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Biomedical subjects

G Kleinberger

Publications and source records attributed to G Kleinberger.

At least 91 records · Page 5Linked to original sources
PubMed1981

[Infection in patients with hepatic coma (author's transl)].

66 patients with hepatic coma were treated from 1972 to 1979 in the intensive care unit. Incidence and etiology of bacterial infections in these patients were evaluated retrospectively. Bacterial cultures were positive in a high proportion of the cases investigated as compared to the situation on a normal ward. Bacterial cultures were performed in 51 patients (77.3%); cultures from 35 patients were positive. Gramnegative bacteria accounted for 56.4%, grampositive bacteria for 34.8% and candida albicans for 8.8% of all the cases. It is pointed out, that invasive diagnostic and therapeutic manoeuvers in intensive care patients carry a high risk of infection.

Adolescent↗
PubMed1981

[Electrolyte content of antibiotics].

The sodium and potassium content of frequently used antibiotics was calculated. Whenever high dose intravenous chemotherapy is used the amounts of sodium or potassium must be taken in consideration in the electrolyte balance. Special attention must be given to patients on restricted sodium diet. In these cases, the additional sodium resulting from intravenous chemotherapy may exceed the daily administered amount of sodium. The summary of electrolyte content of antibiotics may be useful in balancing electrolytes during infusion therapy.

Adult↗
PubMed1981

[Lipid and lipoprotein metabolism in acute pancreatitis].

In 10 patients with acute pancreatitis the lipid- and lipoprotein-metabolism was studied. In all patients blood samples were drawn for estimation of the fasting concentration of the lipoproteins. In 7 patients the postheparinlipasesystem was testet by an intravenous heparintest. Afterwards, 0.2 g fat/kg bodyweight were injected intravenously in 2 min. Before, 5, 10, 30 and 40 min after injection blood was drawn. Lipids were estimated by means of full encymatic methods, lipoproteins were determined according to the lipid research clinics method, NIH, using a combination of ultracentrifuge and polyanion precipitation. In comparison with healthy people the cholesterol, specially the LDL fraction was low. Additionally the triglycerides were elevated in 3 patients, caused by elevation of the VLDL fraction. After injection of heparin in all patients the triglyceride concentrations fell. That shows a functionating lipoprotein lipase system. Intravenously injected fat was eliminated in all patients with an elimination rate between 1 and 2 %/min. From these results it is concluded that exogenous fat is eliminated sufficiently from serum in acute pancreatitis. There is no sign for disturbed fat metabolism in these patients. Therefore the contraindication for fat emulsions in acute pancreatitis does not seem to be justified. Due to the fact of glucose intolerance in these patients fat emulsions could be used for an adequate supply of energy. Patients with a hyperlipoproteinemia should be excluded from this therapy by daily detection of triglycerides.

Acute Disease↗
PubMed1980

[Influence of insulinfree rehydration on diabetic derangements (author's transl)].

