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Biomedical subjects

M Trop

Publications and source records attributed to M Trop.

At least 37 records · Page 2Linked to original sources
PubMed1990

Effect of acute burn trauma on reticuloendothelial system phagocytic activity in rats. II: Comparison of uptake of radiolabelled colloid and bacteria.

The uptake of radiolabelled colloid or bacteria was compared in normal rats and animals subjected to acute burn trauma. The uptake of colloid by the liver was unaffected by burn trauma, but uptake of the labelled bacteria was reduced. Spleen uptake of both colloid and bacteria was reduced by burn trauma while lung uptake was increased. These data are consistent with the hypothesis that acute burn trauma alters reticuloendothelial system phagocytic activity in the rat towards both inert particles and live bacteria.

Acute Disease↗
PubMed1990

Role of skin in the burn-induced reduction of reticuloendothelial phagocytic activity in rats.

Acute burn trauma has been demonstrated to depress reticuloendothelial system (RES) phagocytic activity, which could partially explain the development of septicaemia in burn patients. In the present study we have attempted to determine the role that skin plays in the depression of the RES. One group of Lewis rats was subjected to a 100 degrees C scald burn for 10 s. Eschar was then removed and implanted onto the backs of a second group of normal controls. A third group of Lewis rats were subjected to sham treatment; the eschar of these animals was removed and implanted onto the back of a fourth group of normal rats. The excision sites of the donor animals were immediately covered with Biobrane. Twenty-four hours later the technetium-99m sulphur colloid [( 99mTS]SC) method described earlier (Trop et al., 1989) was used to determine phagocytosis in these four groups of animals. Acute burn trauma produced a marked reduction in colloid uptake by the spleen and a marked increase in the uptake of colloid material by the lung, although no effect was observed on liver or kidney uptake. Implantation of the burn eschar into normal control rats had no statistically significant effect upon colloid uptake. These data suggest that alterations in phagocytic activity of the spleen and lung occur within minutes after burn injury and may be unrelated to the presence of the burn eschar itself.

Acute Disease↗
PubMed1990

Retrospective diagnosis of Jeune's syndrome in two patients with chronic renal failure.

Two patients are reported who presented at the age of 12 1/2 years with advanced chronic renal failure. Clinical findings and renal histology were consistent with nephronophthisis. The retrospective diagnosis of Jeune's syndrome was possible in both. Cone-shaped phalangeal epiphyses of hands and feet and metaphyseal chondrodysplasia of femoral heads and necks were the prominent findings on skeletal survey. One patient had a small bell-shaped thorax; in the other this aspect was present on reevaluation of neonatal X-rays. Our patients support the view that nephronophthisis is the principal cause of renal failure in Jeune's syndrome and that a wider awareness of this association could lead to detection of more so far unrecognized patients.

Asphyxia Neonatorum↗
PubMed1988

[Tasks and organization of a pediatric intensive care unit].

Paediatric intensive care medicine mainly involves infants during the neonatal period and, in particular, premature babies. 70% of the children on assisted ventilation at the paediatric hospital of Graz University in 1985 and 1986 were neonates. Older children needing mechanical ventilation comprised only 1.6% of the total number of patients at our paediatric hospital. Paediatric intensive care units are therefore almost exclusively neonatal care units. Otherwise when serving the needs of children beyond the neonatal period these units are mostly required by paediatric subspecialities (i.e. cardiology, burns unit etc.). In view of the small number of patients in this group a high-standard paediatric intensive care unit should be multidisciplinary and preferentially attached to a university hospital rather than a regional hospital so as to maximise experience in the management of these children and ensure optimal care.

Austria↗
PubMed1988

Vascular access for continuous arteriovenous hemofiltration in infants and young children.

