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Biomedical subjects

P Bachleda

Publications and source records attributed to P Bachleda.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Late infections of aortic prostheses].

The authors present their experience in late infection of aortoilliacofemoral reconstruction by means of the Dacron vascular prosthesis. They found such complication in 8 of 620 (1.5%) reconstructions in that region in period 1988-1998. There is essential position of scintigraphy (Le 99mTc-HMPAO) and CT in diagnostic of location and extent of an affection. Conservative approach and local surgery were not permanently successful. The alternative approach is radical removing of the whole graft. The alternative of aortofemoral reconstruction is axillobifemoral bypass using ePTFE graft in case of an infection of the bifurcation graft.

Aged↗
PubMed1998

[Aneurysm as a complication of arteriovenous anastomoses for hemodialysis].

Angioaccess procedures for hemodialysis over a 12-year period were retrospectively reviewed to ascertain the frequency of aneurysm complications. A total of 571 angioaccess procedures were performed including 88 polytetrafluoroethylene grafts. 1.24% autogenous fistulae and 5.7% ePTFE grafts had uncomplicated aneurysm. Complicated (thrombosis, bleeding, infection) aneurysm occurred in 5.2% autogenous fistulae and in 5.7% PTFE grafts. The authors recommend a surgical repair of all angioaccess-associated aneurysms in the time of uncomplicated occurrence. If the aneurysm is complicated, the risk of the function lose of the av shunt by surgical therapy increase.

Adult↗
PubMed1998

[Indications for enteral nutrition in surgery].

Survey of basic indications of enteral nutrition in Surgery. 1. Application in preoperative preparation. 2. Postoperative preparation in malnutritive and critically-ill patients, at early stage. 3. EN applied also for accelerated motility of the stomach and bowels after major operations (in retroperitoneal operations). 4. Application in traumatology: polytraumas, burns, subsequent sepsis, multiorgan failure; also in specific therapy, e.g. traumatic fistulae of GIT. 5. Use in acute and chronic pancreatitis. 6. Use of enteral probe in special states (e.g. in treatment of fistulae in upper and lower parts of GIT (dehiscence of anastomosis, bowels ruptures). 7. Application in the syndrome of short intestine. 8. Use in reconvalescence after severe operations (sipping) 9. Application in terminal cachectic states.

Enteral Nutrition↗
PubMed1998

[Axillo-axillary contralateral arteriovenous anastomosis with interposition of a Diastat-Gore prosthesis for dialysis].

The authors give an account of their experience with establishment of an arteriovenous fistula for dialysis using interposition with a DIASTAT-GORE prosthesis between the axillary artery and the contralateral axillary or inner jugular vein and its localization on the anterior thoracic wall. The method is apt in patients with a primarily unsuitable or secondarily surgically exhausted autologous circulation of the upper extremities.

Adult↗
PubMed1998

[Hyperfunctional arteriovenous anastomosis and complications in hemodialysis access].

A less frequent late complication of arteriovenous fistulas for haemodialysis is the development of a hyperfunctional fistula with ischaemia of the peripheral part of the extremity. These complications affect autologous fistulas as well as those created by the graft. Ischemia is much more common when the brachial artery is used as the flow vessel. For prevention the size of the arterial anastomosis of the shunt is of basic importance. The authors evaluate therapeutic possibilities of this complication.

Adult↗
PubMed1997

[Peritoneovenous shunt in the surgical treatment of ascites in patients with liver cirrhosis].

The authors present their experience with the surgical treatment of ascites in patients with cirrhosis of the liver by means of a peritoneovenous shunt (PVS). In 1991-1996 they established 25 PVS in 23 patients. The survival of patients, conditioned by the state of the parenchyma and haemorrhagic complications due to portal hypertension was not significantly affected by the shunt. In all patients regression of the tension ascites was recorded with improvement of the quality of life, improvement of the milieu interior and nutritional status.

