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Biomedical subjects

D Larbig

Publications and source records attributed to D Larbig.

At least 19 recordsLinked to original sources
PubMed1999

Reliability and clinical application of fetal RhD genotyping with two different fluorescent duplex polymerase chain reaction assays: three years' experience.

OBJECTIVE: This study was designed to evaluate accuracy and clinical usefulness of fetal RhD genotyping with fluorescent duplex polymerase chain reaction. STUDY DESIGN: Two RhD-specific gene fragments (exon 10 in polymerase chain reaction 1 and exon 7 in polymerase chain reaction 2) were amplified in samples from 213 fetuses. RESULTS: Amplification failed in 0.9% of the specimens, and equivocal results were found in 1.4% of the specimens. Of the analyses, 6.6% had to be repeated. The concordance of genotyping and serotyping was 99.0% for each polymerase chain reaction. False-positive results were noted in 4 fetuses. Concordant findings from both assays indicated the correct serotype for all fetuses. In 44 alloimmunized pregnancies, further invasive procedures were avoided for 5 of the 6 genotypically RhD-negative fetuses. Only two of 38 RhD-positive fetuses had a hemoglobin level <8 g/dL at first fetal blood sampling. CONCLUSIONS: Fetal genotyping at distinct regions of the RhD gene is reliable and improves the care management of sensitized women.

Amniotic Fluid↗
PubMed1997

Right atrial silicone catheters as angioaccess for hemodialysis with special emphasis to their complications.

Right atrial silicone catheters (RASCs) serve as temporary angioaccess in hemodialysis (HD) patients. In a retrospective study of the years 1989 to 1996 we analyzed catheter-related complications, and tried to define patients at special risk for complications. We compared our results with published data on RASCs and percutaneous catheters. In 73 patients older than 64 (mean age 76) years with severe comorbidity 109 single lumen RASCs, type Demers, were implanted. Fifty-five similar catheters implanted in 44 younger patients (mean age 53) with a comparable severe comorbidity were used as controls. In the older patients the mean indwelling time was 157 (1-995) days, median 98 days, in the younger patients 135 (1-623) days, median 61 days. Early complications that led to RASC removal within one week after implantation were kinking, formation of a narrow loop, perforation, infected hematoma, and immediate clotting. Reasons for removal of the RASC after a longer period were infection, occlusion, and dislocation. In the old age group a great proportion (40%) of patients died with functioning RASC. In the literature RASCs are superior to percutaneous (Shaldon) catheters as temporary angioaccess for HD with respect to both better longevity and fewer complications such as venous stenoses or occlusions or infections. This is in accordance with our experience. However RASCs have complications, especially in the high risk groups of diabetics and patients with malignancies.

Aged↗
PubMed1996

Hemofiltration in very severe hypothermia with favorable outcome.

Hypothermia is a dangerous situation. It is defined by a core temperature of less than 35 degrees C. Aggressive rewarming is used if it is lower than 30 degrees C, comprising extracorporeal therapies. A case of a 63 year old lady is reported whose temperature was 21.8 degrees C, circulation was unstable, respiratory insufficiency prevailed and severe neurological dysfunction. Serum potassium was 2.9 mmol/l and pH corrected for temperature 7.61. The patient was rewarmed by hemofiltration (HF) over 6 hours with substitution of 18 l of a solution containing a concentration of potassium of 5 mmol/l. Though potassium levels declined initially and than slowly normalized in 9 hours there were no arrhythmias documented. The ECG showed prolongation of the PQ-, QRS-, and especially the QT-times. All clinical and neurological sequelae had disappeared after four days. HF thus seems to be a safe method of rewarming in very severe hypothermia.

Electrocardiography↗
PubMed1991

[Effect of zinc substitution on lymphocyte subsets and cellular immune function in hemodialysis patients].

