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Biomedical subjects

E Minar

Publications and source records attributed to E Minar.

At least 163 records · Page 9Linked to original sources
PubMed1984

Adenomectomy in a patient on regular dialysis treatment.

A 55-year-old patient presented with terminal renal insufficiency caused by lower urinary tract obstruction due to prostatic adenoma. The case history of the patient on regular dialysis treatment was complicated by recurrent, therapy-resistant urinary tract infections accompanied by septic fever outbreaks and anemic relapses. Following suprapubic transvesical adenomectomy, no fever episodes, negative urine cultures and improvement in the anemic condition were all noted. Due to the fact that the upper age limit for acceptance into a hemodialysis program and possible kidney transplantation has been raised, it is important to note that an increasing number of men with prostatic adenomas may be encountered in these collectives. Dialysis patients require successful treatment of urinary tract obstructions prior to transplantation. Immunosuppressive therapy which follows transplantation increases the risk of infection which can endanger the graft and the patient's life.

Humans↗
PubMed1984

Acquired cystic disease of the kidneys in chronic hemodialyzed and renal transplant patients.

In this study, the appearance of renal cysts in 43 chronic hemodialyzed patients (mean duration of dialysis treatment: 26.3 months) was investigated by sonography with a high resolution (3.5 MHz) sector scanner. In an investigation of the patients' own kidneys, 23 renal transplant patients (mean observation time: 51.3 months after transplantation; mean dialysis treatment before transplantation: 22.8 months) were also studied by sonography. Cysts could be demonstrated in 21 of 43 (49%) patients on maintenance hemodialysis. In 10 of these patients a previous investigation at the beginning of dialysis did not demonstrate any cysts. The diameter of the cysts varied between 5 and 30 mm. With regard to the duration of dialysis, cysts could be demonstrated by sonography in 9 of 23 (39%) dialyzed patients, with a maximum dialysis duration of 2 years, and in 12 of 20 (60%) patients who had been dialyzed for more than 2 years. The development of acquired cystic disease of the kidneys in dialysis patients seems to be promoted by the longer survival of uremic patients. Cysts could be found in the patients' own kidneys in only 4 of 23 (17%) renal transplant patients. The difference in the demonstration of cysts between patients on maintenance hemodialysis and renal transplant patients was statistically significant. This suggests that cystic transformation may possibly be a reversible process.

Adult↗
PubMed1984

Prevention of postvenographic thrombosis by heparin flush: fibrinogen uptake measurements.

The incidence of postphlebographic venous thrombosis was investigated by 125I-labeled fibrinogen uptake tests in 60 patients whose veins were flushed with saline solution containing 10,000 IU of heparin after leg phlebography. Ionic methylglucamine iodamide was used as the contrast medium. In six patients superficial thrombophlebitis extending from the contrast-medium injection site was observed after phlebography. The incidence of deep venous thrombosis was 3.3%, significantly less than that reported for studies using triiodinated ionic contrast media without flushing the veins with a heparin solution. It is comparable to the incidence of venous thrombosis reported after using nonionic contrast media. The authors conclude that flushing the veins with heparinized saline solution can improve the safety of phlebography considerably.

Adult↗
PubMed1983

[Local streptokinase thrombolysis in a Cimino shunt thrombosis].

Local thrombolysis treatment was successful in a 52-year-old woman with a one-day old thrombosis of her Cimino shunt. Three hours after local application of a total of 80 000 IU streptokinase the shunt, which had thrombosed at the distal venous loop, became patent again. Because of the low streptokinase dose local thrombolysis, in contrast to systemic streptokinase administration, can be used without danger even in patients on haemodialysis in whom systemic thrombolytic treatment is frequently contra-indicated.

Administration, Topical↗
PubMed1983

[Prognosis of liver cirrhosis: results of a 14-year-long clinical follow-up study].

