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Biomedical subjects

R Darioli

Publications and source records attributed to R Darioli.

At least 55 records · Page 3Linked to original sources
PubMed1991

Relationship of fasting serum insulin concentrations with blood pressure in a representative sample of the adult population of the Seychelles.

Several studies have been performed to determine if plasma insulin concentration bears a relationship with blood pressure and may be a causative factor in the genesis of hypertension. The results reported were discrepant between studies: insulin was observed to be independently correlated with blood pressure in some studies, whereas no such relationship was observed in others. Serum insulin, whole blood glucose, weight, height, and diastolic and systolic blood pressure of 839 fasting individuals, randomly selected from the adult population of Mahé Island, The Seychelles, were recorded; this population has a high hypertension prevalence rate. The proportion of hypertension was higher in subgroups of individuals with diabetes mellitus (52.4 percent) and with overweight (34.5 percent) than in the general population. Subgroups of individuals with diabetes, excessive weight or high blood pressure had higher mean fasting plasma insulin (13.6 +/- (s.d.) 7.9, 14.0 +/- 8.0, 11.1 +/- 9.7 respectively) than individuals not affected with these conditions (8.1 +/- 4.6 microU/ml). Both systolic and diastolic blood pressure were positively correlated with age, body mass index and fasting blood glucose in a multivariate model. No correlation with insulin was observed. In contrast, in a subgroup of 223 overweight individuals, age, blood glucose and plasma insulin were each positively correlated with blood pressure. It is concluded that, in this cross-sectional study, insulin was not independently correlated with blood pressure except for overweight individuals.

Adult↗
PubMed1990

[Should elderly persons be vaccinated?].

The susceptibility to infectious diseases in the elderly may be explained by the age-related physiological immune deficiency. Influenza and pneumococcal infections are the most frequent ones in this age. These infections can be efficiently prevented by vaccination, a fact that is often not considered. Other vaccinations should be considered in risk circumstances, such as travel to foreign countries. The lack of vaccination programs for the elderly constitutes a problem which should be resolved.

Age Factors↗
PubMed1990

[Evaluation of tolerance, efficacy and safety of 3-year simvastatin use in the treatment of primary hypercholesterolemia].

Simvastatin (synvinolin MK-733) is a potent inhibitor of 3-HMG-CoA-reductase, the key enzyme for cholesterol biosynthesis. To investigate the efficiency and safety of this new drug on a long term basis, simvastatin was administered for 3 years to ten patients with type II hyperlipoproteinemia. Daily dosages were 20 or 40 mg. The drug therapy produced a significant reduction in serum levels of total cholesterol (19-34%), LDL-cholesterol (26-44%) and Apo B (19-33%). Triglycerides decreased moderately (2-23%) while HDL-cholesterol and Apo A1 changed only slightly (-3 to 6% and 5-13% respectively). Simvastatin was well tolerated. No consistent adverse clinical or biochemical effects were observed during the three-year therapy. The results indicate that simvastatin is a promising new therapy for high risk hypocholesterolemic patients.

Aged↗
PubMed1990

[Vaccinations for travel abroad].

Travel to the developing world by Swiss citizens has been increasing. Vaccine-preventable diseases challenges the physician to provide pre-travel advice. Each traveler's itinerary, duration of stay and medical history, including previous immunization, should be reviewed. Vaccinations are required or recommended according to the requirements and the epidemiology of countries being visited. This article summarizes updated recommendations to individual vaccines and immunoglobulins.

Child↗
PubMed1989

[Hyper-HDL-cholesterolemia: prevalence and clinical aspects].

The prevalence and clinical aspects of high-HDL-cholesterolemia were investigated in 2000 patients (1215 males and 785 females) aged 14-88 years in our medical outpatient department. The incidence of high-HDL-cholesterolemia was 7% (greater than 1.68 mmol/l) in males and 9.9% (greater than 1.94 mmol/l) in females and was associated in 80% of cases with a normal lipid profile according to the Fredrickson classification. Compared with patients with low-HDL-cholesterolemia, high-HDL-cholesterolemia distinguished by a lower incidence of obesity, of hyperlipidemia, of diabetes and of cigarette smoking. In contrast, daily alcohol intake was significantly higher. Fewer patients had a history of ischemic cardiovascular events. High-HDL-cholesterolemia appears to arise from both environmental and genetic factors.

Adolescent↗
PubMed1989

[Medical evaluation of travelers returning from the tropics: which diagnostic studies and for whom?].

Annually ten percent of Swiss people expose themselves to the risk of acquiring a tropical or cosmopolitic disease during travel to exotic countries. A systematic check-up of returning travellers is however indicated only for those with acute or recurrent symptoms or after a prolonged residence in a critical region. Febrile states should be considered medical emergencies. Investigations comprise routine laboratory tests (examination of blood film and feces for presence of parasites) complemented by special tests based on anamnestic and clinical criteria. Special attention is given to fecal analysis which has to be adapted to the search for specific pathogens (Bacteria, Protozoa, Helminths). Serologic tests are of increasing importance for the detection of parasitic infestation allowing for specific therapy in certain cases.

Algorithms↗
PubMed1989

[Computerized bibliographic retrieval research: a tool at the fingertips of every practitioner].

