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M Rickenbach

Publications and source records attributed to M Rickenbach.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Regular assessment of cardiovascular risk factors and diseases: a valuable tool or not? (The MONICA experience)].

An important aspect of public health policy is the information system through which the health of the whole population and of particular groups at risk can be monitored. In Switzerland, a first national health survey (SOMIPOPS) was carried out in 1981-1982 by questionnaire and interview and paved the way for implementation of the Swiss Health Survey, whose first test run is currently ongoing. Periodic health examination surveys including measurements of physical characteristics have been conducted only at a regional level in the framework of the WHO project MONICA (MONItoring of trends and determinants in CArdiovascular disease). The mainly French-speaking cantons of Vaud and Fribourg and the Italian-speaking canton of Ticino take part in this project and the levels of the major cardiovascular risk factors were measured on representative samples of the population in 1984-86 and in 1988-89. A similar survey was conducted in the German-speaking city of Basel in 1989/89. These studies allow time trend and geographical analysis, and some comparisons are presented in terms of age-standardized prevalence rates of the risk factors. The discussion focuses on the desirability of implementing a periodic health examination survey at the national level. One main advantage of such surveys is that variables of particular interest at a given time can be added to the usual set of measurements, as was the case for blood lead, vitamin D and apolipoproteins in the MONICA surveys.

Cardiovascular Diseases↗
PubMed1992

[Developments in the treatment of myocardial infarction in Switzerland 1986-1990: results of a population survey].

The Swiss cantons of Vaud and Fribourg participate in the international MONICA project (MONI-toring of trends and determinants in CArdiovascular disease). Within this context, drug therapies and procedures were recorded during two separate years (1986 and 1990) for all hospitalizations of men aged 25 to 64 with the diagnosis of myocardial infarction. The medical files were reviewed to classify this diagnosis as possible or definite on the basis of the symptoms, the ECG results and the enzymatic tests. The two study populations (n = 318 in 1986 and n = 332 in 1990) are comparable with respect to age, history of ischemic heart disease and initial care. In 1990, half of the patients arrived at hospital in less than 3 hours, the median time delay being 4 hours for those first attending a general practitioner and 2 hours for those transferred directly. The frequency of treatments between 1986 and 1990 is compared only for cases with a definite diagnosis of myocardial infarction (respectively n = 217 and n = 223). The proportion of patients given thrombolytic therapy rose from 9% to 44% (p < 0.005) and from 51% to 95% (p < 0.005) for those treated with antiplatelet drugs, whereas the proportion fell from 72% to 55% (p < 0.005) for calcium blockers and from 33% to 24% (p < 0.05) for inotropic drugs. The use of anticoagulants (in 98% of patients) and of beta blockers (in 57%) remained stable across time.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1992

Serum 25-hydroxyvitamin D: distribution and determinants in the Swiss population.

The serum 25-hydroxyvitamin D [25(OH)D] concentration was measured in a representative sample of the general adult population in Switzerland (n = 3276). The median concentration was 46 nmol/L and no significant difference was found between men and women. Between the ages of 25 and 74 y, 25(OH)D was not significantly correlated with age (r2 = 0.01). Six percent of the population was vitamin D deficient [ie, 25(OH)D less than or equal to 20 nmol/L] and between 34% and 95% had a relatively low concentration of vitamin D (ie, less than 38 or less than 95 nmol/L, respectively). Among the determinants of low 25(OH)D were indicators of little sunshine exposure, such as the winter season [odds ratio (OR) 2.4, 1.5-3.7 (95% confidence interval)] and less than 30 min of time spent outdoors daily by individuals greater than 65 y of age (OR 5.6, 1.5-21.2), as well as indicators of low nutritional intake of vitamin D, such as the absence of regular intake of butter or margarine (OR 2.0, 1.3-3.1) and the consumption of few dairy products (OR 1.7, 1.2-2.4).

25-Hydroxyvitamin D 2↗
PubMed1991

[Acute viral hepatitis in Switzerland: physicians' reports from 1984 to 1987].

In 1983, the regulation on reporting transmissible diseases was extended. At that time, the doctors were obliged to report all cases of acute viral hepatitis to the Cantonal physician. The Federal Office of Health commissioned a statistical evaluation of the reports from the years 1984 to 1987. Of the 4543 reports analysed, 40% relate to hepatitis A, 47% to hepatitis B and 7% to non-A non-B hepatitis. Men suffered hepatitis more frequently than women, with the exception of the non-A non-B hepatitis, where the sexes are roughly equally represented. Adolescents and young adults are the most frequently affected age group for all types of hepatitis. Those dependent on drugs have a particularly high risk of infection for all types of hepatitis. The cases of hepatitis occurring after journeys abroad are even more significant in terms of numbers. The medical personnel can no longer be regarded as a high-risk group. An age-standardized comparison shows that, with regard to hepatitis B, the risk for men in medical professions is the same as the average risk for all men, while the risk for women is still slightly higher than that for the female population as a whole.

