Search PubMed⌕ Search

Biomedical subjects

A Gassner

Publications and source records attributed to A Gassner.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Effect of nifedipine on hemodynamics in precapillary pulmonary hypertension at rest and during exertion].

The effect of sublingual nifedipine (20 mg) on haemodynamics at rest and during bicycle ergometry in supine position was assessed in 22 patients with precapillary pulmonary hypertension (obstructive form: n = 17, restrictive form: n = 2, combined obstructive-restrictive: n = 3). At rest nifedipine resulted in an increase of cardiac frequency from 85 to 89/min, during exercise from 109 to 120/min (P less than 0.05). Concomitantly the mean arterial blood pressure decreased significantly both at rest and during exercise. The mean pulmonary arterial pressure showed significant reduction from 42.9 to 36.2 mm Hg (P less than 0.0005) only during exercise. The total body vascular resistance at rest decreased by 21% (P less than 0.005), during exercise by 15% (P less than 0.1). Pulmonary arteriolar resistance at rest decreased by 9%, during maximum loading by 34% from 312 to 215 dyn X s X cm-5 (P less than 0.05). Nifedipine was shown to be a suitable agent for lowering right ventricular afterload in secondary pulmonary hypertension due to chronic lung disease. The beneficial effect at rest depends on the extent of the pulmonary arteriolar resistance and the mean pulmonary arterial pressure. However, during exercise conditions it can be observed in the majority of patients (93%). Due to the variable response haemodynamic assessment is required prior to routine use in order to establish patients with optimal response.

Adult↗
PubMed1982

Duration of the hypotensive effect of guanfacine.

Guanfacine given intravenously causes a brief rise in blood pressure. This is followed by a sustained decrease of blood pressure, accompanied in one case by a marked orthostatic effect. In addition to its lowering effect on blood pressure, guanfacine also reduces heart rate. The duration of action for up to 72 h is due to the long half-life of the drug. The main side effects observed are fatigue and sedation.

Adult↗
PubMed1981

[Acute leukemia associated with lactic acidosis].

The clinical course and metabolic disturbances in three patients with acute leukemia and severe lactic acidosis (lactic acid concentrations 11.2, 17.0 and 21.0 mmol/l) are described. Circulatory failure could be ruled out as a possible cause of elevated lactic acid. Clinical findings included somnolence, hyperventilation and diffuse abdominal pain. In patients with malignant disease, a number of factors may contribute to elevated lactic acid levels. However, in our cases the excessive lactic acidosis was due to increased production of lactic acid by the leukemic cells, together with impaired hepatic metabolization. The diminished hepatic gluconeogenesis is also documented by a severe hypoglycemia in our patients. The essential step in treatment is early diagnosis of this syndrome and prompt initiation of cytotoxic medication.

Acidosis↗
PubMed1981

[Infection in patients with hepatic coma (author's transl)].

66 patients with hepatic coma were treated from 1972 to 1979 in the intensive care unit. Incidence and etiology of bacterial infections in these patients were evaluated retrospectively. Bacterial cultures were positive in a high proportion of the cases investigated as compared to the situation on a normal ward. Bacterial cultures were performed in 51 patients (77.3%); cultures from 35 patients were positive. Gramnegative bacteria accounted for 56.4%, grampositive bacteria for 34.8% and candida albicans for 8.8% of all the cases. It is pointed out, that invasive diagnostic and therapeutic manoeuvers in intensive care patients carry a high risk of infection.

Adolescent↗
PubMed1981

Cardiovascular effects of diltiazem in healthy volunteers at rest, supine and erect, and during physical and mental stress.

The hemodynamic effects of diltiazem were investigated in six volunteers at rest, supine and erect, under psychologic stress and orthostatic conditions. Plasma concentrations were also estimated. Under all conditions diltiazem showed a vasodilating property that was more pronounced on the arterial resistance vessels than on the pulmonary vessels. The first plasma concentrations were detected 15 min after drug intake, and the highest values were seen at the end of the study in the 3rd h.

Adult↗
PubMed1980

[Haemodynamic effects after application of nitroglycerin sublingually or as ointment in patients with left ventricular heart failure (author's transl)].

