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Biomedical subjects

R Shapiro

Publications and source records attributed to R Shapiro.

At least 505 records · Page 28Linked to original sources

Warfarin elimination and responsiveness in patients with renal dysfunction.

Plasma warfarin half-life was estimated in four patients with renal dysfunction and five normal control subjects. Hypoprothrombinemic responsiveness to a single oral dose of warfarin (0.75 mg/kg) was also evaluated for both groups. The mean warfarin half-life of 29.9+/-5.0 (S.E.M.) hours for renal patients was significantly shorter than the 44.8+/-6.0 hours half-life for normal controls (P less than 0.05). Additionally, a positive correlation was found between warfarin half-life and creatinine clearance. Pharmacologic responsiveness to warfarin was comparable for both groups. It therefore appears that patients with renal dysfunction do not possess an increased susceptibility, either pharmacokinetic or pharmacologic, to the hypoprothrombinemic effect of warfarin.

Adult↗

Rapid development of extensive macrovascular calcifications in a type I diabetic patient.

This is a case report of a 35-year-old woman with a 15-year history of type I diabetes mellitus, who developed extensive macrovascular calcifications of the abdominal aorta and all its tributaries within 7 months of developing renal insufficiency. The patient was maintained on hemodialysis and peritoneal dialysis for a total of 3 months, then underwent combined cadaveric renal and pancreatic islet transplantation. Although some vascular calcifications are known to occur in elderly patients and in patients with long-standing uremia, it was the rapidity and extent of development of these lesions in this young woman that is astonishing.

Adult↗