The blood flow through the hemofilter device is the key point for ultrafiltrate production during continuous arteriovenous hemofiltration. It mainly depends on arteriovenous pressure gradient and vascular access, which is the major problem for arteriovenous hemofiltration in infants and small children. In infants, we inserted short 18-20 gauge catheters into the radial or brachial artery and the internal jugular vein and achieved mean blood flow and ultrafiltration rates of 6.5 +/- 2.2 and 1.3 +/- 0.3 ml/min, respectively. In small children, we placed 4 or 5 French catheters into the femoral vessels, and achieved mean blood flow and ultrafiltration rates ranging from 18.5 to 63.6 and 1.9 to 6.9 ml/min, respectively. The only catheter-related complication was a femoral artery thrombosis, which needed surgical revision. These results show that vascular access for arteriovenous hemofiltration in infants and small children provides sufficient blood flow through the device for ultrafiltrate production.

Blood Pressure↗
PubMed1988

Suction-supported continuous arteriovenous hemofiltration in children.

Spontaneous continuous arteriovenous hemofiltration (CAVH) may fail to control azotemia in small patients with renal failure due to poor blood flow. To produce adequate ultrafiltrate a continuous negative pressure was added to the ultrafiltrate line. Two hemofilter systems of different membrane and surface area were used. Suction support approximately doubled ultrafiltration rate in both hemofilters. No side effects such as severe hypotonia or early hemofilter clotting occurred. Added suction can serve as a useful support of spontaneous CAVH in children with renal failure and too poor a blood flow to control azotemia.

Acute Kidney Injury↗
PubMed1988

Anticoagulation for continuous arteriovenous hemofiltration in children.

Continuous arteriovenous hemofiltration requires continuous anticoagulation to prevent early hemofilter clotting. We used heparin given continuously in the arterial line of the extracorporeal circuit as anticoagulant in children with initially normal coagulation status, and heparin and/or prostacyclin in high-risk bleeding patients with preexisting coagulopathy. Heparin infusion enabled a mean running time of 22.2 +/- 9.6 h, with the 0.1-m2 hemofilter and of 26.6 +/- 4.7 h with the 0.25-m2 hemofilter. The mean filter running time with combined heparin/prostacyclin infusion was 31 +/- 8.8 h. Prostacyclin as the sole antithrombotic agent provided good filter function only in 1 patient with preexisting coagulopathy. No adverse effects such as bleeding thrombosis, or hypotension were observed.

Anticoagulants↗
PubMed1987

Continuous arteriovenous haemofiltration in children with postoperative cardiac failure.

Six children with refractory heart failure were treated by continuous arteriovenous haemofiltration. The cause of the failure was postoperative fluid overload or low cardiac output with anuria or oliguria. This produced a mean (2 SD) negative fluid balance of 1.4 (0.6) ml/kg/h and reduced mean (2 SD) body weight from 4.7 (2.2) to 4.2 (2.3) kg over a period of 57.5 (31.1) hours. Central venous pressure fell significantly from 13.7 (3.1) to 7.7 (0.7) mm Hg while the mean (2 SD) arterial pressure increased significantly from 44.6 (5.5) to 52.6 (5.1) mm Hg. In three infants urine production resumed when normal blood volume had been achieved. The other three infants needed further haemofiltration because of prolonged renal failure. All but one was weaned from artificial ventilation and catecholamine treatment. No adverse haemodynamic effects were noted. One child need operation for a femoral artery thrombosis after 12 days of continuous arteriovenous haemofiltration.

Female↗
PubMed1987

Continuous arteriovenous hemofiltration in critically ill children with acute renal failure.

Last year, five critically ill children with acute renal failure were treated by continuous arteriovenous hemofiltration. Mean treatment duration was 326 +/- 89 (SD)h, for a total of 1632 h. Mean ultrafiltration rates of 5.4 +/- 1.7 ml/min X m2 achieved mean serum urea levels of 150 +/- 25 mg/dl and a decline of mean prehemofiltration serum creatinine level of 3.5 +/- 3.6 to 2.9 +/- 2.0 mg/dl posthemofiltration. Continuous arteriovenous hemofiltration allowed adequate parenteral nutrition with a mean caloric intake of 79.6 +/- 9.2 kcal/kg X day. In the four surviving patients, urinary output started between 12 and 42 days after the onset of acute renal failure. Continuous arteriovenous hemofiltration is a very effective extracorporeal therapeutic system to control azotemia, fluid, and electrolyte balance in critically ill children with acute renal failure and hemodynamic instability.