The incidence of primary liver cancer (PLC) was assessed in 652 patients (429 male, 223 female) with liver cirrhosis. By the end of the study 64% of all patients had died. The autopsy rate was 65%. 138 patients (49%) died after acute gastrointestinal hemorrhage. PLC developed in 73 patients (11.3%). Histologically 67 cases were classified as hepatocellular, one as mixed hepatocellular-cholangiocellular, and 5 as cholangiocellular carcinoma. In 32 cases PLC was confirmed within a year of diagnosis of cirrhosis, while in the remaining 41 cases PLC developed 2 to 13 years later. At autopsy the frequency of PLC was twice as high in males (30%) as in females (15%) (p less than 0.025). This difference occurred in alcoholic and posthepatic cirrhosis but not in cryptogenetic cirrhosis. HBsAg was detected in 18.5% of male and 8.9% of female patients (p less than 0.01). Comparison of patients with and without PLC revealed no significant differences in the prevalence of HBsAg. These data indicate that PLC is common in Austrian patients with cirrhosis and represents 64% of all malignant tumors in this group. In view of the high HBsAg carrier rate and the prevalence of chronic alcoholism in patients with cirrhosis, it is suggested that both factors together lead to an increased risk of cirrhosis followed by an increased incidence of PLC. Survival curves show that that the prognosis of severe liver cirrhosis is the same as that of patients with malignant diseases. Therefore, it is important to detect these patients at an early stage of the disease.

Adult↗
PubMed1983

[Effect of acute viral hepatitis B on erythropoiesis in chronic hemodialyzed patients].

The influence of acute hepatitis B on erythropoiesis has been investigated in 30 chronic hemodialyzed patients (mean age 48.3 years; mean duration of dialysis until first demonstration of Hbs-antigen 6.5 months). After onset of hepatitis the mean hematocrit value increased significantly (p less than 0.005) and in 15 of the 30 dialysis patients this increase was more than 10% of the initial value. In these 15 patients the mean value of the hematocrit increased from 21.7 to 27.7%. This maximum value was observed after 4 months on average, and the favourable effect on erythropoiesis was observed for 7.8 months on average. The groups of patients with and without increase in hematocrit (more than 10% of the initial value) after hepatitis differed significantly (p less than 0.01) in extent of the observed increase in transaminases. The importance of extrarenal, hepatic erythropoietin production for the stimulation of erythropoiesis during hepatitis in chronic hemodialyzed patients is discussed.

Acute Disease↗
PubMed1983

Acute effect of cimetidine and pirenzepine on plasma parathyroid hormone and calcitonin in haemodialyzed patients.

The acute effects of intravenous injection of cimetidine and pirenzepine on plasma iPTH and CT were studied in seven patients on chronic haemodialysis and seven healthy controls. As expected, the resting iPTH and CT levels were significantly higher in patients on RDT than in the healthy subjects. Both drugs decreased to a similar extent the increased plasma iPTH in the patients, but neither was able entirely to normalize the elevated level. The CT concentration in the patients on haemodialysis was significantly decreased by cimetidine but was only moderately reduced by pirenzepine. As neither drug was able to normalize the elevated PTH level in patients on chronic dialysis, it can be assumed that neither used alone would improve signs and symptoms of secondary hyperparathyroidism.

Adult↗
PubMed1983

[Sonographic problems in the assessment of abdominal aortic aneurysms].

Ultrasound has taken a solid position in the diagnostic management of aneurysms of the abdominal aorta as it is a non-invasive, simple and quickly practicable method with a low expenditure. After clinical examination ultrasound holds the second place in the sequence of various diagnostic procedures in the case of an aneurysm of abdominal aorta. Diagnostic problems are demonstrated in the sonographic judgement of aortic aneurysms. 42 patients with an abdominal aortic aneurysm have been evaluated in relation to the sonographic features of the aneurysm.

Aged↗
PubMed1983

[Rare cause of ureteral obstruction following renal transplantation].

The case of a 22-year-old man with an urinary tract obstruction which developed 4 weeks after renal transplantation is reported. Ureteral obstruction was caused by the ductus deferens, a very rare cause of ureteral obstruction. The importance of ultrasound examination as a very convenient, noninvasive method in the differential diagnosis of possible complications after renal transplantation is stressed.

Adult↗
PubMed1983

[Prostatic adenomectomy in dialysis patients].

A case of a 55-year old patient is presented with terminal renal insufficiency and a massive prostatic adenoma causing urinary tract obstruction. The case history of the patient on mandatory dialysis was complicated by recurrent, therapy resistant urinary tract infections accompanied by septic fever outbreaks and anemic relapses. Following suprapubic transvesical adenomectomy, no fever episodes, negative urine cultures and improvement in the anemic condition were all noted. Due to the fact that the upper age limit for acceptance into a hemodialysis program and possible kidney transplantation has been raised, it is important to note that patients with prostatic adenomas may be frequently encountered. Dialysis patients require successful treatment of urinary tract obstructions prior to transplantation. Immunosuppressive therapy which follows transplantation increases risk of infection which can endanger the graft and the patient's life.

