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Biomedical subjects

H Wagemaker

Publications and source records attributed to H Wagemaker.

At least 19 recordsLinked to original sources
PubMed1987

Hepatorenal syndrome. Studies of the effect of vascular volume and intraperitoneal pressure on renal and hepatic function.

Eleven patients with well-documented hepatorenal syndrome were studied by measurement of blood volume, glomerular filtration rate, renal plasma flow, plasma aldosterone concentration, renin substrate concentration, and plasma renin activity. They were then given 750 ml of stored plasma, 750 ml of fresh frozen plasma, and then an infusion of angiotensin II, in random order on successive days. Infusion of fresh frozen plasma improved function more than did stored plasma and in addition returned a very low filtration fraction toward normal. Angiotensin II infusion increased filtration fraction, but decreased glomerular filtration rate, renal plasma flow, and urine flow sharply. Patients were then given a daily infusion of 1,000 ml of fresh frozen plasma for seven to 18 days to expand the blood volume to supranormal levels as assayed by serial measurement of blood volume. Plasma aldosterone levels decreased to a normal range, glomerular filtration rate and renal plasma flow both increased, and urinary excretion of sodium and potassium both returned toward normal. The effect of intraperitoneal pressure was then studied by measuring glomerular filtration rate, renal plasma flow, pressure in the vena cava, hepatic vein free flow, and hepatic vein wedged pressure before, during, and after paracentesis to reduce the intraperitoneal pressure from 30 to 40 cm H2O to 12 to 17 cm H2O. Venous pressures moved parallel to ascitic fluid pressures, and glomerular filtration rate, renal plasma flow, and urine flow all improved sharply; then, as ascitic fluid continued to form, reducing vascular volume, urine flow, glomerular filtration rate, and renal plasma flow all decreased slowly. Six patients then underwent placement of a LeVeen shunt. Improvement in glomerular filtration rate and renal plasma flow and clinical condition was dramatic. During postoperative observation of up to two years, progressive improvement in hepatic function has occurred.

Angiotensin II↗
PubMed1985

Acutely psychotic patients: a treatment approach.

Treating acute psychosis by rapidly producing a neuroleptic state is safe and effective. Getting psychotic patients quickly out of the hospital, keeping them out, and enabling them to function maximally are the treatment goals. Many such patients respond to a trial of lithium therapy; responders are usually better able to work or attend school and to live independently, and they less often show the degree of personality deterioration present in classical schizophrenia. Patients with schizophrenic, schizoaffective disorder, or bipolar illness should receive trial lithium therapy. Responders to lithium treatment are found in all three diagnostic categories.

Acute Disease↗
PubMed1984

Schizophrenia, hemodialysis, and the placebo effect. Results and issues.

This report presents the results of a double-blind study that examines the impact of hemodialysis on patients with chronic schizophrenia. Twelve patients were randomly assigned to sham and 12 patients to active dialysis. All patients experienced a drug washout period and were then followed up over an eight-week period. A statistically significant condition by weeks interaction was found, with patients in the sham group improving and patients in the active dialysis group decompensating over the last weeks of the trial. This complex finding fails to support the hypothesized efficacy of hemodialysis in the treatment of schizophrenia but also fails to support a simple placebo explanation for positive results reported in earlier open studies. The methodologic complications are reviewed, and a possible direction for future research is presented.

Adult↗
PubMed1984

Effect of aerobic exercise training on patients with systemic arterial hypertension.

One hundred five patients with established diastolic hypertension were enrolled in an exercise program to examine the effect of aerobic conditioning on blood pressure. In four patients, the decrease in mean blood pressure was less than 5 mm Hg; in all others, there was a significant decline in arterial blood pressure. In 58 patients who were not taking drug medication in the pre-exercise period, mean blood pressure decreased by 15 mm Hg. Of 47 patients receiving drug therapy during the pre-exercise period, 24 were able to discontinue all medication. Mean blood pressure in this group fell from 116.9 +/- 6.5 mm Hg to 97.2 +/- 9.2 mm Hg as a result of exercise. In patients still taking antihypertensive drugs, mean pressure decreased from 120.9 +/- 28.8 mm Hg to 104.4 +/- 17.9 mm Hg after three months of exercise. It is concluded that in patients physically and emotionally able to exercise, a significant decline in blood pressure can be achieved.

Adult↗
PubMed1983

The HTP as a measure of change in dialyzed schizophrenic patients.

Used the House-Tree-Person as a measure of pathology in 10 schizophrenic patients of both sexes between the ages of 19 and 30 before and after experimental hemodialysis treatment. Results obtained through the quantitative HTP scoring method, and reflected in HTP IQs, indicate that significant improvement as a function of treatment is seen in pre- to post-dialysis drawings. Data analysis, using the Two Factor Repeated Measures Analysis of Variance (ANOVA), indicates that drawings done after dialysis improve at the .005 and .001 levels. The HTP evaluations support the continued use of hemodialysis as an effective treatment for schizophrenia.

Adult↗
PubMed1983

Effectiveness of hemodialysis in chronic schizophrenic patients: a double-blind study.

Twenty-four chronic schizophrenic patients were treated with active or sham hemodialysis in a double-blind, randomized-group design. Treatment outcomes, as measured by the Schedule for Affective Disorders and Schizophrenia (version PD), are presented. Patients in both active and sham conditions responded to the dialysis process. The research design may have prevented the separation of these groups of responders. Further research is needed to evaluate the effectiveness of hemodialysis on a selected group of schizophrenic patients.

Adult↗
PubMed1981

A practical approach to management of lithium concurrent with hyponatremia, diuretic therapy and/or chronic renal failure.

Lithium therapy concurrent with hyponatremia, thiazides and possibly other diuretics and/or chronic renal failure has generally been avoided. However, despite greater risk for lithium toxicity, such combinations are feasible with appropriate precautions, especially lower lithium dosage and closer follow-up. Under the right circumstances hyponatremia, diuretics, and/or chronic renal failure are only relative lithium contraindications.

Bipolar Disorder↗
PubMed1978

Hemodialysis in chronic schizophrenic patients.

Ten schizophrenic patients were dialyzed once a week for 16 weeks. They showed marked abnormalities in thinking, affect, and behavior. When out of the hospital, they lived vegetative, nonproductive lives. Seven patients at the end of the 16-week period showed no or minimal symptoms involving thinking, affect, and behavior. One patient showed moderate improvement, and there were two treatment failures.

Adult↗