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Biomedical subjects

S Spitzer

Publications and source records attributed to S Spitzer.

At least 55 records · Page 3Linked to original sources
PubMed1990

Posture, place, and mood effects on ambulatory blood pressure.

Ambulatory blood pressure was studied as a function of posture, place, and mood in 131 subjects classified according to race, gender, and hypertensive status. The effect of posture was significant and explained a substantial proportion of within-subject variability. After controlling for posture, significant place and mood effects were observed when subjects were sitting but not when they were standing. Home vs. work differences in both systolic and diastolic blood pressure were significantly greater in Whites than in Blacks. Similar differences in systolic blood pressure were greater in mild hypertensive than in normotensive subjects. The results of this study underscore the need to control for effects of posture when interpreting ambulatory blood pressure readings.

Adult↗
PubMed1990

[The clinical rheological laboratory].

To quantify the fluidity of blood it is not suitable to measure whole blood viscosity as blood is no Newton's fluid. For this reason, it is necessary to measure characteristic blood flow parameters direct. This study presents methods of measurement for plasma viscosity, haematocrit, thrombocyte aggregation, erythrocyte rigidity, erythrocyte aggregation and leukocyte adhesivity.

Blood Viscosity↗
PubMed1990

[Third replacement of the tricuspid valve in combined aortic-tricuspid defect].

The implantation of valvular prostheses in tricuspid position is problematic due to the slow blood flow in the low-pressure system with the risk of valvular thromboses. Today there are prostheses with supportable low transvalvular gradients; nevertheless, the risk of valvular thromboses is, in spite of anticoagulation, increased by using mechanical prostheses in tricuspid position. We report on a 51-year-old woman in whom a dysfunction of the Starr Edwards ball prosthesis 15 years after its implantation in the tricuspid position was diagnosed. The prosthesis, which was unable to function due to connective tissue proliferation, was replaced by a St. Jude Medical prosthetic valve, which also presented a disturbed function a few days after the implantation. Because of a suspected valve thrombosis the patient was treated with rt-PA-lysis which proved to be ineffective. Thus it was inevitable to implant a third tricuspid valve; this time a bioprosthesis was used.

Aortic Valve↗
PubMed1989

[Hemodilution in patients with multiple morbidity and peripheral arterial occlusive disease].

The treatment of multi-morbid patients suffering from peripheral arterial occlusive disease (PAOD) is rendered difficult due to concomitant diseases such as coronary heart disease, chronic obstructive pulmonary affection, arterial hypertension or diabetes mellitus. Haemodilution can be a clinically efficient therapy for some of the concomitant diseases as well. It is, however, necessary to use a weak colloidal solution which has no additional volume effect as an iso-oncotic substance. Hydroxyethyl starch 200/0.5 6% meets all these demands. In a double-blind, placebo-controlled study over a period of 6 weeks a marked and significant increase of almost 40% in painfree walking distance was achieved for 19 of 37 multi-morbid patients with PAOD II by moderate hypervolaemic haemodilution with venesections. Besides the clinical improvement, blood fluidity also increased through a reduction in haematocrit, plasma viscosity, and erythrocyte aggregation.

Adult↗
PubMed1989

[Iso- and hypervolemic hemodilution with hydroxyethyl starch (HES 200/.05 10%) in patients with II b peripheral arterial occlusive disease].

The basic therapy in stage IIb of peripheral arterial occlusive disease (PAOD) according to Fontaine is exercise. The aim of this study was to test whether (given initial physiological hematocrit values of 43 to 46%) a mild hypervolemic to isovolemic to hematocrit values of 40% with HES 200/0.5 10% or Ringer lactate in combination with exercise is even more favorable. In order to answer this question, 3 groups of 25 patients each were formed. One group exercised three times weekly and the second group, in addition to exercise, underwent a mild, hypervolemic to isovolemic 6-week dilution therapy with HES. In the final group the hematocrit value was reduced to the same extent by means of venesection and volume substitution with Ringer lactate. The walking distance increased in the HES group from 216 to 311 m (44%), in the Ringer lactate group from 214 to 258 m (20%), and in the exercise group from 213 to 242 m (14%). In comparison of the groups, the increase in pain-free walking distances in the HES group is found to differ significantly from those in the other groups. It was clearly demonstrated that hemodilution with HES in combination with exercise brings about a clinical effect of an order three times of that achieved by exercise alone. Venesection with subsequent administration of Ringer lactate and exercise is superior to exercise alone, but is markedly inferior to the combination therapy with HES.