In two groups of pts with diabetic derangements the effect of infusion therapy was investigated with regard to metabolic and endocrine functions. The rate of infusion was adapted to the height of the central venous pressure and the administration of electrolytes to their serum concentration. Insulin was withheld until no further decrease of blood glucose was noted. Group A consisted of 8 pts with severe diabetic ketoacidosis (blood glucose higher than 25 mmol/l, pH below 7.0 and/or bicarbonate below 10 mmol/l). The duration of insulinfree rehydration was 8.8 +/- 1.3 (x +/- SE) hrs and the fluid retention 4060 +/- 3 633 ml. The osmolality in serum decreased from 356 +/- 12 to 340 +/- 8 mosm/kg H2O and the blood glucose from 37.9 +/- 2.9 to 28.6 +/- 3.4 mmol/l. No correlation existed between the decrease of blood glucose and the expansion of the intravascular volume. Therefore, the decrease of blood glucose was not caused by a simple dilution effect. High renal glucose excreation was observed (408 +/- 83 mmol) but could not explain the decrease of blood glucose. The glucose clearance fell from 25.9 +/- 6.9 to 21.5 +/- 3.8 ml/min/1.73 m2 body surface from the first to the last 2-hr periods. It must be concluded that the initial rehydration deminished gluconeogeneses and/or increased tissue glucose utilization without exogenous insulin administration. This conclusion is supported by the decrease in the plasma concentration of the contrainsular hormons. Glucagon decreased 579 +/- 209 to 319 +/- 88 pg/ml (n.s.). Cortisol from 49.9 +/- 4.6 to 35.8 +/- 6.7 micrograms/100 ml (p < 0.05) and Adrenalin from 2.43 +/- 1.03 to 0.4 +/- 0.22 ng/ml (p < 0.05). Blood gas analysis revealed only minimal and ketobodies in serum no changes. Therefore, it can be concluded that rehydration and decrease of plasma concentration of contrainsular hormones do not influence the enhenced lipolyses in diabetic ketoacidosis. Group B consisted of 8 pts with nonacidotic diabetic derangements (blood glucose higher than 25 mmol/l, pH above 7.3 and/or bicarbonate above 18 mmol/l) and an acute weightloss of more than 3 kg. The insulinfree rehydration lasted 13 +/- 1.6 hrs and the fluid retention was 4620 +/- 380 ml. The serum osmolality decreased from 317 +/- 5.3 to 288 +/- 1.9 mmol/l. The decrease of blood glucose could not be explained by delution effect. The renal glucose excreation was 370 +/- 120 mmol/l in total and the glucose clearance decreased from 15.3 +/- 8.4 to 8.0 +/- 2.8 ml/min/1.73 m2 body surface (p < 0.01). Decrease of gluconeogenese and/or increase of glucose assimilation of the tissues can also be expected for the pts with nonacidotic diabetic derangements during plain rehydration.

Acidosis↗
PubMed1980

[Haemodynamic effects after application of nitroglycerin sublingually or as ointment in patients with left ventricular heart failure (author's transl)].

The haemodynamic effects of a 2% nitroglycerin ointment and of sublingual nitroglycerin in patients with left ventricular heart failure were investigated. The well-known pulmonary blood pressure and pulmonary wedge-pressure lowering effect were observed with both forms of administration. Differences exist between onset and duration of the haemodynamic effects. With sublingual administration of nitroglycerin the peak effect was seen after 5 minutes, whilst the pulmonary blood pressure rose again 30 minutes later. After application of nitroglycerin ointment a peak effect was seen 30 minutes later and the effects were sustained for 3 to 6 hours.

Administration, Oral↗
PubMed1980

Oral and parenteral nutrition with L-Valine: mode of action.

The intravenous application of the branched chain amino acid L-valine to patients with hepatic coma resulted in a specific drop of tryptophan, serotonin and 5-hydroxyindole acetic acid. Clinical improvement of hepatic encephalopathy and of the underlying neurotransmitter (serotonin) and ammonia derangements by administration of L-valine suggest a possible role of this competitive amino acid on intermediary metabolism and ammonia detoxification.

Aged↗
PubMed1980

Prolactin in diabetic praecoma.

Prolactin has been suggested to exert a diabetogenic action in animal and man. Thus this report is concerned with the changes of serum prolactin in severely hyperglycaemic patients in a praecomatous state (n = 12). Basal serum prlactin levels were 12.0 +/- 3.4 (SE) ng/ml on admission and well within the normal range (less than 20 ng/ml). Rehydration of the patients which induced a significant fall in blood glucose (31.2 +/- 2.1 to 21.6 +/- 2.9 mmol/l) and in serum osmolality (336 +/- 9 to 316 +/- 10 mosmol/kg H2O) was however without any effect in serum prolactin concentration (9.9 +/- 2.5 ng/ml at the end of the rehydration period). We conclude that prolactin is not involved in the severe endocrine and metabolic derangements seen in diabetic praecoma; its secretion does not seem to be markedly altered by acute changes in blood glucose and serum osmolality.

