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Biomedical subjects

K Dalhoff

Publications and source records attributed to K Dalhoff.

125 records · Page 7Linked to original sources
PubMed1990

[Acute kidney failure during psoriasis therapy with fumaric acid derivatives].

24 days after starting treatment of psoriasis with fumaric acid derivatives (0.8-1.0 g orally, plus unknown quantities locally) a 21-year-old woman developed acute oliguric renal failure with a rise of serum creatinine levels to 1094 mumol/l (12.4 mg/dl). Deterioration of renal function had been preceded by severe abdominal symptoms with nausea, vomiting and colicky pain. On admission to hospital she was dehydrated with hyponatraemia and hypokalaemia. There was glomerular microhaematuria, increased excretion of renal epithelia, and tubular proteinuria. Renal biopsy demonstrated acute tubular damage with vacuolization of proximal epithelia, dilated tubules and scattered necroses. After intermittent haemodialysis (13 courses over two weeks) renal function gradually recovered, as demonstrated at a follow-up examination four months after discharge.

Acute Kidney Injury↗
PubMed1990

[Long-term substitution in homozygous alpha 1-antitrypsin deficiency. Effect of the proteinase-antiproteinase equilibrium in plasma and sputum].

Long-term replacement with human alpha 1-antitrypsin (60 mg/kg once a week intravenously) was carried out in seven patients with homozygous alpha 1-antitrypsin deficiency (7 males, mean age 50.8 [40-59] years) and progressive pulmonary emphysema for an average of 16 (13-20) weeks. After at least 12 weeks' therapy the concentrations of alpha 1-antitrypsin, elastase-alpha 1-antitrypsin complex, alpha 2-macroglobulin, lactoferrin and elastase inhibition capacity in plasma and sputum were assayed, these assays being performed before starting the alpha 1-antitrypsin infusion and at various times during the following week. After the infusion the plasma concentration of alpha 1-antitrypsin rose from a depressed initial level (median 1.22 g/l) to a level approximately five times higher (median after 1 hour: 5.96 g/l, P less than 0.001), and then declined exponentially, though it never fell below the threshold of 35% of normal which is regarded as the protective level. Elastase inhibition capacity displayed similar changes (r = 0.85). The sputum concentration of alpha 1-antitrypsin rose more slowly than the plasma concentration; from the initial level (median 8 mg/l) it reached a maximum about four times higher after 24 hours (median 36 mg/l; P less than 0.02). Elastase inhibition capacity rose from 151 mIU/ml (median) before the alpha 1-antitrypsin infusion to 450 mIU/ml at 24 hours. These findings suggest that alpha 1-antitrypsin replacement will have beneficial effects on proteinase-antiproteinase equilibrium. Determination of elastase inhibition capacity in the sputum is suitable for monitoring dosage during replacement therapy.

Adult↗
PubMed1990

Consumption, overdose and death from analgesics during a period of over-the-counter availability of paracetamol in Denmark.

During the period 1978-1986, annual sales of paracetamol in Denmark increased from 1 million defined daily doses (DDD) (3 g) to 47 million DDD, while the number of admissions and deaths from overdose increased from 26 to 202 and from 1 to 3-4, respectively. The corresponding figures for salicylates are a decrease in sales from 113 to 94 million DDD, an increase in admissions from 282 to 595, and an increase in deaths from 5 to 22. From 1 January 1984 paracetamol became available on an over-the-counter basis. The figures for 1983 and 1984 were an increase in sales from 14 to 28 million DDD, an increase in admissions from 114 to 198, and an increase in deaths from 0 to 4. The number of deaths from opioid overdose remained constant at a value of about fifty during this period, the mortality per dose being about 20-fold higher than for paracetamol and salicylates. Dextropropoxyphene-related deaths increased twofold to 121 in 1986, with unchanged sales figures. A campaign launched by the National Board of Health resulted in a reduction in the number of deaths from dextropropoxyphene to 66 in 1987. The main effect of over-the-counter release of paracetamol was a dramatic increase in sales, without the epidemic of deaths observed a decade ago in the UK. It is suggested that the higher mortality of paracetamol poisonings in the UK compared to Denmark is related to the dextropropoxyphene content of the combination product, which is not available in Denmark. From an epidemiological toxicological viewpoint such combinations are not justified.