Adult↗
PubMed1989

Increased theophylline clearance in asthmatic patients due to terbutaline.

The pharmacokinetic mechanism of the theophylline-terbutaline interaction has been studied. Sustained release theophylline 200-400 mg b.d. was given with placebo or terbutaline 2.5 mg t.d.s. to six adult asthmatic patients. Terbutaline decreased the serum trough theophylline levels from 8.1 to 7.3 micrograms/ml, improved daily the clinical score from 1.51 to 1.26 and increased the peak expiratory flow rate from 316 to 370 l/min. In a single dose study following the chronic therapy, it was shown that there was no change in the peak theophylline concentration or in the timing of the peak, but the t1/2 was reduced from 9.0 to 7.5 h, and the systemic clearance was increased from 20.2 to 24.8 ml.h-1.kg-1. Thus, terbutaline reduced the serum theophylline concentration by increasing its systemic clearance.

Adult↗
PubMed1989

Effect of altering heart rate on oxygen uptake at exercise onset.

At the onset of exercise, both cardiac output and ventilation increase abruptly. We investigated the hypothesis that a rapid change in cardiac output, as effected by an immediate increase in heart rate at the start of exercise and a decrease in heart rate at the termination of exercise, affects the responses of oxygen uptake. Five patients in whom programmable pacemakers had been previously inserted for complete heart block were studied. Responses in ventilation and gas exchange were recorded breath by breath during studies in which each subject performed 16 transitions between rest and moderate exercise on a cycle ergometer. In a randomized fashion, in half of the transitions, heart rate was accelerated from a low rate to a high rate as exercise began; in the other half, heart rate was held constant at the low rate as exercise began. Oxygen uptake increased by 30 percent in the first 20 seconds of exercise, when heart rate was constrained, while it increased by 70 percent when heart rate was abruptly accelerated. Similarly, smaller changes were observed at the cessation of exercise when the heart rate was constrained, as compared to an abrupt decrease in heart rate. Despite this difference in the responses of oxygen uptake, at the transitions in exercise, the ventilatory responses were indistinguishable. We have demonstrated that ventilation-independent changes in oxygen uptake can be induced at the onset and cessation of exercise. These alterations in oxygen uptake are predictable from differences in blood flow which occur as a consequence of the differences in time course of the heart rate.

Adult↗
PubMed1989

[Hemorheologic, micro- and macrocirculatory effects of an infusion of 500 ml of 6% medium molecular weight hydroxyethyl starch (Haes 200,000/0.5)].

In an open study the influence of hypervolemic hemodilution (Infusion of 500 cc hydroxyethyl starch 200,000/0.5 6% within 1 h) on macro- and microcirculation, fluidity of blood and conjunctival oxygen tension was investigated. Blood pressure and heart rate remained unchanged during and after the infusion. One hour after the infusion there was a tendency towards an increase in blood flow in the common carotid artery which then returned to normal again. The capillary circulation as well as the conjunctival oxygen partial pressure were significantly increased after 3 h. This correlated well with the decrease in plasma viscosity and erythrocyte aggregation. The effect of hemodilution using 6% middle molecular weight hydroxyethyl starch with a substitution degree of 50% on microcirculation was probably due to the rheological and not to the hemodynamic effect.

Adult↗
PubMed1988

Inhibition of deoxyribonucleases by phosphorothioate groups in oligodeoxyribonucleotides.

