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Biomedical subjects

G Biesenbach

Publications and source records attributed to G Biesenbach.

72 records · Page 4Linked to original sources
PubMed1989

[Disorders of lipid metabolism in diabetes mellitus].

Diabetes mellitus is the most frequent endogenous cause of fat metabolism-disorder. In diabetics the risk for arteriosclerosis is significantly higher and the clinical significance of hyperlipidemia should be estimated more serious as in non-diabetics. The predominant abnormality of fat metabolism in diabetes is hypertriglyceridemia due to an increase of triglyceride-carrying lipoproteins, the chylomicrons and the very-low-density lipoproteins. In type I-diabetics the decisive pathogenetic factor for hypertriglyceridemia is the impaired degradation of VLDL and the reduced chylomicron-clearance, caused by decreased activity of the lipoproteinlipase. In ketoacidosis there is an additional increase in hepatic VLDL-triglyceride-production due to increased lipolysis with elevated free-fatty-acid flux. Total cholesterol in type I-diabetics is only significantly elevated when metabolic control is poor, low-density lipoprotein (LDL-)-cholesterol-levels can be increased and high-density lipoprotein (HDL-)cholesterol decreased in dependence on the metabolic control. In type II-diabetics the decisive pathogenetic factor for hypertriglyceridemia is increased VLDL-triglyceride-synthesis in the liver especially due to augmented free-fatty-acid flux. Additionally the activity of the lipoproteinlipase can be reduced. Usually in non-insulin-dependent diabetics LDL-cholesterol-levels can be seen elevated and HDL-cholesterol-concentration decreased in correlation with the metabolic control. Primary hyperlipoproteinemia appears frequently in diabetics, but this can be explained by the association with obesity in type II-diabetics.

Arteriosclerosis↗
PubMed1988

["Diabetic" proliferative retinopathy and nodular glomerulosclerosis without diabetes mellitus].

A 65-year-old woman of normal weight, hospitalized because of pleuritis, was found to have chronic renal failure (creatinine clearance 20 ml/min). Renal biopsy (light and electron-microscopy) revealed nodular glomerulosclerosis (Kimmerstiel-Wilson disease), described as a diabetes-specific renal change. Fundoscopy discovered bilateral proliferative retinopathy as seen in diabetes. But oral and intravenous glucose tolerance tests were normal, excluding a manifest diabetic metabolic disorder. No other cause of the glomerulosclerosis (such as amyloidosis or multiple myeloma) was found. The patient had been overweight for a time when younger, reversed by dieting. It is suggested that the "diabetic" changes in the kidneys and eyes without diabetes could be the result of a transitory disorder of glucose tolerance during the period of obesity.

Aged↗
PubMed1988

[Personal preparation of bicarbonate solutions--cost comparison and quality control].

Haemodialysis with bicarbonate dialysate is well established in the treatment of chronic renal failure. The costs of bicarbonate haemodialysis are higher than acetate haemodialysis. Commercially available bicarbonate solutions are sold from AS 129.- to AS 189.- per 8 litre canister (December 1987). The self-prepared solution contains 650 g bicarbonate (for AS 8.-) in 8 litres of deionized water. In 10 patients on regular dialysis treatment haemodialysis were performed with both commercially available and self-prepared solutions for a 3 week period. Blood and dialysate samples were obtained before and 10 minutes, 1 h, 2 h, 3 h and 4 h after starting haemodialysis. Osmolality, Na+, K+, Cl-, pO2, pCO2 and pH were measured in the dialysate and in the serum, as well as serum lactate levels. There were no significant differences and the biochemical changes were similar with both preparations. In our centre with about 4000 bicarbonate dialyses yearly, AS 500,000.- to AS 700,000.- could be saved by self preparation of the dialysate.

Bicarbonates↗
PubMed1988

[Transient extra-osseous increase of isotope activity in the bone scintigram in acetolyt-induced hypercalcemia].

