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Karczewski M, Simic S, Saleh L, Nowak A, Schubert MG, Moretti D, Swinkels DW, Beuschlein F, Suter PM, Krayenbuehl PA. The magnitude of the plasma hepcidin response to oral iron supplements depends on the iron dosage. Swiss Med Wkly 2024; 154:3635. [PMID: 38579297 DOI: 10.57187/s.3635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Iron deficiency without anaemia is a common health problem, especially in young menstruating women. The efficacy of the usually recommended oral iron supplementation is limited due to increased plasma hepcidin concentration, which reduces iron absorption and leads to side effects such as intestinal irritation. This observation raises the question of how low-dose iron therapy may affect plasma hepcidin levels and whether oral iron intake dose-dependently affects plasma hepcidin production. METHODS Fifteen non-anaemic women with iron deficiency (serum ferritin ≤30 ng/ml) received a single dose of 0, 6, 30, or 60 mg of elemental oral iron as ferrous sulfate on different days. Plasma hepcidin was measured before and seven hours after each dose. RESULTS Subjects had an average age of 23 (standard deviation = 3.0) years and serum ferritin of 24 ng/ml (interquartile range = 16-27). The highest mean change in plasma hepcidin levels was measured after ingesting 60 mg of iron, increasing from 2.1 ng/ml (interquartile range = 1.6-2.9) to 4.1 ng/ml (interquartile range = 2.5-6.9; p < 0.001). Iron had a significant dose-dependent effect on the absolute change in plasma hepcidin (p = 0.008), where lower iron dose supplementation resulted in lower plasma hepcidin levels. Serum ferritin levels were significantly correlated with fasting plasma hepcidin levels (R2 = 0.504, p = 0.003) and the change in plasma hepcidin concentration after iron intake (R2 = 0.529, p = 0.002). CONCLUSION We found a dose-dependent effect of iron supplementation on plasma hepcidin levels. Lower iron dosage results in a smaller increase in hepcidin and might thus lead to more efficient intestinal iron absorption and fewer side effects. The effectiveness and side effects of low-dose iron treatment in women with iron deficiency should be further investigated. This study was registered at the Swiss National Clinical Trials Portal (2021-00312) and ClinicalTrials.gov (NCT04735848).
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Affiliation(s)
- Maximilian Karczewski
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Stana Simic
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Lanja Saleh
- Department of General Routine and Emergency Analysis, Institute of Clinical Chemistry, University Hospital of Zurich, Zurich, Switzerland
| | - Albina Nowak
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
- Department of Internal Medicine, Psychiatric University Clinic Zurich, Zurich, Switzerland
| | - Morton G Schubert
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Diego Moretti
- ETH Zurich, Laboratory of Human Nutrition, Institute of Food Nutrition and Health, Zurich, Switzerland
| | - Dorine W Swinkels
- Translational Metabolic Laboratory (TML), Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen and Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Felix Beuschlein
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
- Department of Internal Medicine IV - Endocrinology, Nephrology, University Hospital Munich, Munich, Germany
| | - Paolo M Suter
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Pierre-Alexandre Krayenbuehl
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
- General Practice, Brauereistrasse, Uster-Zurich, Switzerland
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Radovanovic D, Muggli F, Bianchetti M, Gallino A, Parati G, Suter PM, Schoenenberger-Berzins R, Erne P, Schoenenberger AW. Comparison of office, home and ambulatory blood pressure measurements in hypertensive and suspected hypertensive SWICOS participants. Blood Press 2023; 32:2234496. [PMID: 37452435 DOI: 10.1080/08037051.2023.2234496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Hypertension should be confirmed with the use of home BP measurement (HBPM) or 24h ambulatory BP measurement (ABPM). The aim of our study was to compare measurements obtained by OBPM, HBPM and ABPM in individuals with elevated OBPM participating in the population-based Swiss Longitudinal Cohort Study (SWICOS). MATERIAL AND METHODS Participants with OBPM ≥140/90 mmHg assessed their BP using HBPM and ABPM. The cut-off for hypertension was ≥135/85 mmHg for HBPM, ≥130/80 mmHg for ABPM. White-coat hypertension (WCH) was defined as normal HPBM and ABPM in participants not taking antihypertensive drugs. Uncontrolled hypertension was defined as hypertension in HBPM or ABPM despite antihypertensive treatment. RESULTS Of 72 hypertensive subjects with office BP ≥140/90 mmHg and valid measurements of HBPM and ABPM, 39 were males (aged 62.8 ± 11.8y), 33 were females (aged 57.4 ± 14.2y). Hypertension was confirmed with HBPM and ABPM in 17 participants (24%), with ABPM only in 24 further participants (33%), and with HBPM only in 2 further participants (3%). Participants who had hypertension according to ABPM but not HBPM were younger (59 ± 11 y versus 67 ± 16 y; p < 0.001) and more frequently still working (83% versus 23%; p < 0.001). The prevalence of WCH was 28%. Among the 32 subjects taking antihypertensive drugs, uncontrolled hypertension was found in 49%. CONCLUSION This population-based study found a high prevalence of WCH and potential uncontrolled hypertension among individuals with elevated OBPM. This study, therefore, supports the ESH recommendations of complementing OBPM by ABPM or HBPM. The use of HBPM instead of ABPM for the confirmation of hypertension in individuals with elevated OBPM might lead to underdiagnosis and uncontrolled hypertension, in particular in the younger working population. In these individuals, this study suggests using ABPM instead of HBPM.
