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Biomedical subjects

B Truniger

Publications and source records attributed to B Truniger.

At least 19 recordsLinked to original sources
PubMed1990

[Acute kidney failure in infectious mononucleosis].

Overt renal disease is a rare complication of infectious mononucleosis (MI). In contrast, up to 16% of patients with MI have been shown to exhibit abnormalities in urinary sediment. Histological abnormalities--usually interstitial nephritis, and occasionally glomerular lesions--are rather common. Clinical symptoms include in rare cases isolated macrohematuria, occasionally a nephrotic or nephritic syndrome, and more commonly acute renal failure due to rhabdomyolysis, hepatorenal syndrome or acute interstitial nephritis. We report two observations of acute renal failure with a typically benign course and discuss these observations in the light of an updated literature survey of 34 patients.

Acute Kidney Injury↗
PubMed1990

[Hyperkalemic emergency: causes, diagnosis and therapy].

Eight patients with life threatening hyperkalemia were treated in the intensive care unit over a period of 2 years. Serum potassium at admission was 7.1-11.2. Two patients had to be resuscitated and 3 exhibited quadriplegia or paralyses but were alert. Seven showed marked ECG change: in 5 the QRS-complexes were extremely broadened and in one case an AV-rhythm was observed; the atrial wave was absent in all 7 patients. Renal failure was present in 7 of 8 patients. In 6 of these 8 cases drugs were also involved in the development of hyperkalemia. The following therapeutic procedure is recommended for hyperkalemia: (1) injection of calcium, (2) inhalation or injection of beta 2-mimetics (well documented in the literature; clinical experience limited), (3) insulin and glucose i.v., (4) sodium bicarbonate, but only in case of metabolic acidosis, (5) hemodialysis, (6) cation exchange resins or furosemide in non-acute situations.

Acute Kidney Injury↗
PubMed1989

[Psychogenic water intoxication].

Six new cases of psychogenic water intoxication are discussed in the light of 150 observations published in the literature since 1935. 87% of all patients were schizophrenic, and 13% had other psychoses and a variety of functional and organic psychopathies. Psychogenic polydipsia is a prerequisite of psychogenic water intoxication. Water intake either overrides an intact osmoregulation (46% of all cases) or, allied to an inadequate urinary dilutional capacity (54%), leads to a transitory, sometimes repeated, and (in 8% of all cases) lethal water intoxication and hypoosmolality. - The consequence of hypoosmolality is metabolic encephalopathy, with agitation, convulsions and coma as its most common symptoms. Profuse diuresis, enuresis and urinary retention, gastric dilatation, watery vomiting and watery diarrhea are diagnostically helpful symptoms of polydipsia typically denied by the patients. Hypoosmolality/hyponatremia are the hallmarks of water intoxication. However, fewer than 50% of all patients present with the expected maximal urinary dilution. Inadequate ADH activity and increased sensitivity of the renal tubule to antidiuretic hormone are the pathogenetic factors in this inappropriate urinary dilution, while psychosis, psychotropic drugs, diuretics, nicotine and alcohol withdrawal are possible causes and cofactors of polydipsia and inadequate urinary dilution. New aspects of treatment are discussed.

Aged↗
PubMed1988

[Renal manifestations of sarcoidosis].

Renal manifestations of sarcoidosis are rare. In addition to calcium nephropathy, granulomatous interstitial nephritis and glomerulo-nephritis (GN) account for most cases. The latter two manifestations are described in 4 patients and in a detailed review of the literature. In comparison to a nonselected population of sarcoidosis patients, granulomatous interstitial nephritis is found more frequently in male patients above 40 years of age; it is associated more frequently with other extrathoracic manifestations of sarcoidosis; and it causes renal insufficiency of varying degree, which is at least partially reversible with steroid therapy. Predominant findings are silent microhematuria, sterile pyuria, mild proteinuria and a variety of tubular functional disorders. Glomerulonephritis (39 observations) has been described with increasing frequency in sarcoidosis. Because of the well known immunological abnormalities of sarcoidosis, frequent association of sarcoidosis with GN could be expected but this association has not yet been proven statistically. Sarcoidosis-associated GN includes a variety of histological forms, viz. membranous, proliferative and sclerosing GN. Glomerulonephritis may appear before sarcoidosis. Conversely, both diseases may appear simultaneously, or GN may follow all other manifestations of sarcoidosis with a latency period of many years.

Aged↗
PubMed1987

[Microhematuria of renal origin--differential diagnosis, clarification and interpretation].