The haemodynamic effects of a 2% nitroglycerin ointment and of sublingual nitroglycerin in patients with left ventricular heart failure were investigated. The well-known pulmonary blood pressure and pulmonary wedge-pressure lowering effect were observed with both forms of administration. Differences exist between onset and duration of the haemodynamic effects. With sublingual administration of nitroglycerin the peak effect was seen after 5 minutes, whilst the pulmonary blood pressure rose again 30 minutes later. After application of nitroglycerin ointment a peak effect was seen 30 minutes later and the effects were sustained for 3 to 6 hours.

Administration, Oral↗
PubMed1979

[Course and intensive treatment of acute falciparum malaria (author's transl)].

The case of a nineteen-year-old women with the cerebral form of malaria tropica is reported. She showed hyperpyrexia, abdominal manifestations, haemolysis and disseminated intravascular coagulation. Cerebral symptoms amounting to grade IV encephalopathy occurred. The patient responded rapidly to the administration of chloroquine, anticonvulsants, dextran, corticosteroids, antipyretics, blood and antithrombin III and her symptoms had almost completely vanished one week after the onset of therapy.

Acute Disease↗
PubMed1979

[Forced diuresis].

Forced diuresis (FD) is a frequently used method for eliminating toxins. Its therapeutic effect has yet to be evaluated by a controlled clinical trial. In the absence of such a trial its usefulness can be judged only indirectly from urinary excretion rates. In former times the usual clinical laboratory procedures could not differentiate between the unchanged toxin and its metabolites. Using more selective methods, the discussions of the effect of FD in eliminating various drugs were renewed. The problem for the indication of FD is not only a missing knowledge about the kind and amount of the ingested drug, but also when knowing it, the missing evaluation of the effect of FD on its excretion. In such cases the pharmacokinetic behaviour of the drug can be helpful. If paying enough attention to the contraindications, to the principles of electrolyte and water balance, the complication rate is low. Many infusion regimes are proposed for this treatment, but only a standardized procedure can increase the safety and efficiency of this method. More complicated and more expensive methods should be used, when there is an intoxication with a substance of high mortality or when there is no effect of FD on eliminating the toxin.

Biotransformation↗
PubMed1978

[Hypophosphatemia during parenteral nutrition of patients with renal insufficiency (author's transl)].

Hypophosphatemia is a much commoner condition than generally recognized from investigations on this subject so far. Hypophosphatemia may cause ill-defined disturbances in the course of illness in patients with renal insufficiency. On the basis of our results we recommend the addition of 5--10 mmol phosphate (155--310 mg phosphorus) per 1000 kcal. of the nutrient solution right from the start of parenteral nutrition in patients with chronic renal insufficiency. The phosphate dosage must be further increased, at least temporarily, in hypophosphatemic patients with acute renal insufficiency. Serum phosphate determination should be obligatory in patients with renal insufficiency at the time when the patient is first seen. It should also be performed at least every second day during the first week of parenteral nutrition. Thereafter, the determination of serum phosphate twice weekly should suffice to control the dosage of phosphate required by the patient.

Acute Kidney Injury↗
PubMed1978

[Differences in plasma aminograms in hepatic and diabetic coma].

In hepatic coma as well as diabetic coma severe disturbances occur in the amino acid metabolism. The defect lies in completely different levels which result two different plasma aminograms (PAG). In 24 patients with hepatic encephalopathy stage III-IV (7 patients with acute and 17 with chronic liver failure) the PAG were evaluated. The determination of the plasma amino acids (PAA) was carried out on Multichrom B (Beckmann, Munich). In hepatic coma high concentrations of Met, Tyr, Ala, Lys and Arg are found. The deviations of PAA from normal controls show between acute and chronic hepatic failure no qualitative but only quantitative differences. In diabetic coma the three branches chain AA (Val, Leu and Ile) were elevated upon 3--5 times of normal. Near normal concentrations are found for the AA Thr, Ser, Gly, Ala, Met and the aromatic AA (Phe and Tyr). The quotient between the branched chain and aromatic AA lies for hepatic coma at a mean of 1.18 and by diabetic coma at 7.18 (p less than 0.001). In hepatic coma a correlation exists between the level of the AA-quotient improvement and the decrease with a deterioriation of the metabolic encephalopathy. The high level of the AA-quotient in the patients of diabetic "coma" gives therefore a good explanation for the rare unconscious state of these patients.

Adult↗