Adolescent↗
PubMed1991

[Incidence of use of various myocardial infarct treatments in 2 Swiss regions].

Two regions in Switzerland (Vaud-Fribourg and Ticino) participate in the WHO MONICA project (MONItoring of trends and determinants in CArdiovascular disease). Within this context, all hospitalizations of men for ischemic heart disease will be recorded during a period of ten years. All cases are classified according to uniform criteria, in three categories: definite myocardial infarction, possible myocardial infarction or no myocardial infarction. In 1986, the records were completed with a summary of treatments. The treatment of 334 patients with definite myocardial infarction, aged between 25 and 64 years, surviving after 27 days are analyzed (VD-FR: 217; TI: 117). Results show that anticoagulants were administered in a routine fashion (in 97% of the cases), whilst thrombolysis, applied in 1986 by only one hospital in each area, concerned only 9% of the patients. As compared to Ticino, VD-FR distinguished itself by its significantly higher use of anti-arrhythmia drugs (69% versus 47%; p less than 0.005), nitrates (97% versus 86%; p less than 0.005) and beta-blockers (57% versus 43%; p less than 0.05). Furthermore, patients from VD-FR spent more time in the intensive care unit (6.4 versus 3.7 days; p less than 0.005) and participated more frequently in rehabilitation programmes (47% versus 12%; p less than 0.005). The discussion compares the observed therapy with results published in the literature.

Adrenergic beta-Antagonists↗
PubMed1991

Lifestyle and environmental factors as determinants of blood lead levels in a Swiss population.

The determination of blood lead levels was included in a Swiss population survey on cardiovascular risk factors in 1984-1985; 931 men and 843 women aged 25 to 75 years participated in the study. Mean blood lead levels (+/- SD) were 0.63 +/- 0.27 mumole/liter for men and 0.44 +/- 0.19 mumole/liter for women, respectively, with a slight increase with age for both sexes. These values are below the maximum level recommended by the Commission of the European Community in 1977; 18 cases were found with blood lead higher than 1.5 mumole/liter and in six of these, a professional exposure was suspected. Smoking habits, drinking habits, and consumption of dairy products were selected as lifestyle descriptors and educational level, occupational category, and size of the community as sociodemographic indicators. Smoking and alcohol consumption show a direct association with blood lead, consuming dairy products an inverse one. Occupation and level of education are significantly related to blood lead only for men, blue-collar workers and less-educated men being more exposed. A higher blood lead level in cities was only found for women presumably because they stay at home more often than men and are therefore more sensitive to local exposure. In a multiple stepwise logistic regression, the lifestyle indicators showed a consistently stronger effect on blood lead than sociodemographic indicators. For men, smoking has an effect on blood lead for blue-collar workers much stronger than that for nonindustrial employees and may compound in some way the professional exposure to lead. This stresses the fact that interactions between lifestyle and environmental factors on blood lead are significant, complex, and need further investigation.

Adult↗
PubMed1990

[Total cholesterol, HDL-cholesterol and blood pressure in relation to life style: results of the first population screening of the Swiss MONIKA Project].

To evaluate the association of individual health habits with levels of cardiovascular risk factors such as serum cholesterol and blood pressure, data from a representative population sample of 860 men and 788 women, aged 25 to 64 years and residing in Western Switzerland, were analyzed cross-sectionally. The data had been collected during 1984/85 as a part of the WHO MONICA project, an international research project on the epidemiology of cardiovascular diseases. In age-adjusted analysis, a score of prudent diet was a reasonably strong inverse correlate of total cholesterol in men (p less than 0.001) but less so in women (p = 0.11); the diet score was unrelated to HDL cholesterol. In both genders, alcohol consumption was associated with elevated levels of systolic and diastolic blood pressure (men: both p less than 0.001; women: p = 0.05 and 0.01 respectively) and of HDL cholesterol (men and women: p less than 0.001). Coffee consumption was unrelated to either blood lipids or blood pressure. In both men and women, leisure-time exercise was a predictor of a low-risk lipid profile, i.e. a low total cholesterol/HDL ratio (both p less than 0.001). Better educated persons, especially women, revealed consistently lower levels of cardiovascular risk factors. The independent character of these lifestyle-risk factor-associations was largely confirmed in a multivariate analysis, with cigarette smoking emerging as another significant predictor of a deteriorated lipid profile, while education was not an independent determinant of biological risk factors. Lifestyle variables, including body mass index, explained 9 to 19% of variance in cardiovascular risk factors, with relative weight being the strongest of the predictors related to behaviour. Entering age and sex into the regression models enhanced the predictive power of the equations to 16 to 26% explained risk factor variance. We conclude from this population-based, cross-sectional study that personal health habits such as diet, exercise, alcohol consumption and smoking, as well as body weight are significantly and independently related to blood lipid and blood pressure levels; the apparent size of effect of these behavioural traits on biological risk factors for cardiovascular diseases was only modest, but it may nevertheless be relevant to prevention.

