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Biomedical subjects

F Scheler

Publications and source records attributed to F Scheler.

At least 181 records · Page 10Linked to original sources
PubMed1975

Management of uraemic pericarditis.

Of 250 patients undergoing haemodialysis from 1967 to 1974 17 presented with uraemic pericarditis. Seven of these patients who had been transferred early enough to peritoneal dialysis treatment were cured without pericardiectomy (mean survival 18 months (range 6-36); no deaths). Only one patient was cured from his pericarditis by "aggressive haemodialysis." In seven out of 10 patients treated with haemodialysis, pericardiectomy finally had to be performed because of pericardial tamponade (postoperative survival 20 months (range 8-36); one death). Two patients died from pericardial tamponade before surgery. In patients with evidence of uraemic pericarditis frequent peritoneal dialysis with high fluid withdrawal is the treatment of choice, but in cardiac tamponade pericardiectomy should follow a preoperative pericardiocentesis with limited fluid aspiration. Of possible significance in the aetiology of pericarditis were the findings that 10 of the 17 patients had hypertension with cardiac enlargement and that 14 presented with evidence of underdialysis, possibly due to the reuse of dialysis components.

Cardiac Tamponade↗
PubMed1975

[Severe side-effects during peritoneal dialysis caused by sorbitol-containing dialysate (author's transl)].

In seven patients with chronic renal failure in an advanced stage 17 episodes of upper abdominal pain, hypertension, vomiting and (in some of them) coma occurred during peritoneal dialysis with sorbitol-containing dialysate. The signs recurred in some of the patients but did not when glucose-containing dialysate of otherwise identical composition was used. Very high levels of sorbitol in CSF and serum were measured in the comatose patients. The precipitating factor is probably a reduced metabolic breakdown of sorbitol in renal failure with preferential intracellular deposition of sorbitol and subsequent cellular oedema. To avoid this dangerous reaction it is necessary to use glucose instead of sorbitol in peritoneal dialysates, despite the technical problems of sterilisation. Where this is not possible, glucose should be added in order to reduce the sorbitol concentration in the dialysate to less than 15g/l.

Adult↗
PubMed1975

Fluoride determination in plasma by ion selective electrodes: a simplified method for the clinical laboratory.

A potentiometric method for the determination of fluoride (F-) in serum and plasma is proposed; it is based on a combination of the single-known-addition method and the electrode slope-by-dilution method. This procedure provides reliable results in extremely low measuring ranges down to 2.5 mug/l, where the electrode slope deviates markedly from Nernstian behaviour. In this method no electrode calibration is required and only one standard is necessary. 1 ml of plasma is sufficient for one analysis. Apart from a 5% enrichment of all samples with a concentrated total ionic strength adjustment buffer, no further preparation of the sample is required. The simplicity of the various pipetting and analytical steps, and also of the evaluation of the readings, may render this method highly suitable for the clinical laboratory. Investigations into the accuracy and precision of the method produced satisfactory results. The recovery in plasma amounted to 99.7%, even in the low measuring ranges. The discrimination capacity of the method amounts to 0.1 mug/l. With the apparatus and experimental procedures described, 18 plasma analyses per day can be performed even at low F- concentrations with which longer electrode stabilization periods are required. Storage of the plasma samples frozen at --20 degrees C for up to 8 weeks exerts no effect on the F- concentration. Problems of sample contamination and other disturbances are discussed. Determinations of normal values in 20 test subjects resulted in a mean value of 10.4 plus or minus 4.01 mug/l (Mean plus or minus S.D.). The modal value amounted to 9.5 mug/l, and the range was between 5.9 and 18.8 mug/l. The F- content of the drinking water supplied to this group of persons amounted to 180 mug/l. The importance of the method has been illustrated using a clinico-nephrological study as an example.

Adult↗
PubMed1975

[Simplified rapid determination of plasma digoxin. Methods and clinical evaluation].

