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Biomedical subjects

K Wolff

Publications and source records attributed to K Wolff.

450 records · Page 25Linked to original sources
PubMedDate not supplied

Use of 'very low-dose phenobarbital' to investigate compliance in patients on reducing doses of methadone (detoxification).

Incorporation of very low doses of phenobarbital into a methadone linctus has enabled us to monitor the compliance of 7 patients receiving a reducing dose of methadone (detoxification) for treatment for opioid addiction. By measuring both plasma phenobarbital and methadone we detected 4 patients who consumed extra illicitly obtained methadone during the detoxification regime. Treatment outcome was poor; 11 of the original 18 patients dropped out of treatment within 14 days and of those who remained, 4 patients relapsed and reabused illicit drugs and 2 returned to a fixed dose of methadone. Laboratory measurements were successfully used to detect poor methadone compliance.

Adult↗
PubMedDate not supplied

The role of endogenous endothelin in the regulation of uteroplacental and renal blood flow during pregnancy in conscious rats.

Advancing pregnancy is characterized by a ten-fold increase in uterine blood flow and a 50 per cent increase in renal blood flow. To evaluate the involvement of endogenous endothelin (ET) in these haemodynamic changes the effect of bosentan, an ETA/B receptor antagonist, on uteroplacental and renal blood flow was studied in awake pregnant Sprague-Dawley rats. Regional blood flows were measured using microsphere technique immediately prior to and 30 min after bosentan administration (20 mg/kg i.v.). Four groups of animals (term: 23 days) were included: bosentan was administered to ten rats at gestation day (GD) 19 and nine at GD 20-21. In addition, four rats at GD 19 and five animals at GD 20-21 received saline and served as control groups. Basal placental blood flow increased significantly from 19 days' gestation to 20-21 days. Basal myometrial blood flow did not change with gestational age. At gestation day 19 bosentan increased placental and myometrial blood flow significantly (80 per cent and 43 per cent, respectively, P<0.05). This effect was not observed at gestation days 20-21. Renal blood flow did not change in response to bosentan at GD 19 but decreased by 20 per cent at GD 20-21 (P<0.01). In conclusion, in the awake pregnant rat there is a significant endogenous ET dependent vasoconstrictor tone in the uteroplacental vessels that diminishes towards term. We speculate that this change in responsiveness to endogenous ET contribute to the increase in placental blood flow in late gestation.

Animals↗
PubMedDate not supplied

Hospitalization of patients with diabetes.

To determine annual hospitalization rates for patients with diabetes mellitus, we retrospectively analyzed the frequency of hospitalization among 905 patients with diabetes receiving primary care in a private practice outpatient program during a 20-month period (1,508 patient-years). We assessed the annual hospitalization rates stratified by diabetes clinical severity index, type of diabetes, type of treatment, age, sex, and mean glycosylated hemoglobin. The all-cause annual hospitalization rate was 211 per 1,000 patients (95% confidence interval, 184 to 238). Hospitalization rates were strongly correlated with measures of clinical severity; hospitalization rates did not vary significantly with type of diabetes, age, or sex. Among patients with type II diabetes, rates were higher in the group treated with insulin. A trend was noted for hospitalization rates to increase with mean glycosylated hemoglobin (not statistically significant in this sample). Overall, 14% of hospitalizations were for metabolic reasons, 45% were related to clinical complications of diabetes, and 41% were unrelated to the presence of diabetes. In analysis of hospitalization rates and therefore health-care expenditures for patients with diabetes, the characteristics of the patient population--and especially measures of clinical severity--must be considered. Interventions to reduce hospitalization can be targeted at high-risk groups.

Journal Article↗
PubMedDate not supplied

Efficacy of cyclosporin A in systemic sclerosis.

In this open pilot study, the potential therapeutic efficacy of Cyclosporin A (CsA) in systemic sclerosis (scleroderma) was investigated. Eight patients with severe scleroderma (skin manifestation and at least three organ manifestations such as pulmonary, intestinal, cardiac, renal, and severe hypertension) were included in the study. CsA administration was started at a dose of 5 mg per kg body weight per day and then, to obtain whole blood levels of 300-500 ng/ml, adjusted to a mean dosage of 4.3 mg/kg/day. Therapeutic effects were evaluated by monitoring the measures of cutaneous, pulmonary, cardiac, gastrointestinal, and renal involvement as well as laboratory parameters. After 6 to 12 months of CsA-administration, cutaneous abnormalities improved in seven, arterial oxygen tension slightly increased in four, pulmonary hypertension decreased in five, and smooth muscle esophageal contraction amplitudes improved in three patients. However, the disease progressed in one patient. No serious side effects were observed, and occurring renal side effects were mild. Taken together, these observations indicate that CsA administration may be effective mainly in the skin involvement, but also in some organ manifestations of scleroderma. The results of this pilot investigation therefore indicate that a controlled study of the efficacy of CsA in scleroderma is needed and ought to be performed.

Adult↗
PubMedDate not supplied

Improvement of the diagnostic accuracy in pigmented skin lesions by epiluminescent light microscopy.

Epiluminescent light microscopy (ELM) represents a technique which permits to examine details of the surface of the skin and also--in by using the oil immersion technique--of the dermal-epidermal junction zone. Criteria are described which allow the distinction of benign from malignant growth patterns of pigmented skin lesions; thus ELM adds considerably to the diagnostic armamentarium of pigmented skin lesions at the clinical level.

Humans↗