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Biomedical subjects

C A Pierach

Publications and source records attributed to C A Pierach.

At least 37 records · Page 2Linked to original sources
PubMed1994

Porphyrias.

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Emergencies↗
PubMed1993

Spa therapy for heart disease Bad Nauheim (circa 1900).

The development of Bad Nauheim, a German spa that over 2 centuries became dominant in the attraction of patients with heart disease is described. Here, patients experienced a regimen of saline baths and mostly static exercises developed by the Schotts, 2 physician brothers. Concomitant with the bathing and exercises, there was a social atmosphere conducive to relaxation. Many visiting physicians were impressed that there were improvements in the patients' cardiac status. One skeptical exception was Sir James Mackenzie, whose views are synopsized. The reported improvements may have had a modicum of a physiologic base, from recent investigations on the nature of heart failure, and may have anticipated the current use of exercise in cardiac rehabilitation.

Balneology↗
PubMed1992

And nor are we.

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Clinical Competence↗
PubMed1991

Bile porphyrin analysis in the evaluation of variegate porphyria.

BACKGROUND: Variegate porphyria is a genetic disorder of porphyrin metabolism in which patients may have both neurologic dysfunction and photocutaneous lesions. Biochemical confirmation of the diagnosis can be difficult, particularly in patients without neurologic dysfunction at the time of testing. The demonstration of increased fecal excretion of porphyrin is frequently used for this purpose, but levels may be normal. Since elevated fecal porphyrin levels in variegate porphyria are presumably a consequence of increased biliary excretion, we evaluated whether analysis of porphyrins in bile distinguishes better between patients with variegate porphyria and controls. METHODS: Bile samples were collected by duodenal aspiration from 10 patients with proved variegate porphyria who had no neurologic symptoms when they were studied and 17 control subjects. Bile and fecal porphyrin levels were measured fluorometrically. RESULTS: The mean total porphyrin concentration in bile in the patients with variegate porphyria was significantly higher than that in the controls (67.8 vs. 0.71 mumol per liter; P less than 0.00002). There was more than a ninefold difference between the highest level in any control subject and the lowest level in any patient with variegate porphyria. The mean fecal porphyrin level in the patients with variegate porphyria also differed significantly from that in the controls (0.79 vs. 0.14 mumol per gram of dry weight; P less than 0.007), but four patients had levels within the control range. CONCLUSIONS: The concentration of porphyrin in bile is higher in patients with variegate porphyria than in controls, and the difference is greater than that for fecal porphyrin. Bile porphyrin measurements may be helpful in the evaluation of asymptomatic patients suspected of having variegate porphyria.

Adolescent↗