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Biomedical subjects

P Schmidt

Publications and source records attributed to P Schmidt.

At least 325 records · Page 18Linked to original sources
PubMed1982

Diminished serum folic acid levels in renal transplant recipients.

Serum folic acid levels were determined by radioimmunoassay in 26 chronic hemodialysis patients, in 52 renal transplant recipients and in 20 healthy controls. In the dialyzed patients, the mean serum folic acid level was 3.37 +/- 1.25 ng/ml and was significantly lower than that of the controls (6.1 +/- 1.38 ng/ml, P less than 0.001). In renal transplant recipients the mean folic acid concentration was 4.09 +/- 1.58 ng/ml and was also significantly decreased (P less than 0.001). 15 (29 per cent) out of 52 renal transplant patients showed serum folic acid concentrations lower than 3.0 ng/ml. Diminished serum folic acid levels were found not only in patients shortly after surgery but also in cases with excellent graft function up to 6 years after transplantation. The highest serum folic acid level was observed in one transplant patient who had taken no azathioprine for 24 months. Macrocytosis was found in 52 per cent of our renal transplant patients. There was no significant difference between the serum folic acid levels of renal transplant recipients with (n = 27) and without (n = 25) macrocytosis; however, serum creatinine levels were significantly lower in cases revealing macrocytosis. Relative folic acid deficiency does not seem to be responsible for macrocytosis after renal transplantation. Macrocytosis was observed only in patients with good graft function treated with azathioprine. Serum vitamin B12 levels were within the normal range in both dialyzed and renal transplant patients.

Adolescent↗
PubMed1982

[Secondary oxalosis in chronic renal insufficiency].

The concentration of oxalic acid was determined in the plasma of 15 patients with conservatively treated chronic renal insufficiency and 17 dialysis patients. A cumulation of oxalic acid was found in connection with uraemia. The extent to which plasma oxalic acid concentrations were raised depended on the degree of renal insufficiency and was directly related to the plasma creatinine values in all patients with or without dialysis. In the patients with chronic renal insufficiency the median plasma oxalic acid concentration was 74.4-18.5 (control group 27.0 +/- 7.4) mumol/l. In the dialysis patients the levels were even higher, at 137.5 +/- 56.0 mumol. By means of haemodialysis it was possible to lower the plasma oxalic levels by about the same amount as creatinine concentrations. The higher plasma oxalic acid concentrations seem to be an important pathogenetic factor in the formation of uraemic calcification in various organs. The therapeutic consequences are to increase the duration and frequency of dialysis and to remedy possible vitamin B6 deficiency.

Adult↗
PubMed1981

[Alpha-1-antitrypsin and fibrinogen levels in chronic renal failure and after kidney transplantation (author's transl)].

In ten non dialyzed patients with chronic renal failure, 18 patients on regular dialysis treatment and 70 renal transplant recipients alpha-1-antitrypsin and fibrinogen levels were investigated. Alpha-1-antitrypsin and fibrinogen concentrations were highest in dialyzed patients with values of 314 +/- 98 and 485 +/- 127 mg/dl respectively. In renal transplant recipients a significant positive correlation between alpha-1-antitrypsin and fibrinogen concentration was found (p less than 0.001). High alpha-1-antitrypsin and fibrinogen levels seem to be a possible consequence of reactive processes due to underlying disease or complications. Our results seem to indicate that both alpha 1-antitrypsin and fibrinogen can be classified as "acute phase protein".

Creatinine↗
PubMed1981

Cholinergic and catecholaminergic interaction and fluid intake in the rat.

The effect of simultaneous topical application of adrenergic agonists was investigated on the polydipsia caused by direct carbachol (CCh) stimulation of the rat brain. In addition, fluid selection (4-choice arrangement) was studied. Noradrenaline and isoprenaline fully antagonized the CCh effect after either intracerebroventricular, intraseptal or intrapreoptic application. Phenylephrine inhibited CCh polydipsia after intracerebroventricular or intrahypothalamic but not after intraseptal injection. Previous experiments had shown that adrenergic agonists also exerted a marked modulatory influence on an affective behavioural reaction pattern (rage reaction) of the cat. The results of the present experiments corroborate the assumption that, also in non-striatal brain structures, adrenergic modulation of cholinergic behavioural patterns is perhaps a more general and important phenomenon than had been assumed so far.

Adrenergic Agonists↗
PubMed1981

[Fungal infections -- always dangerous for immunosuppressed patients (author's transl)].

Four renal transplant recipients, treated with the immunosuppressive combination of azathioprine-prednisolone, developed organ or systemic mycoses caused by Candida albicans and, in one case, additionally by Trichophyton rubrum. Ketoconazole, a new wide-spectrum antimycotic drug, was successfully used in the treatment of the fungal infections in these patients. The oral route of administration, good tolerance and excellent results are good recommendations for this drug.

