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Biomedical subjects

K Balzer

Publications and source records attributed to K Balzer.

At least 73 records · Page 4Linked to original sources
PubMed1987

[Treatment of hypertensive crises with nifedipine (Adalat) in patients at risk of infarct during interventions on the extracranial cerebral vessels].

Nifedipine (Adalat) was used in managing acute hypertension in 20 patients with coronary heart disease during endarterectomy for carotid stenosis. Nifedipine (Adalat) was given if the cardiac index dropped below 2.5 l/min and the total peripheral resistance increased above 2,500 dyn/sec cm-5. In these patients the systolic blood pressure was 20% higher than the control value. After IV bolus injection of 1 mg nifedipine we noticed a 64% increase of the stroke volume index and a statistically significant 56% decrease of the total peripheral resistance. These values became stable under a maintenance dose. The left ventricular stroke work index increased after IV bolus injection and subsequently, by about 7%. This increase was statistically not significant. To evaluate the myocardial contractility, the heart rate and systolic pulmonary capillary wedge pressure were measured. After greatly raised values in hypertensive emergency, these parameters showed a 27% decrease following IV bolus injection and during the subsequent intraoperative course they stabilised at standard levels. The heart rate increased by about 10%, but this was statistically not significant. In accordance with the increase in heart rate, the coronary perfusion pressure decreased by about 31% (expressed in mm Hg) (mean value) and dropped even lower in some patients. The parameters for preload, central venous pressure and pulmonary capillary wedge pressure did not show any statistically significant changes. The authors conclude that nifedipine (Adalat) can be used with good results in treating hypertensive emergencies associated with low-output syndrome in patients with coronary heart disease during carotid endarterectomy.

Adult↗
PubMed1986

[Asymptomatic carotid artery stenosis: when should one--when must one--when should one not operate].

More differentiation than in the past is necessary for the indication of surgery in asymptomatic carotid stenosis. Surgery is indicated in the case of high-degree stenosis (above 80%) before major surgery, rapidly increasing stenosis--especially filiform stenosis--and if non-characteristic complaints are associated with cerebrovascular insufficiency or suspicious CT. Symptomatic carotid stenosis, however, requires surgical treatment. Unilateral asymptomatic stenosis below 70% requires careful observation and no surgery, particularly if the patient is older than 70 years. Surgical experience as well as collaboration with other disciplines are basic requirements.

Carotid Artery Diseases↗
PubMed1986

Epidemiology of gallstones in a German industrial town (Essen) from 1940-1975.

The prevalence of gallstones was studied in 11,840 consecutive autopsies from 1940 to 1975 in the University hospitals of Essen. The total prevalence was 20.7%: 13.1% for men and 33.7% for women. The male to female sex ratio is 1:2.6. The crude prevalence for three 12-year periods showed a significant increase from 8.2 to 15% in men and from 25.7 to 36.3% in women (p less than 0.001). A detailed analysis showed that this increase occurred only in the age groups over 60 and was the consequence of the fact that a greater proportion of women over 60 came to autopsy. The age- and sex-specific morbidity ratio was calculated to standardize the data. This demonstrated considerable fluctuations in 3-year periods since 1940. It can be concluded that no real increase in the prevalence of gallstones occurred in the last 30 years.

Adult↗
PubMed1985

[Function tests of the lower small intestine with 75selenium-labeled homotaurocholic acid in Crohn disease and resections of the small intestine].

UNLABELLED: Faecal excretion of bile acids was investigated using 75Se-homotaurocholic acid (75SeHCAT) in a total of 75 patients: 9 with irritable colon, 58 with Crohn's disease and 8 with small-bowel resection due to various indications but without Crohn's disease. Bile acid malabsorption, taken as a pathological bile acid retention of less than 19%, was found present in 43 patients with diseased terminal ileum or with more than 20 cm resection of this organ, except in one case (12 cm). On the other hand a normal bile acid retention (21 to 27%) was found in 29 of 72 patients (including 9 patients with irritable colon) who showed either no radiologically detectable lesion of the ileum (n = 21) or changes involving an extension of up to 30 cm (inflammation or resection) in the terminal ileum (n = 8), with the exception of one case (50 cm). Three patients had a raised bile acid excretion contrary to clinical expectation: they had colitis Crohn without radiologically detectable involvement of the small intestine. Thus using the 75SeHCAT-retention test it seems possible to recognize functional disorders in diseased segments of the bowel before the appearance of radiologically detectable changes. CONCLUSION: 75SeHCAT is a suitable substance for investigations on the function of the lower small intestine.

Adolescent↗
PubMed1985

Effect of rifampicin treatment on hepatic drug metabolism and serum bile acids in patients with primary biliary cirrhosis.

Six patients with primary biliary cirrhosis (PBC) were treated with a daily oral dose of 600 mg rifampicin for 2 weeks to induce the hepatic metabolism of drugs and bile acids. On rifampicin 5 of 6 patients experienced a pronounced decrease of their pruritus. In all patients the oxidative cytochrome P-450 dependent drug metabolism was induced as shown by an increase of antipyrine-clearance from 36.3 +/- 8.8 to 80.6 +/- 20.1 ml/min and an enhanced urinary excretion of 6-beta-hydroxycortisol from 454 +/- 1.99 to 1607 +/- 362 micrograms/24 h. Furthermore, in all 6 patients the serum alkaline phosphatase declined. In the 3 cholestatic patients (bilirubin greater than 1.0 mg/dl) the serum concentration of total and conjugated bile acids was strikingly reduced. Thus, rifampicin is an inducer of hepatic metabolism in PBC-patients, ameliorates the pruritus and can lower serum concentrations of alkaline phosphatase and bile acids.