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Affiliation(s)
- D Radovanovic
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - F Muggli
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - M Bianchetti
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - A Gallino
- Cardiovascular Research Unit, Dep. Medicina Interna, San Giovanni Hospital, Bellinzona, Switzerland
| | - G Parati
- Istituto Auxologico Italiano, IRCCS, Cardiology Unit and Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - P M Suter
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
| | | | - P Erne
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - A W Schoenenberger
- Department of Geriatrics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
- Medizinische Klinik, Kantonsspital Münsterlingen, Münsterlingen, Switzerland
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Schoenenberger AW, Radovanovic D, Muggli F, Suter PM, Schoenenberger-Berzins R, Parati G, Bianchetti MG, Gallino A, Erne P. Prevalence of ideal cardiovascular health in a community-based population - results from the Swiss Longitudinal Cohort Study (SWICOS). Swiss Med Wkly 2021; 151:w30040. [PMID: 34581550 DOI: 10.4414/smw.2021.w30040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
AIMS OF THE STUDY The American Heart Association (AHA) developed a concept to measure cardiovascular health in populations. We aimed to analyse participants in the Swiss Longitudinal Cohort Study (SWICOS) according to the AHA concept. METHODS We analysed cardiovascular health according to the AHA concept in all 474 participants of the prospective, population-based SWICOS study who were 18 years or older. The AHA concept uses seven health metrics of known cardiovascular risk factors (blood pressure, total cholesterol, blood glucose, smoking, body weight, physical activity and diet), and classifies each health metric according to three levels (ideal, intermediate and poor) using pre-defined cut-offs. RESULTS Ideal cardiovascular health for three or more of the seven health metrics was found in 259 participants (54.9%; 95% confidence interval [CI] 50.1-59.4%), but a relevant number of participants (n = 213, 45.1%, 95% CI 40.6-49.7%) showed ideal cardiovascular health for only two or fewer of the seven health metrics. Poor cardiovascular health for three or more of the seven health metrics was found in 40 participants (8.5%; 95% CI 6.1-11.4%); a majority of 432 participants (91.5%; 95% CI 88.6-93.9%) showed a poor level for only two or fewer of the seven health metrics. CONCLUSIONS Overall, we found favourable results for cardiovascular health in the population-based SWICOS cohort. Nevertheless, we see the need for further health prevention campaigns given the fact that a relevant proportion of the participants could optimise their cardiovascular health.
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Affiliation(s)
- Andreas W Schoenenberger
- Department of Geriatrics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.,Department of Internal Medicine, Kantonsspital Münsterlingen, Switzerland
| | - Dragana Radovanovic
- Faculty of Biomedical Science, Università della Svizzera Italiana, Lugano, Switzerland
| | - Franco Muggli
- Faculty of Biomedical Science, Università della Svizzera Italiana, Lugano, Switzerland
| | - Paolo M Suter
- Department of Medicine, Outpatient Clinic, University Hospital of Zürich, Switzerland
| | | | - Gianfranco Parati
- Department of Cardiology, San Luca Hospital, Istituto Auxologico Italiano, and Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Mario G Bianchetti
- Faculty of Biomedical Science, Università della Svizzera Italiana, Lugano, Switzerland
| | - Augusto Gallino
- Department of Cardiovascular Medicine, Hospital of San Giovanni, Bellinzona, Switzerland
| | - Paul Erne
- Faculty of Biomedical Science, Università della Svizzera Italiana, Lugano, Switzerland
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Schneemann M, Suter PM. [Self-Determined Dying]. Praxis (Bern 1994) 2021; 110:599-600. [PMID: 34465195 DOI: 10.1024/1661-8157/a003747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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5
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Lepori L, Radovanovic D, Schoenenberger AW, Suter PM, Erne P, Parati G, Gallino A, Bianchetti MG, Muggli F. Age-Dependency of Cardiometabolic Risk and Protective Factors in Females Living in a Countryside Area of Switzerland. Praxis (Bern 1994) 2021; 110:252-256. [PMID: 33849291 DOI: 10.1024/1661-8157/a003622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We investigated the effect of age on cardiometabolic risk and protective factors in females living in a countryside area of Switzerland. For this cross-sectional analysis, data from 268 female adults, who live in two neighboring countryside villages in Italian-speaking Switzerland were retained. 89 study participants were premenopausal, 82 climacteric and 97 postmenopausal. Television viewing time, short duration of sleep, overweight, blood pressure, levels of atherogenic lipids and glycated hemoglobin significantly increased with age. Walking time also significantly increased with age. Tobacco smoking was more common among premenopausal women. It is concluded that in these countryside villages climacteric and postmenopausal women generally have an unfavorable cardiometabolic risk profile. On the other side, low physical activity and smoking are, compared to premenopausal and climacteric women, less prevalent in postmenopausal women.
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Affiliation(s)
- Letizia Lepori
- Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Dragana Radovanovic
- Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Andreas W Schoenenberger
- Department of Geriatrics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Paolo M Suter
- Department of Internal Medicine, University Hospital Zurich and University of Zurich, Switzerland
| | - Paul Erne
- Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Gianfranco Parati
- Istituto Auxologico Italiano, IRCCS, Cardiology Unit and Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Milano, & Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Augusto Gallino
- Cardiovascular Research, San Giovanni Hospital, Bellinzona, Switzerland
| | - Mario G Bianchetti
- Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Franco Muggli
- Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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6
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Schnoz D, Suter PM. [CME: Harmful Alcohol Consumption in the Elderly]. Praxis (Bern 1994) 2021; 110:121-130. [PMID: 33653099 DOI: 10.1024/1661-8157/a003650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CME: Harmful Alcohol Consumption in the Elderly Abstract. Harmful alcohol consumption is an increasing clinical problem in many patients. Often excessive alcohol consumption is not addressed in clinical practice and there is still a high level of stigmatization around this topic. The early recognition and early therapeutic intervention are crucial for success. The general practitioner plays a key role in the (early) diagnosis, initiation and follow-up of alcohol-related problems. In this article the ideal procedures for the recognition of high-risk consumption are summarized. In daily practice, an ideal tool is the 'brief intervention' approach. The major steps and procedures for brief intervention for alcohol misuse are summarized and discussed.
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Affiliation(s)
- Domenic Schnoz
- Zürcher Fachstelle zur Prävention des Suchtmittelmissbrauchs (ZFPS), Zürich
| | - Paolo M Suter
- Klinik und Poliklinik für Innere Medizin, Universitätsspital, Zürich
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7
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Schnoz D, Suter PM. [CME/Answers: Harmful Alcohol Consumption in the Elderly]. Praxis (Bern 1994) 2021; 110:187-188. [PMID: 33726513 DOI: 10.1024/1661-8157/a003651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CME/Answers: Harmful Alcohol Consumption in the Elderly Abstract. Harmful alcohol consumption is an increasing clinical problem in many patients. Often excessive alcohol consumption is not addressed in clinical practice and there is still a high level of stigmatization around this topic. The early recognition and early therapeutic intervention are crucial for success. The general practitioner plays a key role in the (early) diagnosis, initiation and follow-up of alcohol-related problems. In this article the ideal procedures for the recognition of high-risk consumption are summarized. In daily practice, an ideal tool is the 'brief intervention' approach. The major steps and procedures for brief intervention for alcohol misuse are summarized and discussed.