Adult↗
PubMed1981

[Cytur-test used in nephrology out-patients (author's transl)].

Assessment of the value of test strips for demonstration of white cells in urine (Cytur-test) in 161 out-patient urine samples showed that a quick method such as the Cytur-test is no substitute for conventional methods. In hospital nephrology out-patients methods such as the Addis count or the investigation of urine sediment cannot be replaced. However, in a preliminary test with test strips information can be obtained as to the white cell content of the urine. Samples from patients in whom Addis count or sediment results showed no pathological leucocyturia, also had negative results in the test strip in a high percentage (84 out of 88 cases). A positive Cytur-test indicates lysed white cells in such cases (4 out of 88 cases). Due to the different sensitivity, as a consequence of a wider negative range, the Cytur-test resulted in fewer positive findings when compared to the other methods: 6 out of 24 in the Addis count and 2 out of 11 in urinary sediment.

Ambulatory Care↗
PubMed1981

[Portal hypertension and chronic renal insufficiency. Successful treatment with hemodialysis].

We present three cases with portal hypertension, ascites and concomitant chronic renal failure, successfully treated for 38, 26 and 5 months respectively with chronic hemodialysis. The causes of portal hypertension were alcoholic cirrhosis of the liver in 2 cases and cavernous transformation of portal vein with intrahepatic block, in one case. The complications of portal hypertension, the conservative and surgical treatment of oesophageal varices and ascites are discussed.

Adult↗
PubMed1981

Comparison of the effects of muzolimine and furosemide in patients with end-stage renal failure on chronic dialysis.

The pharmacodynamic effects of muzolimine and furosemide were compared in a single dose cross-over study in 8 patients on regular dialysis treatment, who had a residual diuresis of more than 300 ml/day. The study periods comprised two dialysis-free intervals of 3 days. On the second dialysis-free day either muzolimine 240 mg or furosemide 240 mg was administered orally. Urine was collected in 12-h periods on the pre-treatment, treatment and post-treatment days, and the excretion of sodium, potassium, urea and creatinine were measured. After administration of muzolimine 240 mg urine volume rose to twice that of the previous day, and sodium excretion increased approximately threefold. In contrast, the effect of furosemide 240 mg was not a pronounced; the diuresis was only 1.6 times that on the previous day and natriuresis was only 2.2 times as large. Excretion of potassium and creatinine was only slightly increased by either substance. The elimination of urea was increased by both substances to the same degree as the corresponding increase in diuresis.

Creatinine↗
PubMed1981

Protection of the eyes with ophthalmic ointments during general anaesthesia.

In a double blind trial 47 anaesthetized patients were given eye protection with the paraffin-based neutral eye ointment Ph. Nord. 63 in one eye and the water-based Methyl cellulose (MC) 4% in the other. Twenty-four hours later the eyes were vital-stained with rose bengal/fluorescein. No unintended effects of the ointments were found and no injury to the eyes were seen. Compared with the paraffin-based ointment the MC ointment produced a more firm adhesion of the eyelids. A water-based 4% MC ointment is therefore as alternative to the fat-based neutral eye ointment.

Adolescent↗
PubMed1981

Failure of cimetidine to prevent gastroduodenal ulceration and bleeding after renal transplantation.

Treatment of renal transplant patients with the H2-antagonist cimetidine has previously been assumed to be of reasonable prophylactic value in controlling the incidence of the postoperative complications of gastric or duodenal ulceration. We attempted to evaluate the performance of the drug in a controlled trial by treating transplant patients with either cimetidine or a placebo. Of the 59 patients accepted for the trial, four had to be excluded eventually because of irregularities in the administration of the drug and, in on case, nonfatal respiratory failure. Six of 27 from the cimetidine group had erosions or ulcers by the third day after surgery and two more had them by the end of the fourth week. Three of 28 placebo patients developed lesions after 3 days and three more developed them after 7 weeks. In the months after transplantation, one cimetidine and two placebo patients developed ulcers. Bleeding occurred three times with cimetidine and twice with the placebo. Renal function was similar in both groups as was the necessity of transplantectomy because of irreversible rejection. We conclude that cimetidine does not lower the incidence of gastroduodenal mucosal lesions and upper gastrointestinal bleeding after renal transplantation, nor does it influence rejection of the allograft.

Adolescent↗
PubMed1981

Increased danger of bone marrow damage in simultaneous azathioprine-allopurinol therapy.

Two renal transplant recipients with reversible bone marrow damage in the course of a simultaneous azathioprine-allopurinol therapy are discussed. Anemia, leukocytopenia and thrombocytopenia were found in both patients. Discontinuation of the azathioprine-allopurinol treatment was followed by increase of hematocrit, hemoglobin, erythrocytes, white blood cells and platelets. Interaction of azathioprine and allopurinol seems to be responsible for bone marrow damage in these patients. It can be concluded that the dose of azathioprine should be reduced when allopurinol is given concomitantly.

Adult↗