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H Schulte

Publications and source records attributed to H Schulte.

At least 109 records · Page 6Linked to original sources
PubMed1989

Comparison of the reflectance method (Reflotron reflectance photometer) with the absorbance method (automatic analysers) for the determination of cholesterol.

The European Atherosclerosis Society (1) and the Expert Panel of the US National Cholesterol Education Program (2) have issued detailed guide values for recognition and management of hyperlipidaemia in adults. In these guidelines, the diagnosis of dyslipidaemia based on the measurements of total cholesterol, triacylglycerols, HDL and LDL cholesterol plays an important role. A prerequisite for the desired success of interventive measures is the reliability of the analytical data. The aim of this study was to investigate the precision and accuracy of Reflotron Cholesterol, a method based on the dry chemistry principle. Accuracy was assessed by establishing the correlation with the standardized automated methods used in routine lipid diagnosis. In addition, it was also examined whether the Reflotron Cholesterol results in plasma and blood are comparable. The Reflotron cholesterol (sample: blood) showed a good correlation with the CHOD/PAP method on a Hitachi 737 instrument (sample: plasma). The median value of the differences of the test results was -0.4%. Similarly, the method comparison of Reflotron Cholesterol (sample: blood) versus CHOD/PAP method on a SMAC instrument (sample: plasma) showed that Reflotron produces slightly (1.8%) higher results. The Reflotron Cholesterol values obtained from blood samples were slightly lower than those from plasma samples (median value of the differences: -2.2%). The results suggest that for routine purposes Reflotron Cholesterol provides results which are in good agreement with those obtained by standardized wet chemistry methods.

Autoanalysis↗
PubMed1989

[The course of Crohn disease and side effect profile with long-term treatment using metronidazole].

In a prospective study 21 patients with Crohn's disease not responding to standard treatment (salazosulfapyridine and/or corticosteroids) received metronidazole in a dose of 12 to 20 mg per kg body weight over 6 and 12 months respectively. The objectives were documentation of side effects and pharmacokinetic behaviour of metronidazole in relation to the course of the disease. In 3 months intervals and 3 months after the end of treatment activity indices were determined, the side effects of metronidazole were recorded and the drug plasma concentration was measured. Compliance of drug intake was excellent (94%). Best-Index decreased to a minimum after 6 months, orosomucoid after 3 months. Side effects from metronidazole (black tongue, dark urine, paraesthesia, metallic taste, epigastric pain, skin reactions, nausea) were reported by over 80% of the patients at any time of the study. Nearly 50% of patients developed paraesthesia, which was still present 3 months after the end of treatment. A mean dose of 15.4 mg per kg corresponded to a mean plasma concentration of 10.9 micrograms/ml of metronidazole. Plasma concentrations were not related to treatment success nor to the incidence of side effects. Treatment of Crohn's disease with metronidazole for longer than 3 months is not recommended both because of lack of additional therapeutic gain and because of the increasing risk of side effects.

Adolescent↗
PubMed1988

[Results of the "Munster Prospective Cardiovascular" study].

In the 'Prospective Cardiovascular Münster' (PROCAM) study since 1979 employees have been examined for cardiovascular risk factors and held under observation for the onset of clinically significant signs of atherosclerosis (myocardial infarction, stroke, coronary death). Until the end of recruitment (end of 1985) 20,060 male and female employees aged 17-65 from 52 industrial companies in Westfalia have participated. The voluntary examination at the start of the observation period includes a standardised questionnaire, a physical examination, blood pressure measurements and an ECG. Blood samples are taken after an overnight fast. The data presented here describe the longitudinal evaluation of initially healthy men aged 40 to 65 who had suffered no myocardial infarction or stroke before the examination. In an uniform follow-up period of four years 73 myocardial infarctions and coronary deaths were observed while 2681 men had survived without myocardial infarction or stroke. By far the best single parameter for establishing a risk group was HDL cholesterol. Using the characteristic hyper/dyslipoproteinemia which means cholesterol greater than = 300 mg/dl or HDL cholesterol less than 35 mg/dl combined with cholesterol greater than = 200 mg/dl and/or triglyceride greater than = 200 mg/dl or a multiple logistic function including age, cholesterol, HDL cholesterol, systolic blood pressure, cigarette smoking, diabetes mellitus, angina pectoris and a family history of myocardial infarction patients at high risk for coronary heart disease could be identified. More than two thirds of new events happened in each of these high risk subgroups, which comprise less than 20 percent of men under consideration each.

