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Biomedical subjects

D P Mertz

Publications and source records attributed to D P Mertz.

At least 19 recordsLinked to original sources

[Is there a change in the trend of the risk factor profile in the adult population?].

In a comparative study of a total of 7169 unselected patients of both sexes, that has been admitted as inpatients for rehabilitation reasons concerning rheumatic diseases, has been examined which differences result between 1988 und 1990 with respect to the prevalence of overweight of more than 20% in relation to the individual ideal weight and to impairment of the carbohydrate metabolism. Age structure, professions and social levels were comparable in both populations. In comparison with the large upward trend of the risk factor profile between 1976 and 1988 there was a slight but significant increase of the prevalence of overweight between 1988 und 1990 only for males (53.9% vs. 57.7%), whereas among females the prevalence showed an insignificant downward trend (67.9% vs. 66.6%). At the same time the prevalence of an impaired carbohydrate metabolism did not differ significantly (10.5% vs. 9.5%). There is evidence for a small success of public and medical efforts to improve public health.

Adult

[First indications of decrease in the incidence of hyperuricemia in North Germany].

For the first time after onset of the economic miracle since 1948/49 the continuous considerable upward trend of the prevalence of hyperuricemia among the adult population in northern Germany seems to be stopped. In a comparative study of a total of 7169 unselected patients of both sexes, that has been admitted as inpatients for rehabilitation reasons predominantly concerning rheumatic diseases, has been examined which differences result between 1988 and 1990 with respect to the prevalence of hyperuricemia in relation to overweight. Age structure, professions and social levels were comparable in both populations. In comparison with the large upward trend of the risk factor profile between 1976 and 1988 the prevalence of hyperuricemia in males decreased significantly from an average of 17.9 per cent to 15.2 per cent. For females only an insignificant trend to a decrease of the prevalence of hyperuricemia (4.5 per cent vs. 4.2 per cent) was noted. In hyperuricemic males the prevalence of overweight of more than 20 per cent in relation to the individual ideal weight was significantly more frequent than in the whole male population (70.1 per cent vs. 57.7 per cent). Just as for obesity and diabetes mellitus the prevalence of hyperuricemia among the adult population in northern Germany appears to have culminated or crossed its summit. There is further evidence for a small success of public and medical efforts to improve public health. Of a total of 3584 patients who were investigated in 1990 1977 males showed a mean serum uric acid level of 5.71 +/- 1.62 mg/dl whereas in females the corresponding mean value was highly significantly less (4.22 +/- 1.06 mg/dl).

Adult

[Changes in the epidemiology, symptomatology and prognosis of gout].

Hardly any other disorder in this century has been subject to such strong changes--referring to epidemiology and symptomatology--as was gout. These changes were all linked to fundamental social upheavals. In the past 4 decades effective medicamentous possibilities of treating hyperuricaemia and gout have been added. The clinical picture of gout is being obscured by many and partly indiscriminate beginnings of treatment of innocuous or symptomless hyperuricaemias that were found by accident on the occasion of a medical checkup; attacks of gout and classical gout-specific morphological degenerations have become rare in spite of a still increasing number of hyperuricaemias among the general population. For these reasons epidemiological inquiries about gout lack any solid foundation. It is rather appropriate to speak only of "potential" gout, of a constellation which--if untreated--would probably mean manifest gout sometime. Because of the numerous accompanying diseases which usually attack patients with gout and which mostly occur combined with other disorders (such as obesity, lesions of the liver and kidneys, high blood pressure, disorders of the lipoprotein and carbohydrate metabolism), those patients' life expectancy--if they are not treated--is limited anyway. Most of these accompanying diseases can contribute to the development of an early severe atherosclerosis the consequences of which do lead to the death of most of the untreated "cases". Today gout as an arthropathy can be considered to be overcome--punctual and correct medical treatment provided; also the numerous accompanying diseases are well treatable today.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross-Sectional Studies

[Trends in the risk factor profile between 1976 and 1988].

In a comparative study of a total of 5740 unselected patients of both sexes, that had been admitted as inpatients for rehabilitation reasons concerning rheumatic diseases, it has been examined which differences result between 1976 and 1988 with respect to the prevalence of one or more of the following 5 diseases: diseases of the liver, arterial hypertension, disturbances of the lipid, uric acid or carbohydrate metabolism. Underlying were the same conditions and valuation standards. 2155 consecutively hospitalized patients in 1976 of a medium age of 53.75 +/- 10.89 years (standard deviation) were compared to 3585 patients with a medium age of 55.25 +/- 10.74 years in 1988. Age structure, professions and social levels were comparable in both populations. Whereas 1976 41.1% of the males and 27.9% of the females had one or more of the 5 diseases, this applied for 71.0% of the males and 59.5% of the females in 1988. Between 1976 and 1988 diseases of the liver, arterial hypertension, hyperlipoproteinemia and impairment of carbohydrate metabolism increased highly significant by 66%, 73%, 128% and 41%, respectively. Also hyperuricemia was found more frequently in 1988 among males than 1976 (17.9% vs. 14.2%), whereas among females the prevalence lowered significantly from 8.5% to 4.5% during this period. At the same time the prevalence of overweight of more than 20% of the ideal weight increased from 56.6% of the patients suffering from one or more of the 5 diseases in 1976 to 63.9% in 1988 significantly. Of a total of 3585 patients that was investigated in 1988 2395 patients (66.8%) had one or more of the additional diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Cause of Death

