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Biomedical subjects

J F Moskovtchenko

Publications and source records attributed to J F Moskovtchenko.

At least 55 records · Page 3Linked to original sources
PubMed1986

Atracurium in patients with renal failure. Clinical trial of a new neuromuscular blocker.

Atracurium was given to 30 patients with terminal chronic renal insufficiency, in two regimens. Group I (20 patients) received a single dose of 0.6 mg kg-1 and group II (10 patients), received one or several injections of 0.2 mg kg-1. Tracheal intubation was performed with ease in all patients 3 min after the injection of atracurium. A supramaximal stimulus was applied to the ulnar nerve at wrist level, and thumb adduction force was recorded. Muscular blockade was 100% in 29/30 patients and 95% in one. Mean time between atracurium injection and reappearance of 25% of the initial muscular power (HT25) was 49 min. The recovery time index (IR25-75) was 12 min and did not increase after re-injection. No side-effects were observed and no significant differences in any of the measurements made were seen between the two groups.

Adult↗
PubMed1985

[Retroperitoneal fibrosis and generalized scleroderma].

A Raynaud's phenomenon was observed in a 72 year-old man affected by progressive systemic sclerosis. Few months later, the patient was readmitted to the Hospital because of acute renal failure, and a retroperitoneal fibrosis was first suspected on the basis of typical urinary tract alterations, and subsequently confirmed at the post-mortem examination. Such association does not appear fortuitous on histological data, but it has been rarely described. HLA B27 antigen is not always present. Symptomatic therapy includes association between prednisone and percutaneous nephrostomy.

Aged↗
PubMed1985

[Survival of patients in acute renal failure: effect of nutrition and its associated complications].

A retrospective study of 150 patients with acute renal failure (ARF) was conducted to assess the influence of both protein and caloric intake and non-renal complications on the prognosis, as well as the predictive value of plasma protein levels. The majority of ARF had occurred in medical or surgical settings (46% and 32.7%, respectively). Nutritional data were available from 94 patients, fed either by parenteral or enteral routes, or both. The mean caloric intake was higher (29 kcal/kg/day) in patients who recovered than in those who did not (24 kcal/kg/day, p less than 0.01). A caloric intake above 35 kcal/kg/day resulted in an improved survival, independently of either patients' age or non-renal complications. Serum prealbumin and transferrin levels were higher in surviving patients than in those who died, 0.25 vs 0.16 g/l (p less than 0.001) and 1.7 vs 1.4 g/l (p less than 0.01), respectively. Nutritional support in ARF could be adapted according to the variations of these serum markers. Its influence on survival should be assessed with regard to the associated prognosis factors.

Acute Kidney Injury↗
PubMed1978

[Deliberate self-overdose with propranolol. Changes in serum levels (author's transl)].

Suicidal attempt using beta-blockers are rare. Overdose by the ingestion of a large number of tablets rarely exceeds the high therapeutic doses suggested for the treatment of certain resistant cases of hypertension. The case described is that of a 65-year-old patient who took 800 mg of propanolol. Observation of plama levels showed that the half-life propanolol in the case of overdose is prolonged: 8.6 hours in this case, with a maximum plasma level of 1536 ng/ml. Plasma renin activity levels were low during the phase of intoxication and showed evidence of a rebound effect at its end. Treatment is above all that of the circulatory insufficiency produced: isopropylnoradrenaline or glucagon. Indications for extra-renal dialysis should take into account knowledge concerning the pharmacokinetics of these drugs and their prolonged physiological action.

Aged↗
PubMed1977

[Acute renal failure after cardiac surgery under extracorporeal circulation].

Acute renal failure (ARF) following cardiac surgery under extra-corporeal circulation is a grave but infrequent complication. Numerous physiopathological factors accounting for its origin are analyzed, those related to ECC and those of the immediate post-operative period. The course of these cares of ARF and the elements of the treatment are looked at.

Acidosis↗
PubMed1977

[Pseudo-late onset cutaneous parphyria in haemodialysis patients. Clinical and histological features. 9 cases (author's transl)].

In the context of a study of cutaneous problems seen in chronic renal failure patients on intermittent haemodialysis, the authors noted bullous eruptions very similar to late onset cutaneous porphyria. The bullae occur during the summer and are situated on exposed areas, in particular the head and neck. There is skin fragility and the bullae are transient, giving place to erosions and later to atrophic scarring. Even pseudo-miliary cysts have been observed. Histology reveals a sub-epidermal bulla, the basis of which consists of spiky papillary dermis. Immunofluorescence show immunoglobulin deposits in the vessels and basal membrane. All porphyrin measurements are negative. This disorder may be due to the presence of a non-porphyrinogenic photo-sensitising substance, found in certain types of plastic tubing.

Adult↗
PubMed1976

[Classification of corticoids].

A pharmacological classification of corticoids can be carried out, based on the ratio of their glucocorticoid and mineralocorticoid activities. Their large number is due to the fact that they are practically all synthetic, and that minimal modifications in their structure gives rise to new drugs with variable gluco and mineralocorticoid activity.

Adrenal Cortex Hormones↗
PubMed1975

[Study of the criteria of evaluation of the exercise capacity of the chronic hemodialyzed subject].

Direct measurement methods (or the forecast related to indirect measurements) of the maximal oxygen uptake are reviewed. 15 patients suffering from renal failure, performed a total of 28 exercises. One can draw the conclusion that the maximum VO2 is inferior in these subjects to the values usually determined in normal healthy subjects of the same age. This decrease can be significantly correlated with the haematocrit. Comparison between direct measurement methods of the maximal oxygen uptake and indirect methods allowing its forecast from the heart rate, shows that only direct methods are to be used in these patients.

Adult↗
PubMed1971

Infection in acute renal failure.

The results are reported of the incidence, severity, and description of infectious complications in 646 cases of acute renal failure (ARF). Infection was felt to represent an important cause of ARF in 34% of the cases. However, the frequency and extent of the infection varied according to the biologic classification. It was present constantly in postabortion ARF, was frequent in medical and in postoperative ARF, and was rare in traumatic and postpartum ARF. The renal lesions vary according to the cause of the infections. Staphylococcus septicemia, leptospiral infections, and rickettsial infections are the causes of interstitial nephritis; whereas gram-negative septicemia, probably via infectious shock, leads more readily to tubular lesions. Hemolytic septicemias most often cause tubular necrosis, although this is usually reversible. When the initial clinical picture is complicated by disseminated intravascular coagulopathy, bilateral cortical necrosis is a distinct possibility. During the established phase of ARF, infections are equally frequent, whether primary or secondary. The most frequent complications are septicemia and bacteremia--or local complications, most often pulmonary or urinary tract infections. The organisms are mainly Staphylococcus (often mephicillin-resistant) and gram-negative, usually E. coli. The most effective treatment is a combination of cephalothin and gentamicin. Pseudomonas infections are the most difficult to treat. The frequency of these serious infections and the difficulty with antibiotic therapy, often dangerous in renal insufficiency, stress the importance of preventive treatment of prophylactic measures. Infection was primarily responsible for 19% of the deaths in our series and may be also largely responsible for some of the persistent residual renal functional impairments.

Abortion, Spontaneous↗