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Affiliation(s)
- Domenic Schnoz
- Zürcher Fachstelle zur Prävention des Suchtmittelmissbrauchs (ZFPS), Zürich
| | - Paolo M Suter
- Klinik und Poliklinik für Innere Medizin, Universitätsspital, Zürich
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8
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Schneemann M, Steurer J, Suter PM. [Not Available]. Praxis (Bern 1994) 2020; 109:141. [PMID: 32126923 DOI: 10.1024/1661-8157/a003434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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9
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Suter PM, Perger L. [Alcohol and the Bariatric Patient: When One Drink Becomes Two Drinks]. Praxis (Bern 1994) 2019; 108:753-754. [PMID: 31480957 DOI: 10.1024/1661-8157/a003281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Paolo M Suter
- Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Ludwig Perger
- Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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10
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Suter PM, Perger L. [Alcohol and the Bariatric Patient: When One Drink Becomes Two Drinks]. Praxis (Bern 1994) 2019; 108:655-662. [PMID: 31387501 DOI: 10.1024/1661-8157/a003280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Alcohol and the Bariatric Patient: When One Drink Becomes Two Drinks Abstract. Moderate consumption of alcohol is a risk factor for weight gain and obesity. Alcohol affects all components of the energy balance. Alcohol consumption is - as in the general population - also a widespread phenomenon in obese and bariatric patients. As a function of the bariatric surgery technique, alcohol metabolism is altered: gastric bypass surgery and sleeve gastrectomy lead to a faster absorption of alcohol, higher peak alcohol concentration and a longer alcohol persistence in the circulation. Further reward mechanisms for alcohol are changed, so that alcohol consumption is enhanced and promoted, with an increased risk to develop alcohol dependency. It is time to address these issues in the daily practice and to fill the existing research gaps.
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Affiliation(s)
- Paolo M Suter
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Ludwig Perger
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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11
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Suter PM. [Thoughts about Light and Sleep]. Praxis (Bern 1994) 2019; 108:139-143. [PMID: 30722742 DOI: 10.1024/1661-8157/a003175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Thoughts about Light and Sleep Abstract. Many aspects of health and disease are mainly determined by the constant change between light and darkness during a solar day. The resulting physiological rhythms correspond to the circadian rhythm, which was one of the most central drivers in the evolution of humans. However, over the last 20-30 years, these natural rhythms of the change of light and darkness are being increasingly ignored by modern societies. It is well known that these rhythms are modulators of many physiological pathways and any desynchronization or misalignment will activate different pathophysiological pathways, which contribute to the risk of chronic diseases. Light pollution by widespread illumination of our environment and the night sky and uncontrolled man-made use of any light source plays a key role in the pathogenesis of sleep disturbances. Blue light exposure in the evening from any artificial light source (especially from electronic device screens) is of special relevance in this context. In this article a few key facts concerning light, sleep and diseases are presented. We should by all means account for the effects of light and darkness and stop any further light pollution.
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Affiliation(s)
- Paolo M Suter
- 1 Medizinische Poliklinik, Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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12
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Zumsteg U, Suter PM. [Not Available]. Praxis (Bern 1994) 2019; 108:87-88. [PMID: 30722740 DOI: 10.1024/1661-8157/a003183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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13
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Suter PM. [There Is No Such Thing as a Free Lunch]. Praxis (Bern 1994) 2018; 107:1005. [PMID: 30227800 DOI: 10.1024/1661-8157/a003108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Paolo M Suter
- 1 Leitender Arzt, Klinik und Poliklinik für Innere Medizin, Universitätsspital, 8991 Zürich
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14
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Jonas H, Annema W, von Eckardstein A, Suter PM. [Not Available]. Praxis (Bern 1994) 2018; 107:285. [PMID: 29486643 DOI: 10.1024/1661-8157/a002893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Henriette Jonas
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Wijtske Annema
- 2 Institut für klinische Chemie, Universitätsspital Zürich
| | | | - Paolo M Suter
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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15
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Jonas H, Annema W, von Eckardstein A, Suter PM. [Not Available]. Praxis (Bern 1994) 2018; 107:215-222. [PMID: 29439638 DOI: 10.1024/1661-8157/a002892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Zusammenfassung. Herz-Kreislauf-Erkrankungen sind nach wie vor die wichtigsten Morbiditäts- und Mortalitätsursachen in der modernen Gesellschaft. Entsprechend hoch ist der Stellenwert der verschiedenen kardiovaskulären Präventionsmassnahmen. Auch wenn die internationalen Empfehlungen geschlechtsspezifisch sind, darf folgende allgemeine Empfehlung zum Lipidscreening formuliert werden: Bei Erwachsenen über 35 Jahren sollte bei Gelegenheit ein Lipidscreening durchgeführt werden. Falls aufgrund der Risikokonstellation ein erhöhtes kardiovaskuläres Risiko vorliegt, soll bereits in der Altersgruppe der 20- bis 35-Jährigen ein präventives Lipidscreening erfolgen. Mit Hilfe der klinischen und laborchemischen Daten wird das kardiovaskuläre Risiko mittels AGLA-Score (oder anderen validierten Scores) berechnet und gegebenenfalls eine Therapieindikation gestellt. Welche Lipidparameter sollten für eine Screeninguntersuchung bestimmt werden? Zum initialen Lipidscreening gehören Gesamtcholesterin, HDL-Cholesterin, LDL-Cholesterin (direkt bestimmt oder berechnet) und die Triglyzeride (idealerweise nüchtern). Eine immer wiederkehrende Frage ist, ob das Lipoprotein(a), Lp(a), gemessen werden soll und welche Bedeutung und Konsequenz erhöhte Werte haben. Die im Moment herrschende Unklarheit und Unsicherheit «spiegelt» sich sehr deutlich in der Anzahl der Bestimmungen von Lp(a) am Institut für klinische Chemie des Universitätsspitals Zürich wider: Die Messung des Lp(a) wird im Vergleich zum LDL-Cholesterin sehr selten angefordert. In diesem CME wird der Stellenwert der Messung von Lp(a) für den praktisch tätigen Arzt kurz und knapp aufgearbeitet.
