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Biomedical subjects

U C Dubach

Publications and source records attributed to U C Dubach.

At least 55 records · Page 3Linked to original sources
PubMed1987

Lack of influence of etretinate on the intestinal absorption of D-xylose and of phytomenadione (vitamin K1) as representatives of hydrophilic and lipophilic compounds.

The possible influence of the aromatic retinoid etretinate (Tigason ) on the intestinal absorption of D-xylose and phytomenadione (vitamin K1) has been studied in 7 healthy male volunteers between 22 and 25 years of age. D-xylose and phytomenadione were selected as being representative of water-soluble and fat-soluble test compounds, respectively. Following an oral dose of 25 g D-xylose the plasma levels and urinary excretion pattern of the compound were followed over 6 h. The plasma concentrations of phytomenadione after an oral dose of 20 mg of the vitamin were measured over 14 h. These absorption tests were performed before (baseline) and at the end of a 3-week treatment period with 25 mg b.i.d. etretinate. In addition some parameters on the serum lipid status pre and post etretinate treatment were monitored. The pharmacokinetic and biochemical determinants after treatment with etretinate were referenced to the pretreatment values and nonparametric confidence intervals (a less than 0.05) for these ratios were calculated. With respect to the area, AUC, under the D-xylose plasma concentration--time curve (0.79 less than or equal to RAUC = 1.00 less than or equal to 1.17) as well as to the cumulative amount excreted into urine over 6 h (0.90 less than or equal to RSUM = 1.04 less than or equal to 1.28) and to renal clearance (0.91 less than or equal to Rcl = 1.05 less than or equal to 1.25), no effect of etretinate on absorption and/or renal handling of D-xylose was discernible.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1986

[Importance of ECG and chest x-ray of ambulant patients with chest pain].

107 consecutive outpatients were examined prospectively to evaluate the contribution of clinical history, ECG and chest X-ray to diagnosis of chest pain. Based on patient history, clinical examination, ECG and chest X-ray, 23 (21.5%) of all patients had chest pain related to organic disease, whereas in 84 (78.5%) patients the symptomatology was of a functional/psychosomatic nature. In chest pain of organic origin ECG and chest X-ray contributed to diagnosis in 1/4 of the cases. In patients with so-called functional chest pain, ECG and chest X-ray were of no diagnostic value but had a psychological and therapeutic effect in a way that facilitated patient management.

Adolescent↗
PubMed1986

[Clinical manifestations of tuberculosis today].

In developed countries tuberculosis has not yet been eradicated and diagnostic problems still remain. The purpose of this study was to analyze the clinical pattern, epidemiological data and risk factors in 85 patients (59 males and 26 females, mean age 41 +/- 15 years) seen from 1975-1984 in the medical outpatient clinic of Basle with the diagnosis of tuberculosis. The organ distribution of the tuberculosis was as following: lung n = 54, cervical lymph nodes n = 9, pleura n = 7, peritoneum n = 3, endometrium n = 2, bones n = 2, pericardium n = 1, middle ear n = 1, urinary tract n = 1, skin n = 1, cerebrum n = 1, miliary tuberculosis n = 3. In the younger age group (20-40 years) cervical lymph node tuberculosis predominated, whereas in the age group over 50 pulmonary tuberculosis was most frequent. The leading symptoms were: cough (59%), expectoration (48%), fever (39%), night sweat (24%). Risk factors were: cigarette smoking in 51%, alcoholism in 37%, preexisting lung disease in 20%, past tuberculosis in 19%. In pulmonary tuberculosis the most accurate diagnostic procedure was examination of bronchial secretion, followed by examination of sputum and gastric juice. Histological examination was the most appropriate procedure in tuberculosis of lymph nodes and peritoneum. In all patients treatment was as follows: isoniacid (INH), rifampicin and ethambutol for the first 4 months, followed by isoniacid and ethambutol for 6-10 months. In summary, tuberculosis has no typical clinical pattern and biochemical tests are unhelpful in establishing diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Do doctors understand their patients?].

The extent to which doctors understand the complaints of their patients has been investigated by comparing patient complaints with the observation and assessment of these by the doctor. This involved questioning 259 patients and 30 doctor. From the 259 patients, three groups (a total of 57 patients) were formed, having common main symptomatologies. The extent to which the complaints of each of these patients corresponded with the clinical assessment was evaluated. The results revealed a close agreement between patient complaints and clinical assessment, not only for those patients with organo-medically diffuse symptoms (feeling of illness, tiredness, nervousness) but also for those with organ-medically clearly defined, localised (cardiac and thoracic pain) and mixed diffuse-localised complaints.