Acetaminophen↗
PubMed1990

[The diagnostic value of bronchoalveolar lavage in opportunistic pneumonia following kidney transplantation].

In 18 renal transplant patients with pneumonia under ciclosporin therapy the diagnostic value of BAL and of covered micro brush smears were compared. In 10 out of 18 cases partly atypical bacterial pathogens were cultivated and cytomegaly was diagnosed 4 times, mycosis twice, whereas 2 cases could not be clarified. A granulocytosis in the differential cell pattern correlated with a bacterial infection.

Bronchoalveolar Lavage Fluid↗
PubMed1989

NcoI restriction fragment length polymorphism (RFLP) of the tumour necrosis factor (TNF alpha) region in primary biliary cirrhosis and in healthy Danes.

The restriction fragment length polymorphism of the human tumour necrosis factor (TNF alpha) region was investigated by means of 20 different restriction enzymes and a human TNF alpha cDNA probe. Only one of the enzymes, NcoI, revealed a polymorphic pattern consisting of fragments of 10.5 and 5.5 kb, which behaved as alleles. In a panel of 108 random, healthy, unrelated Danes, the phenotype frequencies of the 10.5 and 5.5 kb bands were 0.94 and 0.53 and the gene frequencies were 0.71 and 0.29, respectively. The test for Hardy-Weinberg equilibrium showed no significant deviation from the expected values. The 5.5 kb band was strongly positively associated with HLA-DR3, HLA-B8, and HLA-A1. In 22 patients with primary biliary cirrhosis a significantly (corrected P = 0.024) decreased frequency of the 10.5 kb fragment was found. Additional studies are in progress to substantiate this association.

Chromosome Mapping↗
PubMed1989

[Voice therapy according to Smith. Comments on the accent method of treating voice and speech disorders].

The accent method (A.M.) is based on the myoelastic and aerodynamic phonatory theory. The aim of the respiration exercises is to establish a predominantly abdominal respiration. Following the exercises of accentuated phonatory pulsations, patients work on reading special texts designed to enable them to become aware of the accentuated or unaccentuated sections. The AM is based on a holistic understanding of the voice and of speech. Whilst the exercise of AM is linked to a physiological phenomenon, such as phonatory aerodynamics and muscular function, the method is to be understood as a therapy aimed at producing an overall change in the behaviour related to oral communication disorders. The aim is not so much to eliminate a given particular defect, but rather to condition a subconscious automatism.

Humans↗
PubMed1988

[Diagnostic value of lymphocyte differentiation in the early phase following kidney transplantation].

In 50 patients who had a renal transplantation, treated with ciclosporin, regular monitoring of lymphocyte subpopulations was undertaken prospectively to assess its value with respect to cellular rejection, herpes virus infection, and ciclosporin overdosage. Herpes virus infection was characterized by inversion of the T4/T8 ratio below 1.0 (sensitivity 90%, specificity 88%), caused by proliferation of the T8 subpopulation, which--compared with the findings in patients with rejection crises--was significantly raised (P less than 0.001). But such rejection crises could not be predicted from the T4/T8 ratio. Ciclosporin had no effect on the ratio, total lymphocyte count in this group being higher (P less than 0.002) than in patients with rejection.

Creatinine↗
PubMed1987

Buspirone pharmacokinetics in patients with cirrhosis.

The pharmacokinetics of a single oral dose of buspirone (20 mg) were determined in 12 patients with cirrhosis and 12 normal subjects. The mean AUC of buspirone was 55 +/- 38 s.d. ng ml-1 h in cirrhotics and 3.5 +/- 2.4 s.d. ng ml-1 h in normals. The time until maximum concentration (tmax) attained was similar in the two groups (0.6 vs 0.7 h), but mean maximum concentration Cmax was higher in patients (18.8 +/- 16.3 s.d. ng ml-1) than in normals (1.2 +/- 0.8 s.d. ng ml-1). Mean elimination half-life of buspirone was greater in cirrhotics, but this difference was marginally significant statistically (cirrhotics, 6.1 +/- 3.5 s.d. h, normals 3.2 +/- 1.5 s.d. h, P = 0.05). Eight of 12 patients and seven of 12 normal subjects had a second peak in the plasma concentrations of buspirone. In patients this occurred at 10.8 +/- 7.4 s.d. h after the dose, and its mean concentration was 3.1 +/- 6.6 ng ml-1. In normal subjects the second peak occurred at 4.3 +/- 2.1 h after the dose and its mean concentration was 0.5 +/- 0.3 ng ml-1. On the kinetic evidence buspirone should be used with caution in liver disease.