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Affiliation(s)
- Henriette Jonas
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Wijtske Annema
- 2 Institut für klinische Chemie, Universitätsspital Zürich
| | | | - Paolo M Suter
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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Suter PM. [Not Available]. Praxis (Bern 1994) 2018; 107:5-6. [PMID: 29295680 DOI: 10.1024/1661-8157/a002876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Abstract
Zusammenfassung. Trotz aller Kontroversen ist die Empfehlung der Kontrolle der Zufuhr an gesättigten Fetten und Cholesterin bei gleichzeitiger Optimierung der Zufuhr an einfach- und mehrfach ungesättigten Fetten immer noch gültig, sollte aber nicht unabhängig von anderen beeinflussbaren Determinanten betrachtet werden. Diese Empfehlungen können am einfachsten durch Beachtung des gesamten Essmusters erreicht werden, das eigentlich einem semi-vegetarischen Essmuster mit geringer Energiedichte entspricht. Es gilt, regelmässig alle Komponenten des «Foodoms» mit der Ernährung aufzunehmen.
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Affiliation(s)
- Paolo M Suter
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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18
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Suter PM, Perger L. [Not Available]. Praxis (Bern 1994) 2017; 106:859-860. [PMID: 28795629 DOI: 10.1024/1661-8157/a002753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Paolo M Suter
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Ludwig Perger
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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Kuhn E, Suter PM. [Not Available]. Praxis (Bern 1994) 2017; 106:255-259. [PMID: 28253810 DOI: 10.1024/1661-8157/a002612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Zusammenfassung. In diesem Mini-Review wird aufgezeigt, dass die Diagnostik der sekundären Hypertonie eigentlich eine relativ einfache Unternehmung ist. Neben einer umfassenden Anamnese sowie einer korrekt durchgeführten klinischen Untersuchung muss bei jeder Diagnosestellung einer arteriellen Hypertonie an die Möglichkeit einer sekundären Ursache gedacht werden. Oft ist es auch kostengünstiger, beim geringsten Verdacht direkt nach einer sekundären Ursache zu suchen, als durch langwierige Umstellungen der Therapie und damit auch Verunsicherung des Patienten die Diagnostik zu verzögern.
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Affiliation(s)
- Eric Kuhn
- 1 Hypertonie- und Adipositassprechstunde, KPIM, Universitätsspital Zürich
| | - Paolo M Suter
- 1 Hypertonie- und Adipositassprechstunde, KPIM, Universitätsspital Zürich
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Nowak A, Boesch L, Andres E, Battegay E, Hornemann T, Schmid C, Bischoff-Ferrari HA, Suter PM, Krayenbuehl PA. Effect of vitamin D3 on self-perceived fatigue: A double-blind randomized placebo-controlled trial. Medicine (Baltimore) 2016; 95:e5353. [PMID: 28033244 PMCID: PMC5207540 DOI: 10.1097/md.0000000000005353] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Vitamin D deficiency is frequent and has been associated with fatigue in uncontrolled trials. METHODS This is the first double-blind placebo-controlled clinical trial to investigate the efficacy of per os vitamin D3 (cholecalciferol) in treating fatigue among otherwise healthy persons with low serum 25-hydroxyvitamin D (25(OH)D) levels. We enrolled 120 individuals (mean age 29 ± 6 years, 53% women) presenting with fatigue and vitamin D deficiency (serum 25(OH)D < 20 μg/L). Participants were randomized to a single oral dose of 100,000 units of vitamin D or placebo. The primary endpoint was intra-individual change in the fatigue assessment scale (FAS) at 4 weeks after treatment. RESULT The mean age of the participants was 29 ± 6 years, 53% were women. Mean FAS decreased significantly more in the vitamin D group (-3.3 ± 5.3; 95% confidence interval [CI] for change -14.1 to 4.1) compared with placebo (-0.8 ± 5.3; 95% CI for change -9.0 to 8.7); (P = 0.01). Amelioration of fatigue was reported more frequently in vitamin D than in placebo group (42 [72%] vs. 31 [50%]; P = 0.01; odds ratio [OR] 2.63, 95% CI for OR 1.23-5.62). Among all participants, improvement in fatigue score correlated with the rise in 25(OH)D level (R = -0.22, P = 0.02). CONCLUSION Vitamin D treatment significantly improved fatigue in otherwise healthy persons with vitamin D deficiency.This study was registered at the www.ClinicalTrials.gov Protocol ID NCT02022475.
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Affiliation(s)
| | | | | | | | - Thorsten Hornemann
- Institute for Clinical Chemistry, University Hospital Zurich and University of Zurich
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21
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Schoenenberger AW, Muggli F, Parati G, Gallino A, Ehret G, Suter PM, Schoenenberger-Berzins R, Resink TJ, Erne P. Protocol of the Swiss Longitudinal Cohort Study (SWICOS) in rural Switzerland. BMJ Open 2016; 6:e013280. [PMID: 27895066 PMCID: PMC5168533 DOI: 10.1136/bmjopen-2016-013280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Increased longevity and consequent major changes in demographics and population lifestyles necessitate new approaches to reduce the burden of ageing-related diseases (including cardiovascular disease) and maintain an optimal quality of life. This study aims to examine and longitudinally follow health status and disease risk factors in a Swiss rural cohort, evaluating all health-related research and practice disciplines to assure development of new implementable and successful preventive strategies for healthy ageing. METHODS AND OBJECTIVES Small Swiss villages with low migration rates will be selected for this study. 2 villages (Cama/Lostallo) have already been selected as initial study sites. All residents (age ≥6 years, no upper age limit) are eligible. The target enrolment number per village is 300. Examinations and measurements encompass medical history, anthropometry, cardiac and vascular health, pulmonary function, physical performance, nutritional, mental and emotional status, biochemical and molecular analyses. Follow-up examinations (identical to baseline) will be performed after 5 and 10 years, and in 10-year intervals thereafter. The major objective is to assess, and observe change in, health status over time in a prospective manner. Secondary objectives are to: (1) identify 'hidden' (asymptomatic and/or unrecognised) health problems which enhance risk for chronic diseases; (2) identify barriers to accessing healthcare and adapting health behaviours; (3) evaluate efficacy of present preventive strategies and recommendations; (4) evaluate knowledge and attitude towards ongoing health programmes and public health recommendations; (5) monitor change and progress towards the national health objectives; (6) formulate new preventive strategies and recommendations based on the findings and knowledge base of the past 10 years; (7) formulate models for successful prevention of chronic diseases and for healthy ageing. ETHICS AND DISSEMINATION The Ethics Committee of Nordwest-und Zentralschweiz approved this study (EKNZ 2014-209). It is registered at ClinicalTrials.gov (NCT02282748). Findings will be disseminated through scientific articles/presentations and public events.
