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Biomedical subjects

G Eisele

Publications and source records attributed to G Eisele.

67 records · Page 4Linked to original sources
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Experimental study of balloon-expandable metallic vena caval stents in rabbits.

PURPOSE: The reactivity and patency of balloon-expandable Strecker stents were determined in the superior vena cava (SVC) and inferior vena cava (IVC) of rabbits. MATERIALS AND METHODS: One stent was placed in each of 24 rabbits; 15 were placed in the SVC and nine in the IVC. The duration of stent placement varied between 3 days and 15 months. After the animals were killed, the segments in which the stent was placed were sectioned and analyzed under light microscopy for quantification of neointimal hyperplasia with metal struts in situ. RESULTS: Twenty-three stents remained patent throughout. Two SVC stents thrombosed at 1 week; one of these recanalized spontaneously after 4 weeks. Self-limiting neointimal hyperplasia reached a maximum thickness at 1 month and receded over 3-6 months. In five rabbits with long-term SVC stents, there was a radial shift of the stent to the perivascular layer of fat. Despite this shift, these stents remain patent. CONCLUSION: Strecker stents are well adapted to the venous system in terms of both patency and histocompatibility.

Animals↗
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Close clinical observation minimizes the complications of beta-blocker withdrawal.

OBJECTIVE: To determine whether beta-blocker withdrawal under close medical supervision poses undue risks. DESIGN: Retrospective case review. Data extracted from previous study. SUBJECTS: 114 hypertensive subjects tapered from beta-blocker therapy. Subjects were a subset of patients originally studied for blood pressure medication withdrawal and biofeedback training. MAIN OUTCOME MEASURES: Frequency of symptoms and adverse effects reported by subjects during medication taper to the study nurse. RESULTS: Symptoms were no more likely to occur with beta-blocker withdrawal than with withdrawal of other types of antihypertensive medications. Most adverse effects were classified as minor. Two subjects experienced major symptoms. One subject required reinstitution of beta-blockers for palpitations, and another exhibited angina upon beta-blocker withdrawal. CONCLUSIONS: In well-screened patients under careful monitoring, withdrawal from beta-blockers appears to present a small, manageable risk.

Adrenergic beta-Antagonists↗
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Pharmacokinetics of intermittent intraperitoneal cefazolin in continuous ambulatory peritoneal dialysis patients.

OBJECTIVE: To investigate the pharmacokinetic parameters of intermittent intraperitoneal (IP) cefazolin, and recommend a cefazolin dosing regimen in continuous ambulatory peritoneal dialysis (CAPD) patients. DESIGN: Prospective nonrandomized open study. SETTING: CAPD outpatient clinic in Albany, New York. PATIENTS: Seven volunteer CAPD patients without peritonitis. Three of the patients were nonanuric while 4 were anuric. INTERVENTIONS: Cefazolin (15 mg/kg total body weight) was given to each patient during the first peritoneal exchange. Blood and dialysate samples were collected at times 0, 0.5, 1,2,3,6 (end of the first antibiotic-containing dwell), 24, and 48 hours after the administration of IP cefazolin. Urine samples were collected in nonanuric patients over the study period. RESULTS: The mean+/-SD amount of cefazolin dose absorbed from the dialysate after the 6-hour dwell was 69.7%+/-8.0% of the administered dose. The cefazolin absorption rate constant from dialysate to serum was 0.21+/-0.1/hr (absorption half-life 3.5+/-0.8 hr). The mean serum concentrations reached at 24 and 48 hours were 52.4+/-3.7 mg/L and 30.3+/-5.9 mg/L, respectively. The mean dialysate cefazolin concentrations reached at 24 and 48 hours were 15.1+/-3.4 mg/L and 7.9+/-1.4 mg/L, respectively. The cefazolin serum elimination rate constant was 0.02+/-0.01/hr (elimination half-life 31.5+/-8.8 hr). The total cefazolin body clearance was 3.4+/-0.6 ml/min. In the 3 nonanuric patients the mean renal clearance of cefazolin was 0.6+/-0.4 ml/min. The peritoneal clearance of cefazolin was 1.0+/-0.3 mL/min. The systemic volume of distribution of cefazolin was 0.2+/-0.05 L/kg. No statistical difference was detected in pharmacokinetic parameters between anuric and nonanuric patients, although this may be due to the small number of patients in each group. CONCLUSION: A single daily dose of cefazolin dosed at 15 mg/kg actual body weight in CAPD patients is effective in achieving serum concentration levels greater than the minimum inhibitory concentration for sensitive organisms over 48 hours, and dialysate concentration levels over 24 hours. Caution is warranted in extrapolation of dosing recommendations to patients who maintain a significant degree of residual renal function.

