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Biomedical subjects

R Mordasini

Publications and source records attributed to R Mordasini.

At least 73 records · Page 4Linked to original sources

[Effect of the lipid-lowering agent, procetofen, on the makeup of human biliary lipids].

The effect of lipid-lowering treatment with procetofen (3 x 100 mg/day for 4-6 weeks) on the cholesterol saturation index (S.I.) of bile has been studied in 6 patients with type IIa or IIb pattern hyperlipoproteinemia. Compared with a control period with placebo, the S.I. was increased by more than 20% during active treatment in 2 patients. Oversaturation was reached in one case. In the other 4 patients, the changes did not exceed 20% of the control value. Thus, increased lithogenicity of bile does not appear to be a frequent effect of procetofen. A larger number of patients should therefore be studied to establish its true incidence.

Adult↗

[The effect of diuretic therapy on serum lipoproteins: an undesirable effect?].

The effect of diuretics on serum lipids and lipoproteins was evaluated in 23 patients with essential hypertension treated with chlorthalidone for six weeks. Compared to placebo conditions, diuretic therapy significantly increased serum beta (+8%, p less than 0.05) or low-density-lipoprotein (LP) cholesterol (+17%, p less than 0.025). Since alpha-LP or high-density-LP cholesterol was unchanged or tended to decrease slightly, there was also an increase in the beta/alpha-LP (+26%, p less than 0.025) or low/high-density-LP cholesterol (21%, p less than 0.025) ratio. Serum cholesterol (+4%), triglycerides (+3%), phospholipids and the Apo-LP A-I, A-II and B were not changed significantly. Blood pressure and plasma potassium were decreased (p less than 0.01), blood volume and serum insulin were not changed significantly, and serum glucose was increased mildly. Plasma renin, aldosterone and norepinephrine levels rose significantly (p less than 0.05), while circulating epinephrine was unaltered. Alterations in LP were not related to variations in blood pressure, blood volume, plasma electrolytes or serum glucose or insulin; and they did not correlate with chlorthalidone-induced increases in plasma renin, aldosterone or norepinephrine. Treatment with certain diuretics may have an adverse influence on lipoprotein metabolism.

Adolescent↗

A bile-acid-rich high-density lipoprotein (HDL) in acute hepatitis.

Severe liver dysfunction is often associated with alterations of plasma lipids and lipoproteins. In this study the high-density lipoprotein (HDL) class has been further investigated. HDL from patients with acute, cholestatic hepatitis (n = 10) was isolated and compared with that of normals. Lipid and protein analyses were performed during the acute stage of the disease, with consequent follow-up studies. It was found that (1) only apo A-I was decreased by 50% in the isolated HDL fractions, whereas apo A-II remained unchanged; apo A-I in total plasma was normal; (2) immunoelectrophoresis of hepatitis HDL against monospecific anti-A-II revealed one precipitin line but two or more bands against anti-A-I; (3) concomitant with an increase of phospholipids and a decrease of triglycerides and the total cholesterol fraction, hepatitis HDL contained 10--12 times more bile acid than normal HDL. Chenodeoxycholic acid was the predominant bile acid. These alterations were fully reversible when patients recovered. These parameters seem to be sensitive markers for the degree of disturbance and restoration of liver function. The structural-functional implications of the observed compositional changes of HDL during cholestasis are discussed.

Acute Disease↗

Abnormal low density lipoproteins in children with familial hypercholesterolemia--effect of polyanion exchange resins.

In 20 children and adolescents with familial Type II a hyperlipoproteinemia, serum lipids and lipoproteins were examined before and during treatment with polyanion exchange resins. The composition of LDL was compared to that of helthy siblings. The patients were given Colestyramine (0.6 g/kg body weight) and Colestipol (0.5 g/kg body weight) in a cross-over study for 8 weeks each, after they had been under dietary treatment for at least 12 months. In 6 children, drug treatment had to be stopped due to side-effects. The most common complaints were gastrointestinal discomfort and constipation. Cholesterol, triglycerides and phopholipids were measured in whole serum and cholesterol, triglycerides and Apolipoprotein-B in isolated lipoprotein fractions after ultracentrifugation. Apo-B was determined by radial immunodiffusion. The Apo-B: cholesterol ratio in whole serum and in the LDL fraction was identical in the patients and in the controls. The LDL triglyceride: Apo-B ratio, however, was about 50% lower in the patients. This abnormal LDL composition was not altered by therapy with polyanion exchange resins. HDL cholesterol levels were significantly lower in the patients than in healthy children, and remained low during therapy. The decrease of total and LDL cholesterol (25%) and Apo-B (20%) was similar under both Colestipol and Colestyramine. Triglycerides and phospholipids showed no significant changes in therapy.

Adolescent↗

[Coronary heart disease in patients with primary type V hyperlipoproteinemia (author's transl)].