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Affiliation(s)
- Andreas W Schoenenberger
- Department of Geriatrics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Franco Muggli
- Outpatient's Medical Clinic, Via i Platani, Vezia (Lugano), Switzerland
| | - Gianfranco Parati
- Department of Cardiology, San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Augusto Gallino
- Department of Internal Medicine, Hospital San Giovanni, Bellinzona, Switzerland
| | - Georg Ehret
- Division of Cardiology, University of Geneva, Geneva, Switzerland
| | - Paolo M Suter
- Department of Medicine, Outpatient Clinic, University Hospital of Zürich, Zürich, Switzerland
| | | | - Therese J Resink
- Laboratory of Signal Transduction, Department of Biomedicine, Basel University Hospital and University of Basel, Basel, Switzerland
| | - Paul Erne
- Laboratory of Signal Transduction, Department of Biomedicine, Basel University Hospital and University of Basel, Basel, Switzerland
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Abstract
Zusammenfassung. In diesem Übersichtsartikel werden die Ursprünge, der mögliche Nutzen und auch Risiken der supra-physiologischen Gabe an Mikronährstoffen diskutiert. Am Beispiel von Vitamin A und Vitamin C werden die präventive Bedeutung und potentielle Gefahren von Superdosing praxisnahe erörtert. Beim genauen Hinsehen ist die Evidenz für Superdosing bei gesunden Menschen für die meisten Nährstoffe leider kaum vorhanden.
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Affiliation(s)
- Paolo M. Suter
- Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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23
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Curcio R, Stettler H, Suter PM, Aksözen JB, Saleh L, Spanaus K, Bochud M, Minder E, von Eckardstein A. Reference intervals for 24 laboratory parameters determined in 24-hour urine collections. Clin Chem Lab Med 2016; 54:105-16. [PMID: 26053007 DOI: 10.1515/cclm-2014-1041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 05/05/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Reference intervals for many laboratory parameters determined in 24-h urine collections are either not publicly available or based on small numbers, not sex specific or not from a representative sample. METHODS Osmolality and concentrations or enzymatic activities of sodium, potassium, chloride, glucose, creatinine, citrate, cortisol, pancreatic α-amylase, total protein, albumin, transferrin, immunoglobulin G, α1-microglobulin, α2-macroglobulin, as well as porphyrins and their precursors (δ-aminolevulinic acid and porphobilinogen) were determined in 241 24-h urine samples of a population-based cohort of asymptomatic adults (121 men and 120 women). For 16 of these 24 parameters creatinine-normalized ratios were calculated based on 24-h urine creatinine. The reference intervals for these parameters were calculated according to the CLSI C28-A3 statistical guidelines. RESULTS By contrast to most published reference intervals, which do not stratify for sex, reference intervals of 12 of 24 laboratory parameters in 24-h urine collections and of eight of 16 parameters as creatinine-normalized ratios differed significantly between men and women. For six parameters calculated as 24-h urine excretion and four parameters calculated as creatinine-normalized ratios no reference intervals had been published before. For some parameters we found significant and relevant deviations from previously reported reference intervals, most notably for 24-h urine cortisol in women. Ten 24-h urine parameters showed weak or moderate sex-specific correlations with age. CONCLUSIONS By applying up-to-date analytical methods and clinical chemistry analyzers to 24-h urine collections from a large population-based cohort we provide as yet the most comprehensive set of sex-specific reference intervals calculated according to CLSI guidelines for parameters determined in 24-h urine collections.
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Dias S, Günther V, Suter PM. [Not Available]. Praxis (Bern 1994) 2016; 105:1107. [PMID: 27606921 DOI: 10.1024/1661-8157/a002466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Saskia Dias
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Viola Günther
- 2 Institut für Klinische Chemie (IKC), Universitätsspital Zürich
| | - Paolo M Suter
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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25
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Dias S, Günther V, Suter PM. [Not Available]. Praxis (Bern 1994) 2016; 105:995-1000. [PMID: 27560811 DOI: 10.1024/1661-8157/a002465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Zusammenfassung. Eine Erhöhung der Plasma-Vitamin-B12(=Cobalamin)-Spiegel findet sich unerwartet häufig als asymptomatischer Zufallsbefund in der Routinelaboruntersuchung. Eine diagnostisch zielführende Klinik fehlt in der Regel. Der Cobalamin-Stoffwechsel und der Metabolismus seiner Transportproteine ist komplex, jedoch für das Verständnis der verschiedenen Differenzialdiagnosen einer Hypervitaminämie B12 von entscheidender Bedeutung. Neben der übermässigen Cobalaminzufuhr von aussen kann eine Vitamin-B12-Erhöhung auch bei soliden Neoplasien, hämatologischen Grunderkrankungen, Leber- und Nierenfunktionsstörungen und rheumatologischen Erkrankungen auftreten. Eine gezielte Anamnese verhindert dabei die Überdiagnostik. In diesem Artikel möchten wir auf Abklärungsstrategien und Differenzialdiagnosen einer Hypervitaminämie B12 eingehen.