In medical practice, the consultation of specific information often proves necessary, but not all practitioners have access to a library rich enough in periodicals and up-to-date articles. However, since the rise of combined telecommunication and computer technology, it is possible to correct this deficiency by access to medical and scientific data bases using a personal computer and an easily learned technique. The object of this article is to present the steps necessary for such an acquisition.

Humans↗
PubMed1989

Phospholipids and other lipids in angiographically assessed coronary artery disease.

Lipoprotein subclasses and their composition in cholesterol, triglycerides and in 5 types of phospholipid as well as apolipoproteins A-I and B were determined in blood of 114 patients undergoing coronary angiography for suspected or confirmed myocardial ischaemia. Lipid concentrations of lipoproteins were measured after preparative ultracentrifugation; high performance thin-layer chromatography was used to separate phospholipid subfractions. Patients with angiographically defined coronary artery disease (CAD) significantly differed from those without CAD in 25 different lipid or phospholipid parameters. Using discriminative analysis, apo A-I/apo B ratio was the only parameter with more than 70% success in reclassifying the patients in the CAD group. When correlated with a coronary atheromatous score reflecting either the number and degree of stenoses (Jenkins score) or the number of diseased vessels alone, only LDL-cholesterol was found to correlate with the Jenkins score. We conclude that serum phospholipid fractions may differ significantly in CAD group as compared with controls, but they are, however, no better predictors of CAD than other lipids.

Adult↗
PubMed1988

[Comparison of fructosamine and Hba1c for the evaluation of metabolic control of diabetic patients].

Fructosamine values, and the influence thereon of age, BMI and sex, were determined in 384 nondiabetic individuals aged between 20 and 95 years. In this control group mean F levels were 2.45 +/- 0.25 mmol/l and were age-related only, rising from 2.3 in the second decade to 2.6 in the eighth. We compared F and HbA1c in 135 diabetic patients. F correlated with HbA1c in the diabetic group (r = 0.76, p less than 0.001). Because of its biological properties fructosamine could become a useful pointer in the metabolic follow-up of diabetic patients, especially where clinic visits are frequent.

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↗
PubMed1987

[Comparative study of the treatment of simple urinary infection with a single dose of norfloxacin versus cotrimoxazole].

53 women with acute, uncomplicated urinary tract infection proven clinically and bacteriologically were treated, after double-blind randomisation, with a single dose of norfloxacin (1200 mg) or a single dose of cotrimoxazole (480/2400 mg). Follow-up one week after treatment showed a comparable success rate (85%) for both antibiotics. Only few minor side effects were recorded in both patient groups. Most failures were due to gram positive bacteria (coagulase-negative staphylococci). These results suggest that single dose therapy for urinary tract infections due to gram positive germs should be reconsidered.

Adolescent↗
PubMed1987

[Standard values for serum esterified fatty acids in adult women in good health].

Serum was obtained from two groups of 23 healthy female volunteers to determine the standard values of esterified fatty acids (EFA) contained in phospholipids, triglycerides and cholesterol. One group consumed an 'optimal' diet in regard to lipid and caloric content, under strictly controlled conditions, the other a free diet. All lipid fractions in serum from both groups were in the physiologic range so that the levels of EFA could be expected to be in the normal range. These data are comparable to those obtained from other series but they differ strongly from values established among the Eskimos, who have very low serum levels of arachidonic acid due to their traditional diet and probably to genetic factors. Determination of the standard values of EFA in healthy caucasian women may contribute to a better assessment of role of the therapeutic intervention on lipid parameters considered as atherogenic risk factors.

Adult↗
PubMed1984

[Effect of the PSMF diet on plasma lipids and lipoproteins in obese subjects].

The influence of weight reduction on plasma lipids, lipoproteins and apoproteins was studied in 14 patients (8 females and 6 males) with varying degrees of obesity. After 4 weeks on hypocaloric diet (PSMF), an 8% weight loss was associated with a significant decrease in total cholesterol (18%), triglycerides (47%) and phospholipids (20%). No significant change was observed in HDL-cholesterol. The HDL-cholesterol/total cholesterol ratio was increased. The greatest decrease was observed in VLDL fractions. The decreases in apoprotein A and B were 19% and 15% respectively. These findings indicate that favourable changes in plasma lipoproteins are achieved after weight loss on hypocaloric diet.

Adult↗
PubMed1984

Mechanical controlled hypoventilation in status asthmaticus.

This study reports the results obtained with mechanical ventilation in severe respiratory failure secondary to status asthmaticus. Of the 159 patients with status asthmaticus admitted to the Intensive Respiratory Unit over a 5-yr period, 26 required mechanical ventilation for a total of 34 episodes of acute respiratory acidosis. At the time of intubation, 10 patients were in coma and 5 were in respiratory arrest. Controlled mechanical ventilation was maintained for a mean of 2.5 days. Complications were few and reversible. All patients survived. These favorable results are attributed to a new strategy: mechanical ventilation is used to obtain a correction of hypoxemia with hyperoxic mixtures without attempting to restore an adequate alveolar ventilation. The respirator is adjusted to avoid high airway pressures, which appear to be more dangerous than persistent hypercapnia itself. Correction of hypercapnia is obtained later when bronchial obstruction relief provides better conditions of ventilation-perfusion distribution. So the risks of barotrauma and cardiocirculatory failure, which are frequently reported as fatal complications, appear to be significantly decreased.

Acid-Base Equilibrium↗