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Biomedical subjects

G Katz

Publications and source records attributed to G Katz.

At least 91 records · Page 5Linked to original sources

Shock-wave treatment for stones in the kidney and ureter. The Jerusalem experience.

We report on our first 6 months' experience with the extracorporeal shock-wave lithotripter (ESWL). During this period, 410 treatments were given to 350 kidneys and ureters. Our series was characterized by a particularly high proportion (40%) of multiple and large calculi and included 25 complete staghorns. The latter required multiple treatments (up to five), but no adjunct percutaneous nephrolithotomies were used in this series. A percutaneous nephrostomy was inserted in 20 cases. Thirty-six ureteric calculi above the pelvic level were treated in situ, with 95% success. The presence of a ureteric catheter is useful in these cases. Posttreatment pain was graded, and 61% of the patients did not require any analgesia. High-frequency jet ventilation was used in 91% of the 172 patients receiving general anesthesia and was of great value in minimizing respiratory-stone movement. The principal complication encountered was ureteric obstruction due to impacted particles. Temperature greater than 38 C occurred in 8.5% of the cases. It is suggested that the availability of the ESWL should encourage the early treatment of both renal and ureteric calculi, as well as enable the treatment of certain patients rejected for conventional surgery.

Adolescent↗

[Evaluation of scintigraphic procedures for clarifying pain conditions in hip joint prostheses].

59 patients with implanted one- or two-sided hip prostheses (n = 74) have been investigated by two different scanning techniques to detect both possible loosening of the prostheses and a possible infection as the cause of the loosening. Of the investigated prostheses 47 were loose; in 45 cases this was evidenced by the bone scan using Tc-99m-DPD, thus showing a sensitivity of 95%. Specificity was 89%. In 21 cases (45%) of loose prostheses an infection could be clinically proven. With the aid of In-111 labeled leukocyte scans, 17 of 21 cases were correctly diagnosed as infected, showing a sensitivity of 91%, while the specificity was 94%. In view of the 93% accuracy, bone scanning can be regarded as the method of choice in detecting loosening of prostheses. The 91% accuracy in proving or ruling out infection by means of the leukocyte scan is high enough to assert correct findings in most cases. The main disadvantage of this method is the very demanding technique for marking of white blood cells.

Diphosphonates↗

Glycerol-3-phosphate excretion in fructose-1,6-diphosphatase deficiency.

A patient aged 23 months with fructose-1,6-diphosphatase deficiency is reported. This infant demonstrated an increased urine excretion of glycerol-3-phosphate during episodes of hypoglycaemia. The excretion of this compound has not previously been described in this disease or in those disorders associated with a deficiency in one of the other three gluconeogenic enzymes associated with hypoglycaemia. Its presence in the urine from patients may be useful in diagnosis.

Carbohydrate Metabolism, Inborn Errors↗

Congenital varicella causing neurogenic bladder and anal dysfunction.

An infant with congenital varicella syndrome due to maternal varicella zoster is presented. Unlike other reports in which such infection caused multiple congenital defects, our patient suffers from atonic bladder and anal dysfunction as the sole manifestation of congenital varicella syndrome. Attention is called for maternal varicella as a possible cause for limited neurologic damage in the fetus.

Anus Diseases↗

Moving experiences: a model for inpatient transfer based on interviews with patients and their families.

Although transfer of psychiatric patients from one unit to another is a routine clinical procedure, it may constitute a crisis for patients and their families. The 61 recently transferred patients and 46 family members interviewed for this study expressed substantial dissatisfaction with the transfer process, especially with the planning and preparation stages. Based on their responses, the authors developed a model for understanding and improving inpatient transfers. The transfer process consists of four stages--planning, preparation, transfer, and adjustment--each of which presents different tasks for the patient, his family, and staff. The authors believe their transfer model is applicable to the transfer of medical inpatients and psychiatric outpatients.

Adolescent↗

Pharyngoesophageal barotrauma in children: a report of six cases.

