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Biomedical subjects

R Gabriel

Publications and source records attributed to R Gabriel.

At least 145 records · Page 8Linked to original sources
PubMed1985

Some observations on the role of the abdomen in breathing in patients on peritoneal dialysis.

We studied a total of 29 patients on continuous ambulatory peritoneal dialysis (CAPD), who had no present or past respiratory impairment, before and after drainage of dialysate (2.324 +/- SE 0.033 litres). We measured spirometry, lung volumes and carbon monoxide transfer sitting and supine in 20 patients. The only statistically significant changes on drainage were a small increase in supine functional residual capacity (+214 +/- SE 61 ml, P less than 0.01) and a small fall in supine peak expiratory flow rate (-26.6 +/- SE 12.1 litres/min, P less than 0.05). Measurement of maximal mouth and transdiaphragmatic pressures in ten patients made under the same circumstances showed no statistically significant changes on drainage. A model of the abdomen demonstrates that fluid distension is likely to be better tolerated than gaseous distension, and review of previous studies suggests that a wide range of changes in intraabdominal fluid volume can be tolerated without respiratory embarrassment. These results suggest that fluid volumes used for CAPD do not interfere with breathing in patients with previously normal lungs. The nature of the mechanisms compensating for the fluid suggests that patients with chest disease should be able to tolerate this form of dialysis.

Abdomen↗
PubMed1985

Pharmacokinetics of metronidazole in patients with varying degrees of renal failure.

Twenty-nine patients with varying degrees of renal insufficiency were given a single intravenous dose of metronidazole (500 mg). Plasma and urinary concentrations of metronidazole and two major metabolites were determined using a specific high performance liquid chromatographic assay. The pharmacokinetic parameters of metronidazole elimination half-life, area under the metronidazole concentration against time curve, apparent volume of distribution, metronidazole clearance and predicted degree of accumulation of metronidazole on repeated dosing were not statistically significantly affected by renal inadequacy of any degree. The urinary excretion of metronidazole in patients with moderate or severe renal insufficiency was approximately half the value in healthy volunteers. The renal clearance of metronidazole was significantly greater in healthy volunteers compared to renally insufficient patients, but accounted for less than 10% of the total metronidazole clearance in all groups. The elimination half-life and predicted accumulation (on three times daily dosing) of metabolite I [1-(2-hydroxyethyl)-2-hydroxymethyl-5-nitroimidazole] were significantly increased with decreasing renal function from 9.2 h and 2.3, respectively, in healthy volunteers to 34 h and 6.7, respectively, in patients with total renal failure. The degree of accumulation of this metabolite on repeated dosing is probably of limited clinical significance in all patients except those with severe or total renal failure for reasons detailed in the text. The elimination half-life and predicted accumulation on three times daily dosing of metabolite II, [2-methyl-5-nitroimidazole-1-acetic acid] increased rapidly with decreasing renal function.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Cancer in uremic patients.

We have studied the notes of 834 uremic patients. Five developed malignant disease whilst uremic, an incidence of 0.6%. Two other patients developed carcinoid tumors. The number of observed cancers in this series is lower than the expected incidence of cancer (p less than 0.05). We conclude that the uremic state does not predispose to malignancy.

Adolescent↗
PubMed1983

Comparison of the hypotensive effects of bendrofluazide, bumetanide and xipamide.

A randomized, triple crossover study was carried out in 24 elderly patients requiring chronic diuretic therapy to assess the different hypotensive effects of a fixed daily dose of 5 mg bendrofluazide, 1 mg bumetanide and 40 mg xipamide. Each treatment was given for 3 months. The results showed that no significant weight change took place during the study period. There was, however, a significant (p less than 0.001) decrease compared to baseline values both in systolic and diastolic blood pressure during the xipamide period and a decrease in diastolic blood pressure (p less than 0.05) when taking bumetanide. Only minor side-effects were reported.

Aged↗