Adolescent↗
PubMed1988

The Prospective Cardiovascular Münster (PROCAM) study: prevalence of hyperlipidemia in persons with hypertension and/or diabetes mellitus and the relationship to coronary heart disease.

The ongoing Prospective Cardiovascular Münster (PROCAM) study was initiated in 1979. The objectives of this trial were to determine the prevalence of coronary heart disease (CHD) risk factors in the German population, improve the prediction and early detection of CHD, and derive recommendations for the primary prevention of vascular disease from the trial results. Of male PROCAM trial participants, ages 40 to 65 years, who had been free of myocardial infarction or stroke at the time of entry and had been followed up for 4 years, longitudinal data analysis shows that hypertension, diabetes mellitus, and hyperlipidemia are independent risk factors for CHD. The concomitant occurrence of these factors leads to a cumulative increase in CHD risk. Hyperlipidemia is a more significant risk factor for CHD than hypertension or diabetes mellitus. Ongoing data from 4043 men and 1333 women, ages 50 to 65 years, show that more than 50% of all diabetics are hypertensive. Cholesterol is slightly increased in male hypertensives and diabetics of either sex, whereas low-density lipoprotein cholesterol is slightly raised in male hypertensives and female diabetics only. The serum triglyceride concentrations are higher for hypertensives and markedly higher for diabetics of both sexes. High-density lipoprotein cholesterol concentrations are decreased in hypertensives, especially in hypertensive women, and even more so in diabetics. The European Consensus Conference for primary prevention of CHD has classified hyperlipidemia into five groups (A to E). For hypertensives, the proportion of patients in group D (cholesterol between 200 and 300 mg/dl and triglyceride levels between 200 and 500 mg/dl) is 20.4% for men and 6.2% for women, about twice as high as those in the control groups. The occurrence of combined (group D) or massive hyperlipidemia (group E: cholesterol greater than 300 mg/dl and/or triglycerides greater than 500 mg/dl) is prevalent in more than 30% of all diabetics: two to three times more frequently than in nondiabetic patients. When concomitant hypertension is included, this prevalence increases to more than 40% for diabetic men. Among those patients endangered by three risk factors, approximately 40% of all men and 60% of all women have the particularly atherogenic combination that includes lowered high-density lipoprotein cholesterol.

Adult↗
PubMed1987

The Prospective Cardiovascular Münster Study: prevalence and prognostic significance of hyperlipidemia in men with systemic hypertension.

The ongoing Prospective Cardiovascular Münster (PROCAM) trial was initiated to identify risk factors for coronary artery disease (CAD). By comparing patients' long-term cardiac status (clinical signs of atherosclerosis, myocardial infarction, stroke or death due to atherosclerotic disease) with results from entrance questionnaires, physical examinations, blood pressure measurements, electrocardiograms at rest and blood analyses, the characteristics and strategies for identifying people in the general population who are at risk for developing CAD were to be determined. From PROCAM trial data, 3 predictive criteria for identifying such people have been determined: They are a total cholesterol/high density lipoprotein (HDL) cholesterol ratio of 6.5 was determined to be the threshold for CAD risk. Combined analysis of lipid parameters identified high-risk patients as those with cholesterol values of greater than or equal to 300 mg/dl, and low-risk patients as those with cholesterol and triglyceride values less than 200 mg/dl. The remaining subjects are classified according to their HDL cholesterol values. If the HDL cholesterol value is less than 35 mg/dl, the subject is considered to be at high risk, if HDL cholesterol is greater than or equal to 35 mg/dl the patient is considered to be at average risk. The upper 20% of risk was computed by means of a multiple logistic function based on statistics for age, total cholesterol and HDL cholesterol levels, systolic blood pressure, angina pectoris, diabetes mellitus, cigarette smoking and family history of myocardial infarction. A further analysis was the risk incurred by hypertension. Hypertension was observed in 16.5% of men and 13.9% of women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