The Rp- and Sp-diastereomers of the phosphorothioate-containing oligonucleotide d[ApAp(S)ApA] have been synthesized. They and the tetramer d[ApApApA] were tested as substrates for staphylococcal nuclease, DNase II and spleen phosphodiesterase. For digestions with DNase I these oligonucleotides were converted to the 5'-phosphorylated derivates. The reactions with the nucleases were analysed by HPLC. The phosphorothioate groups of both diastereomers were resistant to the action of staphylococcal nuclease, DNase I and DNase II. While the phosphorothioate group of the Rp-diastereomer was resistant to the action of spleen phosphodiesterase, the Sp-diastereomer was hydrolysed at an estimated rate 1/100 the rate of cleavage of the unmodified tetramer. The presence of the phosphorothioate group in the center of the molecule affected the rate of hydrolysis of neighbouring phosphate groups for some enzymes. In particular, very slow release of 3'-dAMP from the Rp-diastereomer occurred on incubation with staphylococcal nuclease but the Sp-diastereomer was completely resistant. DNase II produced 3'-dAMP quite rapidly from both diastereomers of d[ApAp(S)ApA] and DNase I released 5'-dAMP from both diastereomers of d[pApAp(S)ApA] only slowly.

Animals↗
PubMed1988

[Bag plasmapheresis in patients with stage IIb peripheral arterial occlusive disease].

The clinical effect of bag-plasmapheresis was investigated in 60 patients with peripheral arterial occlusive disease stage II according to Fontaine. The initial number of patients was subdivided in three groups of 20 individuals using a randomised double-blind placebo-controlled design. Each patient gave 300 ml of blood twice a week for a 6 week duration. Blood plasma was separated in two groups and replaced with Hydroxyethyl-starch (200/0.5 10%) in group 1 and with Laevulose 5% in group 2. Patients in group 3 received their whole blood without any processing. All patients had to undergo a physical training of 45 minutes three times a week. The group who received Hydroxyethylstarch presented a 20% increase in walking distance whereas the increase in the Laevulose group was 5% and approximately 1% in the group receiving whole blood. The increase in walking distance in the Hydroxyethylstarch-group was significant on the 0.1%-level and significantly better than the improvement in walking distance of the other groups. Additionally in this group plasma viscosity showed a 3% decrease, erythrocyte aggregation was reduced by 10%. Results in the Laevulose group were only half as good as in the Hydroxyethylstarch group while parameters remained unchanged in the whole-blood-group. Bag plasmapheresis with Hydroxyethylstarch as substitute leads to an improvement in the walking capacity and blood fluidity thus offering a promising therapy for peripheral vascular occlusive disease.

Adult↗
PubMed1988

[Hemorheologic, micro- and macrocirculatory effects of hypervolemic hemodilution with middle molecular weight hydroxyethyl starch (Haes 200/0.62; 6 percent)].

During a single blind study the influence of hypervolemic hemodilution (Infusion of 500 cc Elohäst 6%) on micro- and macrocirculation, transcutaneous pO2 and fluidity of blood of apparently healthy subjects was investigated. Blood pressure and heart rate remained unchanged during and after the infusion. One hour after the infusion there was a significant increase in the blood flow of the common carotid artery and the cutaneous circulation, and after 3 h a significant increase in conjunctival oxygen partial pressure was observed. The decrease in hematocrit was significant at all measuring points but most marked after 3 h (with 4.2 by volume). After 3 h and 6 h a significant increase in plasma viscosity and erythrocyte aggregation could be observed, whereas both parameters were unchanged during the early phase.

Adult↗
PubMed1988

Systemic lupus erythematosus presenting with lingual infarction.

A 73-year-old woman developed a lingual infarction, Raynaud's phenomenon, cutaneous lesions, pancytopenia, and pleuritis. Serologic studies supported a diagnosis of systemic lupus erythematosus (SLE), and anticardiolipin antibodies were detected in significant titers. This is the first reported case of SLE presenting with an infarction of the tongue.

Aged↗
PubMed1988

Attitudes about AIDS.

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Acquired Immunodeficiency Syndrome↗