Search PubMed⌕ Search

Biomedical subjects

S Degenhardt

Publications and source records attributed to S Degenhardt.

30 records · Page 2Linked to original sources
PubMed1990

[Cardiac involvement within the scope of HIV-1 infection: preliminary results of echocardiography study].

The results of one- and two-dimensional echocardiography in 128 patients (117 males, 11 females; median age 37 years) who were seropositive for HIV-1 were analyzed in addition to clinical, electrocardiographic, and laboratory data. Follow-up controls are available for 51 patients over an observation period of 1 to 24 months, median 9.5 months. Probably HIV-related echocardiographic abnormalities were identified in 36 patients (28%): small to moderate pericardial effusions (n = 34) and left ventricular dilation (n = 5). Pericardial effusions resolved in seven patients during follow-up, in three cases after tuberculostatic chemotherapy. Compared to patients without cardiac involvement patients with HIV-related echocardiographic abnormalities showed lower CD4-lymphocyte counts (143 +/- 138 vs 289 +/- 219/microliters, p less than or equal to 0.01), and left ventricular endsystolic dimensions were increased (34.2 +/- 4.5 vs 32.6 +/- 3.0 mm, p less than or equal to 0.05). Cardiac involvement occurred predominantly in the advanced stages of the HIV-1 infection with unclear etiology in the majority of cases, even though active concomitant diseases could be frequently demonstrated. The clinical course of some patients might be consistent with intercurrently completed perimyocarditis, probably of viral genesis. CD4-lymphocyte counts less than or equal to 100/microliters could be identified as a risk factor for the development of cardiac manifestations. The significance of a demonstrated involvement of the heart with regard to therapeutic consequences and prognosis appeared to be slight. Use of echocardiography as a routine method for the detection of cardiac involvement in HIV-1 infection has proved to be valuable, since indicative clinical symptoms were lacking in almost all cases.

Adult↗
PubMed1989

[Status of the captopril test in the diagnosis of hypertension].

The place of captopril (C) testing in the screening for renovascular hypertension is still controversial. Baseline and C-stimulated plasma renin concentrations (PRC) were measured in 113 hypertensives, who where referred for the exclusion of secondary hypertension. In addition intravenous digital subtraction angiography (DSA) and a renal scintigraphy were performed. When renal artery disease was revealed by DSA or renin was stimulated the renal arteries were visualized by direct arteriography (and treated by angioplasty if possible). 86 patients underwent each diagnostic test: 21% had renovascular hypertension. Unilateral renal artery stenosis (n = 10) was detected by the captopril test (cutoff values: baseline greater than 40 microU/ml, after C greater than 180 microU/ml, sensitivity 100%). Bilateral renal artery stenosis (n = 8) was missed when the disease was equally severe on either side (sensitivity 50%). The specificity of C testing was 82%, overall sensitivity (uni- and bilateral disease 78%, prevalence 21%, predictive value of the positive test 0.56, predictive value of the negative test 0.93). With i.v.-DSA the renal arteries were technically evaluable in 91% (82/92) of cases. The sensitivity for the detection of all renal artery stenoses was 79% (uni-lateral 100%, bilateral 40%, specificity 97%). The sensitivity of renal scintigraphy for the detection of unilateral renal artery stenoses was 50%, for the detection of bilateral renal artery stenoses 43%, specificity 81%. The present study demonstrates the usefulness of captopril for the detection of unilateral renal artery stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Diagnosis and clinical aspects of gastrointestinal cytomegalovirus diseases in patients with human immunodeficiency virus 1 infection].

Eleven Human Immunodeficiency Virus 1 (HIV1)-infected patients (10 male, 1 female; age 23-51 years (median 36); 10 male homosexuals, 1 IV drug abuser; WR3 1 patient, WR5 5, WR6 5) with intestinal Cytomegalovirus (CMV)-manifestations were compared with a group of 78 HIV1-infected patients in respect to their clinical, immunological and virus-serological data and the results of the histological and microbiological examination of endoscopically obtained biopsies. No differences were observed on age, sex, risk of infection, stage and immunological status. Bloody diarrhea was most important in discriminating CMV-colitis and non-CMV-related intestinal manifestations. Dysphagia and other symptoms occurring in patients with CMV-esophagitis were not able to predict CMV-esophagitis specifically. 6 of 11 patients with serological findings consistent with an active CMV-infection had no detectable CMV-manifestations; 6 of 11 patients with intestinal CMV-manifestations did not show serological findings suggestive of active CMV-infection. Ulcerative alternations of intestinal mucosa represent the most powerful indicator of intestinal CMV-disease in endoscopical examination. Only in two patients, ulcerative alterations were seen without diagnosis of CMV-disease being established. CMV was isolated in one of 11 patients, in two patients CMV was isolated from biopsies of unchanged mucosa. Simultaneous infection by HSV and CMV was detected in three patients, in one patient in the same localisation. Histology revealed inclusion bodies in 8 of 11 patients with intestinal CMV-disease, in no case inclusion bodies were seen without CMV-disease.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Impact of acute and chronic sodium loading on atrial natriuretic peptide and renin in man.

