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Biomedical subjects

J W Merkus

Publications and source records attributed to J W Merkus.

14 recordsLinked to original sources
PubMed1991

Assessment of hemodynamic changes in human kidney grafts induced by cyclosporin infusion.

Cyclosporin A (CyA) nephrotoxicity is at least partly caused by the vasoconstrictive action of the drug. In this study we set out to assess this hemodynamic effect of CyA on Doppler spectra obtained in arteries of human renal allografts. Doppler spectra of renal arteries were obtained shortly before and after the start of CyA infusion in renal transplant recipients. Doppler spectrum analysis revealed a significant change in several spectrum-derived parameters. Tmax (acceleration time of the systolic frequency peak), in particular, showed a decrease after 4 h of CyA administration (106 +/- 58 ms vs 76 +/- 36 ms in segmental arteries; P less than 0.05). On day 2 the Tmax returned to its original value (117 +/- 57 ms). Thus, Doppler spectrum analysis enables one to detect temporary hemodynamic changes in the transplanted kidney following CyA administration. These observations may be useful in differentiating causes of renal dysfunction by Doppler spectrum analysis in clinical transplantation.

Cyclosporine↗
PubMed1991

Detrimental effect of acute renal failure on the survival of renal allografts: influence of total ischaemia time and anastomosis time.

In a retrospective study the incidence and consequences of acute renal failure were evaluated in 324 renal transplantations performed in our centre. The overall incidence of acute renal failure was 31.2%. In recipients with acute renal failure, patient and graft survival were significantly worse than in those without acute renal failure (P less than 0.02 and P less than 0.0001 respectively). Acute renal failure also increased the morbidity during the first 3 months after transplantation. Three months after transplantation renal function as determined by serum creatinine and proteinuria, was less satisfactory. Factors influencing the incidence of acute renal failure appeared to be: match grade on the AB locus, percentage of antibodies, duration of dialysis, number of blood transfusions prior to transplantation, anastomosis time and total ischaemia time. Recipients transplanted for the first time were less likely to develop acute renal failure, but also for this group total ischaemia time was a prognostic factor for the development of acute renal failure. When recipients were allocated to different classes of total ischaemia time it appeared that the incidence of acute renal failure differed, especially between groups with total ischaemia time 32-36 h (27%) and 36-40 h (38%). The difference in acute renal failure between these groups was also reflected in a difference in graft survival for total ischaemia time less than 36 h and greater than 36 h. Thus, it appears that acute renal failure has a detrimental effect on graft survival and postoperative morbidity in renal transplantation. Total ischaemia time is one of the prognostic factors for the development of acute renal failure. To improve renal transplantation results it is worth attempting to shorten total ischaemia time.

Acute Kidney Injury↗
PubMed1985

[Drug utilization in 3 nursing homes for somatic patients].

An investigation was carried out of the drug-use of 198 patients in three nursing homes. Almost 80% of the patients used 2 to 7 drugs. The average number of drugs per patient relating to regular medications for internal use was 4,36. It was 5,25 when p.r.n. medications and medications for external use were also included. The most frequently used drugs were psychotropics, analgetics, cardiac drugs, diuretics and laxatives. Combinations of drugs (including alcohol) that can lead to interaction, were often prescribed. The following combinations were found to have the highest frequency: two drugs with anticholinergic action, digoxin with a potassium-loosing diuretic, two or more drugs which can cause hypotension. The number of patients with one or more of these combinations as well as the number of combinations per patient increased in correspondence with drug-use per patient.

Aged↗
PubMed1984

[Constipation in the elderly. II. Prevalence and causes of the use of laxatives and experiences with volume expanders and lactulose in nursing home patients].

A study in a nursing home in the Netherlands confirmed findings from previous studies that a high percentage of geriatric patients use laxatives. This applies especially to patients taking antidepressants or hypnotics in combination with other psychotherapeutic agents or suffering from a neurological disease or to those who are rather inactive. Our study shows that it is possible for the large majority of geriatric patients using other laxatives to switch to bulk laxatives. This changing-process requires appropriate instructions and demands close attention. Eventually it will result in the normalisation of the patients' defecation, to the daily relief not only of the patient but also of the nursing staff.

Aged↗
PubMed1984

[Constipation in the aged. I. Significance, prevalence, causes and treatment].

There is no reason to assume that in old age defecation is different from younger people. Old people who are sound and active often have normal defecation. Their intestinal transit time has been shown to be normal. Nevertheless about fifty percent of the elderly use laxatives. In the very old and in institutions the use is even more frequent. The main cause of this real or supposed constipation is the lack of dietary fibre in the food. In the aged constipation can have dangerous complications, e.g. acute mental confusion, urinary retention, urinary incontinence and fecal impaction. Treatment may include general measurements, the addition of bulk-laxatives to the diet and the prescription of other laxatives. The use of laxatives other than bulk-laxatives may cause many harmful side-effects in the aged. The daily food must contain sufficient dietary fibre. Failing this one can use bran, preparations of psyllium or lactulose syrup.

Aged↗
PubMed1969

[Diuretics].

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Diuretics↗