Infection is a major cause of morbidity and mortality in patients undergoing hemodialysis for end stage renal disease. Low plasma zinc levels have been associated with immunodepression in these patients. In a randomized, placebo controlled double-blind cross over study, plasma zinc levels, delayed hypersensivity to 7 Antigens (Merieux-Multitest), absolute lymphocyte counts, T- and B-lymphocytes, suppressor-T and helper T-cells and natural killer cells were studied in 25 hemodialysis patients before, during and after intravenous zinc supplementation for 8 weeks. The hemodialysis patients had significantly lower predialysis plasma zinc concentrations compared to 76 healthy controls (74 +/- 12 vs. 126 +/- 28 mcg/dl, p less than 0.001). The plasma zinc concentrations increased to the normal range during the treatment period. Lymphocyte subtype analysis showed a significant decrease of suppressor-T cells and an increase of the helper-T/suppressor-T ratio (2.09 +/- 0.26 vs. 3.18 +/- 0.48, p less than 0.05) after zinc supplementation. Delayed hypersensivity to intradermal antigens increased significantly only after zinc treatment (2.0 +/- 0.7 vs. 5.8 +/- 1.7, p less than 0.05), not after placebo. The changes were reversible after finishing the zinc treatment. It is concluded, that plasma zinc levels are reduced in hemodialysis patients and that the substitution of zinc restores some of the depressed immune functions in these patients.

CD4-CD8 Ratio↗
PubMed1980

[Variable acute effects of prazosin on left ventricular failure (author's transl)].

The effect of 2.5 mg prazosin orally was monitored for one hour by cardiac catheterisation in 11 patients with cardiac insufficiency as a result of primary cardiomyopathy. Mean pressures of the pulmonary capillary bed and pulmonary artery decreased on average by 9 mm Hg, of the right atrium by 2.5 mm Hg and systemically by 8 mm Hg. Judging by the increase of cardiac index patients were divided into a group of 7 "responders", all showing congestive cardiomyopathy, and a group of 4 "nonresponders" with various cardiomyopathies. During prazosin treatment cardiac index increased by 23% and pulmonary arteriole resistance decreased by 4% and pulmonary arteriole resistance increased by 41%. It is concluded that not all forms of left ventricular failure respond favourably to prazosin. Divergent effects of prazosin may possibly be caused by unequal effects on pre- and after-load of both ventricles and on variable behaviour of lung arteriole resistance.

Adult↗
PubMed1979

Reversal of digitalis effects by specific antibodies.

Highly digoxin-specific or ouabain-specific antibodies can readily be obtained by immunizing rabbits or sheep with repeated injections of the glycoside coupled to protein carriers. By virtue of their binding capacity digoxin-specific antibodies are capable of removing digoxin concentrations from red blood cells and renal tissue specimens. As evidenced by various experiments with human erythrocytes and isolated cardiac preparations in vitro, digoxin effects are rapidly reversible in the presence of digoxin-specific antibodies. In vivo antidigoxin antibodies can protect animals from digoxin effects and promptly abolish established toxic effects, associated with marked alterations of digoxin pharmacokinetics. However, due to the large molecular weight, complete antibodies cannot be eliminated via the renal route. The use of antigen-binding (Fab) fragments of digoxin-specific antibodies offer the advantage of rapid renal elimination of bound and inactivated digoxin. So far, due to potential immune reactions, the clinical use of purified digoxin-specific antibodies of Fab fragments is restricted to life-threatening accidental or suicidal digoxin or digitoxin poisoning.

Animals↗
PubMed1977

[Hemodynamic changes after angiotensin II blockade by saralasin (author's transl)].

Saralasin, an angiotensin II inhibitor was infused in 10 hypertensive patients. A blood pressure reduction was achieved after stimulation of the renin-angiotensin-system by salt depletion. Heart rate and cardiac output failed to compensate for reduction of blood pressure. Thus circulatory reflex-mechanisms are inhibited by saralasin. A direct influence on baroreceptor mechanism and/or catecholamines is probable. Failure of the hypotensive effect of saralasin in salt-depleted patients after administration of beta-blockers supports this hypothesis.

Adrenergic beta-Antagonists↗