Acute Kidney Injury↗
PubMed1987

[Continuous arteriovenous hemofiltration in childhood. Indications and technics].

CAVH is an extracorporal treatment modality by which fluid and solutes can be removed from the body by convective transport. Without using a blood pump the blood passes through the hemofilter driven only by the arteriovenous pressure gradient. From May 1985 to October 1986 18 critically ill children with a mean age of 5.1 years (range 10 days to 18 years) and a mean body weight of 20.8 kg (range 3 to 80 kg) were treated by CAVH. Indications for CAVH were: acute renal failure, multiple organ system failure, diuretic-resistant hypervolemia, interstitial pulmonary edema, electrolyte disorders, and metabolic crisis in maple syrup urine disease. Five different hemofilter systems with a membrane surface of 0.015 m2 to 0.6 m2 and an extracorporal filling volume of 9 to 70 ml were used. Mean duration of CAVH was 132 h (range 10 to 432 h), for a total time of 2344 h. Mean ultrafiltration rates ranged from 0.34 +/- 0.1 (SD) ml/min (Amicon Minifilter 0.015 m2) to 9.1 +/- 1.47 (SD) ml/min (Gambro FH55 0.6 m2). The application of a continuous negative pressure of 200 mmHg onto the ultrafiltrate line the ultrafiltrate increased from 3.96 +/- 0.62 (SD) ml/min to 13.4 +/- 1.63 (SD) ml/min. CAVH allowed good compensation of azotemia in critically ill children with acute renal failure, rapid correction of severe hypervolemia, interstitial pulmonary edema, electrolyte disorders, and metabolic crisis in maple syrup urine disease. It was well tolerated by all children. The only complication due to hemofiltration was a femoral artery thrombosis which needed surgical revision.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1987

Arteriovenous hemofiltration in children with multiple organ system failure.

In the last year nine critically ill children with multiple organ system failure (MOSF) were treated by continuous arteriovenous hemofiltration (CAVH). The mean number of organ systems involved was five per patient (range 4 to 7). Mean duration of hemofiltration was 136 hours (range 10 to 432 h.). Mean ultrafiltration rates of 6.4 +/- 3.0 ml/m2 b.s./min achieved mean serum creatinine levels of 2.39 +/- 1.49 mg/dl. Hypervolemia and pulmonary edema were corrected rapidly by CAVH. Total parenteral nutrition with a mean caloric intake of 62 +/- 15 kcal/kg b.w./day was provided throughout the hemofiltration period. In addition high ultrafiltration rates allowed delivery of large amounts of i.v. medications. CAVH is an ideal extracorporeal renal replacement system to control azotemia, fluid, electrolyte, and acid-base status in critically ill children. It carries the potential to improve survival rate in children with MOSF.

Adolescent↗
PubMed1987

Continuous arteriovenous renal replacement therapy.

As urea and creatinine clearances achieved by continuous arteriovenous hemofiltration tend to be low, efforts were made to increase urea and creatinine elimination by modifying the original continuous arteriovenous hemofiltration system. We investigated the urea and creatinine clearances of different continuous renal replacement therapy systems. Urea clearance achieved by spontaneous arteriovenous hemofiltration was 9.1 ml/min, suction-supported arteriovenous hemofiltration 15.3 ml/min, arteriovenous hemodiafiltration 15.4 to 19.3 ml/min, arteriovenous hemodialysis 18.9 to 22.1 ml/min. Creatinine clearances ranged between 11.1 (spontaneous arteriovenous hemofiltration) and 25.1 ml/min (arteriovenous hemodialysis). Continuous arteriovenous hemodialysis seems at present to be the ideal renal replacement therapy system to compensate azotemia in hypercatabolic patients. Its urea and creatinine clearances are high, its clinical tolerance good and it is simple and safe.

Child↗
PubMed1986

Arteriovenous haemofiltration in hypervolaemia.

Arteriovenous haemofiltration was used for removal of fluid overload in a 9 month old burned infant with diuretic resistant hypervolaemia. After 60 hours of arteriovenous haemofiltration hypervolaemia had disappeared. Arteriovenous haemofiltration proved to be a safe and simple extracorporal method of managing severe fluid overload.