The introduction of the Gamma Coat 125I-Digoxin Radioimmunoassay has simplified the digoxin determination to an extent that it may be used even in general hospitals with an intensive care unit. The total time for a stat determination has been reduced to 70 min. The coefficient of variation of the digoxin determination at low levels (less than 0.8 ng/ml) was less than 15% for simultaneous and repeated measurements even when using one of the inexpensive nuclear counting systems. At high levels (greater than 2.5 ng/ml) the coefficient of variation showed to be less than 6%. Hemolysis, low albumine concentration and other than digoxin-bound isotopes in the blood samples did not cause methologic problems. Provided that resorption and elimination kinetics of the different digoxin preparations were taken into account, digoxin levels of more than 2 ng/ml as measured by the Gamma Coat method in patients with normal renal function plasma were usually associated with clinical signs of overdosage; therapeutic concentrations were mostly higher than 1.2 ng/ml. The incidence of digitalis toxicity with high digoxin levels was lower in uremic than in normal patients. According to preliminary observations in dialysis patients this increase in tolerance to digitalis, may be a consequence of hyperkalemia and renal acidosis. Erroneously high digoxin concentrations were found in patients up to 2 hrs after injection of high doses of spironolactone (400-1000 mg) due to cross reaction. Therapeutic concentrations of digitoxin (10-25 ng/ml) caused only subtherapeutic digoxin concentrations of 0.4-0.9 ng/ml.

Anuria↗
PubMed1975

Dailysate calcium and plasma calcium fractions during and after haemodialysis.

Dialysate calcium and plasma calcium fractions during and after haemodialysis: The effect of differenct dialysate Ca concentrations on the plasma Ca fractions was examined in 28 patients. In 10 patients dialysed with a dialysate Ca concentration of 3.0 mEq/l the Ca fractions were determined at the start and end of dialysis. 8 patients were dialysed with dialysate with dialysate Ca of 3.5 mEq/l. In this group the Ca fractions were also estimated in the dialysis-free interval. The third group was dialysed with a dialysate Ca of 4.5 mEq/l. Total calcium and protein-bound calcium rose significantly in all groups. Ionised calcium in the first group was significantly reduced, in the second group it remained constant and in the third group it was significantly raised. Since parathyroid function depends on the plasma ionised calcium it is concluded that a dialysed concentration of 3.0 mEq/l is partly responsible for the pathogenesis of secondary hyperparathyroidism and of renal osteodystophy. In normocalcaemic patients a dialysate Ca concentration of 3.5 to 4.0 mEq/l is optimal. In patients entering long-term haemodialysis treatment with pronounced calcium deficiency symptoms a dialysate Ca of up to 4.5 mEq/l may be indicated for a short period after having normalized the inorganic phosphate levels in order to prevent extraosseous calcification.

Bicarbonates↗
PubMed1975

The effect of indomethacin on plasma renin activity in man under normal conditions and after stimulation of the renin angiotensin system.

1) The influence of oral indomethacin on basal and stimulated plasma renin activity in normal human subjects was determined. 2) Indomethacin lowers the basal plasma renin activity in man. 3) The response of the plasma renin activity after indomethacin to physiological and pharmacological stimuli is maintained at a lower level. 4) There is no evidence from our experiments that major changes in the sodium balance are responsible for the effects observed.

Administration, Oral↗
PubMed1975

Proteinuria and distribution of fibrinogen split products in various forms of glomerulonephritis.

The microelectrophoresis on gradient gels allows differentiation between the different types of proteinuria in 1 h in a one-step procedure. Due to their different molecular weights and forms, fibrinogen split products are separated by this method. The determination of fibrinogen split products not only offers a possibility for dicrimination between the various forms of glomerulonephritis but also offers a possibility for following the course of the disease.

Electrophoresis, Polyacrylamide Gel↗
PubMed1975

Ultrafiltration for middle molecules in uraemia.

An ultrafiltration system for the purification of toxic substances is demonstrated. Using this system, it is possible to eliminate substances with a molecular weight up to 5,000 in the same amount as smaller molecules. The clearances for smaller molecules are lower and for larger molecules higher compared to haemodialysis and they depend mainly on the ultrafiltrate flow. Amino acid loss did not exceed the amount which was eliminated by plate haemodialysers. Side effects, such as excessive haemolysis, platelet or fibrinogen depletion, were not to be found.

Amino Acids↗