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Biomedical subjects

K Sevela

Publications and source records attributed to K Sevela.

10 recordsLinked to original sources
PubMed2006

[Contrast medium induced nephropathy].

Contrast medium indicated nephropathy (CMIN) is a iatrogenic disorder by which patients become inflicted due to contrast medium exposure. Prevalence of this disorder might increase as more and more diagnostic and intervence radiology has been used. The article is focused on known pathofysiological mechanisms that are responsible for CMIN incidence. There are many risk factors guided by more frequent development of this complication, in particular diabetes mellitus, preexisting renal disease, hypertensis. Plus, the risk of CMIN is much higher in patients with risky medication. Measures to prevent contrast nephropathy coincidence are mentioned; however, some of them require more support and evidence in studies. The possible incidence of CMIN has to be taken into account and prevented by respective measures.

Contrast Media↗
PubMed2006

[Risky medication and contrast media-induced nephropathy in patients with diabetes and hypertension].

Contrast media-induced nephropathy (CMIN) is accompanied by high morbidity, lengthy hospitalization, and a higher mortality rate. In proportion to the rising number of diagnostic and interventional radiological procedures, the prevalence of this complication is also rising The study briefly tackles the currently known pathophysiological mechanisms that lead to CMIN and deals with various risk factors which increase the probability of development of contrast nephropathy. Among these factors are, in the first place, diabetes mellitus, a pre-existing renal illness and hypertension. In addition, the risk of developing CMIN significantly increases in patients on risky medication. In our study, this medication was a combination of ACE-inhibitors (ACEI) and furosemide. Even though none of the patients met the criteria defined for CMIN, radiocontrast examination showed a significant statistical decline in glomerular filtration (GFR) and a rise in proteinuria (PU) in the sub-group which used this combination of medication. The risk level of this medication especially in patients with pre-existing nephropathy is also underlined by the suggested dependency of the relative rise in the serum levels of creatinine in terms of its input value. It is necessary, as early as the radiocontrast examination is being done, to bare in mind the possibility of CMIN occurring and avoid it also through the modification of the risk factors which can be influenced, e.g. elimination of risky medication and in indicated cases, taking preventive measures.

Aged↗
PubMed1999

[Effect of ACE-inhibitors on changes in creatinine in the blood-- introduction].

In a retrospective study a total of 44 ambulatory examinations were made before enalapril was administered to 13 patients with essential hypertension and 52 ambulatory examinations during enalapril treatment of these patients. All patients were followed up on a long-term basis: 1. without enalapril treatment (2-24 months), 2. during enalapril treatment (4-24 months). For both investigation periods arithmetic means of plasma creatinine were calculated. The length of the investigation period was intentionally used as the sole criterium for inclusion in the group of patients. In nine patients during treatment the serum creatinine levels rose. The authors found a close positive correlation between the rise of plasma creatinine levels and the patients' age (correlation coefficient r = 0.59, n = 13, p < or = 0.02). Between the rise of creatinine (dependent variable) and independent variables (daily enalapril dose, initial creatinine blood level, the drop of the median arterial pressure during enalapril treatment) no close relationships were found. The rise of creatinine during enalapril treatment can be explained by a drop of the filtration pressure in the glomeruli during dilatation of the vas efferens. This drop of the filtration pressure was manifested by a slight increase of plasma creatinine only in patients with a drop of the renal perfusion (haemodynamic) reserve, i.e. in more advanced age groups.

Aged↗
PubMed1996

[Phthalic acid esters and the human body].

Phthalic acid esters have been used for its softening and plastification effects as additives to various kinds of products: colours, paintings, glues, cosmetic products, inks, repellents, films, PVC-derived products including medical disposable PVC products. The authors present a basic review of literature on toxicologically important sources including medical disposable products. They refer about the deleterious effects on the mammalian organism, possibilities to replace phthalic acid esters by other softening and plasticizing remedies as well as the use of such kinds of materials, which do not require these additives.