Adolescent↗
PubMed1986

Localization of nucleotide pyrophosphatase in the rat kidney.

Hydrolysis of NAD by a nucleotide pyrophosphatase of renal membrane fractions has been reported previously. The aim of the present study was to localize this enzyme in the rat kidney. Nucleotide pyrophosphatase was assayed in glomeruli, in three parts of the proximal tubule and in four parts of the distal tubule dissected form freeze-dried sections. Nucleotide pyrophosphatase activity, expressed in mumol X min-1 X mg protein-1, ranged between 9.8 and 32.3 in the proximal tubular segments and between 1.1 and 2.7 in the distal tubular segments. It was 3.4 in the glomeruli. The enrichment of the activity during the purification of brush border vesicles was measured. A ten-fold higher specific activity was found in the brush border vesicles as compared to the renal cortical homogenates. Thus, most of the renal nucleotide pyrophosphatase appears to be localized in the luminal membrane of the proximal tubule. A permeabilization of the membrane did not increase the activity of brush border vesicles. This indicates that all catalytic sites are accessible at the outer surface of the membrane.

Animals↗
PubMed1986

Intranasal interferon (rIFN-alpha A, Ro 22-8181) for contact prophylaxis against common cold: a randomized, double-blind and placebo-controlled field study.

The prophylactic efficacy of low-dose intranasal recombinant leucocyte interferon alpha (rIFN-alpha A, Ro 22-8181) was investigated under field conditions in 147 families (n = 587 participants), randomized to receive placebo or rIFN-alpha A intranasally in daily doses of 1.5 or 0.3 X 10(6) IU. Treatment was started within 2 days after the appearance of an index case in the household and was continued for 5 days. Clinical data of the index case and of all members of the household were recorded for 10 days. In index cases and all ill contact persons nasal washes were collected for rhinovirus isolation and immunochemical detection of other respiratory viruses. The local tolerance of the intranasal rIFN-alpha A was excellent. Both doses of rIFN-alpha A failed to exert therapeutic effects on established common cold or to prevent the spread of common cold within families. Prophylactic treatment with 1.5 X 10(6) IU did however shorten the duration of the cold (median of 2 days vs. 4 in the placebo group, P = 0.01) and reduced the severity of any ensuing common cold (median total score of 10.5 vs. 30, P less than 0.001). No correlation was found between viral etiology (55% rhinoviruses vs. 13% other respiratory viruses, n = 122 nasal washes) and prophylactic efficacy or clinical severity.

Administration, Intranasal↗
PubMed1986

Pharmacokinetics of carumonam in patients with renal insufficiency.

The pharmacokinetics of carumonam after a single 1,000-mg intravenous infusion (20 min) were evaluated in four groups of subjects who had various degrees of renal impairment: group 1, CLCR greater than 60 ml/min; group 2, CLCR = 30 to 60 ml/min; group 3, CLCR = 10 to 30 ml/min; and group 4, CLCR less than 10 ml/min). The elimination half-life of carumonam increased with decreasing creatinine clearance (CLCR) from 1.7 h in group 1 to 11.3 h in group 4. Peak carumonam concentration (103 micrograms/ml) and steady-state volume of distribution (12.8 liters) did not change with decreasing CLCR. Total body clearance (r = 0.98), renal clearance (r = 0.98), and nonrenal clearance (r = 0.67) of carumonam correlated with decreasing CLCR. Mean nonrenal clearance was 21 ml/min in group 1 and 12 ml/min in group 4. With regard to dosage, patients with a CLCR above 60 ml/min should receive their standard maintenance dose of carumonam without any changes; patients with a CLCR between 30 and 60 ml/min should receive the dose every 12 h; and individuals with a CLCR between 10 and 30 ml/min should be given the dose once a day. Patients with a CLCR of less than 10 ml/min should receive one-half of the dose once a day. Our recommended dosage regimens should produce within the CLCR borderlines of each group average plasma concentrations that are between one and two times that achieved in normal subjects with a t.i.d. dosage regimen.

Adult↗
PubMed1985

[Does closely monitored control and therapy adjustment improve the prognosis in patients with severe heart insufficiency?].

