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Biomedical subjects

G Kaltenbach

Publications and source records attributed to G Kaltenbach.

At least 37 records · Page 2Linked to original sources
PubMed1996

[POEMS syndrome: role and value of interleukin-6].

POEMS syndrome is a systemic disorder with peripheral neuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes. The association of POEMS syndrome with lympho-proliferative disorder is very commun. The pathogenesis remains poorly understood but implication of cytokines (interleukins 1 and 6) is suspected. We report a case of a classic POEMS syndrome (with polyneuropathy, hepatomegaly, diabetes melitus, hyperpigmentation, monoclonal IgG lambda, anasarca and solitary plasmocytoma), associated with high serum levels of interleukin 6.

Humans↗
PubMed1996

Pharmacokinetic interaction between itraconazole and rifampin in Yucatan miniature pigs.

The objective of this study was to examine the effects of rifampin on itraconazole pharmacokinetics, at steady state, in three Yucatan miniature pigs. Daily for 3 weeks, the pigs received 200 mg of itraconazole orally at the beginning of each meal, and for the following 2 weeks they received itraconazole orally combined with intravenous administration of rifampin at 10 mg/kg/day. Coadministration of rifampin resulted in an 18-fold decrease in the maximum concentration of itraconazole in serum, from 113.0 (standard deviation [SD] 17.2) to 6.2 (SD, 3.9) ng/ml and a 22-fold decrease in the area under the concentration-time curve, from 1,652.7 (SD, 297.7) to 75.6 (SD, 30.0) ng.h/ml. The active metabolite of itraconazole, hydroxyitraconazole, was undetectable. This study demonstrates that rifampin affects itraconazole kinetics considerably at steady state in this miniature-pig model, probably by inducing hepatic metabolism of itraconazole.

Animals↗
PubMed1996

[Model of a miniature pig catheterized for pharmacokinetic and pharmacodynamic studies of anti-infective agents].

The miniature pig exhibits physiological and anatomical similarities to man. In addition, its reduced size and its docility make it appropriate for laboratory use. Curiously, this model remains seldom used in experimental pharmacokinetics. We present here in a chronic model of catheterized micropig allowing long term investigations of antiinfective agents. We work with Yucatan adult female micropigs weighing between 20 and 40kg. A catheter (60 cm x 2 mm) is placed in the external jugular vein under general anaesthesia and exits in the midline dorsal neck. The catheter is flushed every two days with heparinized saline to retain its potency. At the time of kinetic studies, the antiinfective agent is injected in an ear vein. Blood samples are obtained using the jugular catheter. The mean time of viability of the device is 13 weeks (SD: 10 weeks). Thrombosis was the main cause of arrest of the model. In conclusion, this chronic model of catheterized micropig is suitable for long term pharmacokinetic and pharmacodynamic investigations of antiinfective agents.

Adult↗
PubMed1996

[Pharmacokinetic interaction between itraconazole and rifampin in Yucatan miniature pigs].

The objective of this study was to examine the effects of rifampin on itraconazole pharmacokinetics, at steady state, in three Yucatan miniature pigs. The pits received daily during three weeks oral itraconazole at a dosage of 200 mg at the beginning of the meal, then during the next two weeks oral itraconazole combined with an intravenous administration of rifampin at a dosage of 10 mg/kg/day. The coadministration of rifampin resulted in a 18 fold decrease of the Cmax of itraconazole [from 113.0 (SD: 17.2) to 6.2 ng/ml (SD: 3.9)], and in a 22 fold decrease of the AUC [from 1652.7 (SD: 297.7) to 75.6 ng.h/ml (SD: 30.01)]. The active metabolite of itraconazole, hydroxyitraconazole, was undetectable. This study demonstrates that rifampin considerably affects itraconazole kinetics at steady-state in this model of micropig, probably by inducing the hepatic metabolism of itraconazole.

Administration, Oral↗
PubMed1995

Determination of free triiodothyronine by six different methods in patients with non-thyroidal illness and in patients treated with amiodarone.

