Suter P.M.,Universitatsspital Zurich
Praxis | Year: 2017
Despite all controversy, the control of the intake of saturated fat and cholesterol represents a key aspect in the prevention and control of lipid disorders. These strategies should be embedded in a dietary pattern which comprises the whole «foodome», i.e. all kinds of different food mainly following a semi-vegetarian diet principle. © 2017 Hogrefe.
Von Eckardstein A.,Universitatsspital Zurich
Praxis | Year: 2017
The risks for atherosclerotic cardiovascular diseases (ASCVD) as well as acute pancreatitis raise with increasing plasma concentrations of triglycerides. Low levels of HDL-cholesterol are also associated with an increased ASCVD risk. High levels of HDL-cholesterol do not diminish the risk for ASCVD, but increase mortality. Hypertriglyceridemia and low HDL-cholesterol are frequently confounded with each other as well as with other risk factors. Genetic studies and futile intervention studies make a causal relationship of HDL-cholesterol and ASCVD unlikely. Therefore, HDL-cholesterol is no treatment goal. Genetic data are in favor of a causal relationship between triglyceride-rich lipoproteins and ASCVD, but as yet triglyceride-lowering drug interventions failed to reduce ASCVD event rates. Triglyceride lowering is not a primary treatment goal, except in chylomicronemia, to reduce the risk of acute pancreatitis. Primary treatment goals for patients with moderate hypertriglyceridemia (<10 mmol/l) and/or low HDL-cholesterol is the control of causal risk factors, notably lowering of LDL-cholesterol or nonHDL-cholesterol to target values. Elevated plasma levels of triglycerides respond well to life style (physical activity), diet (avoidance of alcohol, saturated fatty acids and easily resorbed carbohydrates) and treatment of underlying diseases (notably diabetes). If these interventions are not successful, fibrates and omega-3-fatty acids should be considered. © 2017 Hogrefe.
Hothorn T.,University of Zürich |
Jung H.H.,UniversitatsSpital Zurich
Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration | Year: 2014
We describe a method for predicting disease progression in amyotrophic lateral sclerosis (ALS) patients. The method was developed as a submission to the DREAM Phil Bowen ALS Prediction Prize4Life Challenge of summer 2012. Based on repeated patient examinations over a three- month period, we used a random forest algorithm to predict future disease progression. The procedure was set up and internally evaluated using data from 1197 ALS patients. External validation by an expert jury was based on undisclosed information of an additional 625 patients; all patient data were obtained from the PRO-ACT database. In terms of prediction accuracy, the approach described here ranked third best. Our interpretation of the prediction model confirmed previous reports suggesting that past disease progression is a strong predictor of future disease progression measured on the ALS functional rating scale (ALSFRS). We also found that larger variability in initial ALSFRS scores is linked to faster future disease progression. The results reported here furthermore suggested that approaches taking the multidimensionality of the ALSFRS into account promise some potential for improved ALS disease prediction. © 2014 Informa Healthcare.
Gerber P.A.,Universitatsspital Zurich
Praxis | Year: 2016
Fructose consumption has increased significantly during the past decades - in particular by using added sugar in food and beverages, either sugars containing free fructose, but also sugars containing fructose in bound form (e. g. sucrose). The metabolism of fructose exhibits distinct differences compared to the metabolism of glucose. Association studies performed in the past years suggest an association of fructose consumption and adverse effects on metabolism. Intervention studies, conducted in part with healthy individuals, could prove such effects and deliver explanations of the mechanisms leading to these adverse effects. A reduction of consumption of added fructose should be recommended, but there is no evidence to support a restriction of fruit consumption (as a natural source of fructose). © 2016 Hogrefe.
Bogdan Allemann I.,UniversitatsSpital Zurich |
Kaufman J.,University of Miami
Lasers in Medical Science | Year: 2010
The novel concept of non-ablative fractional photothermolysis was introduced to the market in 2003 as an answer to the need for effective, yet low risk, resurfacing techniques. Unlike conventional ablative and non-ablative lasers, fractional ablative and non-ablative photothermolysis treats only a fraction of the skin, leaving up to a maximum of 95% of the skin uninvolved. The undamaged surrounding tissue allows for a reservoir of viable tissue, permitting rapid epidermal repair. Non-ablative fractional photothermolysis is currently approved by the US Food and Drug Administration (FDA) for the treatment of pigmented lesions, periorbital rhytides, skin resurfacing, melasma and soft tissue coagulation, acne and surgical scars, and actinic keratoses. However, its off-label use is clearly more extended. In 2007 the concept was further developed, and ablative fractional photothermolysis was introduced, using an erbium yttrium aluminium garnet (Er:YAG) or carbon dioxide laser. These devices are FDA cleared to treat wrinkles, rhytides, furrows, fine lines, textural irregularities, pigmented lesions and vascular dyschromia. In this review we discuss the two concepts, their technical details and clinical indications, and we describe the current literature available. © 2009 Springer-Verlag London Ltd.