The one year mortality of patients with severe congestive heart failure ranges between 30 and 70%. The effect was investigated of a stepped care program, including weekly monitoring and frequent adjustment of medical treatment, on the prognosis of 18 consecutive outpatients with severe congestive heart failure (NYHA class III and IV, 60 +/- 3.5 years). The diagnosis of congestive heart failure was proven by an invasively measured cardiac index below 2.5 l/min/m2 or by a left ventricular ejection fraction below 30%. Plasma adrenaline and noradrenaline values and plasma renin activity were substantially increased in all patients compared with 20 normals. 11 of the heart failure patients had coronary heart disease, 10 with a large left ventricular aneurysm, 6 patients had congestive cardiomyopathy and one patient had valvular heart disease with aortic insufficiency. In 9 patients ventricular tachycardias were registered, four had recurrent syncopes, and in 7 other patients atrial fibrillation, atrial flutter and paroxysmal supraventricular tachycardias were found. Medical treatment in all patients included pre- and afterload reduction by vasodilators. 11 patients received digoxin and 8 antiarrhythmic drugs. After a mean follow-up of 25 +/- 3.3 months, the one-year mortality was 7% and the two year mortality 15%. The favorable prognosis in patients in this special care program shows the favorable effects of individualized therapy, of frequent patient monitoring and the influence of strict compliance on survival and symptoms in patients with chronic congestive heart failure.

Adult↗
PubMed1985

[Diagnostic clarifications and follow-up of 105 patients with syncope].

105 patients with syncope (56 males and 49 females aged 15-87 years) were followed up for 15 +/- 8 months after their first visit in an outpatient clinic. Diagnosis after initial evaluation was syncope of unknown origin (n = 24), vasodepressor syncope (n = 18), orthostatic syncope (n = 18), syncope of cardiac origin (n = 16), seizure disorder (n = 13), syncope occurring during hyperventilation (n = 6), micturition syncope (n = 6), cough syncope (n = 2), and vertebrobasilar transient ischemic attack (n = 2). In 55% of patients the diagnosis was based on the patient's history alone and only in 23 patients was additional laboratory workup of diagnostic importance. During follow-up 4 patients died, but only in one was death related to the syncope (recurrent ventricular tachycardial). In 1 patient the initial diagnosis after follow-up had to be changed (from syncope of unknown origin to cardiogenic syncope) due to sick sinus syndrome. In patients with syncope the history should be carefully evaluated, since it is diagnostic in more than half of the cases. An additional diagnosis workup including resting and 24-hour ECG, as well as EEG examinations, should be ordered not as screening but only in selected patients.

Adolescent↗
PubMed1985

[Sick sinus syndrome--clinical presentation, diagnostic and therapeutic measures in an ambulatory patient sample].

Incidence, clinical picture, ECG features, as well as chosen diagnostic and therapeutic measures were investigated in patients attending the Basel University Medical Outpatients Department with the diagnosis of sick sinus syndrome. A retrospective study was conducted by selecting patients' charts with this diagnosis during the period 1979-1983. Forty-four patients (17 women, 27 men, mean age 64.5 +/- 14.5 years) were "discovered" and divided into three groups: Group 1: asymptomatic patients with pathological ECG (n = 7), Group 2: symptomatic patients with pathological ECG (n = 22), Group 3: main symptom syncope (n = 15). All patients had had an ECG and 15 a 24-hour-ECG. Carotid sinus massage was performed in three patients and sinus node recovery time was measured in another three. Seventeen patients remained without treatment, 13 received a permanent pacemaker, 9 of whom had additional medication, while 12 were anticoagulated. Three patients who were not anticoagulated suffered a stroke. More invasive electrophysiological investigations should be undertaken only with caution. In group 1, further diagnostic or therapeutic consequences need to be drawn. In the symptomatic patients from group 2, 24-hour-ECG is indicated when there is a history of palpitations, dizziness or severe heart failure. The immediate implantation of a pacemaker is justifiable in group 3 patients. Drugs with antiarrhythmic activity should be avoided in these patients before pacemaker implantation.

Aged↗
PubMed1985

Uphill transport of pyrimidine nucleosides in renal brush border vesicles.

The uptake of cytidine, of thymidine and of uridine in brush border vesicles prepared from the cortex of rat kidney has been studied by the technique of rapid filtration. The nucleosides were not metabolized in the vesicles. The time-courses of uptake in the presence of inwardly directed gradients of Na+ and of K+ showed an overshoot, indicating uphill transport. The overshoot was much more pronounced with Na+ than with K+; it was not observed when Na+ was at equilibrium across the membrane. The uptake of the nucleosides was stimulated by an inside negative potential in the presence of Na+. These results provide evidence for a cotransport of pyrimidine nucleosides with Na+. The apparent Km's for the uptake of cytidine, of thymidine and of uridine were 3.76 mumol X 1(-1), 4.18 mumol X 1(-1) and 7.21 mumol X 1(-1) respectively. The uptake of the pyrimidine nucleosides was insensitive to 6-nitrobenzylthioinosine. This insensitivity as well as the high affinity for the nucleosides and the capacity for uphill transport indicate that the nucleoside carrier(s) is renal brush border is (are) different from the carriers found in most other cell types.

