Biomedical subjects

Martin Tepel

Publications and source records attributed to Martin Tepel.

40 records · Page 3Linked to original sources

PubMed2002

Acetylcysteine and contrast media nephropathy.

PURPOSE OF REVIEW: Radiographic contrast media are used at an increasing rate for several diagnostic and therapeutic applications. Therefore, contrast agent-induced nephropathy will become more important, including the risk of patient impairment and costs. The prevention of radiographic contrast-induced nephropathy is mandatory. Radiographic contrast agent-induced nephropathy is caused by vasoconstriction-mediated renal medullary ischaemia and direct toxic damage to renal tubular epithelial cells. These effects may be partly mediated by the generation of reactive oxygen species. Data from experimental studies indicate that antioxidants, e.g. acetylcysteine, may prevent radiocontrast-induced nephropathy. RECENT FINDINGS: Two prospective, randomized, placebo-controlled studies in patients with moderate renal insufficiency confirmed that the prophylactic oral administration of acetylcysteine, at a dose of 600 mg twice a day along with hydration, prevents the reduction in renal function after radiocontrast administration. SUMMARY: The use of acetylcysteine together with hydration is the treatment of choice to protect against radiographic contrast media-induced nephropathy.

Acetylcysteine↗

PubMed2002

Mean platelet volume and coronary heart disease in hemodialysis patients.

BACKGROUND: Mean platelet volume (MPV) has been shown to be an independent risk factor for myocardial infarction in the general population. METHODS: In the present cross-sectional study it was examined whether MPV may be associated with coronary heart disease (CHD) in patients in chronic hemodialysis treatment (n = 518). CHD was diagnosed if there was a history of myocardial infarction, coronary artery bypass grafting, or critical stenosis on coronary angiography. RESULTS: Mean platelet volume in hemodialysis patients was 8.22 +/- 0.06 fl. As compared with hemodialysis patients with a MPV <7.168 fl (the lower quintile limit), significantly more hemodialysis patients with a MPV >9.172 fl (the upper quintile limit) had CHD (odds ratio, 1.29; 95% confidence interval, 1.02-1.64). In a stepwise multiple logistic regression analysis MPV appeared to be an independent factor of CHD together with age, smoking, predialysis systolic blood pressure and serum triglyceride concentration. In a stepwise multiple linear regression model, MPV significantly depended on platelet count, volume of ultrafiltrate removed in one hemodialysis session, white blood cell count, treatment with beta blockers, heart rate, serum sodium and serum potassium concentrations. Additional measurements in 30 patients showed that MPV after a single hemodialysis session was not significantly different compared to predialysis values. CONCLUSION: From the present study it is concluded that MPV may be associated with CHD in hemodialysis patients.

Blood Platelets↗

PubMed2002

A rare cause of pulmonary-renal syndrome.

Diseases affecting both the lung and the kidney have grave prognosis and serious diagnostic and therapeutic consequences. Here, 3 cases of pulmonary-renal syndrome caused by antiphospholipid syndrome are reported. The patients presented with dyspnea, renal insufficiency, pulmonary infiltrates on chest X-ray and areas of ground glass attenuation on computed tomography of the lungs. There were no signs of infectious disease, vasculitis or myocardial insufficiency. Clinical findings, antiphospholipid levels and histological findings in transbronchial and/or renal biopsy proved the diagnosis of antiphospholipid syndrome. Antiphospholipid syndrome is a comparatively rare disorder which is relevant in the differential diagnosis of diseases affecting both lung and kidney and requires specific therapeutic measures.

Adult↗

PubMedDate not supplied

Noninvasive continuous monitoring of digital pulse waves during hemodialysis.

Intermittent hemodynamic instability during hemodialysis treatment is a frequent complication in patients with end-stage renal failure. A noninvasive method for continuous hemodynamic monitoring is needed. We used noninvasive digital photoplethysmography and an algorithm for continuous, investigator-independent, automatic analysis of digital volume pulse in 10 healthy subjects and in 20 patients with end-stage renal failure during the hemodialysis session. The reflective index was defined representing the diastolic component of the digital pulse wave. The properties of the reflective index were studied in healthy control subjects (n=10). An increased reflective index was due to increased peripheral pulse wave reflection (e.g., vasoconstriction). During a hemodialysis session, the reflective index increased significantly from 36+/-3 arbitrary units to 41+/-3 arbitrary units (n=20; p<0.05) measured using digital photoplethysmography. This increase appeared in 15 of the 20 patients with end-stage renal failure. Our data establish digital photoplethysmography as a noninvasive, reliable, and sensitive method for continuous monitoring during the hemodialysis session.

Aged↗