VLDL cholesterol and VLDL apolipoprotein B. Preliminary cross-sectional data of the prospective epidemiological study of company employees in Westphalia.

VLDL cholesterol concentrations were determined in 1641 male and 608 female and VLDL apolipoprotein B concentrations in 505 male and 211 female company employees in Westphalia aged 17-70 years. VLDL cholesterol and VLDL apolipoprotein B values were found to be distributed with positive skew in both sexes but were higher in men than in women (median in men: VLDL cholesterol 0.30 mmol/l, VLDL apolipoprotein B 0.066 g/l, median in women: VLDL cholesterol 0.18 mmol/l, VLDL apolipoprotein B 0.047 g/l). In males VLDL cholesterol and VLDL apolipoprotein B were closely correlated to each other (r = 0.757) as well as to triacylglycerols (VLDL cholesterol: r = 0.673, VLDL apolipoprotein B: r = -0.419). In females these observed correlations were weaker. The VLDL cholesterol/VLDL apolipoprotein B ratio was also higher in men (median 4.28 mmol/g) than in women (median 3.15 mmol/g). The ratio correlated to triacylglycerols (men: r = 0.591, women: r = 0.321). The results suggest that the composition of VLDL may be related to triacylglycerols in serum.

Adolescent↗
PubMed1986

HDL apolipoprotein A-I and HDL apolipoprotein A-II concentrations in male company employees in Westphalia aged 40 years and older.

The major structural components of high density lipoproteins were determined in the sera of 638 male employees aged 40 years and older. It was demonstrated that the HDL apolipoprotein A-I/HDL cholesterol ratio as well as the HDL apolipoprotein A-II/HDL cholesterol ratio are similarly correlated to a cumulative score of established risk factors for atherosclerosis. Most important, however, is the finding that the correlation of these ratios to the risk factor rating of atherosclerosis is found in subgroups with normal or elevated HDL cholesterol values. Furthermore, it is shown that the relative content of apolipoproteins A-I and A-II in individual HDL is partly dependent on the plasma concentration of HDL cholesterol and triglycerides. It is concluded that HDL composition may have an additional predictive significance for the development of atherosclerosis.

Adult↗
PubMed1986

Association of apolipoprotein E polymorphism, low-density lipoprotein cholesterol, and coronary artery disease.

We determined the frequencies of genetic apolipoprotein E isoforms in 570 survivors of myocardial infarction, all with demonstrable coronary heart disease, as compared with 624 healthy persons. In controls, E-4/E-3 heterozygosity was associated with total cholesterol concentrations of 1985 (SD 364) mg/L and low-density lipoprotein (LDL)-cholesterol concentrations of 1306 (SD 332) mg/L. Significantly lower values, 1811 (SD 312) mg/L and 1121 (SD 274) mg/L, respectively, were observed for E-3/E-2 heterozygous persons. In survivors of myocardial infarction, the respective values were significantly higher than in controls, differing between E-4/E-3 and E-3/E-2 heterozygous patients by 233 and 220 mg/L, respectively. Moreover, E-4/E-3 heterozygosity was accompanied by earlier age of myocardial infarction (48.8 +/- 7.4 years) as compared with E-3/E-2 heterozygosity (53.4 +/- 6.9 years) and E-3/E-3 homozygosity (51.2 +/- 7.7 years). Evidently, apolipoprotein E polymorphism can contribute to total and LDL-cholesterol concentrations in serum, thereby affecting risk of coronary heart disease and myocardial infarction.

