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Biomedical subjects

P Schmidt

Publications and source records attributed to P Schmidt.

At least 307 records · Page 17Linked to original sources

Herpes zoster ophthalmicus with retrobulbar neuritis. A case report.

In ophthalmic zoster, involvement of the optic nerve is very rare, and most of the published cases have resulted in optic atrophy. This case report presents a woman who developed a severe visual loss in her right eye 4 weeks after the primary attack. Computer tomography and ultrasonic B-scan showed a spindle-shaped thickening of the optic nerve. Eight months later the visual acuity was 2/60 and the optic nerve showed atrophy. The computer tomography was normal, and the Visual Evoked Potential had reduced amplitudes. Earlier reports and pathogenesis are discussed.

Aged↗

Psychosomatic factors involved in the process of cancerogenesis. Preliminary results of the Yugoslav prospective study.

In a Yugoslav village, psychosocial, anamnestic medical, and pathophysiological data were recorded for 1,353 persons in a longitudinal study. The role of psychosocial stress in carcinogenesis, as far as we have investigated it, may be described as follows: (1) Psychosocial stress in terms of high hopelessness, high antiemotionality, etc. has a strong relevance for cancer incidence which does not act via one of our physiological variables associated with cancer. This follows from the results of our multivariate analysis. (2) Psychosocial stress is substantially associated with a low lymphocyte percentage, which in turn is a relatively strong risk factor for cancer. (3) Psychosocial stress is relatively weakly associated with the cholesterol minimum; but apart from the fact that the cholesterol characteristics of cancer subjects are more marked descriptively under stress conditions, psychosocial stress significantly enhances the efficacy of the most important physiological risk variables for cancer.

Adult↗

[Prostatic adenomectomy in dialysis patients].

A case of a 55-year old patient is presented with terminal renal insufficiency and a massive prostatic adenoma causing urinary tract obstruction. The case history of the patient on mandatory dialysis was complicated by recurrent, therapy resistant urinary tract infections accompanied by septic fever outbreaks and anemic relapses. Following suprapubic transvesical adenomectomy, no fever episodes, negative urine cultures and improvement in the anemic condition were all noted. Due to the fact that the upper age limit for acceptance into a hemodialysis program and possible kidney transplantation has been raised, it is important to note that patients with prostatic adenomas may be frequently encountered. Dialysis patients require successful treatment of urinary tract obstructions prior to transplantation. Immunosuppressive therapy which follows transplantation increases risk of infection which can endanger the graft and the patient's life.

Adenoma↗

Pyridoxine therapy in patients with renal calcium oxalate calculi.

In 12 patients with idiopathic calcium oxalate calculi pyridoxine was administered. Within six weeks mean daily oxalic acid excretion decreased from 480 +/- 122 mumol to 336 +/- 83 mumol. Glycolic acid excretion fell from 208 +/- 51 mumol to 153 +/- 26 mumol (normal range: oxalic acid 228-412 mumol/day, glycolic acid 130-290 mumol/day). The reduction of oxalic acid excretion seems to be beneficial in prevention of idiopathic calcium oxalate calculi.

Calcium Oxalate↗

[Cystic renal changes in chronic hemodialysed patients].

In this study we investigated the appearance of renal cysts in 43 chronic hemodialyzed patients using ultrasound (3.5 MHz-sector scanner). The mean age of the patients was 45 years, and the mean duration of dialysis was 26.3 months. In 21 patients (= 49%) cysts could be found. In 10 of these patients a former investigation at beginning of dialysis did not demonstrate any cystic lesions. The diameter of the cysts varied between 5 and 30 mm. Considering the duration of dialysis, in 9 (= 39%) out of 23 patients with a maximum duration of dialysis of 2 years cysts could be demonstrated by ultrasound, and in 12 (= 60%) of 20 patients, who had been dialysed for more than 2 years. The clinical impact of the demonstration of such cysts was recently reported in cases which developed complications like tumour formation or severe bleeding.

Adult↗

Reduction of elevated plasma oxalic acid by pyridoxine therapy in patients on RDT.

In eight chronic haemodialysed patients with secondary hyperoxalaemia due to renal insufficiency vitamin B6, an important co-enzyme in oxalic acid metabolism, was administered. Mean plasma oxalic acid values decreased from 149.5 +/- 67.0 mmol/L to 99.0 +/- 36.4 mmol/L within two weeks and to 93.8 +/- 33.1 mmol/L after four weeks of pyridoxine treatment (p less than 0.01, p less than 0.01). The mean reduction was 46 per cent (32.0 to 56.1). Patients with high pre-values of plasma oxalic acid had the most pronounced decrease. In order to prevent calcium oxalate deposition a reduction of plasma oxalic acid in patients on RDT seems to be an important goal in long term haemodialysis treatment.

