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Biomedical subjects

H Weitzel

Publications and source records attributed to H Weitzel.

At least 37 records · Page 2Linked to original sources

[Diabetic retinopathy and nephropathy--complications in pregnancy and labor].

The purpose of this retrospective study was to determine the risk factors for the morbidity of the mothers and their fetus in patients with diabetic retinopathy and/or nephropathy with an open family planning. We compared the course of pregnancies, complications as well as the maternal and neonatal morbidity in 76 patients with diabetic retinopathy or nephropathy (White R F) with 85 patients without severe microangiopathy (White C D). We found a correlation between retinopathy progression and hyperglycaemia during the first trimester (p < 0.05). There was an increase in the deterioration of visual acuity up to blindness due to the progression of this microangiopathy in cases of proliferative retinopathy. There was a significant increase of the mean diastolic blood pressure (mdp) and preeclamptic symptoms occurred in 71% of the cases with severe microangiopathy (p < 0.05). Deterioration of the diabetic nephropathy with excessive proteinuria (> 10 g/d) and unmanageable hypertension or a progression of the retinopathy led to an earlier delivery in 80% of the patients (p < 0.05). A high rate of preterm deliveries (39%) and a frequent occurrence of intrauterine growth retardation's (9%) characterised the fetal outcome. The following examinations for a patient with an open family planning, if diabetes is diagnosed during childhood or the course of the disease is between 10 and 15 years, should be done: Ophthalmological evaluation, control of the renal function, contraceptive advice and an improvement of the metabolic situation. In case of a diabetic nephropathy in combination with hypertonus the patients shoud be warned against pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Kinetocardiotocographic and Doppler ultrasound findings before termination of risk pregnancies].

42 pregnancies complicated by severe intrauterine growth retardation (IUGR) were monitored between 1991 and 1992 with the kinetocardiotocogram (K-CTG) comparing them with normal pregnancies of the same gestational age. We evaluated the foetal movements and the heart rate patterns establishing a correlation with pulsed Doppler ultrasound findings. There was a significant reduction of foetal activity in cases of IUGR and pathological Doppler sonography (p < 0.01). The reduction of foetal movements was noticed several days prior to pathological FHR patterns. There was a significant reactivity after vibroacoustical stimulation (VAS) correlating with the Doppler findings. The evaluation of foetal movement patterns in the kinetocardiotocogram proved to be an important complementary method in the monitoring of severe IUGR.

Abortion, Eugenic↗

[Prenatal determination of lung maturity from amniotic fluid--indications and new methods].

Although fetal lung maturity determination is carried out more and more rarely in the German-speaking area, a reliable information about the degree of lung maturity is still very important in the care of high-risk pregnancies. The side effects and costs of a postpartal surfactant administration can be avoided if lung maturity is proved. Indications for determination of fetal lung maturity are the threatening preterm delivery and the premature rupture of membranes before the 34th week of gestation and uncertain gestational age. Furthermore, in preeclampsia resp. in diabetes mellitus, which is difficult to control, premature delivery may be necessary. To improve lung maturity testing we introduce a new "sequence scheme" containing three lung maturity tests which are easy to carry out (in the following sequence: Amniostat-FLM ultrasensitive, counting of the lamellar bodies in amniotic fluid, surfactant/albumin ratio with TDx-FLM). The principle of this scheme is, that if any of these three tests indicates lung maturity, the sequence is terminated and no further test is performed. Only if all three tests indicated immaturity, the child was at risk for RDS. In 87 amniotic fluid samples with 7 RDS-cases, we achieved high predictive values for lung maturity (specificity 90%, sensitivity 100%, predictive value of positive test 47%, predictive value of negative test 100%). In 62% only one test was needed for lung maturity determination. It is possible to use other combinations in such a scheme (e.g. the L/S ratio). This might lead to equal or perhaps better results. An advantage of this suggested "sequence scheme" is that it can be performed in any clinic.

Amniocentesis↗

Thromboxane A2 analogue U 46619 enhances tumour cell proliferation in HeLa cells via specific receptors which are apparently distinct from TXA2 receptors on human platelets.