Adult↗
PubMed1990

Some determinants of body weight, subcutaneous fat, and fat distribution in 25-64 year old Swiss urban men and woman.

Data from a predominantly urban sample of 116 men and 130 women aged 25-64 years and collected in 1984/85 as a part of the Swiss WHO MONICA project, were analysed cross-sectionally to study the interrelationship between relative weight, subcutaneous fat and fat distribution, as well as the dependence of these anthropometric characteristics on behavioral and sociodemographic factors. Skinfold thicknesses were found to increase with age almost linearly in women, while in men they increased only before age 40 to 45. Subcutaneous fat was, but fat distribution was not, highly correlated with relative weight in both sexes. Alcohol consumption, healthy dietary habits (inversely), and exercise (inversely) were all significantly related to subcutaneous fat in men, while the relatively strongest predictors of female skinfold thicknesses were smoking (inversely), coffee consumption, and education (inversely). In multivariate analysis, environmental factors explained up to 10% of skinfold variance in male subjects and between 10 and 15% in females. Fat distribution was more influenced by environmental factors in men (about 8% of explained variance) than in women (about 4%). In men, truncal fat depended more on lifestyle that did upper arm fat, with smoking (directly) and exercise (inversely) being relatively most predictive of abdominal fat. We conclude that, although relative weight, subcutaneous fat, and fat distribution correlate intra-individually, they are not equivalent and interchangeable anthropometric characteristics. This is reflected by the varying associations of the three fatness indicators with age and environmental factors such as smoking, diet, exercise, and education. Gender seems to be an important modifying factor of environment-body fat-associations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1990

Variation in coronary risk factor levels of men and women between the German-speaking MONICA centres.

The aim of this analysis was to compare levels of risk factors for coronary heart disease (CHD) in men and women aged 25-64 years between German-speaking MONICA collaborating centres, the German Democratic Republic (GDR), Augsburg - the Federal Republic of Germany (FRG)(Au), Bremen - FRG (Br), Heidelberg - FRG (He), and Vaud/Fribourg - Switzerland (CH, with a German-speaking minority). Prevalence of cigarette smoking in men showed little variation in four centres (34 to 40%) and was higher in BR men (49%), while it varied from 17% (GDR) to 33% (BR) in women. Mean total serum cholesterol values (mmol/L) were highest in GDR and CH men (both 6.2) and GDR women (6.1), and lowest in both He men (5.7) and He women (5.6). The proportion with cholesterol values greater than or equal to 6.7 mmol/L was largest in CH men (34%) and smallest in FRG (He) women (17%), while lowering the cut-off point from 6.7 to 6.5 mmol/L raised the prevalence of hypercholesterolaemia in all centres by 5 to 10%. Mean values (mmHg) of blood pressure (BP) were highest in both GDR men (140/88) and women (138/86), as was the prevalence of hypertensive BP values. In all centres, women aged 25-34 had BP values approximately 12/5 mmHg lower than age-matched men, but BP values similar to men at age 55-64, which indicates that age-parallel increase in BP was steeper in women than men.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Sports correlate with positive living habits. Results from the population survey the Swiss MONICA project].

Exercise is associated with positive health habits: Findings from the populations survey of the Swiss MONICA-project. Relatively little is known on population-wide relations of habitual exercise to relevant health factors such as diet, cigarette smoking and overweight. Data from a population-based sample of approximately 800 men and women each, aged 25-64, collected in western Switzerland as a part of an international WHO-project, were used to examine cross-sectionally the interrelationships between different lifestyle factors. Men and women training regularly (i.e. greater than or equal to 2 times/wk) exhibited consistently and highly significantly more favourable health habits, regarding diet (i.e. trimming visible fat, higher intake of fruits, salad and vegetables, yogurt and cottage cheese), nonsmoking, and weight control. Men and women with at least some regular physical activity during leisure-time had in turn more favourable health habits than their sedentary counterparts. In both sexes, educational level was directly related to exercise and a healthy diet, and inversely related to smoking and relative weight. Regularly training men and women also had a significantly improved lipid profile compared to inactive ones. It is concluded from this study that leisure-time physical activity and exercise are related to a positive health behaviour including diet, nonsmoking and efficient weight control. This may suggest that exercise should possibly be integrated into any population-wide attempts and efforts to promote health to enhance primary prevention.

Adult↗
PubMed1988

[Screening for and treatment of risk factors of cardiovascular diseases: need for a strategy?].