In two patients with primary Type V hyperlipoproteinemia with typical clinical features including recurrent bouts of abdominal pain a myocardial infarction was diagnosed. In both cases coronary angiography revealed a severe three vessel disease. The case reports demonstrate that the incidence of ischemic heart disease in patients with Type V hyperlipoproteinemia is higher than reported in the literature. In each case of severe abdominal pain, even in younger Type V patients, a myocardial infarction has to be excluded, In both patients a selective depression in the activity of lipoprotein lipase was found. The possible pathogenetic implication of this finding will be discussed.

Aged↗

[Comparison between combination therapy with clofibrate and beta-pyridylcarbinol and clofibrate monotherapy (author's transl].

In order to determine whether the lipid-lowering effect of combined treatment with clofibrate and beta-Pyridylcarbinol exceeds that of clofibrate monotherapy, a double-blind crossover study was performed. 17 patients with primary hyperlipoproteinemia of Type IIa and 10 patients with primary hyperlipoproteinemia of Type IIb received either Lipofacton (1.000 mg clofibrate and 50 mg beta-pyridylcarbinol per day) or clofibrate (1.500 mg per day) for a period of 6 weeks each. Before beginning therapy and between both periods of medication, placebo was administered for 14 days. In both total plasma and in the LDL fraction the cholesterol level was lowered by less than 10% for both substances. In patients with hyperlipoproteinemia of Type IIb, the triglyceride levels were lowered by about 40%.

Adolescent↗

[Treatment with high-dose beta-pyridylcarbinol: results in patients with hypercholesterinemia].

The effect of lipid-lowering therapy with high-dose beta-pyridylcarbinol was studied in 16 patients with primary hyperlipoproteinemia of type IIa and type IIb. After a controlled dietary pretreatment period of at least 3 months, the patients received 900 mg beta-pyridylcarbinol (Ronicol 300) per day for 12 weeks. The patients were then given only dietary treatment for a further 6 weeks. Clinical and laboratory controls were carried out every month and included measurement of cholesterol and triglycerides in whole serum and in the isolated lipoprotein fractions after ultracentrifugation. In 2 patients the treatment had to be discontinued due to side effects (flush). The numerous "safety parameters" were not affected by the treatment. Total and LDL cholesterol were lowered by about 15% and total triglycerides by about 25%. The HDL cholesterol levels remained unchanged.

Cholesterol↗

[Mechanism of action of synthetic heparinoids: results in patients with hypertriglyceridaemia (author's transl)].

The effect of two synthetic heparinoids, SP-54 and Depot-Thrombocid, on serum lipids was studied in 17 patients with primary hyperlipidaemia (types IIb, IV and V of Fredrickson) and 15 healthy persons. SP-54 had no lipid-lowering effect, neither on oral nor rectal suppository application. Intramuscular injection of Depot-Thrombocid, however, resulted in a decrease of serum triglyceride concentrations of maximally 50% after six hours. There was a marked increase in the activity of the two lipolytic enzymes, lipoprotein lipase and hepatic triglyceride lipase in plasma, as well as an increase in free fatty acids and an extension of thrombin time and PTT. Twenty-four hours after injection all values returned to pretreatment levels. Intramuscular administration of Depot-Thrombocid two or three times a week for seven weeks had no lasting effect on serum lipids. However, there were considerable side effects such as haemorrhagic diatheses, hair loss and thrombocytopenia.

Administration, Oral↗

[Drug treatment of primary hyperlipoproteinemia (author's transl)].

Cardiovascular disease has become the major cause of death in the Western countries. There is strong evidence that elevations of serum lipids contribute to the pathogenesis of premature atherosclerosis. The classification of the hyperlipoproteinemias has been most beneficial as a guide to development of dietary and pharmacological regimens for lowering serum lipid concentrations. The results of dietary and drug prevention trials are discussed. Insight into the mechanisms involved in lipoprotein metabolism as well as the mode of action and of side-effects of hypolipidemic drugs is reviewed. Using present knowledge of heart disease research, it is reasonable to suggest dietary and drug treatments for the high risk patient.

Anion Exchange Resins↗

[The when and how of therapy for hyperlipoproteinemia].

Hyperlipoproteinemia is found in about 10--15% of the adult population. There is a strong correlation between elevated total and LDL cholesterol levels, decreased HDL cholesterol values and the incidence of coronary heart disease. Large-scale screening for this strong risk factor should be initiated at an early stage, when possible even in childhood. Dietary treatment is the basis of all lipid-lowering therapy. Lipid-lowering drugs should be given only in addition to a carefully controlled diet. Dietary and drug treatment of hyperlipoproteinemia is discussed.

Arteriosclerosis↗

Secondary type II hyperlipoproteinemia in patients with anorexia nervosa.