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Affiliation(s)
- Saskia Dias
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Viola Günther
- 2 Institut für Klinische Chemie (IKC), Universitätsspital Zürich
| | - Paolo M Suter
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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26
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Suter PM, Wahli W. “Every day I dream ...” An interview with the Rwandan Health Minister. Swiss Med Wkly 2016; 146:w14316. [DOI: 10.4414/smw.2016.14316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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27
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Forni Ogna V, Ogna A, Ponte B, Gabutti L, Binet I, Conen D, Erne P, Gallino A, Guessous I, Hayoz D, Muggli F, Paccaud F, Péchère-Bertschi A, Suter PM, Bochud M, Burnier M. Prevalence and determinants of chronic kidney disease in the Swiss population. Swiss Med Wkly 2016; 146:w14313. [PMID: 27152492 DOI: 10.4414/smw.2016.14313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
QUESTIONS UNDER STUDY The prevalence of chronic kidney disease (CKD) is increasing worldwide, corresponding to an increased risk of cardiovascular disease. The latest study on prevalence of CKD involving the three linguistic regions of Switzerland dates back to 2002-2003 and definitions have changed since then. We aimed to assess the current prevalence and determinants of CKD in the Swiss general population. METHODS We analysed the data of 1353 participants from a cross-sectional population-based survey performed in 2010-2012 in the three linguistic regions of Switzerland. The prevalence of CKD and the derived cardiovascular risk categories were assessed according to the Kidney Disease - Improving Global Outcomes (KDIGO) 2012 classification, using estimated glomerular filtration rate (GFR; CKD-Epidemiological Collaboration equation) and albuminuria level. Multivariate logistic regression was used to analyse factors associated with CKD. RESULTS We included 660 men and 693 women, equally distributed in four age categories (15-29, 30-44, 45-59 and over 60 years). The overall prevalence of CKD was 10.4%. The prevalence in the low, moderate, high and very high risk KDIGO categories were 89.6%, 8.4%, 1.6% and 0.5%, respectively. The prevalence of CKD was similar in all linguistic regions. In multivariate analysis, female gender, older age, diabetes and uric acid were independently associated with CKD in persons ≥45 y. In younger participants, diabetes and lower educational level were associated with CKD. CONCLUSIONS In the general Swiss population, CKD affects one in ten adults. Subjects older than 60 years, as well as patients with diabetes and hypertension, show a high prevalence of CKD. Systematic screening may be recommended in this population.
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Affiliation(s)
- Valentina Forni Ogna
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital, Switzerland
| | - Adam Ogna
- Department of Internal Medicine and Nephrology, Ospedale La Carità, Locarno, Switzerland
| | - Belen Ponte
- Division of Chronic Disease, Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland; Service of Nephrology, Geneva University Hospitals, Switzerland
| | - Luca Gabutti
- Department of Internal Medicine and Nephrology, Ospedale La Carità, Locarno, Switzerland
| | - Isabelle Binet
- Service of Nephrology/Transplantation Medicine, Kantonsspital, St. Gallen, Switzerland
| | - David Conen
- Department of Medicine, University Hospital Basel, Switzerland
| | - Paul Erne
- Hypertension Centre, Luzern, Switzerland
| | - Augusto Gallino
- Cardiology Department, Ospedale San Giovanni, Bellinzona, Switzerland
| | - Idris Guessous
- Division of Chronic Disease, Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland; Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Community Medicine, Primary Care and Emergency Medicine
| | - Daniel Hayoz
- Department of Internal Medicine and Angiology, Hôpital Cantonal, Fribourg, Switzerland
| | | | - Fred Paccaud
- Division of Chronic Disease, Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland
| | - Antoinette Péchère-Bertschi
- Unit of Hypertension, Departments of Specialties of Medicine and Community Medicine and Primary Care and Emergency Medicine, Geneva University Hospitals, Switzerland
| | - Paolo M Suter
- Clinic and Policlinic of Internal Medicine, University Hospital of Zurich, Switzerland
| | - Murielle Bochud
- Division of Chronic Disease, Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland
| | - Michel Burnier
- Service of Nephrology and Hypertension, Department of Medicine, Lausanne University Hospital, Switzerland
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Suter PM. New “Profiles” for tomorrow’s health professionals: Welcome! We need you. Swiss Med Wkly 2016; 146:w14289. [DOI: 10.4414/smw.2016.14289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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29
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Suter PM. [Circadian rhythms and chronic diseases]. Praxis (Bern 1994) 2015; 104:1265-1270. [PMID: 26558932 DOI: 10.1024/1661-8157/a002178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Everything in nature and life is occurring in a rhythmic manner. The major “Zeitgeber” is the change of light and dark during a 24 h day. This circadian rhythm is besides others reflected in circadian rhythms of behaviors or different biochemical parameters. A disruption of the circadian rhythm has a high pathophysiological potential. In this article a few basic issues about the role of circadian rhythms and the pathophysiological importance of desynchronisation are reviewed.
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Affiliation(s)
- Paolo M Suter
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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30
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Nater H, Perger L, Suter PM. [Help me--I do not tolerate my statin]. Praxis (Bern 1994) 2015; 104:491-499. [PMID: 26098050 DOI: 10.1024/1661-8157/a002007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Statins represent the most widely prescribed drugs. Accordingly, in daily practice statin-related muscle pain and other myopathic sensations are frequently seen. In this practice review the clinical approach to statin myopathy is discussed.
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Affiliation(s)
- Harald Nater
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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31
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Suter PM, Pittet D. Prognostic importance of vital organ dysfunction in sepsis. Contrib Nephrol 2015; 116:16-21. [PMID: 8529372 DOI: 10.1159/000424607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- P M Suter
- Division of Surgical Intensive Care, Hôpital Cantonal Universitaire, Geneva, Switzerland
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32
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Suter PM. [Every hour causes damage, the last one kills....]. Praxis (Bern 1994) 2015; 104:383. [PMID: 25851365 DOI: 10.1024/1661-8157/a001967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Paolo M Suter
- Klinik und Poliklinik für Innere Medizin; Universitätsspital Zürich
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Rathod A, Bonny O, Guessous I, Suter PM, Conen D, Erne P, Binet I, Gabutti L, Gallino A, Muggli F, Hayoz D, Péchère-Bertschi A, Paccaud F, Burnier M, Bochud M. Association of urinary calcium excretion with serum calcium and vitamin D levels. Clin J Am Soc Nephrol 2014; 10:452-62. [PMID: 25518946 DOI: 10.2215/cjn.12511213] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Population-based data on urinary calcium excretion are scarce. The association of serum calcium and circulating levels of vitamin D [25(OH)D2 or D3] with urinary calcium excretion in men and women from a population-based study was explored. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS Multivariable linear regression was used to explore factors associated with square root-transformed 24-hour urinary calcium excretion (milligrams per 24 hours) taken as the dependent variable with a focus on month-specific vitamin D tertiles and serum calcium in the Swiss Survey on Salt Study. RESULTS In total, 624 men and 669 women were studied with mean ages of 49.2 and 47.0 years, respectively (age range=15-95 years). Mean urinary calcium excretion was higher in men than in women (183.05 versus 144.60 mg/24 h; P<0.001). In adjusted models, the association (95% confidence interval) of square root urinary calcium excretion with protein-corrected serum calcium was 1.78 (95% confidence interval, 1.21 to 2.34) mg/24 h per milligram per deciliter in women and 0.59 (95% confidence interval, -0.11 to 1.29) mg/24 h per milligram per deciliter in men. Men in the third 25(OH)D3 tertile had higher square root urinary calcium excretion than men in the first tertile (0.99; 95% confidence interval, 0.36 to 1.63 mg/24 h per nanogram per milliliter), and the corresponding association was 0.32 (95% confidence interval, -0.22 to 0.85) mg/24 h per nanogram per milliliter in women. These sex differences were more marked under conditions of high urinary sodium or urea excretions. CONCLUSIONS There was a positive association of serum calcium with urinary calcium excretion in women but not men. Vitamin 25(OH)D3 was associated with urinary calcium excretion in men but not women. These results suggest important sex differences in the hormonal and dietary control of urinary calcium excretion.