Adult↗
PubMed1985

Influence of immunosuppressive therapy with azathioprine and prednisolone on serum-immunoglobulin concentration in renal transplanted patients.

Serological diagnosis of infectious diseases are based on the assumption that a change in virus-specific antibody - titer reflects the response to a certain viral infection due to changes in the concentration of the respective virus - specific antibodies. On the other hand immunosuppressive medication interacts with that system responsible in producing antigen-specific antibodies. This study was outlined therefore to follow the variation of the concentration of serum immunoglobulins of classes IgG and IgM with regard to a better evaluation of virus-specific antibody titers especially for those viruses that remain persistent after a primary infection and an reactivate. The study followed ten patients after allogenic cadaver kidney transplantation under immunosuppressive medication with azathioprine and corticosteroids. Concentration of serum-IgG and -IgM protein was continuously measured for 6 months after transplantation along with measurement of virus-specific antibody-titers with enzyme immunoassay (Elisa) especially for cytomegalovirus. The results show a drastic decrease in serum immunoglobulins IgG and IgM - the lowest concentration being reached 25-50 days after transplantation. The concentration of IgG increased thereafter if no severe infectious diseases occurred during the post-transplant period. The concentration of IgM seems to react more sensitively upon infectious processes. In general, virus-specific antibody-titers (IgG) follow the sometimes drastic variation in the respective immunoglobulin class. It therefore reveals that antigen-specific antibody-titers in those patients should be controlled continuously during the time after transplantation for better evaluation of titer variations that eventually occur in correlation to the absolute concentration of the immunoglobulin class.

Adult↗
PubMed1985

[Herpes simplex infection after kidney transplantation under immunosuppression by cyclosporin. Diagnostic and therapeutic experiences].

Incidence and course of herpes simplex infections was determined prospectively in 22 patients who had a kidney transplant and were treated with cyclosporin. In addition to clinical findings, serial studies were undertaken of throat washings for herpes simplex virus in cell culture, as well as of patient sera for herpes-specific IgG and IgM antibodies. There were 13 clinically manifest infections, 12 of them localized, while one had dissemination with necrotizing retinitis. Virus demonstration was successful in all cases in which virostatic drugs had not yet been used. Asymptomatic virus excretion was noted in three cases. Significant IgG titre rise occurred in six of the 13 cases, but a positive IgM titre in only two. Acyclovir proved to be an effective virostatic drug with few side effects. The outcome in the localized infections was favourable, but in the disseminated one residual defects remained.

Acyclovir↗
PubMed1977

[Observations on the accent-method of Smith in the management of speech and voice disturbances. Part I (author's transl)].

One of the best known methods in northern Europe for the treatment of voice disorders is the "accent-method", which was devised by Svend Smith in Denmark. The method is based on the use of the stressed ("accentuated") syllable as a therapeutic tool to develop pronunciation and a natural attractive voice. Present theories of the physics and the physiology of voice function form the basis for the method, in addition to concepts from modern psychology and pedagogics. By using the technique, it is possible to develop a therapeutic field between patient and therapist within which voice and speech behavior can be treated as a whole. The method is described in detail in the present paper. In a forthcoming paper, the method will be discussed from the viewpoints of the physics and physiology of phonation as well as from pedagogical and psychological aspects,

Breathing Exercises↗
PubMed1977

[Observations on the accent-method of Smith in the management of voice and speech disturbances. Part II (author's transl)].

In an earlier paper [HNO 25, 102 (1977)], the accent-method for the treatment of voice disorders has been described in detail. The rhythmical pronunciation of stressed ("accentuated") syllables with a physiologically correct phonatory respiration and a loose articulation form the basis for this method, and allow treatment of voice disorders as well as problems related to abnormal speech behavior. Further discussion is based on present theories of the physics and the physiology of voice function as well as on concepts from modern psychology and pedagogics.