In 18 patients with anorexia nervosa, plasma cholesterol and triglyceride concentral concentrations were repeatedly determined over a period of 14 mo. In 11 patients elevated cholesterol concentrations were found which were due to an increase of low-density lipoprotein cholesterol, whereas high-density lipoprotein and very low density lipoprotein cholesterol levels were in the normal range. The elevated cholesterol values did not correlate with clinical and laboratory parameters such as the degree of weight loss and thyroid function tests. In follow-up studies it could be shown that in patients who regained their original weight, elevated plasma cholesterol concentrations fell to normal levels parallel to weight increase. In patients who showed no change in weight, however, cholesterol levels remained high. The cause for this secondary type II hyperlipoproteinemia in anorexia nervosa is not known. Hepatic triglyceride lipase and lipoprotein lipase activities in post-heparin plasma were found to be low despite normal triglyceride concentrations.

Adolescent↗

Increased ratio between serum beta- and alpha-lipoproteins during diuretic therapy: an adverse effect?

1. The effect of diuretic therapy on serum lipids and lipoprotein fractions was evaluated in 16 normal or labile hypertensive subjects who received in cross-over fashion chlorthalidone, frusemide or mefruside, each for 4 weeks (group A); and in 13 patients with essential hypertension treated with chlorthalidone for 6 weeks (group B). 2. All three diuretics significantly increased the ratio between serum beta- and alpha-lipoprotein fractions. This was due to an increase of the serum beta-lipoprotein fraction while the alpha-lipoprotein fraction was not changed significantly (group A) or decreased (group B). Serum cholesterol or triglycerides tended to be increased, but mean changes were often not significant. 3. The observed alterations in serum lipoproteins are consistent with the possibility of an increased risk for coronary heart disease which could offset partly the beneficial effects of a lowered blood pressure in diuretic-treated patients with hypertension.

Blood Volume↗

[A comparative study of colestipol and colestyramine in children and adolescents with familial hypercholesterolaemia (author's transl)].

Plasma lipids and lipoproteins were studied in 20 children and adolescents with familial hypercholesterolemia during the administration of two anion exchange resins. All the patients' cholesterol levels had been stabilized by treatment with a cholesterol-lowering diet for at least 12 months. Colestyramin (0.6 g per kg body weight) or Colestipol (0.5 g per kg body weight) were given for eight weeks each in a cross-over design. In 6 children, the study had to be terminated due to gastrointestinal problems. Cholesterol, triglycerides and phospholipids were determined serially in whole serum and in isolated lipoprotein fractions. Apolipoprotein-B was determined by radial immunodiffusion in whole serum and in the LDL-fraction. Total plasma cholesterol and LDL cholesterol were lowered by about 25% from initial values of 290 mg/100 ml and 230 mg/100 ml, respectively and Apo-B was lowered by 20%. Low HDL-cholesterol levels in the patients remained decreased during therapy. Triglyceride and phospholipid levels were not affected by treatment. Efficacy, tolerance and side-effects were similar with both Colestyramin and Colestipol.

Adolescent↗

Selective deficiency of hepatic triglyceride lipase in uremic patients.

To investigate the pathogenesis of hypertriglyceridemia in patients with renal disease we measured plasma lipoprotein composition as well as hepatic triglyceride lipase and lipoprotein lipase in post-heparin plasma. Three groups with renal disease were studied: conservatively treated chronic uremia; patients undergoing maintenance hemodialysis; and renal-allograft recipients. A selective decrease of hepatic triglyceride lipase with normal lipoprotein lipase was found in conservatively treated uremia and in patients undergoing hemodialysis. Elevated levels of very-low-density lipoproteins and increased triglycerides in low-density lipoproteins occurred in these patients. In contrast, hepatic triglyceride lipase and lipoprotein lipase were both normal in patients after renal transplantation who had Type II hyperlipoproteinemia as a common lipoprotein pattern with increased low-density-lipoprotein cholesterol and decreased high-density-lipoprotein cholesterol concentrations. The accumulation of a triglyceride-rich low-density lipoprotein in the majority of patients with renal disease may be the consequence of low hepatic triglyceride lipase.

Adult↗

[Familial hypobetalipoproteinaemia and diabetes mellitus (author's transl)].

In a 60-year-old patient with manifest diabetes mellitus and in his 63-year-old brother with latent diabetes mellitus hypobeta-lipoproteinaemia was diagnosed. Cholesterol values were around 1,8 mmol/1 in whole serum samples. The LDL-cholesterol fraction was 1,04 mmol/1. The beta-lipoprotein band in the lipoprotein electrophoresis was markedly reduced. Apolipoprotein B measured by radial immuno-diffusion was about 30% of the normal for age. The components of LDL were normal. Values of hepatic triglyceride lipase and lipoprotein lipase in heparinised plasma were within the normal range. The simultaneous occurrence of hypobetalipoproteinaemia and diabetes mellitus is described here for the first time.

Adult↗