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Affiliation(s)
- Anita Rathod
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Olivier Bonny
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Idris Guessous
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Paolo M Suter
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - David Conen
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Paul Erne
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Isabelle Binet
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Luca Gabutti
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Augusto Gallino
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Franco Muggli
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Daniel Hayoz
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | | | - Fred Paccaud
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Michel Burnier
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
| | - Murielle Bochud
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
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Muskalla AM, Suter PM, Saur M, Nowak A, Hersberger M, Krayenbuehl PA. G-protein receptor kinase 4 polymorphism and response to antihypertensive therapy. Clin Chem 2014; 60:1543-8. [PMID: 25301854 DOI: 10.1373/clinchem.2014.226605] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND G-protein receptor kinase 4 polymorphism influences blood pressure regulation via modulation of dopamine receptor D1 in renal proximal tubular cells. We investigated the role of G-protein receptor kinase 4 polymorphism in the response to hypertensive therapy in patients with essential hypertension. METHODS In a prospective study, we assessed the G-protein receptor kinase 4 polymorphisms R65L, A142V, and A486V in 100 hypertensive patients. We analyzed the association of the 3 gene variants on blood pressure control and response to antihypertensive therapy with single-locus analysis, haplotype analysis, and regression analysis. RESULTS Hypertensive individuals with a homozygous double variant of 65 L and 142 V needed significantly more antihypertensive treatment (number of antihypertensives 2.59 vs 1.95, P = 0.043) and especially diuretic therapy (0.82 vs 0.49, P = 0.029) to reach the same mean arterial blood pressure than did homozygous carriers of only 1 variant or heterozygous/wild-type carriers of R65L, A142V, and A486V alleles. CONCLUSIONS G-protein receptor kinase 4 polymorphism is associated with antihypertensive treatment response in patients with essential hypertension. Determination of G-protein receptor kinase 4 polymorphism may improve individual antihypertensive blood pressure control in patients with essential hypertension.
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Affiliation(s)
- Anne M Muskalla
- Division of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland
| | - Paolo M Suter
- Division of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland
| | - Matthias Saur
- Division of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland; current affiliation: Rheumatology and pain center, Frauenfeld, Switzerland
| | - Albina Nowak
- Division of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland
| | - Martin Hersberger
- Division of Clinical Chemistry, University Hospital of Zurich, Zurich, Switzerland; current affiliation: Institute of Clinical Chemistry and Biochemistry, University Children's Hospital Zurich, Zurich, Switzerland
| | - Pierre-Alexandre Krayenbuehl
- Division of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland; current affiliation: Division of Internal Medicine, Spital Linth, Uznach, Switzerland.
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Ritter A, Sudano Noll I, Suter PM. [Renal denervation - a novel therapeutic option for resistant hypertension?]. Praxis (Bern 1994) 2014; 103:1169-1178. [PMID: 25270745 DOI: 10.1024/1661-8157/a001799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Alexander Ritter
- Klinik und Poliklinik für Innere Medizin, Hypertoniesprechstunde, Universitätsspital Zürich
| | | | - Paolo M Suter
- Klinik und Poliklinik für Innere Medizin, Hypertoniesprechstunde, Universitätsspital Zürich
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36
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Affiliation(s)
- Stefan Zechmann
- Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
| | - Paolo M Suter
- Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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37
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Muggli F, Suter PM. [How to deal with preoperative hypertension]. Praxis (Bern 1994) 2013; 102:1293-1297. [PMID: 24129297 DOI: 10.1024/1661-8157/a001438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Although there only limited supportive evidence it is suggested that in the setting of elective surgery whenever possible one should aim for a normal preoperative blood pressure in hypertensive patients. If preoperative pressure is >180 mmHg (adequate and correct blood pressure measurement technique, whenever needed 24 h-ABPM) an elective surgical intervention should be postponed and blood pressure control should be optimized. Blood pressure of <180 mmHg is regarded as no contraindication for an elective surgical intervention. The perioperative risk in suboptimally treated hypertensive patients is not elevated as long as perioperative anesthesia handling is optimal and in the absence of relevant comorbidities. In summary present evidence suggests that the pre- and perioperative hypertension is a controllable risk factor of minor relevance. However this does not mean that one should ignore elevated preoperative blood pressure values. More than ten years ago an editorialist brought it to the point by saying: "Preoperative hypertension: remain wary? Yes - cancel surgery? No".
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Clerc O, Sudano I, Kubli Haas B, Suter PM. [Smoking cessation in general practice: the general practitioner is the best medicine!]. Praxis (Bern 1994) 2013; 102:565-575. [PMID: 23644240 DOI: 10.1024/1661-8157/a001317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Olivier Clerc
- Klinik und Poliklinik für Innere Medizin, Universitätsspital, Zürich.