A major reduction in ischemic cardiovascular diseases depends on prevention of risk factors (RF) for atherosclerosis. To assess how screening and treatment of these RF were undertaken in an outpatient setting, we reviewed 300 charts of Swiss men (age 17 to 86, mean 50) who were compliant with medical follow-up. We noticed that the six RF taken into account were insufficiently investigated among young people. Furthermore, hypercholesterolemia was largely underinvestigated, even in the presence of other RF for atherosclerosis. These findings indicate that both the importance of early detection and the clinical significance of dyslipidemia are underestimated by physicians. This situation would be improved by a health policy adapted to Swiss medical practice which defined rules of screening and treatment of RF for atherosclerosis.

Adolescent↗
PubMed1988

[Total plasma cholesterol and HDL in a Swiss population: what attitude and norms should be adopted?].

The reports on the effectiveness of blood lipid lowering in the primary prevention of ischaemic heart disease have promoted the development of statements and strategies for decreasing plasma cholesterol levels. As the risk of ischaemic heart disease gradually increases with the serum cholesterol level, a shift of the whole cholesterol distribution curve towards lower cholesterol values not exceeding 5.2 mmol/l is found to be desirable. The population survey conducted in the cantons of Vaud and Fribourg, as part of the MONICA-project, has yielded the data about the distribution of serum total and HDL-cholesterol for a representative sample of the population. 34% of men and 30% of women aged 25 to 74 have a blood cholesterol value exceeding 6.7 mmol/l, the percentage of people with high cholesterol levels increasing with age, especially in women. HDL-cholesterol levels, higher in women than in men, remain fairly constant according to the particular age group concerned. On application of the norms proposed by the US Consensus Conference on blood cholesterol, one finds that 32% of women and 37% of men have to be considered as 'high risk' and 18% of both sexes at 'moderate risk' concerning the development of coronary heart disease. The consequences of the application of such norms in Switzerland, as well as the current cholesterol values of the Swiss population as compared to those obtained earlier on in Switzerland and the USA have to be considered on a large scale in order to draw up a global strategy for health promotion and the prevention of cardiovascular disease.

Adult↗
PubMed1988

Combining repeated blood pressure measurements to obtain prevalences of high blood pressure.

Blood pressure (BP) levels may be classified as normal, borderline, or high with respect to the World Health Organization (WHO) criteria, but most studies like the MONICA project require at least two BP measurements and must tackle the problem of combining the results of the different readings into a single value for classification. The Swiss MONICA project measured the blood pressure of 1872 individuals in the areas of Vaud and Fribourg. Second BP readings were, on average, lower than the first by 3.2 mmHg for systolic and 1.1 mmHg for diastolic BP. These differences, while trivial at the individual level, nevertheless generate significant effects on prevalences of high BP. The first reading, the second, the mean, and the lowest yield prevalences of 14%, 10%, 11% and 9% respectively. Therefore, any published prevalence of high blood pressure should specify the method of measurement, the number of readings taken, and the way results were combined.

Adult↗
PubMed1987

Health problems after travel to developing countries.

Travelers to developing countries participated in a follow-up study of the health risks associated with short (less than three months) visits to these nations. Travelers to the Greek or Canary Islands served as a control cohort. Participants completed a questionnaire to elicit information regarding pretravel vaccinations, malaria prophylaxis, and health problems during and after their journey. Relevant infections were confirmed by the respondent's personal physician. The questionnaire was completed by 10,524 travelers; the answer rate was 73.8%. After a visit to developing countries, 15% of the travelers reported health problems, 8% consulted a doctor, and 3% were unable to work for an average of 15 days. The incidence of infection per month abroad was as follows: giardiasis, 7/1,000; amebiasis, 4/1,000; hepatitis, 4/1,000; gonorrhea, 3/1,000; and malaria, helminthiases, or syphilis, less than 1/1,000. There were no cases of typhoid fever or cholera.

Adult↗
PubMed1986

[Skinfold measurement and body fat: precise assessment of excess weight in an epidemiologic survey?].

By definition, obesity corresponds to the presence of a mass of fatty tissue that is excessive with respect to the body mass. Body fat can be calculated in terms of age and sex by measuring the skinfold thickness in several different places. During the MONICA project, the survey of cardiovascular risk factor prevalence enabled us to measure the thickness of four skinfolds (biceps, triceps, subscapular, suprailiac) in 263 inhabitants of Lausanne (125 men, 138 women). In men aged 25-34, 21 +/- 5% of the body mass was composed of fat, in women 29 +/- 4%. The proportion of fat increases to 31 +/- 7% in men and 41 +/- 6% in women aged 55-64. A robust regression allows body fat to be simply expressed in terms of the body mass index. This allows us to confirm the validity of this index for evaluating the degree of obesity during an epidemiological study.

Adipose Tissue↗