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Biomedical subjects

M Sedlacek

Publications and source records attributed to M Sedlacek.

8 recordsLinked to original sources
PubMed2001

Hemodialysis access placement with preoperative noninvasive vascular mapping: comparison between patients with and without diabetes.

We retrospectively analyzed data on preoperative vascular mapping in 195 consecutive patients to investigate the common belief that patients with diabetes are poor candidates to have an arteriovenous fistula placed as dialysis access because they lack suitable blood vessels. There was no difference in venous diameter, arterial diameter, and arterial peak systolic velocity measurements between patients with and without diabetes. Patients with diabetes had a greater prevalence of vascular calcifications and greater cuff measurements of systolic segmental arterial pressure. In 140 of 195 patients, subsequent vascular access surgery had been performed in our institution, and 127 of these patients were on hemodialysis therapy at the end of the study period. There was no difference in the prevalence of fistula placement (66% versus 60%; chi-square = 2.6; df = 2; P = 0.28, not significant [NS]) and percentage of functioning fistulae between patients with and without diabetes (67% versus 62%; chi-square = 0.27; df = 1; P = 0.61, NS). The percentage of patients dialyzed through a temporary catheter was equal in patients with and without diabetes (18%). In summary, patients with diabetes seem to be as good candidates for arteriovenous fistula placement as patients without diabetes. Additional studies are required to determine the long-term outcome of fistulae in patients with diabetes.

Arteries↗
PubMed2000

Relationship between phosphorus and creatinine clearance in peritoneal dialysis: clinical implications.

Elevated serum phosphorus levels are associated with increased morbidity and mortality in dialysis patients. To study the determinants of serum phosphorus levels and phosphorus clearance, we measured phosphorus concentrations in 24-hour collections of dialysate and residual urine output during routine urea kinetics in 56 peritoneal dialysis patients. Dietary records were used to estimate oral phosphorus intake, and the net gastrointestinal absorption of phosphorus was determined measuring the amount of phosphorus excreted in 24 hours. Dialysate to plasma ratios of phosphorus and creatinine were very similar, and the peritoneal clearances of phosphorus and creatinine correlated well and were of the same magnitude. High transporters in the peritoneal equilibration test had greater phosphorus and creatinine clearances than low transporters. In patients with residual urine output, the renal clearances of phosphorus and creatinine also correlated well. Comparing two groups of patients with a similar Kt/V of 2 and greater but different levels of creatinine clearance, either greater or less than 60 L/wk, the patients with the greater creatinine clearance also had a greater phosphorus clearance (7.0 +/- 2.2 versus 4.3 +/- 0.7 mL/min/1.73 m(2)) and significantly lower serum phosphorus levels (4.8 +/- 0.9 versus 5.9 +/- 1.4 mg/dL) despite a greater daily amount of phosphorus absorption (490 +/- 190 versus 336 +/- 100 mg/d). In summary, creatinine clearance measurements provide a good estimate of phosphorus clearance and how much dietary phosphorus and therefore protein can be tolerated.

Creatinine↗
PubMed1999

Carboxyhemoglobin and lactate levels do not correlate in critically ill patients.

Endogenous carbon monoxide (CO) is produced in the degradation of heme by heme oxygenase. Studies have shown that hypoxia induces heme oxygenase production of CO in vascular tissue. Because elevated plasma lactate levels are associated with tissue hypoxia, we determined if there was any correlation between lactate and carboxyhemoglobin (COHb) levels in a group of critically ill patients with a high likelihood of hypoxia. In a 7.5-month period, 5322 simultaneous arterial COHb and lactate measurements were performed routinely on 183 patients with a blood gas analyzer in the Department of Veterans Affairs Medical Center, Bronx, New York, Surgical Intensive Care Unit. Sixty-one percent of the patients had elevated lactate levels (> 2.5mmol/L), and 46% had elevated COHb levels (> 1.5%). Lactate levels ranged from 0.12 to 22.7 mmol/L and COHb levels from 0% to 4.8%. There was no correlation between lactate and COHb levels (r = .07 with P < .0001). Levels of endogenous CO do not increase in situations in which lactate production is increased. It is possible that changes in endogenous production of CO may not significantly affect the circulating level of COHb. Although readily available, COHb levels do not seem to be clinically useful as markers of critical illness.

Animals↗
PubMed1982

Anterior bulbus perforation and vitrectomy in the 'minipig'.

Wound healing after experimental anterior eye perforation, including lens, ciliary, body and vitreous, was studied in 12 miniature pigs (minipigs). In half of the eyes, perforation was followed by removal of the damaged lens and suturing of the wound. In the other half, a primary subtotal vitrectomy was performed after removal of the lens. The behaviour of the connective tissue in the wound-healing process was not fundamentally changed by subtotal vitrectomy. In both groups very little fibrous ingrowth into he vitreous structure was observed, suggesting that the pig vitreous has marked antifibroplastic properties. The anatomical and technical features of vitrectomy in the minipig, and the advantages and disadvantages of this animal model are discussed. It appears that the eye of the minipig is ideal for the study of biochemical factors preventing fibrous ingrowth into the vitreous.

Animals↗