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Abstract
OBJECTIVE Environmental factors and behaviors associated with obesity have not been well described in children living in Europe. Although television watching has been repeatedly associated with obesity, it is unclear whether other sedentary activities, such as use of electronic games, are independently associated with obesity in children. The hypothesis was that various types of sedentary activities are associated with obesity in children living in Switzerland. RESEARCH METHODS AND PROCEDURES This was a cross-sectional study of children (grades one to three) from four communities in the Greater Zurich Area (Switzerland). Obesity was defined as a combination of overweight (BMI) and overfat (skinfold thicknesses). Environmental factors were assessed by questionnaire. The children's physical activity was estimated by their teacher (scale 0 to 10). RESULTS Of 922 eligible subjects, 872 (94.6%) took part in the study. Use of electronic games [odds ratio (OR) = 2.03 per hour per day, 95% confidence interval (CI): 1.57 to 2.61, p < 0.001], television (OR = 2.83 per hour per day, 95% CI: 2.08 to 3.86, p < 0.001), physical activity (OR = 0.80 per unit, 95% CI: 0.72 to 0.88, p < 0.001), maternal work (OR = 1.93, 95% CI: 1.13 to 3.29, p = 0.02), and paternal smoking (OR = 1.78, 95% CI: 1.07 to 2.96, p = 0.03) were independently associated with obesity. Further adjustment for socioeconomic status, when available, did not change these results. DISCUSSION In this sample of children living in Switzerland, the use of electronic games was significantly associated with obesity, independently of confounding factors. The association of obesity with television use and lack of physical activity confirms results from other populations and points to potential strategies for obesity prevention.
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Affiliation(s)
- Nicolas Stettler
- Division of Gastroenterology and Nutrition, North 1559, The Children's Hospital of Philadelphia, Thirty-Fourth Street and Civic Center Boulevard, PA 19104-4399, USA.
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Suter PM. Xigris is withdrawn from the market. A 10 year odyssey. Minerva Anestesiol 2011; 77:1128-1129. [PMID: 22134426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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41
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Suter PM, Erne P. Reply to the letter to the editor " Calcium supplementation, vitamin K status and cardiovascular disease: an additional point". Swiss Med Wkly 2011. [DOI: 10.4414/smw.2011.13301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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42
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Schoenenberger AW, Schoenenberger-Berzins R, der Maur CA, Suter PM, Vergopoulos A, Erne P. Thiamine supplementation in symptomatic chronic heart failure: a randomized, double-blind, placebo-controlled, cross-over pilot study. Clin Res Cardiol 2011; 101:159-64. [PMID: 22057652 DOI: 10.1007/s00392-011-0376-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 10/21/2011] [Indexed: 12/13/2022]
Abstract
BACKGROUND Diuretic treatment for heart failure may lead to an increased urinary thiamine excretion and in long-term thiamine deficiency, which may further compromise cardiac function. This study evaluated the effect of high dose thiamine supplementation in heart failure patients. METHODS Nine patients with diuretic treatment for symptomatic chronic heart failure and a left ventricular ejection fraction (LVEF) <40% were randomly assigned to receive thiamine (300 mg/day) or placebo for 28 days. After a wash-out of 6 weeks, the patients crossed-over to a second treatment period. The primary outcome was a change in LVEF. RESULTS Mean age was 56.7 ± 9.2 years (range 44.9-75.4 years). Baseline LVEF was similar for both treatment groups (29.5% in the thiamine group and 29.5% in the placebo group, P = 0.911). After 28 days of thiamine treatment, the LVEF increased to 32.8% which was significantly (P = 0.024) different from the LVEF in the placebo group (28.8%). This corresponds to a treatment effect for LVEF of 3.9% in absolute terms. CONCLUSIONS This study suggests that thiamine supplementation has beneficial effects on cardiac function in patients with diuretic drugs for symptomatic chronic heart failure. Subclinical thiamine deficiency is probably an underestimated issue in these outpatients.
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Affiliation(s)
- Andreas W Schoenenberger
- Division of Geriatrics, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Affiliation(s)
- Bettina Jenni
- Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich.
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44
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Suter PM. [When the past catches up with us...]. Praxis (Bern 1994) 2011; 100:685-686. [PMID: 21739764 DOI: 10.1024/1661-8157/a000643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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45
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Yu B, Wang J, Wang Z, Wang Y, Suter PM, Russell RM, Grusak MA, Yin S, Tang G. High bioavailability of zeaxanthin from deuterium labeled spirulina in humans. FASEB J 2011. [DOI: 10.1096/fasebj.25.1_supplement.975.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bolan Yu
- Carotenoids and Health LaboratoryTufts UniversityBostonMA
| | - Jie Wang
- National Institute for Nutrition and Food SafetyBeijingPeople's Republic of China
| | - Zhixu Wang
- Nanjing Medical UniversityNanjingPeople's Republic of China
| | - Yin Wang
- Zhejiang Academy of Medical SciencesHang ZhouPeople's Republic of China
| | | | | | | | - ShiAn Yin
- National Institute for Nutrition and Food SafetyBeijingPeople's Republic of China
| | - Guangwen Tang
- Carotenoids and Health LaboratoryTufts UniversityBostonMA
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46
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Lüthi S, Zimmerli L, Suter PM, Battegay E. [Primary hyperaldosteronism]. Praxis (Bern 1994) 2011; 100:333-342. [PMID: 21412744 DOI: 10.1024/1661-8157/a000479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- S Lüthi
- Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich, Zürich.
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47
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Jenni B, Suter PM. [After care for patients with gastric bypass operation]. Praxis (Bern 1994) 2011; 100:263-272. [PMID: 21365556 DOI: 10.1024/1661-8157/a000471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- B Jenni
- Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich.
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Hanhart A, Jenni B, Lüthi S, Müller MK, Suter PM. [Doctor, diets don't work for me - I want an operation immediately]. Praxis (Bern 1994) 2010; 99:1383-1392. [PMID: 21082590 DOI: 10.1024/1661-8157/a000306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Andreas Hanhart
- Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich.
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Suter PM. Laws can be unethical. Minerva Anestesiol 2010; 76:548-549. [PMID: 20613696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
ICU teams have the difficult emotional burden of continuing complex life-sustaining therapy beyond the limits of what is felt to be reasonable. Among the reasons leading to a delay in the withdrawal of intensive therapy is the unwillingness or unpreparedness of the team or family members, or inadequate laws. We all have the responsibility to promote a legal framework allowing end-of-life decisions that ensure the autonomy, dignity and integrity of all citizens, in addition to the humane practice of medicine.
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Affiliation(s)
- P M Suter
- Centre Médical Universitaire, University of Geneva, CH-1204 Geneva, Switzerland.
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Hübel K, Suter PM. [Hypertriglyceridemia]. Praxis (Bern 1994) 2009; 98:677-683. [PMID: 19551651 DOI: 10.1024/1661-8157.98.13.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Kerstin Hübel
- Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich, Zürich
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