Search PubMed⌕ Search

Biomedical subjects

S B Kahn

Publications and source records attributed to S B Kahn.

59 records · Page 4Linked to original sources

One year of rHuEPO therapy prolongs RBC survival and may stabilize RBC membranes despite natural progression of chronic renal failure to uremia and need for dialysis.

rHuEPO was administered to eight patients with chronic renal failure (CRF) and uremia (U) for 1 year. Creatinine Clearance (GFR) averaged 14.3 (9-25) ml/min at an Hct of 28% (26-30). Baseline RBC survival by 51Cr T1/2 was highly correlated with GFR (r = 0.66), p less than 0.05 (2), average 21.6 days. Repeat 51Cr T1/2 at 3 months with GFR 10 ml/min at Hct 38% was prolonged by 7 days to 28.6 (p less than 0.005), and at 1 year remained increased to 28 days (p less than 0.001) with Hct 39%, despite further decreased GFR to less than 4 ml/min and need for dialysis. Reticulocytes varied from 1.6% to 7.4 (3-6 weeks) to 3.1 (3 months) and 1.5% (1 year). Bone marrow cellularity increased from 36% to 47% (3 months) and 44% (1 year). M:E ratio decreased from 3.9:1 to 1.7:1 (3 months) to 1.6:1 (1 year). Marrow iron decreased from 4.1/6 to 2.4/6 (3 months) to 1.8/6 (1 year). Doses of rHuEPO had to be reduced to avoid polycythemia. rHuEPO stimulates erythropoiesis in pts with progressive CRF and U for 1 year. The initial increase in hematocrit is due to the early peak of reticulocytes. At 3 months, rHuEPO maintains the increased hematocrit by three mechanisms: 1) increased reticulocytosis, 2) a trend to increased bone marrow erythroid cellularity, and 3) lengthened RBC survival. At 1 year of rHuEPO therapy, the trend to increased marrow cellularity persists, however, the maintenance of target hematocrit is via a lengthened RBC survival. Despite progression of CRF and U, rHuEPO produced RBCs with longer survival than expected. RBC membranes may have been stabilized by rHuEPO.

Adult↗

Effects of zomepirac on hemostasis in healthy adults and on platelet function in vitro.

Zomepirac, a new nonnarcotic analgesic, was studied in 25 healthy adults for possible effects on hemostasis. Given in a single 200-mg dose or for 15 days at 300 mg/day, zomepirac prolonged template bleeding time and caused transient decreases in platelet adhesiveness, in stimulated platelet aggregation, and in the release of platelet serotonin. The short duration of these effects contrasts with the known week-long duration of the effects of aspirin. Data from in vitro platelet function studies, correlated with plasma level determinations, indicate that these effects on platelet function in man are probably dependent only on the presence of intact zomepirac and not on any metabolites. The qualitative effects of zomepirac on platelets are assumed to be the consequence of reversible inhibition of prostaglandin synthetase in these cells. Platelet concentration and the humoral clotting mechanism were not affected by zomepirac. Although no unusual bleeding has been noted in patients given zomepirc postoperatively, it should be used with the same caution as aspirin in patients with known defects in platelet function or coagulation.

Adult↗