Biomedical subjects

B Reichart

Publications and source records attributed to B Reichart.

417 records · Page 24Linked to original sources

PubMedDate not supplied

Registration of thoracic electrical bioimpedance for early diagnosis of rejection after heart transplantation.

In this study, registration of thoracic electrical bioimpedance was used for early detection of acute rejection after heart transplantation. Thirty-five heart transplant recipients were monitored by registration of thoracic electrical bioimpedance signals during the immediate postoperative period and during the outpatient follow-up. At the same time, endomyocardial biopsy specimens were taken. In addition to cardiac stroke volume index and ejection fraction, the acceleration index (seconds -2) was calculated. This acceleration index describes the acceleration of blood volume and represents a function parameter of the myocardial inotropy. Seventeen acute rejection episodes were diagnosed during the follow-up period. The average acceleration index value during the 17 rejection episodes was 92.5 +/- 11.7 sec-2 and thus significantly lower when compared with the nonrejection levels (p < 0.05). The acceleration index values decreased during acute rejections by an average of 36.4 +/- 19.3 sec-2 (28%). The sensitivity of this diagnostic parameter in the examined patients was 71%, and the specificity was 100%. Thus registration of thoracic electrical bioimpedance and calculation of the acceleration index represents a quick and noninvasive monitoring technique and can ideally be used in the outpatient clinic as a supplement to invasive endomyocardial biopsies.

Adult↗

PubMedDate not supplied

The influence of gastrointestinal agents on resorption and metabolism of cyclosporine after heart transplantation: experimental and clinical results.

The clinical effectiveness of cyclosporine is limited by changes in resorption and metabolism of cyclosporine and by possible drug interactions. This study examined the influence of five gastrointestinal agents on duration and resorption of cyclosporine and dosage/level relations: cimetidine, famotidine, pirenzepine, aluminum hydroxide, and omeprazole. These gastrointestinal agents were studied in 64 rat experiments, in which the impact of each single drug and of drug combinations on cyclosporine resorption and metabolism was tested. A standardized dosage of cyclosporine was given orally, and the duration was calculated for the maximum whole blood level of cyclosporine to be achieved; the dosage/level quotient was calculated. Cimetidine, famotidine, pirenzepine, and combination treatment prolonged duration of cyclosporine resorption. Furthermore, cimetidine, famotidine, and omeprazole lowered the dosage/level quotient, thus leading to higher cyclosporine levels with the same dosage; pirenzepine increased the dosage/level quotient. For clinical comparison, 163 heart transplant patients who had received standard triple-drug immunosuppressive therapy were analyzed. The time interval until a therapeutic cyclosporine level was achieved and the dosage/level quotient were once again calculated. Similar to the results in the animal experiments, cimetidine and famotidine significantly delayed the resorption of cyclosporine; cimetidine, famotidine, and omeprazole lowered the cyclosporine dosage/level quotient, thus leading to higher cyclosporine levels with the same dosage. Aluminum hydroxide did not lead to any changes in the resorption or metabolism of cyclosporine. Most examined gastrointestinal agents, and particularly H2-blocking drugs, led to significant prolongation of cyclosporine resorption and cyclosporine level alterations. The initial prolongation of cyclosporine resorption was successfully avoided by intravenous administration of cyclosporine for the first 4 postoperative days in 40 consecutive patients.

Absorption↗

PubMedDate not supplied

Rapid growth of cutaneous neuroendocrine (Merkel cell) carcinoma during treatment of refractory cardiac allograft rejection with OKT3 monoclonal antibody.

OKT3 monoclonal antibody has proved to be a potent immunosuppressive agent in treating refractory heart allograft rejections. Recently, however, an increased incidence of lymphoproliferative disorders after OKT3 therapy has been found. This short report describes the rapid growth of a cutaneous neuroendocrine (Merkel Cell) carcinoma, a rare tumor of the dermis promoted by OKT3 administration. Because OKT3 therapy seems to be associated with an increased incidence of neoplasms, frequent patient follow-up is essential.

Carcinoma, Merkel Cell↗