Soltermann A.,Universitatsspital Zurich
Pathologe | Year: 2012
Non-small cell lung carcinoma (NSCLC) is a highly fibrotic malignancy, which exhibits a prominent desmoplastic stroma. Epithelial-mesenchymal transition (EMT) is one of the main modes of carcinoma invasion. We identified the stromal N-glycoprotein periostin by mass spectrometry of lung adenocarcinoma pleural effusions. Validation on a NSCLC tissue microarray and on tumor whole sections by immunohistochemistry indicated that periostin is strongly upregulated at the invasive front in both tumor epithelia and the surrounding matricellular space. In comparison to collagen, elastin and vimentin, periostin was found to be most closely associated with parameters of tumor progression such as larger size and higher stage, with the squamous cell histotype, and with decreased survival. An association with decreased survival was also found for the cell adhesion molecule L1CAM. In conclusion, enlargement of NSCLC tumors is associated with an increase of desmoplastic stroma and concomitant upregulation of EMT markers at the invasive front. The tumor-stroma interface may be a candidate topographic region for stroma- or EMT-directed therapy. © 2012 Springer-Verlag Berlin Heidelberg.
Schmid-Grendelmeier P.,Universitatsspital Zurich
Therapeutische Umschau | Year: 2012
Pollinosis affects up to 25 % of the Swiss-population and increased substantially during the last centuary. Main causative pollens are birch and related pollens, ash pollen and grass pollen and to a lesser extent also mugwort. Diagnosis of Pollinosis is based on anamnesis, skin tests and determination of specific IgE in the serum. Treatment includes allergen avoidance, pharmacotherapy and allergenspecific immunotherapy (SIT). A proper patient and allergen extract selection, an ideally adapted application regimen and good patient-guidance as well as good compliance and treatment adherence are decisive for the success of the SIT. SCIT is the regimen of choice with well demonstraded efficacy, safety and long term effect. Nowaydays SLIT is an additional complementary approach that mainly for grass pollen also offers good efficacy with good safety. Under such conditions immunotherapy leads to a benefit in more than 80 % of pollinosis- patients. Component-resolved diagnosis is a very useful and important step in more specific diagnosis. Several approaches studying changed application regimens and using molecular technologies to improve the efficacy of SIT are undergoing and will possibly substantially improve the efficacy, safety and acceptance of SIT. © 2012 Verlag Hans Huber, Hogrefe AG, Bern.
Engelsberger W.R.,Max Planck Institute of Molecular Plant Physiology |
Engelsberger W.R.,Universitatsspital Zurich |
Schulze W.X.,Max Planck Institute of Molecular Plant Physiology
Plant Journal | Year: 2012
Nitrogen is an essential macronutrient for plant growth and development. Inorganic nitrogen and its assimilation products control various metabolic, physiological and developmental processes. Although the transcriptional responses induced by nitrogen have been extensively studied in the past, our work here focused on the discovery of candidate proteins for regulatory events that are complementary to transcriptional changes. Most signaling pathways involve modulation of protein abundance and/or activity by protein phosphorylation. Therefore, we analyzed the dynamic changes in protein phosphorylation in membrane and soluble proteins from plants exposed to rapid changes in nutrient availability over a time course of 30 min. Plants were starved of nitrogen and subsequently resupplied with nitrogen in the form of nitrate or ammonium. Proteins with maximum change in their phosphorylation level at up to 5 min after nitrogen resupply (fast responses) included GPI-anchored proteins, receptor kinases and transcription factors, while proteins with maximum change in their phosphorylation level after 10 min of nitrogen resupply (late responses) included proteins involved in protein synthesis and degradation, as well as proteins with functions in central metabolism and hormone metabolism. Resupply of nitrogen in the form of nitrate or ammonium resulted in distinct phosphorylation patterns, mainly of proteins with signaling functions, transcription factors and transporters. © 2011 Blackwell Publishing Ltd.
Taramasso M.,UniversitatsSpital Zurich |
Maisano F.,UniversitatsSpital Zurich
EuroIntervention | Year: 2014
Percutaneous mitral valve therapies have emerged as an alternative option for high-risk patients with mitral regurgitation. Multiple technologies and diversified approaches are today under clinical study or in development and they can be categorised based on the anatomically and pathophysiologically addressed target. This review focuses on the different transcatheter annuloplasty techniques and explores their future perspectives. © Europa Digital & Publishing 2014. All rights reserved.
Hofbauer G.,Universitatsspital Zurich
Hautarzt | Year: 2013
Phototherapy successfully uses the short-term effects of ultraviolet light against inflammation and proliferation. For its long-term effects, however, ultraviolet light was recently classified as a carcinogen. The wave spectrum employed in phototherapy has various carcinogenic effects in experimental systems, most notably DNA mutations in keratinocytes. Clinically, PUVA increases the risk for squamous cell carcinoma of the skin, especially after following 350 or more phototherapy sessions over a lifetime. Melanoma and genital skin cancer are not increased by PUVA alone. Previous UV damage, immunosuppression and other systemic treatments increase cutaneous carcinogenesis through PUVA. In contrast, broad-band UVB, narrow-band UVB and UVA1 have not yet been linked to cutaneous carcinogenesis, but will need careful follow-up in larger studies. Phototherapy remains a safe treatment modality, provided that the indication is well-founded, previous exposure and co-carcinogens are considered, and short and dose-intensive treatment protocols are favored, PUVA is chosen as second-line treatment that should not be used for more than a lifetime total of 250-300 phototherapy sessions. © 2013 Springer-Verlag Berlin Heidelberg.