A 66 year-old man with chronic renal failure developed hypercalcaemia during acetolyte medication. A technetium-99m phosphate bone scan at this time showed extraosseous isotope uptake in the stomach, which disappeared 2 weeks later after normalisation of the serum calcium level. This phenomenon can be interpreted as transient metatastic calcification during hypercalcaemia.

Aged↗
PubMed1988

[The status of managing the type I diabetic patient in Austria. Organization].

During the Annual Meeting of the Austrian Diabetes Association various diabetic centres presented their success and failure rates with respect to metabolic control and prevention of late complications in diabetic patients on a country-wide basis. The analysis revealed that only 30% of all type I diabetic patients are adequately controlled. Intensive education in diabetes self-management, capable of leading to optimal metabolic control in up to 50% of the instructed patients, is however available only to a small minority of the diabetic patients to date. Despite the enormous improvement which has been achieved in the management of pregnant diabetic women, intensive specialized care is often commenced far too late. In rural areas, in particular, even conventional therapy is not fully implemented and late complications are, thus, inevitable.

Austria↗
PubMed1988

[Successful outcome of high-risk pregnancy within 1 year following kidney transplantation with cyclosporin as the immunosuppressive agent].

A 41-year-old female patient with analgesic nephropathy became pregnant 13 weeks after successful renal transplantation using cyclosporin as an immunosuppressant. Because of rhesus incompatibility of the mother this was thought to be a high risk pregnancy. In spite of the increased risk of CyA-induced nephrotoxicity in this early phase after transplantation, the patient showed the same physiological renal changes during pregnancy as healthy control patients: a 24% increase in creatinine clearance and an increase in protein excretion of only 41 mg/day. To maintain a CyA-blood concentration of 200-600 ng/ml throughout the pregnancy the CyA dose had to be increased from 380 to 550 mg daily or from 6.9 to 8.3 mg/kg/day (20%). This increase in CyA requirement may indicate additional metabolism of CyA by the fetal liver.

Adult↗
PubMed1988

[Smoking and health].

Epidemiological investigations have shown, that cigarette smoking is associated with an excess risk of premature death in the industrialized countries. Cigarette smoking is being exported in the Third World and kills there not only people, but also destroys the environment. Cigarette smoking increases the carcinogenicity and causes diseases of many organs.

Cross-Cultural Comparison↗
PubMed1988

Successful treatment of malaria tropica with acute renal failure and cerebral involvement by plasmapheresis and hemodialysis.

A non-immune, 31-year-old woman developed an acute infection with Plasmodium falciparum after travelling to Kenia. The parasites proved resistant to chloroquine and sulfadoxine/pyrimethamine. The course of the disease was complicated by acute renal failure, hepatocellular damage, disorders of blood coagulation, thrombocytopenia, hemolysis and cerebral involvement. Despite a very high level of parasitemia (50% parasitized erythrocytes) a rapid clinical improvement was achieved by plasmapheresis and hemodialysis. Our experience shows that plasmapheresis and hemodialysis are excellent additive methods which rapidly improve clinical symptoms and may reduce morbidity and mortality in severe malaria tropica.

Acute Kidney Injury↗
PubMed1987

[Changes in renal protein excretion and kidney function in type I diabetic patients during and following pregnancy in relation to the stage of preexistent diabetic nephropathy].