In this study, we have demonstrated for the first time by using U 46619, a stable analogue of thromboxane A2 (TXA2), that TXA2 exerts a cell proliferative effect on HeLa cells which is mediated by specific TXA2 receptors, inasmuch as the cell proliferation could be dose-dependently suppressed by TXA2 receptor antagonist BM 13177. The investigation of the phospholipase C pathway by U 46619 and prostaglandin H2 (PGH2) in the presence and absence of BM 13177 in cells with or without pertussis toxin pretreatment, as well as radioligand receptor binding studies, revealed that, in contrast to TXA2 receptors on human platelets, where TXA2 and PGH2 share the same receptor binding sites, HeLa cells possess distinct receptors for TXA2 and PGH2.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗

Pharmacokinetics of fenoterol in pregnant and nonpregnant women.

The pharmacokinetics of the beta 2-adrenergic drug fenoterol, which is used as a tocolytic agent in pregnancy, has been investigated in pregnant (n = 9) and nonpregnant (n = 5) women during a constant rate intravenous infusion. Clearance and mean residence time were found to be 1990 (1879/2220; Median, Q25/Q75) ml/min and 9.2 (8.0/14.0) min in the pregnant and 2126 (1915/2130) ml/min and 16.6 (16.5/32.1) min in the nonpregnant women, respectively. In addition, fenoterol clearance was estimated in 88 women from a single blood sample collected at steady state during IV therapy and the effect of gestational age on clearance was studied. Clearance displayed large interindividual variation. There was no apparent correlation between clearance and gestational age. We conclude that there is no need to adjust the dose on pharmacokinetic grounds in the course of pregnancy.

Adult↗

Local therapy of malignant pleural effusion with mitoxantrone.

Twelve patients received intrapleural instilments of the cytostatic agent mitoxantrone in a total dosage of 30 mg for locoregional palliative therapy of malignant pleural effusion. Effusion could be stopped for a mean period of 3.2 months in 11 patients.

Drainage↗

[Cytologic cancer prevention with smears of the uterine cervix and endocervical canal in pregnancy].

This study was performed to evaluate the importance of obtaining prepartum Papanicolaou smears routinely. 1,417 patients receiving pregnancy care had normal prenatal Pap smears. 88 (5.85%) had abnormal prepartum Pap smears. Thirteen (14.8%) of the abnormal smears showed squamous dysplasia, 2 (2.3%) showed an adenocarcinoma or squamous invasive carcinoma. The results of this study support the practice of performing Pap smears during prenatal care.

Female↗

[Cervix cytology in females with kidney transplants].

Cervical dysplasia has been reported to occur more frequently in female renal transplant patients. In a 4 year surveillance-period no new cases of dysplasia or invasive cancer were found by cytological or histological methods. Despite the low incidence of abnormalities the use of cytological screening is recommended, above all in the view of a slow progress of the disease.

Adult↗

[Diagnosis and therapy of hyperthyroidism in pregnancy].

In pregnancy hyperthyroidism occurs with a prevalence of 0.04-0.2%. It occurs even less frequently de novo in previously undiagnosed patients. Within a short period of time we treated 3 patients, who also developed signs of pre-eclampsia. Specific principles of the management during pregnancy are explained.

Adult↗

[New aspects of anticonvulsive therapy in severe pre-eclampsia and eclampsia].

Parenterally administered magnesium is a reliable and effective treatment to prevent and control convulsions associated with preeclampsia and eclampsia. Because of several side effects in the newborn, especially in the premature child, benzodiazepines are not recommended for prolonged medication. Clomethiazole has also been used with good acceptance, but clinical experience is limited. The anticonvulsive property of magnesium is not clearly understood. Beside a well known peripheral action by neuromuscular blockade through very high serum concentrations, a central mechanism is postulated already at lower levels. The two most widely used regimens of magnesium administration are the intravenous/intramuscular (i.v./i.m.) method popularized by Pritchard and the continuous intravenous (i.v.) route recommended by Zuspan. The concentrations of magnesium in the serum achieved with the i.v./i.m. regimen are significantly higher than those produced by the i.v. administration, especially in the first three hours after initiation of the treatment and if a maintenance dose of 1 g/h is chosen. Although therapeutic concentrations of magnesium effective to prevent seizures have been reported between 1.3 and 4.0 mmol/l, repeated convulsions are occasionally seen during i.v. regimen and at concentrations below 2 mmol/l. Because of this observation, a maintenance dose of 2 g/h and in some cases 3 g/h is required during the first hours of treatment. Side effects in mother and newborn are low, if there is no renal impairment and the treatment instructions are strictly followed. Respiration as well as urinary output have to be monitored at periodic intervals and the patellar reflex should be present. Calcium gluconate, 10 ml of a 10% solution, is an effective antidote in case of magnesium intoxication.

Anticonvulsants↗