Adult↗
PubMed1997

[Endogenous erythropoietin in patients on regular dialysis therapy].

In a group of 66 patients with chronic renal failure having regular dialyzation treatment the serum concentration of endogenous erythropoietin (EPO), haemoglobin levels (Hb), haematocrit (Ht) and serum creatinine (Cr) were assessed. The examined subjects were never treated with recombinant erythropoietin and deficiency of iron, folic acid and vitamin B12 was ruled out. Endogenous EPO was assessed by the authors own RIA method, normal values being 24-42 mU/ml. The mean EPO concentration in the whole group of patients was 37.4 +/- 15.3 mU/ml, whereby 12 patients had an EPO serum concentration higher than the upper range of normal values. Between EPO concentrations and Hb values a certain positive correlation was found (r = 0.42). A similar relationship was revealed also between EPO concentrations and Ht values (r = 0.41). Patients with EPO values higher than 42 mU/ml had, as compared with the other patients, significantly higher values of erythrocytes (p .001). Statistical analysis did not reveal any relationship between EPO and Cr concentrations (r = -0.04). A low negative correlation was found between Cr and Hb values (r = -0.31) and between Cr and Ht values (r = -0.25). In the discussion the authors analyze the contemporary state of the problem of anaemia in chronic renal failure. Based on hitherto assembled knowledge they formulated the hypothesis ascribing considerable pathogenetic importance in the development of anemia to reduced sensitivity of bone marrow to EPO, probably as a result of retention of uraemic toxins and inhibitors of erythropoiesis. Inadequate EPO formation could be only a factor which makes it impossible for the developing anaemia to compensate and is due to an animpaired feedback at the level of recognition of the hypoxic signal.

Adult↗
PubMed1996

[Establishment of arteriovenous anastomoses with interposition of ePTFE (Goretex) prostheses].

The authors remind of the possibility to establish an arteriovenous anastomosis by interposition of an ePTFE prosthesis into the subclavian to brachial artery with an outflow into the subclavian or internal jugular vein. The method is suitable for case when the autologous circulation is exhausted and calls for perfect peroperative evaluation of the vascular system of the patient with subsequent careful monitoring of the function of the anastomosis.

Adult↗
PubMed1996

[Personal experience with establishment of arteriovenous anastomoses for dialysis using blood vessels in the cubital fossa].

The authors use, when establishing secondary arteriovenous anastomoses for haemodialysis, the blood vessels of the cubital fossa. If it is possible from the anatomical and functional aspect, they connect the superficial venous vessels to the arterial ones by means of a perforating vein. If the blood vessels of the forearm are of poor quality, they use this procedure as the primary approach. After two years the group of 38 established fistulas comprises 87% which can be completely used and none of them had to be modified.

Arm↗
PubMed1996

[Erythropoietin and erythropoiesis after kidney transplantation].

In a group of 15 patients after the first transplantation of a cadaverous kidney the authors monitored for the period of one month the serum erythropoietin concentration (Epo), haemoglobin levels (Hb), the haematocrit (Ht) and serum creatinine (Cr). The objective of the investigation was to evaluate in relation to serum concentrations of Epo and the function of the graft. Erythropoietin was examined by the authors own method before and after transplantation during the first 10 days daily and then on the 12th, 15th, 20th, 25th and 30th day. Normal values are 22-44 mU/ml. The mean Epo value before transplantation was 41.9 +/- 18.8 mU/ml. After transplantation the highest mean value of Epo was recorded on the second day when it reached a value of 102.8 +/- 144 mU/ml. The mean Epo serum concentration at the end of the study was 45.9 +/- 20.9 mU/ml and did not differ significantly from values recorded before transplantation. Between Hb and Ht values and Epo serum concentrations no correlation was revealed. Conversely, statistical analysis revealed a close inverse relationship between the drop of creatininaemia and the rise of Hb and Ht values. From the results of the investigation ensues that the decisive condition for the onset of the erythropoietic response after renal transplantation is adjustment of the milieu interiéur, induced by the restored excretory function of the graft which creates prerequisites for a normal response of the bone marrow to Epo.