In 14 female type I diabetics the influence of preexisting diabetic nephropathy on the behaviour of proteinuria and renal function during and after pregnancy was investigated. We compared albumin and total protein in urine, serum-creatinine, creatinine-clearance, uric acid and beta 2-microglobulin in serum before, during and up to sixth months after pregnancy in 5 diabetic women with preexisting normo-albuminuria, stage II of diabetic nephropathy, in 6 women with microalbuminuria, stage III, and in 3 women with overt proteinuria, stage IV of diabetic nephropathy (by Mogensen); in this last patient-group there was a heavy proteinuria with decreased creatinine clearance and high blood pressure still before the begin of the pregnancy. The albumin- and total protein excretion in urine showed in all diabetic patients a 3- to 8-fold increase during pregnancy and in all cases the increased proteinuria dropped after pregnancy to the preexisting values. A transient nephrotic syndrome in pregnancy developed in 2/6 diabetic women with primary microalbuminuria and in all 3 patients with overt proteinuria, but not in any case of pregnant women with primary normo-albuminuria; the difference between the absolute increase of proteinuria in the 2 patient-groups with stage II and III of diabetic nephropathy was statistically significant (p less than 0.005). The renal function parameters serum-creatinine and creatinine-clearance showed in all pregnant women with stage II or III of diabetic nephropathy the same transient changes as in non-diabetic pregnant women, the mean serum-creatinine concentration showed a decline of 36% respectively 14%, the creatinine clearance an increase of 31% and 36%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

[Autoimmune phenomena after silicone implantation].

Eleven years after silicone implantation into the breasts a now 42-year-old woman developed arthralgia with a serological autoimmune phenomenon: antinuclear antibodies of the mottled type (titer 1:320 to 1:1,280), complement consumption, cytoplasmic thyroid antibodies (1:400), and constant elevation of erythrocyte sedimentation rate, concomitant with signs of silicone mastitis (angiotensin-converting enzyme 108 U/min; computed tomography demonstrated an infiltration in the right breast implant). As the patient has only quite minor symptoms she has so far refused removal of the implant.

Adult↗
PubMed1983

[Continuous peritoneal dialysis in acute kidney failure].

The continuous ambulatory peritoneal dialysis (CAPD) has been proved as alternate method in the treatment of chronic end stage renal failure. This new form of continuous peritoneal dialysis can also be used in the treatment of acute renal failure; by CAPD-system you can reach a steady state in noncatabolic renal failure, in catabolic states the number of acute hemodialyses can be reduced. The main advantage of this continuous peritoneal dialysis is the simple practicability and the independence of machines.

Acute Kidney Injury↗
PubMedDate not supplied

How pregnancy influences renal function in nephropathic type 1 diabetic women depends on their pre-conceptional creatinine clearance.

Pregnancy in type 1 diabetic women with overt nephropathy can lead to a further deterioration in renal function but it is not clear at what level of pre-conceptional GFR the risk for worsening of renal function begins to increase. Therefore we investigated the influence of pregnancy on renal function in 12 women (14 pregnancies) with pre-conceptional macroproteinuria and near-normal creatinine clearance (range 37-93 ml/min/1.73m2). S-creatinine, creatinine clearance (CrCL), HbA1c and blood pressure (BP) were measured before conception, during each trimester (12th and 24th week of gestation and last week before delivery) and three and six months post-partum. In five diabetic women with six pregnancies (group A) there was a physiological increase in CrCl of 36% up until the 24th week of gestation; their pre-conceptional mean CrCl was 80 (range 70-93) ml/min/1.73m2. In seven women with eight pregnancies (group B) CrCl decreased by 16% during the first two trimesters; the mean CrCl before conception was 61 (37-73) ml/min/1.73m2. In the last week before delivery CrCl worsened transiently in three cases in group A and four in group B, due to pre-eclampsia. Three months post-partum the mean CrCl in group A was 78 (70-91) ml/min/1.73m2, approximately the same as before pregnancy. In group B the mean CrCl was 39 (22-68) ml/min/1.73m2 at this same time; this was 36% lower than the pre-conceptional clearance. Mean HbA1c in both groups were approximately the same, but mean BP tended to be higher during pregnancy in group B, especially in the week before delivery (p<0.05). We conclude that in a high percentage of nephropathic diabetic women with significantly low CrCl before conception, renal function worsens during and after pregnancy. Inadequate antihypertensive therapy may contribute to this.

Adult↗