PubMed Health⌕ Search

Biomedical subjects

L M Schmidt

Publications and source records attributed to L M Schmidt.

18 recordsLinked to original sources
PubMed2004

House dust mite control measures for asthma.

BACKGROUND: The major allergen in house dust comes from mites. Chemical, physical and combined methods of reducing mite allergen levels are intended to reduce asthma symptoms in people who are sensitive to house dust mites. OBJECTIVES: To assess the effects of reducing exposure to house dust mite antigens in the homes of people with mite-sensitive asthma. SEARCH STRATEGY: Cochrane Airways Group trials register, and PubMed and The Cochrane Library (last searches June 2004), reference lists. SELECTION CRITERIA: Randomised trials of mite control measures vs placebo or no treatment in asthmatic people known to be sensitive to house dust mites. DATA COLLECTION AND ANALYSIS: Two reviewers applied the trial inclusion criteria, assessed their quality and extracted the data independently. Study authors were contacted to clarify information. MAIN RESULTS: Forty-nine trials (2733 patients) were included; the number of patients has more than doubled since the last version of this review. Thirty-one trials assessed physical methods, ten assessed chemical methods, and eight a combination of chemical and physical methods. Despite the fact that many trials were of poor quality and would be expected to exaggerate the reported effect, we did not find an effect of the interventions. For the most frequently reported outcome, peak flow in the morning (1339 patients), the standardised mean difference was -0.02 (95% confidence interval (CI) -0.13 to 0.08). There were no statistically significant differences either in number of patients improved (relative risk 1.01, 95% CI 0.80 to 1.27), asthma symptom scores (standardised mean difference -0.01, 95% CI -0.10 to 0.13), or in medication usage (standardised mean difference -0.05, 95% CI -0.18 to 0.09). REVIEWERS' CONCLUSIONS: Chemical and physical methods aimed at reducing exposure to house dust mite allergens cannot be recommended. It is doubtful whether further studies, similar to the ones in our meta-analysis, are worthwhile. If other types of studies are considered, they should be methodologically rigorous and use other methods than those used so far, with careful monitoring of mite exposure and relevant clinical outcomes.

Allergens↗
PubMed1999

Biodegradation of low aqueous concentration pentachlorophenol (PCP) contaminated groundwater.

Bioremedial treatment to remove low level organic contamination to regulatory standards has met with limited success. In this study source water from a contaminated surficial aquifer at a former wood treatment facility was used to evaluate the potential for indigenous microorganisms to degrade low level (< 1.0 mg) pentachlorophenol (PCP) to a regulatory drinking water standard of 0.001 mg/L. PCP degradation was evaluated in series of batch reactors in a two phase study to (a) determine the rate and extent of PCP removal and (b) evaluate the impact of nutrient amendment (N and P) on removal rate. All reactors with the exception of the abiotic control demonstrated PCP removal to a level < 0.002 mg/L within a maximum period of 32 d with and without nutrient amendment. A regression analysis of reactive phosphate (ortho-P) concentration versus removal rate produced an R2 of 0.94 (p = 0.006) indicating a significant correlation between the level of available phosphate and PCP degradation rate. Selective bacterial enumeration (for PCP degrading bacteria) revealed PCP-degrading bacteria increased in abundance prior to and in conjunction with the degradation phase to a density of between 10(3) to 10(4) CFU/ml. Isolates were also analyzed for total fatty acids using Fatty Acid Methyl Ester (FAME) methodology and the results indicated that PCP degrading bacteria were present in the aquifer and consisted of predominately fluorescent, oxidase positive Pseudomonas species. Overall, data indicate that autochthonous microbes are capable of removing low level PCP (< 1.0 mg/L) to approach if not reach the regulatory standard of 0.001 mg/L with the addition of oxygen, with or without nutrient amendment. Results of this research can be applied to full-scale implementation of in-situ or ex-situ bioremediation of groundwater at former wood treatment facilities.

Bacteria↗
PubMed1993

Home visit effectiveness for peritoneal dialysis patients.

Medicare regulations require follow-up home visits to home dialysis patients, yet routine home visits require a lot of personnel time. The effectiveness of home visits was evaluated by a nurse, dietitian and social worker using a questionnaire. Thirty-six patients were evaluated during an 18-month period. Collectively the team documented an average of 10 pertinent observations per visit and made an average of 4 recommendations for change. Staff members gained new information about the patient as indicated by the fact that they changed their rankings on 5 of 15 parameters following the home visit. The home visit policy that recommended an annual home visit was revised to recommend a single home visit for each new peritoneal dialysis patient. Further visits are performed only if significant problems are identified.