We performed a methodological comparison of free triiodothyronine (FT3) estimates in patients with liver cirrhosis and renal failure. Patients were classified in terms of severity of illness on the basis of their total triiodothyronine, total thyroxine and reverse triiodothyronine profiles. FT3 levels, measured in direct dialysis, microchromatography, labelled analogue and two-step immunoextraction assays were significantly (P < 0.01) lower than the control group in all patient categories. However, FT3 measured by a labelled antibody radioimmunoassay was significantly reduced only in the most severely ill sub-group of patients. In a further group of patients on long-term amiodarone therapy for cardiac disease all FT3 methods, with the exception of the labelled antibody radioimmunoassay and an analogue method, yielded significantly (P < 0.01) reduced levels. A significant negative association between FT3 and subject age was demonstrated for all methods except the labelled antibody radioimmunoassay, and a weak but significant negative correlation between log thyrotropin and FT3 was only seen with this assay. Three methods demonstrated a correlation (P < 0.02) with albumin levels in patients with the 'low T3 syndrome'. In this group, albumin had a predictive value (P < or = 0.02) for four out of six assays as determined by stepwise variable selection. Our findings suggest that users of FT3 assays should exercise caution in interpreting results in non-thyroidal illness and amiodarone treated patients, as there are method-related differences in the profiles obtained.

Adult↗
PubMed1994

[Effects of amiodarone on thyroid hormonal profile. Updating based on new assay methods].

Amiodarone (A) treatment alters the levels of thyroid hormones. We investigated whether new hormonal assays are also altered by this drug. Thyroid function was determined in 21 patients chronically treated with A and in 30 controls. TSH was determined with a third generation assay. Free T3 and Free T4 levels were determined by 5 different immunoassays. Equilibrium dialysis (E.D.) was considered as the reference assay for FT3 and FT4. With this method FT3 is diminished, reverse T3 ans FT4 are increased whereas TSH remained normal. Only FT3 determined by an assay using a labelled monoclonal antibody (MAB) appears not modified by A. Other methods (chromatography, chemiluminescence and radioisotopic) give results in agreement with E.D. Some of these alterations may be explained by a marked increase in plasma levels of non esterified fatty acids. Hormonal changes induced by A are typically with all but one assays. Whatever the method used the determination of TSH remains necessary to avoid misinterpretation of the thyroid function tests in A-treated patients.

Aged↗
PubMed1993

[Effects of blood transfusion on the serum assays of iron, the total binding capacity of transferrin, vitamin B12 and folates].

To evaluate the influence of blood transfusion on the serum levels of different nutrients, the levels of total iron binding capacity, ferritin, cobalamin and folate were determined before and 24 hours after 2 or 3 packed red cell transfusions, by forty patients with anemia of various causes. No significant change was found in these levels before and after blood transfusion, except for iron and folate.

Adult↗
PubMed1993

[Dementia syndrome and intercurrent pathologies in the elderly. A study of 100 patients over 75 years of age in a geriatrics internal medicine unit].

Elderly people with dementia are admitted in ever increasing number to Internal Medicine units for exploration of dementia and treatment of intercurrent diseases. The purpose of this prospective study of 100 demential subjects aged 75 or more (mean: 85.3 +/- 5.4 years) was to discover the cause of dementia, to investigate the associated diseases and to evaluate the effects of treatment of these pathologies on the patients' cognitive performance. The mean duration of stay in hospital was 25.5 +/- 14.5 days (extreme: 6-100 days); 69 returned home, 17 were institutionalized and 14 died. Dementia was degenerative and of the Alzheimer type (73%) with vascular lesions (24%) associated with brain tumours (2%) or normal-pressure hydrocephalus (1%). On average, 2 pathologies were associated with Alzheimer's dementia and 3.5 with dementia cum vascular brain lesions. Repeated evaluation of cognitive performance was carried out using Folster's Mini Mental Status (MMS), a global evaluation test. It showed that 18% of the patients were significantly improved while the other diseases were being treated. The hypothesis of regressive confusional elements superimposed on dementia is accepted by the authors as it fits the model of geriatric multipathology morbidity. Since there is no specific treatment for most types of dementia, particular attention must be paid to associated diseases likely to aggravate the clinical expression of dementia.

Aged↗
PubMed1993

[Sarcoidosis in a cicatrix: apropos of 5 cases].

The authors report 5 cases of sarcoidosis developed on scars. Sarcoidosis may be isolated (1 case); it may precede (1 case) or accompany systemic sarcoidosis, or occur during a relapse (3 cases). Dermatologists who observe cicatricial changes always suspect sarcoidosis. It is therefore important that physicians should examine the scars of their patients with suspected sarcoidosis, since biopsy of these scars is easily performed, confirms the diagnosis and avoids more invasive explorations.

Adult↗