Age Factors↗
PubMed1986

[Significance of lipids in the diagnosis of coronary heart disease in patient groups and individuals].

Several epidemiologic studies confirmed the significance of the risk ratio cholesterol/HDL-cholesterol in predicting coronary heart disease. Therefore we examined the lipid values of 364 men and 133 females who underwent coronary arteriography because of angina pectoris and/or pathological ECG changes at rest or during exercise stress testing. Although patients with coronary heart disease showed higher cholesterol (male 238 mg/dl vs. 210 mg/dl, female 251 mg/dl vs. 219 mg/dl, p less than 0.001), higher triglycerides (male 204 mg/dl vs. 162 mg/dl, female 179 mg/dl vs. 125 mg/dl, p less than 0.001) and significantly lower HDL-cholesterol levels (male 39.9 mg/dl vs. 44 mg/dl, female 45.9 mg/dl vs. 54.9 mg/dl, p less than 0.01) than the control group, lipid values did not lead to a good discrimination between patients with or without coronary heart disease. The patients' histories and ECGs showed a higher sensitivity (male 83%/male 85%) and specificity (male 81%/female 83%) than the lipids (sensitivity male 57%/female 67%, specificity male 55%/female 74%). We conclude from our results that blood lipids, the risk ratio cholesterol/HDL-cholesterol and other risk factors are diagnostic tools which have to be handled with caution when applied to the individual patient with suspected coronary heart disease.

Angina Pectoris↗
PubMed1986

[Hemodynamic side effects of an ionic and a nonionic roentgen contrast medium in patients with heart valve diseases and pulmonary hypertension].

The purpose of this study was to compare the hemodynamic side effects of an ionic and a nonionic contrast medium intra-individually. 20 patients with valvular heart disease (NYHA III-IV) and pulmonary hypertension (PPAsyst greater than or equal to 40 mm Hg) received injections of 40 ml iopamidol (0.8 osmol/kg) and 40 ml amidotrizoate (2.1 osmol/kg) into the right atrium. Heart rate and cardiac output, as well as right atrial, pulmonary-artery, pulmonary-capillary, and aortic pressures were measured. Peripheral and pulmonary vascular resistance and stroke volume were calculated. Right atrial pressure increased more after amidotrizoate (p less than 0.001). Pulmonary artery pressure was elevated with both contrast media to the same extent. An increase in aortic pressure was seen after iopamidol, while a decrease occurred after amidotrizoate (p less than 0.01). Amidotrizoate caused a more marked increase in heart rate (p less than 0.001) and cardiac output (p less than 0.001). Stroke volume was increased with both contrast media. Pulmonary vascular resistance decreased after amidotrizoate as well as after iopamidol, but systemic vasodilatation was more pronounced following injection of amidotrizoate (p less than 0.001). In general, iopamidol caused less hemodynamic side effects than amidotrizoate. Thus, nonionic low osmolality contrast media provide decreased risks in patients with valvular heart disease and elevated pulmonary artery pressures undergoing angiocardiography and intravenous digital subtraction angiocardiography.

Adult↗
PubMed1985

Epidemiological study on factor VII, factor VIII and fibrinogen in an industrial population--II. Baseline data on the relation to blood pressure, blood glucose, uric acid, and lipid fractions.

In a preceding paper the baseline data in the Münster Arteriosclerosis Study (PROCAM study) of the levels of fibrinogen, factor VIIc and factor VIIIc were described, and their correlation of age, body weight, smoking, alcohol, pill-using and menopause discussed. In this part the relationship of these coagulation factors to blood pressure, blood glucose, uric acid and lipid parameters, which were examined in 4186 apparently healthy individuals, is presented. The correlations are described using two different statistical models, first the Pearson correlation coefficients after allowing each clotting factor for the effects of age, cigarette and alcohol consumption, body weight, menopausal state, pill using and the other clotting factors, and secondly by a multiple regression analysis. The data suggest that there are multiple interrelationships between hemostatic factors and the variables under consideration. The most striking positive correlations were found for factor VIIc to blood glucose and triglycerides in men and women and to HDL-cholesterol in women.

