Thyroid hormones and their impact on the hemodynamic and metabolic stability of organ donors and on kidney graft function after transplantation.
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Biomedical subjects
Publications and source records attributed to C Wieser.
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Nalbuphine is a new partly agonistic antagonistic opioid, that may offer some advantages especially in postoperative pain relief. We compared meperidine (1 mg kg-1) in 100 patients and nalbuphine (0.3 mg kg-1) in 70 patients, administering both agents intravenously after gynaecological operations. Standardised halothane anaesthesia without any opioid was used. After arrival in the recovery room, vigilance (sedation), quality and duration of pain relief were measured by different methods at four different times (0, 15, 30, and 60 minutes). Sedation was significantly more pronounced in the nalbuphine group, but no difference could be found in pain relief and duration between both groups. 6 patients of the n-group showed a short lasting wake-up reaction due to receptor antagonism. 36 patients had to be reinjected at the end of the first hour. We consider nalbuphine to be a safe opioid, however, the marked sedation should be taken into account.
On the basis of 88 consecutive cadaveric renal transplants, multiple variables concerning donor conditioning and perioperative recipient management which may have an influence on the occurrence of acute tubular necrosis (ATN), were analysed and their impact on long-term results assessed. Cold ischaemia time turned out to be the greatest risk factor and was seven hours shorter in patients with good initial function when compared with patients with ATN. Although actual one-year graft survival was similar in both groups, the postoperative course was more complicated in the ATN group and management more onerous. Furthermore, two patients of the initial non-function group died of complications directly related to renal replacement therapy. Seventeen hours cold ischaemia time was associated with more than 80% initial function. This time is sufficient to allow careful tissue typing and organ transportation.
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This report presents interim results from a series of studies of the lumbosacral region of the spine. A new classification of the lumbosacral transitional vertebra (LSTV) is proposed. An LSTV was found with similar frequency in patients and in population samples. The radiological findings were related to the presence of symptoms and to evidence of urological problems. Whilst Brocher (1973), Rubin (1971), and others have considered an LSTV to be of importance because it should lead to unfavourable weight bearing in the lower spine, the present extensive material shows that there is no relation between an LSTV and low backache. There may be a genetic factor involved in the various types of LSTV.
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