Absorption↗
PubMedDate not supplied

Variability in creatinine clearance (CCR) and KT/V due to different methods of calculating volume and CCR.

OBJECTIVE: This study aimed to compare the correlations between KT/V and creatinine clearance (Ccr) calculated by different methods and to determine and compare the correlations between KT/V and Ccr. DESIGN: Nonrandomized, retrospective analysis of data. SETTING: Continuous ambulatory peritoneal dialysis (CAPD) outpatient clinic in a teaching hospital. PATIENTS: All patients were included for analysis if the data collection was complete for the calculations of KT/V and Ccr using five different methods. INTERVENTIONS: Volume of distribution for urea (V) was estimated by four methods: Watson nomogram, ideal body weight (IBW), actual body weight, and total body surface area. Ccr was determined by five methods: Dialysate Ccr was calculated by creatinine (Cr) uncorrected and corrected for the presence of glucose; urinary Ccr was calculated using urinary Cr alone and the average urinary clearance of urea and Cr; and by the Cockcroft and Gault method. MAIN OUTCOME MEASURES: Correlations between KT/V and Ccr. RESULTS: Sixty-three data sets were collected from 52 CAPD patients. The correlations between weekly KT/V and Ccr normalized to 1.73 m2 body surface area were found to be highly variable from one method to another (r2 = 0.012 -0.494). For obese patients (20% above IBW), KT/V values obtained were more variable using the Watson nomogram compared to the IBW and BSA methods. CONCLUSION: KT/V calculated using the Watson nomogram and the Ccr determined using average of urinary urea and creatinine clearance gave the best correlation (r2 = 0.49).

Body Constitution↗
PubMedDate not supplied

Pharmacokinetics of once-daily IP gentamicin in CAPD patients.

OBJECTIVE: This study aimed to investigate the pharmacokinetic characteristics of once-daily intraperitoneal (IP) gentamicin in continuous ambulatory peritoneal dialysis (CAPD) patients. DESIGN: Prospective, nonrandomized, open study. SETTING: CAPD outpatient clinic in a teaching hospital. PATIENTS: Ten volunteer CAPD patients without peritonitis. INTERVENTIONS: Each patient received a single IP dose of 0.6 mg/kg of gentamicin. Blood and dialysate samples were collected at 0, 0.5, 1, 2, 3, 6 (end of first dwell), and 24 hours after the administration of IP gentamicin. Any urine produced over the 24-hour study period was also collected. The dialysate concentration/time data were fitted to a monoexponential curve for all patients. RESULTS: The bioavailability was 56 +/- 11% over a six-hour dwell. The mean serum elimination half-life (t1/2) was 35.8 hours. The volume of distribution was 0.23 +/- 0.08 L/kg. Equilibration of gentamicin across the peritoneal membrane was rapid, with a t1/2 equilibration of 4.5 hours. The peritoneal clearance was 5.74 +/- 1.5 mL/min. Patients-with residual renal function had significantly higher systemic gentamicin clearances (7.36 +/- 1.46 mL/min) than those of anuric patients (4.76 +/- 1.08 mL/min, p < 0.024). CONCLUSION: Currently recommended doses of once-daily IP gentamicin for the treatment of peritonitis may not produce the desired therapeutic serum and dialysate concentrations over 24 hours for effective treatment of peritonitis.

Adult↗