Adolescent↗
PubMed1979

[A double blind cross-over study with mepindolol-sulfate in patients with coronary heart disease (author's transl)].

UNLABELLED: The effect of mepindolol-sulfate (2 x 2.5 mg) was tested in 20 patients with coronary heart disease in a controlled study against placebo resp. propranolol (3 x 40 mg). RESULTS: 1. The frequency and intensity of anginal attacks were reduced significantly under mepindolol-sulfate therapy.-- 2. There was a significant improvement of ergometric exercise tolerance under mepindolol-sulfate therapy.--3. Additionally a reduction of ST-depression in ECG was found under mepindolol-sulfate.--4. In patients with coronary heart disease the clinical effect of mepindolol-sulfate in a daily dose of 2 x 2.5 mg was equal to propranolol in a daily dose of 3 x 40 mg.

Adrenergic beta-Antagonists↗
PubMed1979

[Course and intensive treatment of acute falciparum malaria (author's transl)].

The case of a nineteen-year-old women with the cerebral form of malaria tropica is reported. She showed hyperpyrexia, abdominal manifestations, haemolysis and disseminated intravascular coagulation. Cerebral symptoms amounting to grade IV encephalopathy occurred. The patient responded rapidly to the administration of chloroquine, anticonvulsants, dextran, corticosteroids, antipyretics, blood and antithrombin III and her symptoms had almost completely vanished one week after the onset of therapy.

Acute Disease↗
PubMed1979

[Haemodynamic effects of depot zinc protamine glucagon in heart failure (author's transl)].

In contrast to intravenously-administered crystallene glucagon, which acts for 20 minutes only, the depot form, zinc protamine glucagon, shows a prolonged haemodynamic action. Fourteen patients with pre-existing heart failure received a single dose of 20 mg Zn protamine glucagon intramuscularly. The stroke volume and cardiac output were increased, whereas the mean and end-diastolic pulmonary pressure were decreased, indicating a positive inotropic action of the administered drug. Heart rate and mean arterial pressure remained almost unchanged. The haemodynamic changes started 60 minutes after intramuscular administration of the drug, reached a maximum effect at 3 hours and started to decrease after the fourth hour. Zn protamine glucagon can, therefore, be considered a beneficial drug in the treatment of digitalis-resistant heart failure on the basis of its long duration of action and easy route of administration.

Aged↗
PubMed1979

[Forced diuresis].

Forced diuresis (FD) is a frequently used method for eliminating toxins. Its therapeutic effect has yet to be evaluated by a controlled clinical trial. In the absence of such a trial its usefulness can be judged only indirectly from urinary excretion rates. In former times the usual clinical laboratory procedures could not differentiate between the unchanged toxin and its metabolites. Using more selective methods, the discussions of the effect of FD in eliminating various drugs were renewed. The problem for the indication of FD is not only a missing knowledge about the kind and amount of the ingested drug, but also when knowing it, the missing evaluation of the effect of FD on its excretion. In such cases the pharmacokinetic behaviour of the drug can be helpful. If paying enough attention to the contraindications, to the principles of electrolyte and water balance, the complication rate is low. Many infusion regimes are proposed for this treatment, but only a standardized procedure can increase the safety and efficiency of this method. More complicated and more expensive methods should be used, when there is an intoxication with a substance of high mortality or when there is no effect of FD on eliminating the toxin.

Biotransformation↗
PubMed1979

[Acute hemolysis in polycythemia vera].

The clinical course of fulminant haemolysis in a 54 year old patient with polycythaemia vera is described. Haemolysis was due to a complement-activating cold-autoantibody of the IgM class. A pathogenetic association between polycythaemia vera as a myeloproliferative disorder and autoimmune-haemolysis is discussed.

Acute Disease↗