[The role of the practicing physician in treating renal failure].
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Biomedical subjects
Publications and source records attributed to A Seiler.
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Accidental hypothermia, in contrast to medical hibernation, corresponds to a sudden, unforeseen lowering of the body temperature below 35 degrees C. This may occur endogenously in association with various diseases. On the other hand, it may be due to the exogenous influences of very low environmental temperatures. An impressive observation of accidental hypothermia is described and the pathophysiological findings in accidental hypothermia are reviewed.
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A group of 22 patients with Paget's disease of bone was treated with a diphosphonate (sodium etidronate; EHDP), a stable synthetic analogue of inorganic pyrophosphate. This substance was given during 3 months at the dose of 20 mg/kg body weight per day, and proved effective by reducing the raised urinary excretion of total hydroxyproline and by lowering the concentration of serum alcaline phosphatase. It also improved the disease-related osteo-articular pain in 60% of the patients. A rise in serum phosphate under EHDP therapy is due to the increase in renal tubular reabsorption of phosphate. Bone histology showed regression of disease activity and the appearance of lamellar structure in newly formed bone. Because of a transient increase of the amount of uncalcified osteoid, it is advisable to give the diphosphonate in courses not over 3 months or at a reduced daily dose.
Upper endoscopy was performed in 567 patients: 237 under general anesthesia, 261 in intravenous sedation with midazolam and etomidat (mean dosage 0.26 mg/kg bodyweight), 69 without any premedication. In these many patients defended strongly and some investigations have to been interrupted. On the other hand general anaesthesia needed much more time and personnel and produced more costs. In our experience sedation with midazolam and etomidat is most comfortable for patient and endoscopist and the time needed is shorter than in general anaesthesia. Therefore we recommend this method even in therapeutic endoscopy, except only in sclerotherapy of esophageal varices.