Adult↗
PubMed1985

Hereditary pancreatitis. Presentation of an additional family.

A West German family with hereditary pancreatitis is described. Four members are definitely known to have had pancreatitis, while three additional members are suspected of having the disease. The mean age of onset of symptoms was 14 years. Known causes of secondary pancreatitis and amino aciduria were ruled out in each case. HLA-segregation was analysed on the A, B, C, and DR loci in all members of the family, but no coupling between distribution of HLA haplotypes and incidence of pancreatitis was detected.

Adult↗
PubMed1985

[Demographic and social characteristics of patients with Crohn disease in an urban area. A study with neighborhood hospital controls].

120 patients with Crohn's disease were matched for age and sex with a control group out of the neighbourhood (NK) and a second control group out of the hospital (HK). In a personal interview the marital status, the educational attainment, the professional status and the status of invalidity were registered: Marital status, professional status and educational state were not different. Patients with Crohn's disease had higher qualification in medium school types (32,5% against 21,7% in NK and 23,3% in HK, p less than 0,05). Invalidity was significantly higher in Crohn's disease with 17,5% against, 3,3% in NK and 1,7% in KK (p less than 0,001).

Achievement↗
PubMed1985

[Severe malabsorption syndrome and exudative enteropathy in hypogammaglobulinemia: complete involution with intravenous immunoglobulin substitution].

A 35 year old woman with primary hypogammaglobulinaemia developed intestinal villous atrophy, a severe malabsorption syndrome, osteomalacia and protein-losing enteropathy. The syndrome did not respond to treatment with antibiotics, vitamins, or gluten free diet. Regular intravenous administration of a native immunoglobulin preparation induced continuous elevation of IgG serum levels above 240 mg/dl. This led to rapid, complete and persistent normalisation of all clinical symptoms and pathologic findings. Additional therapy was not required. Side effects of the treatment that has now been maintained for 48 months were not observed.

Adult↗
PubMed1984

[Etiology of hyposiderinemia and anemia in Crohn's disease].

UNLABELLED: In a prospective study the frequency of anaemia and serum iron deficiency was investigated in 373 patients with Crohn's disease. Anaemia was present in 52% of patients, hyposiderinaemia in 37%. Involvement of the colon resulted in more pronounced anaemia and hyposiderinaemia than in pure ileitis. For further assessment of iron metabolism serum ferritin or iron binding capacity as well as intestinal iron absorption were determined in 34 patients both anaemic and hyposiderinaemic. In 22 patients sideroachrestic anaemia due to inflammation was found, 5 patients showed iron deficiency due to bleeding. In 6 patients simultaneously lowered serum iron and ferritin or increased latent iron binding capacity with non-increased iron absorption indicated relative iron absorption defects. In one case also the absolute intestinal iron absorption was decreased. However, in only one of these 7 patients typical microscopic changes of Crohn's disease were demonstrable in the upper intestine. CONSEQUENCES: 1. Anaemia in Crohn's disease is most frequently caused by inflammation (sideroachrestic anaemia). 2. In colonic involvement the anaemia can be aggravated by iron deficiency due to bleeding. 3. In rare cases part of the anaemia can be due to iron absorption defects which need not necessarily be associated with macroscopic recognizable mucosal damage.

Adolescent↗
PubMed1984

Buflomedil in arterial occlusive disease: results of a controlled multicenter study.

In a double-blind, randomised multicentre study buflomedil, a vasoactive substance, was compared with placebo in the treatment of 93 patients with chronic arterial occlusive disease. After a run-in period of four weeks the patients received either buflomedil (600 mg daily) or placebo over 12 weeks. The pain-free and the total walking distances improved significantly in both groups. However, the differences in the improvement between the two groups were highly significant and in favour of buflomedil: for the pain-free walking distance p less than 0.001 and for the total walking distance p less than 0.01. The results indicate that buflomedil has a beneficial effect on the symptoms and lengthens the walking distance in patients with arterial occlusive disease.

Aged↗
PubMed1983

[Stenosis of the internal carotid artery with contralateral occlusion--primary vascular operation of externo-internal bypass?].

Among 2135 patients undergoing vascular surgery of the carotid artery, 144 revealed a stenosis of the internal carotid in combination with an occlusion on the contralateral side. Temporary inlying bypass shunts to support cerebral circulation during the endarterectomies were employed when technically feasible. The mortality among the in-patients amounted to 3.47%. Postoperative permanent neurologic deficits did not appear. During the follow-up period lasting between 1 month and 9 years 6.5% had further TIA's or strokes. Approximately 90% of the patients remained without neurologic symptoms. Neurosurgeons generally recommend a prophylactic external-internal bypass, prior to the removal of the stenosis of the internal carotid artery. According to our experience the primary objective should be the reconstruction of the stenosed artery, particularly since complications in primary external-internal bypassed occur in an average of 3-4%.

Arterial Occlusive Diseases↗