Adult↗
PubMed1993

Roentgenographic densitometry of bone adjacent to a femoral prosthesis.

A digital imaging method was developed to quantitate the stress-related changes in roentgenographic bone density after total hip arthroplasty. A technique termed "histogram-directed equalization" was used to compensate for differences in postimaging data caused by the effects of variable quality obtained from ten patients. Quantitative change due to variation in delivered energy was decreased by 7% for roentgenograms obtained with a 2 kVp variation and 31% for roentgenograms obtained with a 4 kVp variation. The method allowed the authors to accurately describe the changes observed on annual postoperative roentgenograms obtained over the past decade. The utility of the method was demonstrated in 15 of the senior author's long-term cases treated with fully porous-coated implants. These cases were divided into two groups based on the diameter of the prosthetic stem implanted in each case. Five patients were grouped with small-diameter stems and ten with large-diameter stems. Both groups showed substantial decrease in roentgenographic bone density (from 11% to 28%) in the medial and lateral proximal regions. The large-diameter group had an overall larger decrease in roentgenographic bone density at two and five years. Roentgenographic bone remodeling changes were most pronounced in the first two years. Changes between two and five years progressed at a slower rate. The results also confirmed the predicted effect of stem diameter on bone remodeling patterns.

Absorptiometry, Photon↗
PubMed1991

The peritoneal equilibration test: a nursing discussion.

The peritoneal equilibration test is used to assess peritoneal membrane permeability. Results provide a reliable estimate of peritoneal clearances and ultrafiltration rates. This information can be used to make decisions about the preferred dialysis prescription. Repeat tests may be used to evaluate clinical changes. The first part of this two-article series will discuss the clinical interpretation of findings and three case studies. The second article will describe the procedure.

Cell Membrane Permeability↗
PubMed1991

How to do a peritoneal equilibration test.

This article, part 2 of a 2-part series, describes the process and procedures used to perform a peritoneal equilibration test. Data from the test may be used to assess the peritoneal membrane permeability. Knowledge of peritoneal membrane permeability may be useful in selecting a treatment regimen and in determining the appropriate dialysis prescription.

Cell Membrane Permeability↗
PubMed1991

What effect does glucose have on measured creatinine in the peritoneal equilibration test?

Very high glucose concentrations falsely elevate measured creatinine. An appropriate correction factor may be applied to obtain an accurate creatinine value; however, the glucose interference is of a low magnitude in most dialysate samples at a 4-hour dwell time. Clinical interpretation of the peritoneal equilibration test using uncorrected creatinine values to determine the dialysate-to-plasma ratio at 4 hours is associated with minimal error.

Colorimetry↗
PubMed1990

Tidal peritoneal dialysis with racemic or L-lactate solutions.

UNLABELLED: To see if rapid lactate absorption on tidal peritoneal dialysis (TPD) would overwhelm D-lactate metabolism using racemic lactate and/or L-lactate metabolism using all L-lactate, five patients underwent 8-h TPD treatments with racemic lactate solution one day and with L-lactate another. Lactate concentrations (total) were 40 mmole/L, flow rates 27.3 L/8 h, tidal and reservoir volumes each 1.5L, tidal cycles 24-26 min, and net ultrafiltration per tidal cycle 70 to 99 mL. RESULTS: Mean absorptions of D and L-lactate were 24.2 and 25.1%, respectively, compared to glucose at 14.6%. Urea clearances averaged 21.4 mL/min. Mean blood D-lactates at baseline were 0.6 +/- 0.5 SD mmole/L and after 8 h of TPD were 0.6 +/- 0.4 and 0.7 +/- 0.3 using L-lactate and racemic solutions, respectively; similar values for L-lactate were 1.2 +/- 0.3 at baseline and 1.2 +/- 0.3 and 1.2 +/- 0.5 after 8 h with L-lactate and racemic solutions. delta blood pH values were + 0.02 +/- 0.01 and + 0.04 +/- 0.03, while delta bicarbonate values were + 1.7 +/- 0.9 and + 0.7 +/- 1.0 for the all L and racemic studies, respectively. The total mmoles of L-lactate absorbed per 8 h of TPD with all L solution (greater than 300 mmoles) are greater than ever reported for peritoneal dialysis, but did not increase blood lactate levels. It would seem that either type of solution is suitable for TPD. Absorptions and metabolic rates are similar for L-Lactate and D-Lactate.

