54 years of age without hysterectomy (n = 3096). Prevalence of pap smear test for the last three years was 19% among women without gynaecological operation and 10% among women with a gynaecological operation (excepted hysterectomy). A multivariate analysis has shown that: 1. The lack of pap smear test was relatively high among nulliparous women as well as in multiparous women (greater than = 3 children). 2. This prevalence was high, on the one hand among overweight women and women with particular lifestyle (high alcohol and caffeine consumption, low calcium intake), on the other hand among women having adopted a good lifestyle (no use of birth control pills or hormonal therapy, no alcohol or caffeine consumption, diet without meat).

Female↗
PubMed1988

Infertility in Central Africa: infection is the cause.

Determinants of infertility were studied in 340 women in Eastern Gabon, an area situated in the "infertility belt" of Central Africa. Fallopian tube occlusion was diagnosed in 82.8% of cases, showing the importance of infection-related causes. Women with tubal occlusion did not differ significantly from women with normal tubes in obstetrical history or prevalence of Neisseria gonorrhoeae or Chlamydia trachomatis on endocervical culture. Antecedents of pelvic inflammatory disease or a pelvic mass were significantly more common in the group with tubal occlusion. This group also had a significantly higher prevalence of serum chlamydial antibodies at a titer of 1/64 or higher. Hormonal factors were found in 31.7% of women, a cervical factor in 29.0% and mechanical factors in 5.6%. No diagnosis could be made in 12.2% of cases. During the investigation, 4.4% of women became pregnant. The predominance of infectious related causes of infertility makes it imperative to focus resources on prevention programs of upper genital tract infections in women.

Adult↗
PubMed1988

Evaluation of the dose-effect relationship of a new ace inhibitor (perindopril) by an automatic blood pressure recorder.

Repeated blood pressure recordings by non-invasive devices are of better predictive value than single measurements in the evaluation of antihypertensive treatment. Such a method has been used to establish the dose-effect relationship of perindopril. After a two-week placebo run-in period, 40 patients with essential hypertension (age 56.6 +/- 1.5 years, 31 males, nine females) were treated with placebo or 2, 4 or 8 mg of perindopril once daily for one month following a randomized double-blind design. They were included if at least 75% of diastolic blood pressure recordings, made over an 8 h diurnal period using an automatic blood pressure recorder, were greater than 95 mmHg on placebo. Values (mean +/- SEM) before and after treatment were assessed using analysis of variance. These data showed a significantly greater reduction of blood pressure with 4 mg and 8 mg daily doses compared to placebo and the 2 mg daily dose. Such results were not obtained with blood pressure levels recorded by a mercury sphygmomanometer, confirming the value of an automatic blood pressure recorder as a tool in therapeutic trials.

Adult↗
PubMed1987

[Cancer mortality according to occupation].

The 55 profession groups, fully enclosing the male population of Switzerland, can be adjoined to a cancer risk category, according to their absolute and proportional mortality rate from 1979 to 1983 (age standardized for 35- to 74-years old). Lung-cancer mortality is for all building trade professions, even for building engineer and truck drivers, three times higher as for professions asking school-leaving examination. The carcinoma of the superior digestion tract and the bladder follow this falling incidence, while the opposite, profession specific falling incidence being shown by colon and rectum cancers and by the tumours of the lymphatic tissue and the prostata. Deduction of the results is cancer prevention: this should be carried out by a general, profession-orientated furtherance.

Adult↗