The relationship between the renin-angiotensin system and the atrial natriuretic peptide and its contributions to the control of sodium balance is not clarified. We therefore studied plasma renin concentration (PRC) and plasma levels of atrial natriuretic peptide (ANP) in normal subjects during acute and chronic salt loading. Acute intravascular volume expansion by iv infusion of 2000 ml of normal saline resulted in sharp rise in plasma ANP from 122 +/- 24 to 405 +/- 141 pg/ml (p less than 0.05). This increase was only transient with plasma ANP returning to control levels after 240 min. In contrast, reduction in plasma renin concentration was less pronounced, however it was persistent for up to 240 min paralleled by a reduction in plasma protein. Reciprocal changes in ANP plasma levels and PRC were observed during dietary modification in sodium intake. At the end of low sodium diet over 4 days, supine plasma ANP averaged 49 +/- 7 pg/ml and levels increased to 128 +/- 38 pg/ml after 6 days of high sodium intake in 11 healthy subjects (p less than 0.05). In contrast, PRC values averaged 69.8 +/- 19.8 microU/ml and 14.4 +/- 6.5 microU/ml during low and high sodium diet respectively (p less than 0.01). The inverse relation between PRC and ANP was seen after prolonged dietary sodium loading over 15 days in 8 additional subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Peripheral hemodynamics, blood viscosity, and the renin-angiotensin system in hemodialysis patients under therapy with recombinant human erythropoietin.

Treatment of renal anemia with rhEPO (120 U/kg body weight/hemodialysis) in transfusion-dependent patients on maintenance hemodialysis led to an increase in blood pressure, regional peripheral resistance and whole blood viscosity. Our results are in agreement with earlier findings that partial correction of renal anemia results in hemodynamic changes characterized by a fall in cardiac output together with an increase in blood pressure due to increased vascular resistance. The increase in whole blood viscosity correlated with the increase in regional peripheral resistance but not with the increase in mean arterial blood pressure. Thus, other regulating factors of vascular resistance must be involved. Correction of renal anemia does not influence the reninangiotensin system. However, peripheral responsiveness of vascular smooth muscles may have changed due to improved tissue oxygenation and thus leading to an increase in vasoconstriction.

Adult↗
PubMed1988

[Early and late results of percutaneous transluminal angioplasty of renal artery stenoses].

The initial and long-term results of percutaneous transluminal angioplasty of renal artery stenoses are reported. In 4 out of 73 (5.5%) patients the angioplasty catheter could not be placed in the stenotic area. In 67 patients partial or complete dilatation of the segments treated was possible. Complications requiring therapy occurred in 12.3%. Most (80.3%) of the patients were discharged from hospital with completely corrected or improved hypertension. Cure or improvement was noted more often in patients with fibromuscular dysplasia, short history of hypertension, pathologic renin quotient, normal total hippuric acid clearance, or age under 40 years. On follow-up examination a mean of over 14 months after angioplasty 51.7% of the patients had normal blood pressure or less pronounced hypertension, while in 60.9% the total hippuric acid clearance had increased.

Adult↗
PubMed1987

[Acute reversible kidney insufficiency due to enalapril during diuretic-treated heart insufficiency].

Acute reversible renal failure with hyperkalemia developed in a 42-year-old woman during treatment of heart failure and hypertension with high doses of enalapril and diuretics. Creatinine clearance fell as low as 9 ml/min. Renal-artery stenosis and prerenal renal failure were excluded. Reduction in blood pressure in conjunction with reduced renal perfusion in heart failure can make glomerular filtration angiotensin dependent. Interruption of angiotensin II formation in this situation triggers off functional renal insufficiency.

Acute Kidney Injury↗
PubMed1987

[Diagnosis of renovascular hypertension using venous DSA (digital subtraction angiography): image quality and predictive value 1987. Determination of current status].

Using optimal equipment and an adequate examination technique, renal venous DSA for renal artery stenosis is today a diagnostic procedure in 98% of cases. Its sensitivity equals 85%, its specificity reaches 95%. Comparing accuracies and positive predictive values, renal venous DSA is superior to radionuclide studies. Pre-selection of patients with captopril as a pharmacologic test is expected to increase the predictive values of renal venous DSA and to confirm the hemodynamic significance of an angiographically detected renal artery stenosis.

Adolescent↗
PubMed1985

Immunopathology of AIDS (acquired immune deficiency syndrome) observations in 75 patients with pre-AIDS and AIDS.

Sequential changes in the morphology of immunocompetent and other organs, in the accompanying immunocytological and immunovirological measurements are described in 75 patients with lymphadenopathy syndrome and with AIDS. The data presented demonstrate a stepwise development of the disease from a hyperimmunization syndrome to T-cell immune deficiency. Excessive antigenic stimulation by a large number of infectious organisms or by transfusion of blood and blood products account for antigenic overloading and hyperimmunization. Among such infectious organisms are certain viruses which per se interfere with cells of the immune system as for instance Epstein-Barr virus, cytomegalovirus, and HTLV3. Developing immunological incompetence will favor the persistence of these and other infectious organisms enhancing the damage of the immune reactivity and finally allow lethal infections or malignant tumors to occur.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Proton spin tomographic changes of the femoral shaft in patients with kidney transplantation].

In a prospective study 43 patients were reviewed 3 and 12 months after renal transplantation. The patients had MRI examinations and plain x-rays of the hips as well as punch biopsies of the iliac crest. In 9 patients diffuse, inhomogeneous bilateral changes of the MRI-signal patterns of the femoral diaphysis were seen. They were hypointense in the T1-weighted images and hyperintense in the STIR-images. All plain x-rays were inconspicuous. These changes of the femoral shaft were significantly more frequent in patients with renal osteodystrophy of the histological type Delling Ila. We conclude that these changes of MRI-signals patterns might be connected with an osteoidosis.

Adult↗