Animals↗
PubMed1985

Lack of effect of tenoxicam on glibornuride kinetics and response.

The pharmacokinetics of glibornuride (25 mg i.v.) and the accompanying insulin and glucose responses were characterized in eight human subjects in the presence and absence of steady-state tenoxicam (20 mg p.o./day for 2 weeks). Tenoxicam affected neither the pharmacokinetic parameters of glibornuride (systemic clearance, volume of distribution and biological half-life) nor the responses of plasma insulin and blood glucose to glibornuride. The single i.v. dose of glibornuride had no detectable effect on the kinetics of tenoxicam.

Adult↗
PubMed1985

Concentrative transport of purine nucleosides in brush border vesicles of the rat kidney.

Nephrotoxicity has been reported in humans and in animals during treatment with nucleosides. We described recently a Na+ gradient-dependent concentrative transport of adenosine in brush border vesicles isolated from the cortex of the rat kidney. The results of the present study suggest that that transport is shared by other purine nucleosides. The transport of adenosine is inhibited by several purines at micromolar concentrations. The transports of deoxyadenosine, of inosine and of guanosine are concentrative in the presence of a Na+ gradient and they are inhibited by adenosine. We conclude that there exists a concentrative system for reabsorption of various purine nucleosides in the proximal tubule. The transport of nucleosides is non-concentrative in all other cell types studied so far. The concentrative capacity of the transport of nucleosides in the kidney might explain the particular sensitivity of that organ during treatment with nucleosides.

Animals↗
PubMed1985

Properties of an ecto-5'-nucleotidase of the renal brush border.

A decrease of glomerular filtration rate can be observed during accelerated catabolism of ATP in kidney. It has been proposed that this effect is due to the increase in the renal production of adenosine from ATP. The last reaction in the pathway concerned is the conversion of 5'-AMP to adenosine. We found that brush border membranes purified from homogenates of the rat renal cortex carry out this reaction. The enzyme involved in the hydrolysis has the characteristic properties of ecto-5'-nucleotidases: It is inhibited by ATP, ADP, and by alpha, beta-methyleneadenosine-5'-diphosphate, and it is not stimulated by magnesium. All catalytic sites are accessible from the outside of the vesicles. The Km of the enzyme for 5'-AMP is 5.77 microM. The enrichment of the 5'-AMP-hydrolyzing activity in the brush border fraction as compared to the homogenate is 9.2 +/- 1.5 times. Histochemical staining of kidney sections reveals hydrolysis of 5'-AMP only at the brush border of the proximal tubule. We conclude that the brush border of the proximal tubule of the rat kidney possesses an ecto-5'-nucleotidase which has the same properties as the ecto-5'-nucleotidases in other tissues.

5'-Nucleotidase↗
PubMed1985

Physician compliance in the management of hypertensive patients.

The aim of the present study was to investigate prospectively the value of different forms of intervention in the quality of diagnosis and treatment of essential hypertension in an Outpatient Clinic. In a first phase (phase 0) 115 patients with a blood pressure of greater than or equal to 140/greater than or equal to 90 mmHg at the initial visit in our Outpatient Clinic were registered. After a 3 months period the charts of these patients were reviewed. This review revealed that 61 (53%) of these patients were not followed by the treating physicians and that half of the patients who had an elevated blood pressure at the second visit and thereby an indication for therapy were not treated. In a first intervention the results of this investigation were discussed with the treating physicians and the necessity for an improved management of patients with essential hypertension was pointed out. After this intervention 116 patients with a blood pressure greater than or equal to 140/greater than or equal to 90 mmHg were again followed for 3 months without knowledge of the treating physicians (phase 1). The chart review of these patients revealed no improvement in the management of the patients, 57% of these 116 patients were again not followed by the treating physicians and 48% of the patients identified by a follow-up visit as hypertensives were not treated. Thereafter a second intervention took place which included a nurse who scheduled 295 patients with an initial blood pressure of greater than or equal to 140/greater than or equal to 90 mmHg automatically for a follow-up visit.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1985

[Inflammatory diseases of the kidney and efferent urinary tract].

On the basis of a specific definition a summarizing description of the inflammatory diseases of the kidney and the efferent urinary tract is given. Apart from the description of the bacteriology of the infections of the urinary tract the author particularly deals with the significance of the asymptomatic bacteriuria, the acute bacterial cystitis, the acute pyelonephritis as well as the reflux nephropathy. Besides proposals for therapy references are given to the conduction of the patients after treatment. In the description of the chronic interstitial nephritis the nephropathy by analgesics is emphasized as most common disease.

Adult↗