Microhematuria offers a wide spectrum of diagnostic possibilities. Once the finding is confirmed, the diagnosis of prerenal, renal-parenchymatous and postrenal (or even factitious) hematuria and differentiation between glomerular and nonglomerular bleeding sources is based on the patient's history, a complete clinical status, special urinary findings (mainly red cell casts, proteinuria and red cell morphology) and blood chemistry (serum creatinine or creatinine clearance). If on the basis of this information glomerular or renal-parenchymatous microhematuria seems likely, further diagnostic procedures include immunological tests and, if indicated and justified, renal biopsy. Urography and other imaging procedures, urinary cytology and cystoscopy (firmly indicated when doubts persist or all the evidence points to postrenal hematuria) are deferred whenever glomerular hematuria seems likely. The special aspects of isolated renal microhematuria are discussed.

Diagnosis, Differential↗
PubMed1987

[Generalized melanosis of macro- and microphages in metastasizing melanoma].

A patient suffering from a metastasizing malignant melanoma of the skin developed diffuse melanosis of the skin and melanuria a few weeks before death occurred. At autopsy, disseminated metastases of malignant melanoma were associated with marked melanosis of the organs and particularly of the mononuclear phagocytic system. In addition, neutrophilic granulocytes of the peripheral blood frequently contained melanin granules. The presence of melanin in blood monocytes and granulocytes may be useful for the diagnosis of (metastasizing) malignant melanoma.

Humans↗
PubMed1979

[Myasthenia gravis and visceral lupus erythematosus].

The patient described in this clinical demonstration suffered from severe myasthenia gravis shortly before the detection and for 3 years after surgical removal of a cystic thymoma. At the end of this period, when the myasthenia subsided, she developed systemic lupus erythematosus simultaneously with pleural implantation metastases of the thymoma. After local radiation therapy and under systemic immunosuppression she has remained asymptomatic since the spring of 1978. The pathogenetic and immunogenetic basis of myasthenia gravis and autoimmune diseases associated with thymoma and thymus hyperplasia is reviewed, and a plea is entered for more comprehensive and integrative internal medicine.

Acetylcholine↗
PubMed1978

[Atenelol and bendrofluazide in the treatment of medium and severe hypertension (preliminary report)].

In 15 patients with moderate to severe hypertension (WHO II--III) atenolol was evaluated against a thiazide diuretic (bendrofluazide) in a single blind crossover study. Systolic blood pressure values were lowered more efficiently by the diuretic, while diastolic pressure values were significantly better controlled by atenolol. Atenolol and bendrofluazide, by mere addition of the pressure effects of the single components, clearly afforded the best pressure control. Side effects of atenolol were frequent but mild, never causing major concern with the patients or a dropout from the study. Although the pressure response to atenolol was significantly better in the normal and high renin group of patients, there was no statistically significant correlation between the reduction in plasma renin and blood pressure induced by atenolol. In turn, the pressure response to the diuretic was significantly better in low renin than in normal and high renin patients.

Atenolol↗
PubMed1978

[Partial lipodystrophy and intramembraneous glomerulonephritis].

The case is presented of a young woman with partial lipodystrophy and intramembranous glomerulonephritis. Light and electron microscopic changes in the kidney biopsy are described and discussed. With immunosuppressive therapy very slow progression of the renal insufficiency was observed. Finally, regular dialysis treatment was required to sustain life. The follow-up after detection of intramembranous glomerulonephritis lasted 8 years.

Adult↗
PubMed1978

Renal function and intrarenal hemodynamics in acutely hypoxic and hypercapnic rats.

On the basis of microsphere distribution, inert gas washout, and standard clearance data, the effects of acute hypoxia and hypercapnia on the kidney were studied in anesthetized, mechanically ventilated rats. Moderate hypoxia (mean PO2, 48 mm Hg) did not significantly change diuresis, GFR, and tubular sodium rejection. Due to a decrease in renal vascular resistance (R) from 40.1 to 31.8 mm Hg ml-1 min, mean renal blood flow stayed constant in spite of a significant drop in mean arterial blood pressure. Hypoxic changes in R were not accompanied by significant changes in intrarenal distribution of blood flow (IDBF). In severe hypoxia (PO2 less than 45 mm Hg) with oliguria and marked arterial hypotension, R was the lowest of all groups (28.8 mm Hg ml-1 min). Hypercapnia did not significantly change the renal excretory parameters, although an increase in R (without change in IDBF), together with a decrease in MAP caused a marked drop in mean renal blood flow. From these studies we conclude: 1) in the anestheized rat, acute hypoxia caused significant changes in intrarenal hemodynamics without changes in excretory function, 2) hypoxic renal vasodilation persists even in severe hypotension with oliguria and anuria, 3) in acute hypoxia and hypercapnia, changes in renal blood flow and renal vascular resistance are not accompanied by significant changes in IDBF.

Animals↗