Pharyngeal and pharyngoesophageal penetrating injury occurred in six children following the explosive discharge of compressed carbon dioxide into their mouths. The gas was contained in plastic, screw-cap soft-drink containers overpressurized by the addition of dry ice. Three children were managed surgically and three conservatively. All recovered fully, and at follow-up of from 3 to 52 months, swallowing is normal.

Anti-Bacterial Agents↗

Acute bronchoconstriction associated with transtentorial herniation in a patient with elevated intracranial pressure.

A patient with acutely elevated intracranial pressure (ICP) and a severe attack of bronchoconstriction is presented. Further investigation after treating the combined emergency situation revealed uncompensated hydrocephalus. Possible mechanisms which might be responsible for the coexisting emergency states are discussed. The urgent need for immediate simultaneous treatment of both disease entities is emphasized.

Acute Disease↗

Population pharmacokinetic parameters in patients treated with oral mexiletine.

A new data analysis approach, NON-MEM, proposed by Sheiner and Beal, has been employed to estimate the population pharmacokinetic parameters of oral mexiletine in patients treated for arrhythmias. 452 serum concentration measurements in 58 patients were available for analysis. 27 patients had congestive heart failure and 8 had abnormal liver function tests at the time of the study. The population averages of the pharmacokinetic parameters and their interindividual variability were: oral total body clearance (Cl) 0.38 l/h/kg +/- 43% (C.V.), apparent volume of distribution (Vd) 5.3 l/kg +/- 40%, absorption rate constant 3.1 h-1 +/- 205%, absorption time-lag 0.3 h. Congestive heart failure and sex did not show a significant effect on Cl and Vd; the number of patients with severe liver function impairment was too small for a definite conclusion. Normalizing Cl and Vd for body weight significantly decreased their interindividual variability. Based on these results, a dosage regimen is recommended which is expected to produce a "therapeutic" serum concentration (0.8-2 mg/l) in over 60% of patients. Because of its unique features, which allow estimation of pharmacokinetic parameters and their variability from fragmentary patient data, the NONMEM system has great potential applicability to clinical pharmacokinetic studies.

Aged↗

Talampicillin in the treatment and prophylaxis of urinary tract infection in children.

9 children presenting with an ampicillin-sensitive coliform urinary tract infection were treated with talampicillin using 1 week of full-dose treatment followed by low-dose prophylaxis. The bowel coliforms were ampicillin-resistant at the start in one girl and became resistant in the remaining 8 within 4 months. During a total of 44 months of talampicillin therapy, 6 girls (2 with vesico-ureteric reflux) developed a symptomatic re-infection of the urinary tract, a recurrence rate of 1 per 7.3 months, or 1.6 recurrences per annum. A further 12 girls were given prophylactic talampicillin, 9 after an initial therapeutic course of co-trimoxazole for 1 week and 3 following a period of prophylaxis with low-dose co-trimoxazole. The rectal swab from one girl showed partial ampicillin resistance but 9 of the remaining 11 showed that a predominance of ampicillin-resistance coliforms had emerged in the bowel flora within 4 months. 5 of the 12 also developed a symptomatic ampicillin-resistant urinary infection within 4 months, a recurrence rate of 1 per 7.1 months or 1.7 recurrences per annum. Talampicillin, though very effective in treating urinary infection, is not recommended for the prevention of subsequent recurrence.

Ampicillin↗

[Relation of dose, serum concentration and side effects in intravenous aminophylline therapy].

Routine intravenous aminophylline therapy was monitored by drug level measurements in 45 hospitalized patients with chronic obstructive bronchitis. Only 44% had theophylline serum concentrations (Cp) in the optimum range (10-20 mg/l), while in 36% of patients potentially toxic Cp values were observed. The incidence of side effects was related to theophylline serum concentration: 78% in cases with Cp greater than 30 mg/l against 24% in cases with Cp less than 20 mg/l. Theophylline toxicity occurred most frequently in elderly patients with cardiac failure, who had markedly reduced theophylline clearances. To avoid excessive drug accumulation the usual aminophylline dose should be reduced by 50% when clinical signs of cardiac failure are present. In addition, measurement of theophylline serum concentration is often necessary for optimum dosage adjustment.

Adolescent↗