Adolescent↗
PubMed1996

[Stenosis and thrombosis of the central venous tract as a cause of manifestations of venous hypertension after establishment of an arteriovenous anastomosis for hemodialysis].

The authors draw attention to stenoses and occlusions of the central venous tract (subclavicular and brachiocephalic vein) which may be the cause of manifestations of venous hypertension on the upper extremity after establishment of an arteriovenous anastomosis for haemodialysis. In patients where this condition is suspected, careful preoperative examination of the venous circulation is essential. Possible treatment is discussed.

Adolescent↗
PubMed1995

[Ultrasonographic examination in the follow-up of patients after kidney transplantation].

The authors followed-up in 1988-1994 a total of 134 patients after renal transplantation by ultrasonographic examinations in the B mode, Doppler frequency analysis and coloured Doppler mapping. They summarize the basic sonographic pictures during a normal development after transplantation and in case of surgical and non-surgical complications. They evaluate sonography as the basic examination method which is not quite specific for different complications but makes it possible to detect them in the initial stage and to indicate in time further examinations and treatment.

Graft Rejection↗
PubMed1994

[The role of iron deficiency on the development of anemia in patients on regular dialysis therapy].

In the course of regular dialyzation treatment very frequently iron deficiency develops. The objective of the work was to evaluate the participation of sideropenia in the development of the hypoproliferative component of anaemia and to evaluate the effectiveness of oral iron administration in a group of 24 dialyzed patients whose serum ferritin concentration was lower than 100 micrograms/l. Administration of 105 mg elemental iron per day (1 tablet of Ferronat retard, Spofa) for a period of 6 months led in 17 patients (71%) to a statistically significant increase of erythrocytes, serum ferritin, the iron plasma level and transferrin saturation. In these patients the mean haemoglobin value increased from 65 +/- 6 milligrams to 105 +/- 17 milligrams (increase by 40 milligrams), the mean number of red cells increased from 2.6 +/- 0.4 x 10(12)/l to 3.5 +/- 0.7 x 10(12)/l (increase by 0.9 x 10(12)/l) and the mean haematocrit increased from the initial value of 0.21 +/- 0.02 to 0.31 +/- 0.05 (increase by 0.10). In seven patients (29%) after oral substitution of iron deficiency no significant rise of any of the investigated indicators was observed. Four subjects of this group responded by a rise of red blood cells to intravenous iron administration and in the remaining three patients anaemia was favourably influenced by administration of recombinant erythropoietin (Eprex, Cilag). The results of the investigation provide conclusive evidence that iron deficiency plays a very important part in the development of anaemia in hemodialyzed patients. Substitution treatment with iron preparations extends the opportunities to treat anaemia during regular dialyzation treatment and is at the same time also very important from the economical aspect as it makes more expedient selection of patients suited for recombinant erythropoietin treatment possible.

Adult↗
PubMed1993

[Indications for arteriovenous fistula for hemodialysis].

In the course of a 13-year period, 295 fistulas had been introduced for hemodialysis. In 32 patients with hypoplastic vessels or with insufficient arterial flux on the distal forearm and from other reasons, the fistula was introduced in the cubital fovea. This type of fistula has a distal flux into the antebrachial vessels. The obtained results are promising, complications being sporadic.

Arteries↗
PubMed1993

[Late complications for hemodialysis specific arteriovenous fistulas].

Late complications of the arteriovenous fistulas for hemodialysis occur after the AV fistulas development and functioning. The following complications are frequent: stenoses and late thromboses, hemorrhage, inflammatory complications, aneurysms and undesirable hemodynamic consequences of the fistulas. A good functioning of the fistula requires an early diagnosis of the complication and a prompt surgical intervention at the clinic where these operations are made routinely.

Aneurysm↗