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Biomedical subjects

B Grabensee

Publications and source records attributed to B Grabensee.

At least 199 records · Page 11Linked to original sources
PubMed1988

[Captopril-stimulated plasma renin activity in the diagnosis of renovascular hypertension].

In 67 patients thought to have renovascular hypertension, plasma renin activity was measured in both renal veins and peripherally (common femoral v.) before and after administration of 25 mg captopril. Other antihypertensive medication, except diuretics and ACE inhibitors, had been discontinued. The renin ratio, renin secretion indices before and after ACE inhibition, as well as the percentage rise in peripheral plasma renin activity, after captopril were calculated from the measured data. The diagnostic and prognostic value of the various calculation models were compared on the basis of blood pressure changes in 29 patients after intervention (28 operations, one percutaneous transluminal angioplasty). Of the various calculations the renin ratio after ACE stimulation--measuring plasma renin activity separately for each side--was of the greatest value in discriminating for renovascular hypertension (sensitivity 89%, specificity 100%). Comparable results in the discrimination for renovascular hypertension were achieved by determining the rise in peripheral plasma renin activity after captopril. This method is, therefore, a simple, noninvasive test for diagnosing renovascular hypertension with great accuracy even while existing medication is being continued.

Adult↗
PubMed1988

Ultrasound guided percutaneous biopsy or operative biopsy in patients with renal impairment?

Sixty-four percutaneous renal biopsies under ultrasound guidance done in 60 patients with renal impairment are compared with 33 open, operative biopsies. In 62 percutaneous biopsies (96.8%), more than 3 glomeruli could be obtained. Eight biopsies (12.5%) presented with minor complications afterwards. All of them were spontaneously reversible. In the operative biopsy group, there were complications in 6 patients (18.2%). In 2 cases, operative revision was necessary. In conclusion, percutaneous ultrasound guided biopsy in experienced hands offers several advantages in patients with renal impairment. It must be kept in mind that from a minority of patients only an operative biopsy can be taken due to certain risks.

Adult↗
PubMed1988

CAPD and transplantation in diabetics.

Treatment of diabetics with end-stage renal failure is still a hazard. We report on 33 insulin-dependent diabetic patients who were treated with CAPD over a period of up to 70 months. Seven of them have been transplanted. The evaluation of the clinical and biological parameters serum protein, phosphate, calcium, revealed acceptable values. Hemoglobin rose during the treatment period. Hypertension improved and medication was reduced. HbAlc levels were near normal with subcutaneous application of insulin. Peritonitis rate was 1/18 patient-months. Survival rate was comparable with other centers with 83% in the first and 62% in the second year. In 7 patients that have been transplanted no CAPD-related problems arose after transplantation. 6 of them are still doing well; one returned to CAPD because of graft failure. In conclusion, because of good control of hypertension, blood glucose and anemia and the avoidance of fluctuating volumes, we think CAPD to be the best method for diabetics awaiting transplantation and for those that cannot be transplanted.

Diabetes Mellitus, Type 1↗
PubMed1987

[Ultrasonic-guided percutaneous renal biopsy in patients with renal insufficiency].

64 percutaneous renal biopsies were done on 60 patients with renal impairment (serum creatinine level more than 1.5 mg%) under sonographic guidance. In 62 biopsies (96.8%), more than 3 glomeruli were seen, in 45 biopsies (70.3%) the amount of at least 10 glomeruli could be obtained, this being the amount desirable for a good histological diagnosis; 8 cases (12.5%) presented with minor complications after the biopsies. All of them resolved spontaneously. Ultrasound-guided percutaneous renal biopsy is a safe procedure for rapid diagnosis and induction of a specific therapy in patients with renal impairment.

Adolescent↗
PubMed1987

The interaction of mofebutazone with furosemide.

A study was carried out in 10 healthy male subjects to investigate whether mofebutazone, a phenylbutazone derivative, influenced furosemide-induced diuresis and PGE2 excretion as has been shown with other non-steroidal anti-inflammatory agents such as aspirin and indomethacin. The subjects received, at random, a single dose of either 40 mg furosemide or 40 mg furosemide plus 600 mg mofebutazone and were then crossed over to the other regimen after 10 days. Urine was collected for 45 minutes before and then for six 45-minute clearance periods after drug administration. Urine volumes and excretion of sodium, potassium, chloride, magnesium, creatinine and the main metabolite of PGE2 were measured at the end of each period, as were blood levels of creatinine and mofebutazone from samples taken before, during and after administration. The results showed no significant differences between the two groups, indicating no interaction between mofebutazone and the diuretic.

Adult↗
PubMed1986

Severe hemolysis caused by antibodies against the mushroom Paxillus involutus and its therapy by plasma exchange.

It has been shown that fatal "poisoning" with the mushroom species Paxillus involutus is caused by antibodies against the fungus in sensitized patients. Because circulating immune complexes play an important role, therapeutic procedures which can eliminate those complexes could stop immune hemolysis. A 37-year-old patient became severely ill after repeated ingestion of sufficiently cooked Paxillus involutus. As a result of hemolysis with reversible shock symptoms, acute renal failure developed. Plasma exchange with 3,000 ml albumin 5% was carried out daily during the first 3 days after admission. Each plasma exchange lowered free hemoglobin and immune complex levels by 60%-75%. Acute renal failure was successfully treated with hemodialysis. Specific IgG-antibodies against membrane particles of Paxillus involutus were detected by hemagglutination tests in the serum of the patient. The sequence of reactions resulting from the testing procedures strongly suggests the formation of immune complexes. These complexes are likely to bind to erythrocytes acting as innocent bystanders. Activation of the complement system finally results in hemolysis and shock. In addition to adequate shock treatment elimination of these immune complexes by plasma separation seems to be the therapy of choice.

Adult↗
PubMed1986

[Therapy of severe propafenone poisoning--an attempt at elimination by hemoperfusion].

After suicidal ingestion of 9 g Propafenone, a 31-year-old woman showed unconsciousness, cerebral convulsions, respiratory depression, sinus arrest, ventricular tachycardia and recurrent atrioventricular block. The maximum Propafenone plasma level was 4,702 ng/ml. Only 67.2 mg of Propafenone were eliminated within 4 h of hemoperfusion. Successful therapy could be achieved by symptomatic intensive care treatment. Additionally, 2 X 25 ml of 20%-saline solution were infused. In this case no efficacy of hemoperfusion in the treatment of Propafenone intoxication could be documented.

Adult↗