Adult↗
PubMed1989

Long-term increase in peritoneal membrane transport rates following incidental intraperitoneal sodium hypochlorite infusion.

A patient on continuous ambulatory peritoneal dialysis using an "O" set connection system with sodium hypochlorite as a disinfectant incidentally infused the disinfectant intraperitoneally on two occasions. The product of peritoneal membrane permeability and peritoneal membrane surface area increased after both infusions as judged by peritoneal equilibration test results and/or serum chemistries. Elevated peritoneal solute transport rates and reduced ultrafiltration gradually subsided but did not return to preinfusion values. This observation suggests that intraperitoneal sodium hypochlorite infusion may cause significant long-term alteration in peritoneal membrane transport characteristics.

Dialysis Solutions↗
PubMed1989

Effectiveness of a phosphorous educational program for dialysis patients.

Fifty-four percent of all dialysis patients followed by a single center had elevated serum phosphorus levels on more than 25% of all measurements. A phosphorus patient education program was developed and implemented and knowledge was measured with a pretest and posttest. The continuous ambulatory peritoneal dialysis group had a significant increase in knowledge and a minor, but statistically significant, decrease in serum phosphorus after participating in the education program. In contrast, center hemodialysis patients did not demonstrate a significant increase in knowledge or decrease in serum phosphorus. These different outcomes could not be attributed to specific differences between the two groups. Serum phosphorus control is a complex process, and this education program did not result in a clinically significant improvement in serum phosphorus levels.

Adolescent↗
PubMed1986

Continuous ambulatory peritoneal dialysis for psoriasis. A report of four cases.

Four patients with psoriasis were treated with continuous ambulatory peritoneal dialysis (CAPD). Two were being treated for renal failure; the other two had normal renal function and were being treated exclusively for psoriasis. With CAPD at a rate of three to four exchanges per day, the psoriasis cleared completely in the two patients with renal failure and improved in the other two. In the patients without renal failure, low-flow peritoneal dialysis (one exchange per day) seemed to be of some value in maintaining remission but was ineffective in treating more active disease. Long-term therapy (greater than or equal to 12 weeks) with three or four daily exchanges may be needed for initial complete remission, and continuous treatment may be needed to prevent relapse. Thus, CAPD shows promise for the study of psoriasis and may be a last-resort treatment for severe, disabling cases.

Adult↗
PubMed1976

Warts: their diagnosis and treatment.

Warts are common skin lesions caused by a papova virus. Their clinical appearance is variable. There is no definitive therapy. Therapy must be individually modified to get the best result with the least discomfort to the patient. Most warts will spontaneously resolve after an average of two years, so any therapy that has serious side effects or results in scarring should not be used. New modes of therapy, particularly immunotherapy, look promising but are still in the experimental stage.

Adolescent↗
PubMedDate not supplied

Chronic nightly tidal peritoneal dialysis.

Nightly tidal peritoneal dialysis (NTPD) is a technique in which, after an initial fill of the peritoneal cavity, only a portion of dialysate is rapidly cycled. Five anuric, stable, PD patients entered a 4 month study to determine the NTPD session length necessary for clinically adequate dialysis and creatinine clearance similar to those on four daily 2 L CAPD exchanges. NTPD was performed using a modified PAC-X-2 cycler, with the drain phase regulated by a target volume. One patient completed 3.5 months of study, one 4 months, three 6 months, and one patient each continued on NTPD for 13, 14, and 32 months. The mean NTPD session time was 9 hr 24 min (range 8 hr 35 min to 9 hr 55 min) at the end of 4 months. All patients had clinically adequate dialysis. Three patients preferred NTPD over CAPD, particularly because of an empty abdomen during the daytime. One patient required an increase in NTPD time, and an addition of one daytime exchange, because of low creatinine clearance. In conclusion, NTPD provides weekly creatinine clearances comparable to CAPD, with an acceptable duration of nightly dialysis sessions in most anuric patients. A new PD machine providing inexpensive dialysis solution in large quantities, as well as safe and false alarm free dialysis sessions, is needed for practical NTPD implementation.

Blood Urea Nitrogen↗