Humans↗
PubMedDate not supplied

Diagnostic value of bronchoalveolar lavage in patients with opportunistic and nonopportunistic bacterial pneumonia.

In 29 patients with community-acquired pneumonia, 24 patients with hospital-acquired pneumonia and 35 patients with pneumonia in the immunocompromised host the diagnostic value of bronchoalveolar lavage (BAL) with quantitative bacterial and fungal cultures was studied; 32 patients with noninfectious pulmonary diseases and 14 healthy volunteers served as controls. An infectious etiology could be established in 81% of the pneumonia patients without differences between the three groups; significant infection was associated with colony counts of > or = 10(4) cfu/ml. Prior antibiotic therapy lowered the yield of BAL culture only in community-acquired pneumonia (94% vs 55% positive cultures in untreated vs pretreated patients, p < 0.02). Furthermore the culture results were related to the radiographic extension of pulmonary infiltrates (92% positive cultures in multilobar vs 54% in lobar or segmental infiltrates, p < 0.001). Therapeutic consequences of BAL were shown by resistance of the isolated organisms to predefined empiric treatment regimens in 41% community-acquired pneumonia, 43% pneumonia in the immunocompromised host and 67% hospital-acquired pneumonia patients.

Adult↗
PubMedDate not supplied

Role of interleukin-8 in community-acquired pneumonia: relation to microbial load and pulmonary function.

In pneumonia local phagocyte activation is crucial for clearing of pathogenic microorganisms. In this context alveolar macrophage interleukin-8 secretion, phagocyte oxidative response and concentrations of lavage proteins were quantified, including interleukin-8, in 31 patients with pneumonia, 13 age matched patients with peripheral lung consolidation and six healthy volunteers; these findings were related to the impairment of gas exchange and the bacterial load in the alveolar space. Increased interleukin-8 levels were found in bronchoalveolar lavage fluid (BALF) and in alveolar macrophage supernatants from patients with pneumonia (214 ng/10(5) AM +/- 121 vs 71 ng/10(5) AM +/- 35 and 66 ng/10(5) AM +/- 30, p < 0.05). Interleukin-8 release from alveolar macrophages correlated with the upregulated spontaneous luminol enhanced oxidative response of pulmonary phagocytes but not with the neutrophil count in BALF. In pneumonia patients a significant difference was found between patients with 10(4) or more colony forming units (CFU)/ml BALF of one pathogen and patients with less CFU or nonspecific microbiological results (261 ng/10(5) AM +/- 89 vs 179 ng/10(5) AM +/- 81 and 7.5 ng/ml BALF +/- 17 vs 0.44 ng/ml BALF +/- 1, p < 0.05). Further, a negative correlation between interleukin-8 release of alveolar macrophages and the arterial pO2 at the time of BALF could be demonstrated (r = -0.47, p < 0.05). The results demonstrate local cellular activation in community-acquired pneumonia, which is related to the bacterial load in the alveolar space and to impairment of gas exchange. This is consistent with the hypothesis that pulmonary phagocytes play a central role in the pathogenesis of bacterial pneumonia, contributing not only to bacterial clearing but also to local tissue damage.

Adult↗
PubMedDate not supplied

[Therapy of pneumologic diseases in the aged].

Chronic obstructive lung disease (COLD), especially obstructive bronchitis and obstructive lung emphysema, are the most common pulmonary diseases of the elderly. In around 10% of over 65's they cause the death of the individual. The aetiology of these phenomena is still not clear. In pathophysiological terms, a loss in lung function occurs during the natural process of aging, pulmonary and extrapulmonary disease and other environmental factors. Any reduction in function of other organ systems must be taken into consideration when ordering therapeutical measures in treating COLD. The following stepwise-orientated scheme can be recommended in the treatment of COLD in elderly patients: Theophylline, beta 2-adrenergic agents, Anticholinergic drugs, Corticoid therapy, Mucolytica and secretolytica, Physiotherapy, Measures to increase arterial pO2 - either with oxygen therapy at home or with Almitrin, Antibiotica.

Adrenal Cortex Hormones↗