Animals↗
PubMed1996

[Clinical use of infusion pumps with rotors in occlusive tracts].

The authors used in clinical practice an infusion pump driven by a rotation system with an occlusive pathway whereby the movement of the rotor is ensured by a stepper with reduction of the steps to 12,800 microsteps per revolution. As regards the degree of mechanical damage of the inserted tube of the infusion set this system did not differ from the keyboard system which is used by the majority of manufacturers as the driving unit of infusion pumps. Mechanical damage of the infusion set made from PVC was evaluated by the authors with regard to the amount of phthalic acid extracts which are added to PVC as softening agents and are not chemically linked. The authors recorded an increase of the temperature of the infusion solution during the flow through the driving unit in both investigated systems, however, the increase was smaller in the keyboard system. The increase of temperature was, however, in both instances small and has no impact on clinical practice. Contrary to the infusion pump with the keyboard system, the infusion pump with a rotor in an occlusive pathway and a microstep motor (12,800 microsteps per revolution) was significantly more accurate as regards dosage (evaluated as the difference between the required and actually achieved value of flow). The revealed difference was statistically significant at the 1% level. This greater precision of dosage can be ascribed to the point compression of the inserted and to the microvibrations transmitted from the rotor to the inserted tube of the infusion set which helps to recover after every compression the original volume (circular shape of section) of the inserted tube.

Diethylhexyl Phthalate↗
PubMed1996

[Phthalic acid esters in the peritoneal cavity of patients treated with continuous ambulatory peritoneal dialysis].

A solution for peritoneal dialysis stored in bags made from material which does not contain diethylhexyl phthalate is significantly less contaminated with this plasticizer, as compared with a solution stored in bags made from PVC with diethylhexyl phthalate. The afferent tube which contains diethylhexyl phthalate in all sets investigated by the authors is not an important source of this plasticizer for the peritoneal solution. Contamination of the peritoneal solution with dibutyl phthalate added to colours used for print on the bags (inscription on the outside of the bag) was found in both types of bags (no significant differences were found). It may be thus assumed that dibutyl phthalate penetrates through the wall of both types of bags with the same intensity. This applies only, provided that the peritoneal solution is not contaminated with dibutyl phthatate during preparation, before it is filled into bags. After six hours instillation in the peritoneal cavity diethylhexyl phthalate and dibutyl phthalate was not detectable in the peritoneal solution (detection limit 0.5 microgram/l). They are completely retained and metabolized resp. in the patient's peritoneal cavity.

Ascitic Fluid↗
PubMed1996

[Evaluation of factors affecting the formation of thrombi in hemoperfusion columns].

The formation of thrombi in the haemoperfusion column is undesirable as it deprives the patient of blood elements and reduces the eliminating capacity of the haemoperfusion column. This applies in particular to patients with acute intoxications treated by haemoperfusion. In experimental haemoperfusions in animals the authors provided evidence of a close correlation between thrombus formation in the haemoperfusion column and the number of stops of the blood flow in the course of individual experimental haemoperfusions. The period of stops was always 1.5 min. A further even closer correlation was found only between the formation of thrombi in the haemoperfusion column and the products of the number of stops of the blood flow (and the total period of arrests of the blood flow resp.) and the pressure gradient on the blood pump (difference of actual pressure readings before and beyond the blood pump). This gradient differed in every haemoperfusion but was constant during operation. It was induced and maintained by means of mechanical keys on the tube of the suction set. The objective of the work was to evaluate the influence of blood pressures in the area of the blood pump on the process of blood clotting in the haemoperfusion column. The blood flow, another factor influencing the intensity of blood clotting in the haemoperfusion column, was therefore the same in all experiments and constant in the course of their implementation. The extent of thrombus formation was evaluated after completed haemoperfusion and destruction of the cover of the haemoperfusion column by quantitative assessment of protein nitrogen referred to the weight of the adsorbent. The authors maintain that poor suction of blood, which precedes in clinical practice forced arrest of the circulation promotes the process of thrombus formation in the haemoperfusion column.

Animals↗