Adenoma↗
PubMed1983

[Clinical significance of bacterial contamination of enteral nutrition solutions].

Tube feeding with elemental and peptide diets is used as therapy for the acute phase of Crohn's disease. It should improve the nutritional status of the patients and reduce bacterial counts in the intestine. In this study we investigated the frequency of bacterial contamination of solutions of chemically defined diets and the clinical effects of the application of contaminated diets (stool frequency, body temperature, leucocyte counts). 15 patients with acute phase of Crohn's disease were treated with chemically defined diets over a total period of 323 days via a nasoduodenal tube. 7 patients received BSD, 8 patients Peptisorb. In all 36 BSD solutions examined in concentration procedures we found microbes, most frequently Streptococcus and Bacillus spp. Without concentration procedures it was possible to cultivate bacteria in 12% out of BSD solutions and in 81% out of Peptisorb solutions; in BSD mostly Streptococcus and in Peptisorb solution E. coli, Bacillus spp. and aerobic spore forming bacilli. Stool frequency, body temperature and leucocyte counts did not show significant differences after application of contaminated solutions in comparison to the others. Deterioration of the disease has not been observed in any case.

Adult↗
PubMed1983

[Fat in the parenteral feeding of malnourished patients].

In malnutrition lipoprotein lipase activity in the liver and the beta-lipoprotein concentration in serum are reduced. The lipolysis is increased. One suspected a reduction of fat elimination in such patients. In 10 malnourished patients with a mean body weight of 73% ideal body weight an intravenous fat tolerance test was performed. The elimination rate was in mean 5.77%/min, that is in the normal range. Studies with radioactive triglycerides showed a metabolization of 30% of infused fat during 24 hours. These results were confirmed by measurements of gas exchange. Energy expenditure and nitrogen balance in malnourished patients correlate with the energy intake but not with the amount of fat in the parenteral nutrition. That could be confirmed in a prospective randomized study in 8 malnourished patients. The carbohydrate oxydation provided 70% to 80% of total energy expenditure independent from the dosage of fat in these patients. The minimum of fat needed in total parenteral nutrition to avoid essential fatty acid deficiency is 100 g per week. The tolerable maximum dose ist not known. In 10 malnourished patients with a mean time of 36 days of parenteral nutrition a dosage of 2.5 g/kg X d-1 was well tolerated and no side effects were seen. In 3 of these patients a previous cholostasis improved during parenteral nutrition.

Dose-Response Relationship, Drug↗
PubMed1983

[Emergency endoscopy in patients with liver cirrhosis].

A report is given about emergency endoscopy in 389 patients because of bleeding from the upper gastrointestinal tract; 60 of these patients had cirrhosis of the liver as confirmed by biopsy. In the total group 17.4% were found to have bleeding from esophagus varices, in the cirrhotic group the incidence was 53%. Erosive lesions of the stomach came second in incidence, accounting for 27% of the cases in the latter group. In 60% of patients with cirrhosis, who had had acute bleeding, esophageal varices were present in abundance, whereas only 27% of patients without bleeding did have such excessive formation of varices. Thrombotest and thrombocyte count were equal in both groups. In 50% of 133 patients with cirrhosis of the liver without acute bleeding complications, a second potential source of bleeding beside esophageal varices could be detected. This underlines the importance of emergency endoscopy in patients with cirrhosis of the liver suffering from acute upper gastrointestinal bleeding.

Acute Disease↗
PubMed1983

Pyridoxine therapy in patients with renal calcium oxalate calculi.

In 12 patients with idiopathic calcium oxalate calculi pyridoxine was administered. Within six weeks mean daily oxalic acid excretion decreased from 480 +/- 122 mumol to 336 +/- 83 mumol. Glycolic acid excretion fell from 208 +/- 51 mumol to 153 +/- 26 mumol (normal range: oxalic acid 228-412 mumol/day, glycolic acid 130-290 mumol/day). The reduction of oxalic acid excretion seems to be beneficial in prevention of idiopathic calcium oxalate calculi.

Calcium Oxalate↗