Age Factors↗
PubMed1985

Epidemiological study on factor VII, factor VIII and fibrinogen in an industrial population: I. Baseline data on the relation to age, gender, body-weight, smoking, alcohol, pill-using, and menopause.

The Münster Arteriosclerosis Study (MAS) is a prospective, longitudinal epidemiological study on an industrial population in Westfalia aimed to establishing clinical and laboratory data with possible relationship to cardiovascular events. The data presented here describe the baseline measurements of fibrinogen, factor VIIc and factor VIIIc from the recruitment of 2880 male and 1306 female persons and their relationship to age, gender, bodyweight, smoking, alcohol, pill-using and menopause. The correlations were made by means of a multiple regression analysis. We found an increase of those coagulation factors with age, a correlation of F VII and fibrinogen with body-weight index and of fibrinogen with cigarette smoking. No correlation was found for alcohol consumption. F VIII and F VII were significantly higher after onset of menopause and F VII and fibrinogen in women using the pill.

Adolescent↗
PubMed1985

Influence of low molecular weight heparin on the hemostatic system after abdominal surgery.

The hemostatic effect of two low molecular weight heparin fractions and of one unfractionated heparin preparation administered subcutaneously b.i.d. was examined in 6 healthy subjects and in 53 patients after major abdominal surgery. Among other tests platelet count, prothrombin time, fibrinogen, beta-thromboglobulin, antithrombin, antiplasmin, FPA and F-CB 3 related antigen, as well as various heparin activities, were repeatedly determined pre- and postoperatively. Under all tested conditions the low molecular weight fractions induced higher heparin levels, both in terms of anti-Xa and of anti-thrombin activity. No further significant differences of the laboratory results between the treatment groups were documented. Total blood loss measured at the first postoperative day was higher in patients with malignancy and negatively correlated with antithrombin and antiplasmin levels, while no relation was observed with the heparin activities and the other tested parameters. Whereas evidence for a hemorrhagic property of the tested low molecular weight heparin fractions was found, a particular mechanism underlying this effect could not be identified.

Abdomen↗
PubMed1984

Clinical efficacy of low molecular weight heparin in postoperative thrombosis prophylaxis.

In a randomized controlled clinical trial, the efficacy and safety of two low molecular weight heparin ( LMWH ) fractions in the prophylaxis of deep vein thrombosis (DVT) were assessed. One hundred twenty-six patients undergoing major abdominal surgery received alternatively 2,500 APTT units b.i.d. of two LMWH fractions or 5,000 APTT units b.i.d. of an unfractionated sodium mucosal heparin ( UFH ). LMWH 2 differed from LMWH 1 by presenting a lower mean molecular weight and a higher anti-Xa/APTT ratio in vitro. Patients were randomly allocated to the three groups, and the development of DVT was studied with the 125I-fibrinogen uptake test ( RFUT ). The study was interrupted and the code broken prematurely because of otherwise unexplainable bleeding events. While no thrombosis and no severe bleeding were detected in the UFH group, three (7%) RFUT -positive DVT and two (5%) hemorrhagic complications occurred in the LMWH 1 group. No thrombosis and nine (22%) cases of severe bleeding were observed in the LMWH 2 group. Thus, the latter group differed significantly from the control group with regard to subjective and objective criteria for postoperative bleeding. Although these results do not allow general conclusions as to the value of LMWH fractions in the prevention of DVT, they indicate that these preparations just as ordinary heparin have a limited therapeutic range.

Adult↗