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Biomedical subjects

H Thieler

Publications and source records attributed to H Thieler.

At least 19 recordsLinked to original sources
PubMed1992

Pharmacology of r-hirudin in renal impairment.

The pharmacokinetic properties of r-hirudin were studied in nine patients suffering from different degrees of renal insufficiency. To this end, r-hirudin was administered intravenously at dosages of 0.1 mg/kg. The elimination half-life t1/2 beta was determined in blood plasma and the cumulative r-hirudin excretion in urine was measured over 48 h. In healthy volunteers t1/2 beta was 0.9 +/- 0.2 h; the cumulative r-hirudin excretion in urine after 48 h amounted to 38 +/- 10% of the dose administered, most of this quantity was excreted during the first hours. In seven patients with chronic renal failure, t1/2 beta was 15 to 41 h; in three of these patients cumulative urinary r-hirudin excretion was increased to 70-80%, in four patients cumulative r-hirudin excretion in urine within 48 h amounted to 39 +/- 8%, but was delayed in time. In 2 bilaterally nephrectomized patients, t1/2 beta was 168 and 316 h, resp. The renal clearance of hirudin was significantly and linearly correlated with the creatinine clearance (r = 0.872). In all patients aPTT and bleeding time were only moderately prolonged. Because of the modified pharmacokinetic behaviour the administration of hirudin in patients with impaired renal function requires individually adjusted dosages or prolonged administration intervals.

Adult↗
PubMed1988

[The diagnosis of analgesic nephropathy].

Inspired by the large proportion of at least 17% of nephropathy due to analgesics as the basic disease among the patients undergoing chronic dialysis in Erfurt and under the impression of a greatly distributed "underdiagnosis" of this avoidable disease the actual diagnostic possibilities for recognition are demonstrated. Above all, in analgesic syndrome the thinking-of is of greatest importance, and the sensible making of the patient's analgesics history. The presumable diagnosis analgesic nephropathy is than made secure by means of imaging methods, with the help of which the almost pathognomonic papillary necroses can be demonstrated. Finally, the reasons are given for the importance of the exact diagnosis analgesic nephropathy, even in the stage of nephrocirrhosis.

Analgesics↗
PubMed1987

[Bacteriologic studies of bicarbonate dialysate and suitable initial solutions].

Dialysates for the haemodialysis are produced unsterile and usually contain bacteria. Own investigations of bicarbonate dialysate and adequate initial solutions comprised sterility tests, determinations of the germ count and germ tolerance experiments. Only the "acid concentrate" was sterile. In the other solutions Corynebacteria, Acinetobacter and Pseudomonas bacteria dominated as typical water germs. In the fresh reverse osmosis water and the bicarbonate dialysate as well as in the recently produced 35-mmolar and 1-molar NaHCO3-solution the germ count was in each case about 10(5)/l and did not change itself essentially at room temperature within 6 hours. The "acid concentrate" and at a lower level also the 1-molar NaHCO3-concentrate have an antibacterial effect. The reverse osmosis water is the main contamination source for the bicarbonate dialysate, the application of which within 6 hours seems worth being used on account of the low germ count.

Bacteriological Techniques↗
PubMed1979

[Prevention of hepatitis in dialysis centers. A catalog of recommendations and suggestions. 3].

This last of three reports on the prevention of hepatitis in dialysis centres deals with the kind and frequency of desinfection measures in the dialysis area, contains advices to the mode of transfer of patients between dialysis centres and makes demands to the tests of hepatitis-B-antigen and antibodies. Finally proposals concerning the frequency of controls for HBs-antigen and anti-HBs and for the passive immunisation with anti-HBs-enriched immunoglobulin are rendered.

Formaldehyde↗
PubMed1979

[Prevention of hepatitis in dialysis centers. A catalog of recommendations and directions. 2].

On 33 patients who underwent a lung resection under conditions of stress in the majority of cases also after parenchyma-sparing operation a pulmonary hypertension, in about 50% already a slight hypertension in rest could be proved. The increase of the pulmonary pressure correlated with an increase of the resistance of the pulmonary vascular system, of resistance and age and showed tendencies to the increasing postoperative interval.

Cross Infection↗
PubMed1979

[Hepatitis prophylaxis in dialysis centers. A list of recommendations and tips. I].

From the standpoint of prevention of hepatitis in this first report references are given to the construction of dialysis centres, to their apparative equipment with special regard to the artificial kidneys, to the dialysators and to the blood-leading systems. Finally the author deals with the technique of punctures and to the possibilities for avoiding too large blood losses in patients undergoing a chronic dialysis.

Hepatitis B↗
PubMed1978

[2 1/2-year experience with highly-effective short-term dialyses in Erfurt].

At present 18 of 19 dialysis patients undergo the highly effective short-term dialysis, which is used in the Erfurt centre since November 1974. The therapy is performed by two parallel dialysators C-DAK 4 for 3 to 4 hours (24.4 square metres -- hours/week). During the period of observation of 2 1/2 years altogether 35 patients were treated with the short-term dialysis. There are compared clinical and paraclinical parameters of 12 patients who on an average for 2 years underwent the short-term dialysis. The serum levels of retained substances of protein and albumin as well as the "optimum weight" did not or only unessentially differ from each other. Also the blood pressure values scarcely deviated from each other before and after dialysis. The manifold use of the C-DAK 4 is the cause for an increased substitution of erythrocytes. Insufficient compensation of the circulation and a low body weight are regarded as contraindication to the short-term dialysis.

Adolescent↗
PubMed1977

[Highly effective short-term dialysis with two parallel-connected capillary dialysators type C-DAK4. 2. Clinical parameter, subjective symptoms and performance control of patients compared to conventional dialyses].

8 male patients with chronic dialysis (5 of them with binephrectomy) were thrice a week dialysed in 2 groups alternately 2 months conventionally for 6 hours with a capillary dialysator C-DAK mod. 4 and 2 months for 3 hours with 2 parallel connected C-DAK 4. In a constant square metre-hour-product (23.4 m2h/week), homogeneous criteria of treatment and, as a rule, four times repeated use of the C-DAK 4 clinical parameters, subjective complaints and efficiency of the same patients were compared.

Blood Transfusion↗
PubMed1977

[Comparison of repeated use of capillary dialysators model C-DAK 4 and C-DAK 5].

18 dialysators C-DAK 5 and 4 each were again used in the same patients with chronic dialysis under the same conditions of dialysis and regeneration (short-acting dialyses of more than 3.5 h with 1 C-DAK 5 or 2 parallel acting C-DAK 4, respectively). A volume of the blood compartment of more than 70% of the initial value was regarded as criterion for the further usability. Thus, model 5 could be used on an average 3.7 times, model 4, however, 6.3 times (p less than 0.0001). Already at the end of the 3rd use in model 5 the capillary volume decreased below 63%, in model 4 only below 88%. The volumetrically determined ultrafiltration showed a decrease parallel to the volume of the blood compartment -- with the same differences between the two models of the C-DAK. In model 15 the effectiveness concerning the elimination of creatinine and urea clearly decreased after the 2nd use, whereas it did not reveal a change also in an application four times repeated. The larger coagulation processes in a more than once repeated use of the C-DAK 5 -- with adequate losses of blood -- are explained with the large length of the capillary and the other distribution of blood with regard to the cross section of the capillary. Summarizing we can say that in chronic routine dialyses -- without testing the individual exemplars -- model 5 of the C-DAK can be used twice, model 4, however, four times.

Creatinine↗