PubMed Health⌕ Search

Biomedical subjects

K Marczewski

Publications and source records attributed to K Marczewski.

27 records · Page 2Linked to original sources
PubMed1991

Three years of experience with the swan-neck Tenckhoff catheter.

In a retrospective study over three years, 23 patients were provided with a swan-neck Tenckhoff catheter (SNC) and 49 patients (control group) with a straight Tenckhoff catheter (STC) at the beginning of CAPD and were observed over a follow-up period of 608 patient-months. The aim of the study was to examine the reduction of complications in the course of CAPD with SNC resulting from technical causes, such as catheter dislocations, infections at the catheter's point of exit, the tunnel and the peritoneum. The causes of renal insufficiency, the reasons for choosing CAPD as a dialytic procedure, the causes of catheter loss as well as the frequency of infections associated with CAPD were analyzed. The main reasons for catheter loss were peritonitis and dislocations. In the SNC group a significant reduction of dislocations to 8.7% was observed as against 26.5% with STC. On the other hand, with SNC significantly more cases of peritonitis were observed in terms of statistics, with 1.1 episodes per patient-year (EOP/PY) compared with 0.3 EOP/PY with STC. The frequency of the exit site and tunnel infections and the cumulative survival probability of the catheters did not differ. The SNC is an interesting alternative to the STC; however, the expectations were only partly met.

Catheterization↗
PubMed1991

[Renal failure--concepts for drug therapy in intensive care].

This article describes concepts of drug treatment for patients with severe renal failure (creatinine clearance less than 10 ml/min), especially in intensive care. These subjects often develop multiorgan failure and require special considerations: 1. Not only should the maintenance dose of digoxin be reduced to 0.05-0.1 mg/day, but the loading or digitalizing dose should also be diminished to 0.4-0.6 mg. 2. Penicillins, cephalosporins, quinolones, and other antibiotics with a high therapeutic ratio can be given as recommended by the manufacturer or reference lists according to renal insufficiency. 3. For drugs with a low therapeutic index, such as aminoglycosides, vancomycin, flucytosine, some antiarrhythmic agents, cardiac glycosides, and theophylline, therapeutic drug monitoring is mandatory. 4. Steroids, insulin, atropine, catecholamines, anticoagulants, thrombolytic agents, antihypertensive drugs, and organic nitrates can be given according to their effect. However, nitroprusside should be discontinued after 2 days because its metabolites may be toxic. 5. The dose of H2-receptor antagonists used for the control of gastric acidity and the treatment of peptic ulcers should be reduced to 20-50% of the normal. The administration of aluminum, magnesium, and bismuth compounds should be avoided. 6. Loop diuretics (e.g., furosemide) can be effective at increased doses in patients with chronic renal failure and fluid overload, particularly when used in combination with a thiazide in refractory edema. Thiazides alone are useless, and potassium-sparing diuretics are contraindicated. 7. Colloid-containing solutions should be infused cautiously at a maximal rate of 2 x 500 ml/week only when the plasma volume is contracted.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1990

[Arrhythmia in patients on dialysis treatment for chronic renal failure].

In 6 patients treated with repeated peritoneal dialyses 48-hour ECG monitoring was carried out. In no patient significant heart rhythm disturbances were demonstrated during the dialysis and 24 hours after its completion. On the ground of pathological results of Valsalva's manoeuvre function disturbances of the autonomic nervous system were disclosed but these showed no correlation with premature ventricular and supraventricular++ ectopic beats appearing periodically in some patients. The study showed that under conditions of sufficient control of electrolyte balance (especially potassium) the patients treated with peritoneal dialyses are not a group at risk for arrhythmia development.

Adult↗
PubMed1984

Leukopenia with different regenerated haemodialysis membranes.

The white blood cell count (WBC) decreases during haemodialysis and it was investigated as a function of different dialysis membranes. Each of them was used four times, applying different sterilization methods. Twelve chronic haemodialysis patients were studied and dialysed with cuprophan and polyacrylonitrile (PAN) membranes. Cuprophan was studied by a dry sterilization method and after perchloric acid and formalin treatment. PAN was studied with dry sterilization and after perchloric acid. As it has been shown, cuprophan membranes cause significantly more marked neutropenia than PAN. No significant difference was seen in pO2, pH, pCO2 and bicarbonate between dialysers used four times. The results indicate differences in biocompatibility between cuprophan and PAN membranes, independent of the sterilization method employed.

Acrylic Resins↗
PubMedDate not supplied

Human erythropoietin improves the blood platelet phospholipid composition in chronically hemodialyzed patients.

Phospholipids play an essential role in platelet structure and function. In uremic patients an abnormal platelet phospholipid pattern is observed. We examined the influence of recombinant human erythropoietin (rhuEPO) on platelet phospholipid composition in hemodialyzed patients. Before rhuEPO therapy, phosphatidylethanolamine, phosphatidylinositol, and phosphatidylcholine were significantly reduced as compared with a healthy control group. After rhuEPO treatment, the phosphatidylethanolamine, phosphatidylinositol, and phosphatidylcholine concentrations showed a significant increase. We conclude that rhuEPO partially normalizes the platelet phospholipid composition in uremia.

Adult↗