Dose-Response Relationship, Drug↗

[Recurrence of spontaneous kidney rupture in a dialysis patient].

The case is reported of a 35-year-old man who had been treated with hemodialysis for five years because of renal insufficiency due to chronic glomerulonephritis. Renal cystic disease acquired during maintenance dialysis was complicated by bilateral kidney rupture within an interval of two months. Development of cystic changes of kidneys during long-term hemodialysis was first reported in 1977. The main complications of this cystic transformation are, according to the literature, development of neoplasms and hemorrhage into the cysts. In the present case the clinical symptomatology consisted of episodes of severe pain in the flank, hematuria, hypotension and lowering of hematocrit. An ultrasound study demonstrated enlargement of some cysts compared to another study some months ago, and internal echoes due to hemorrhage could be seen in some of the cysts. Because of the danger of spontaneous kidney rupture with consecutive life-threatening hemorrhage, surgery is indicated in such cases.

Adult↗

[Angiological functional evaluation following transluminal catheter recanalization].

The percutaneous transluminal angioplasty is regarded as valuable enrichment of the therapeutical possibilities in peripheral arterial obstructive disease. Frequently by its application an arterial dilatation of the lumen and thus a local improvement of the blood supply can be achieved. As was shown by our measurements the haemodynamic factors and the quality of the prophylaxis of recidivations by medicaments have a decisive influence on the early results. Apart from clinical and X-ray morphological findings also oscillographic, Doppler-sonographic, plethysmographic and ergometric parameters are used for indication. In the same way angiological examinations of the function were performed within the further control of course and therapy. Changes of the peripheral haemodynamics could be particularly well read at the behaviour of the systolic pressure gradients and indices. When the technical and apparative prerequisites for the performance of the percutaneous transluminal angioplasty are given, the close interdisciplinary cooperation between radiologists and angiologists is important for achievement of optimum results of the treatment.

Aged↗

Effect of vitamin B6 administration on elevated plasma oxalic acid levels in haemodialysed patients.

Accumulation of oxalic acid resulting in elevated plasma levels is a common finding in uraemic patients. Since vitamin B6 is an important coenzyme in oxalic acid metabolism the influence of vitamin B6 administration on plasma oxalic acid levels was investigated. Vitamin B6 was administered to eight chronic haemodialysis patients with secondary hyperoxalaemia. Mean plasma oxalic acid concentration decreased from 149.5 +/- 67 mumol/l to 99.0 +/- 36.4 mumol/l within 2 weeks and to 93.8 +/- 33.1 mumol/l after 4 weeks of pyridoxine treatment (P less than 0.01) the mean reduction being 46% (32.0-56.1%). The decrease in plasma oxalic acid levels was most pronounced in patients with the highest pretreatment values. Two patients who received pyridoxine therapy prior to the beginning of the study had low initial values of plasma oxalic acid concentrations and showed no further decline.

Administration, Oral↗

Psychosomatic factors in the process of cancerogenesis. Theoretical models and empirical results.

The core of the authors' research program consists in the assumption that complex statistical interactions of sociological and psychological factors with pathophysiological and standard risk factors are more important for the early detection, prediction and prevention of cancer than one or just a few medical risk factors, e.g. the relationship between smoking and lung cancer. As the analysis of these relationships can only be done in interdisciplinary research, interpretation and discussion of social scientific, molecular biological and epidemiological aspects was attempted. In the first part we explicate a model of relevant propositions from the psychosomatic literature to explain the relationship between psychosocial factors of carcinogenesis. A discussion of the authors' research program contains additional variables and propositions. It appears to the authors that among the psychosocial and sociological factors of carcinogenesis, the molecular biological variables are especially relevant, as they form the intervening link between the social science variables and cancer. Discussion of the methodology and the sampling of the authors' empirical studies follows. Two prospective studies, carried out in Yugoslavia and West Germany, are described in detail. The data of these studies are used in the empirical analysis. In the next part the empirical results of different multivariate analyses are presented: The effects of the sociological and psychological variables on carcinogenesis are described; standard risk factors and biochemical-molecular biological factors are brought together, special attention being given to the interaction between these two groups of variables.

Adult↗

The successful treatment of mycotic infections in immunosuppressed renal transplant recipients with ketoconazole.

Ketoconazole, a new broad-spectrum antimycotic drug, was administered to six renal transplant recipients with mucocutaneous and/or systemic candidosis. A beneficial clinical and microbiologic effect was seen in the treated patients. This orally administered drug was well tolerated, and side effects were not evident. Our results indicate that good treatment of mycotic infections can be expected even in patients with impaired graft function, since ketoconazole metabolism occurs mainly in the liver.

Adult↗