[The social medicine significance of rheumatic diseases].

There is no doubt that the various rheumatoid diseases constitute a socio-medical and socio-economic problem of first order. Surely the importance of this problem will even grow till around the turn of the millenium because the share of older people in the total population of the German Federal Republic is continuing to increase. Concerning frequency and duration the rheumatoid diseases figure at the top of all the insurance benefits. The following measures are essentials to a successful combat of this popular disease: Purposive information, prevention, early diagnosis, adequate treatment and a fitting the patient back into the productive process. Among the rheumatoid diseases the degenerative changes are ranking foremost in the range of frequency, unchallenged and at a considerable distance from the primarily inflammatory diseases. Arthroses and spondyloses are by no means a simple "articular detrition" but a disease in which the time factor is not always of decisive importance. There are ascertainable degenerative articular changes to be found in every person virtually by the age of fifty-five although not everybody has physical complaints. As to the increase in frequency observed in the past few years regarding fillings of applications for therapies because of so-called rheumatic complaints, changes of the conditions at someone's workplace alone cannot be blamed for it at all, rather bad posture and unsound stresses in one's leisure time as well as a new kind of consciousness of being sick supervene. A prophylactic healthful conduct depends strongly upon a person's social status and upon socio-cultural conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Disability Evaluation

[HDL diagnosis].

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Arteriosclerosis

[A simple test for quantitative determination of LDL-cholesterol].

The subject of the report is a novel precipitation test for the quantitative recording of LDL cholesterol based on the precipitation of LDL by dextran sulphate. Parallel assays of LDL cholesterol according to the new method and using quantitative lipoprotein electrophoresis as reference showed the results, in terms of the individual values and collectively, to be practically identical for a wide concentration range of various lipids and lipoproteins in the serum. The concentration ratio of the means obtained according to the two methods is 1.014 +/- 0.102 (standard deviation). The regression function displays a correlation coefficient of 0.9470. Double assays with the new technique yield a variation coefficient of 1.7 +/- 0.4%. Limitations of the method, which are insignificant for application in practice, are pointed out. The new precipitation method is simple, safe and useful for the quantitative estimation of the LDL cholesterol concentration in freshly obtained human serum. The method requires only little time and equipment.

Cholesterol, LDL

[Different levels of lipoprotein Lp(a) in adult diabetic patients depending on the therapeutic regimen].

A total of 60 newly admitted hospital patients with maturity onset diabetes mellitus and normal kidney function were studied. They were either treated only with a diet (group I), or also with blood-sugar lowering sulfonylureas (group II). Some patients had become insulin-dependent (group III). It was found that the mean serum concentration of lipoprotein Lp(a) was significantly increased in patients in groups II and III, but not in group I, as compared to the median of the group of 51 normal controls. All three groups of diabetics showed normal LDL cholesterol levels but lowered HDL cholesterol values, most pronouncedly in group II. Groups I and II, but not group III, showed a significant increase of the mean serum concentration of triglycerides and of the mean values for the LDL/HDL ratio as compared to normal controls. A correlation between the serum concentration of Lp(a) on the one hand, and the HbA1 value, LDL cholesterol, VLDL, HDL cholesterol, phospholipids, triglycerides and total cholesterol on the other, cannot be found for any of the three groups of diabetics.

Adult

Does benzbromarone in therapeutic doses raise renal excretion of oxipurinol?

Twenty male hyperuricaemic patients with normal kidney function were studied and it was found that the serum concentrations and excretions rates in the 24-hour urine of allopurinol and oxipurinol do not differ significantly after 9 days of oral treatment with either 300 mg allopurinol or a combination of 300 mg allopurinol and 60 mg benzbromarone daily. The sum of the excretion rates of the two pyrazolopyrimidines in the 24-hour urine represents 80.9% and 77.1%, respectively of the daily dose of allopurinol given alone or in combination with benzbromarone. As expected, the hypouricaemic effect of the combined therapy turned out to be stronger than that observed after monotherapy with allopurinol, due to the uricosuric component of benzbromarone. The difference was found to be highly significant.

Adult