Blood↗
PubMed1986

Pilot study of the efficacy of spent grain dietary fiber in the treatment of constipation.

Spent grain is the crude fiber obtained by decanting the fermented distillate of barley. The spent grain was processed to yield dietary fiber composed of: cellulose and hemicellulose 65.6% (by weight), lignin 5.2%, pectin 2.2%, protein 10.9% and lipid 8.0%. Biscuits and scones were prepared by 25% substitution of wheat flour by fiber, yielding 7 to 8 g fiber per biscuit/scone. Nineteen ambulatory patients with chronic, laxative-dependent constipation were treated in a pilot study for 4 weeks with 20 to 25 g fiber daily. Fifteen patients (79%) showed improvement in some or all of five factors, while four patients were largely unresponsive to fiber. Specific symptoms improved as follows: bowel movement frequency in 15 patients (79%), flatulence in 12 (63%), abdominal pain in 10 (53%), stool consistency in 8 (42%) and laxative dependence in 14 (74%). A 4-week post-treatment follow-up showed a return to prefiber status in 11 of 13 improved subjects. This preliminary study suggests a role for spent grain fiber in the treatment of constipated patients, and a comparative study with placebo and wheat fiber is now warranted.

Adult↗
PubMed1985

[Combined propyphenazone and codeine poisoning in childhood (analysis of 6 patients with Spasmoplus poisoning)].

The case histories are presented of 6 patients with accidental poisoning by Spasmoplus suppositories. The main toxic constituents are codeine and the pyrazolone derivative, propyphenazone. All patients had symptoms of codeine intoxication with somnolence, miosis and oedema, 2 patients had also symptoms of prophyphenazone intoxication with hypotension, coma and convulsions. 1 patient died during the acute stage in a state of shock, with arrhythmia, and asystole.

Aminopyrine↗
PubMed1984

[Mortality and morbidity of newborn infants in intensive care (birth weight less than 1,501 grams)].

A comparative analysis of the mortality and morbidity of premature infants with a birthweight below 1.501 g, born in the years 1974, 1978 and 1981, is given. The mortality rate has remained unchanged in the years 1974 (when a neonatal intensive care unit was installed at the University Children's Hospital Graz) and 1981 with 33% and 32% respectively. The total number of admissions rose from 36 (1974) to 67 (1978) and 91 (1981). Simultaneously the number of patients, who needed neonatal intensive care increased. Whilst in 1974 only 2 of 24 surviving infants needed artificial ventilation, in 1978 19 of 38 patients had respirator therapy. Despite the increasing severity of neonatal affections the number of severe handicaps caused by perinatal complications remained constantly low with altogether 5 cases in the years 1978 and 1981. Two children had a spastic tetraplegia, two others had a posthaemorrhagic hydrocephalus and one child was blind due to bilateral septic abscesses of the vitreous body. Only two of these children had long time artificial ventilation. Approximately 80% of the surviving children exhibited normal psychomotor development and showed no neurological sequelae. This rate was unchanged in the investigated periods.

Child↗
PubMed1983

[Life-threatening hypernatremia caused by faulty preparation of fully adapted infant formula].

Two male newborns developed severe life threatening hypernatremia with serum sodium levels of 181 and 196 meq/l respectively. Both children were fed a two-to fivefold concentrated powdered infant formula since birth. Shortly before admission diarrhea developed in both patients. The children were admitted during the third week and fourth week respectively, of their lifes with clinical signs of severe hyperosmolar dehydration. In both, treatment of shock was instituted and was followed by rehydration therapy. Great care was taken to lower serum sodium by not more than 15 meq/l/day in order to prevent cerebral edema. Inspite of these measures, the first patient developed cerebral seizures 5 hours after initiation of fluid replacement. The patient was intubated, and measures aimed at prevention of cerebral edema were started (hyperventilation). The eventual outcome was satisfactory, on follow up the patient showed no signs of persistent cerebral damage. In the second patient the same management was started from the beginning and no cerebral problems occurred. Restoration of stable body functions with a normal electrolyte status was achieved within five days.

Brain↗