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Biomedical subjects

R Arendt

Publications and source records attributed to R Arendt.

At least 19 recordsLinked to original sources
PubMed1995

Increased psychological distress in post-partum, cocaine-using mothers.

This study investigated psychological symptoms, self-reported postpartum by poor, primarily African American women who used cocaine during pregnancy. Ninety-nine cocaine-using mothers (COC+) were compared to 44 noncocaine-using mothers (COC-) on standardized measures of psychological distress and verbal comprehension. Mothers were interviewed to determined extent of drug involvement. COC+ mothers reported using alcohol, marijuana, and tobacco at two to three times the rate of comparison mothers during pregnancy and reported earlier initiation of marijuana use. COC+ women were more likely to admit to interpersonal difficulties and to report phobic anxiety and paranoid ideational symptoms. The COC+ group was also more likely to have clinically elevated scores on subscales indicating feelings of personal inadequacy, phobic anxiety, and paranoia. The use of cocaine, in combination with either alcohol or marijuana, was the best predictor of psychoticism, hostility, and total number of distress symptoms.

Adult↗
PubMed1994

Direct and indirect interactions of cocaine with childbirth outcomes.

OBJECTIVE: To evaluate neonatal sequelae of maternal cocaine use during pregnancy. METHODS: One hundred women positive for cocaine use during pregnancy were compared with 100 matched controls who did not use cocaine. Maternal characteristics and infant neonatal outcomes were compared. We used t tests, chi 2, and multiple regression analyses to evaluate the contributions of cocaine vs other drugs to outcome. RESULTS: Cocaine was the best predictor of increased incidence of abortions, higher maternal gravidity, and poorer prenatal care. Cocaine was also the best predictor of preterm birth and of lower birth weight, after controlling for prematurity. Maternal use of cocaine and alcohol in combination was the best predictor of decreased linear growth, after controlling for prematurity. CONCLUSIONS: Maternal cocaine use predicts negative birth outcomes directly, as well as through obstetric risk factors of abortion history and less prenatal care. Interactive effects of cocaine and alcohol should be considered in future studies of birth outcomes.

Abortion, Spontaneous↗
PubMed1989

[Transpapillary endoprostheses in malignant and benign bile duct diseases].

During the last years the non-surgical drainage of the bile ducts developed to an efficient treatment method and is a real enrichment in the concept of treatment of the malignant obstruction of the bile ducts. In no more radically operable carcinomas in the area of the bile ducts, the pancreas or the porta of the liver it is to be preferred to a palliative drainage operation. In case the drainage of the bile ducts shall not be used therapeutically (through-drainage), an inner drainage in form of an endoprosthesis should always be preferred. As a procedure of the 1st choice the endoscopic retrograde technique is recommended, as procedure of 2nd choice the percutaneous transhepatic technique. Benign basic diseases are more infrequently the reason for the insert of a bile duct drainage. The main indications are general inoperability in non-extractable calculi in the common bile duct. In our own cases patients could be followed up up to 3.5 years. No complications were observed. The occlusion of prostheses does apparently not play a role.

Ampulla of Vater↗
PubMed1989

[Endoscopic perfusion manometry: diagnosis of functional biliary disorders].

During the last years the endoscopic perfusion manometry developed many new recognitions about the courses of pressure and motility at the sphincter Oddi. The clinical and experimental application of the method concentrated itself to the proof of functional disturbances. Many results are contradictory and a whole series of questions is unsolved. The own investigations concentrated themselves on pressure measurements in the common bile duct in patients with removed gallbladder, in whom by comprehensive diagnostic measures no organic disease of the biliary tract could be found. Two groups of patients were compared. Patients of group 1 (n = 14) had no biliary symptoms after cholecystectomy. The patients of the second group (n = 20) continued to have biliary complaints after cholecystectomy, or they again occurred after symptom-free interval. At the beginning of the investigation the pressure in the common bile duct was the same in the two groups. In group 1 the pressure remained constant also during the manometry and the patients remained without any complaints. However, in group 2 a gradual increase of pressure and biliary complaints developed during manometry. These occurred after an average pressure increase of 8 Torr. The velocity of the increase of pressure well correlated with the intensity of the complaints. The symptoms during manometry were identical with those cited in the anamnesis. The pressure increase in the common bile duct is regarded as an expression of a functional disturbance of the sphincter of Oddi. The constant perfusion rate (1.3 ml/min) in this group of patients is sufficient as volume load, in order to detect a disturbed drainage capacity of the papilla. On its part the increase of the pressure is responsible for the evocation of the complaints.

Ampulla of Vater↗
PubMed1989

[Biliary pancreatitis--pathogenesis, therapy, results].

According to current knowledge biliary (gallstone-associated) acute pancreatitis is induced by transient obstruction of the papilla by migrating gall stones. It seems, therefore, rational to remove the occluding stone as early as possible by endoscopic papillotomy (EPT). Uncontrolled studies have shown that patients with acute pancreatitis are not more endangered by EPT than those without pancreatitis and that the intervention seems to beneficially influence the course of the pancreatic disease. Early endoscopy (within 48 h), however, revealed incarcerated papillary stones only in 10% but common bile ducts free of stones in 24%. There seems to be only a small subgroup with acute biliary pancreatitis who might benefit from early EPT. This subgroup should be characterized more precisely. Early EPT indiscriminately performed in any kind of acute pancreatitis has little rational ground and is, up to now, not justified.

Acute Disease↗
PubMed1988

Inflammation of the hind limb as a model of unilateral, localized pain: influence on multiple opioid systems in the spinal cord of the rat.

Inoculation of the right hind paw with Mycobacterium butyricum rapidly led to swelling and inflammation. The afflicted limb showed an enhanced sensitivity to noxious pressure (hyperalgesia) and a reduced sensitivity to noxious heat 24 h following treatment. Both naloxone and MR 2266 (which has greater activity at kappa-opioid receptors) further increased the sensitivity to pressure (that is, potentiated the hyperalgesia) but did not affect the response to heat. They did not affect the response of the uninflamed paw. At 1 week, only MR 2266 was effective. At both 24 h and 1 week, the inflamed paw showed pronounced supersensitivity to the antinociceptive action of morphine against noxious pressure. At both 24 h and (to a greater extent) 1 week, a rise in levels of immunoreactive (ir)-dynorphin (DYN) was seen in the ipsilateral dorsal horn of the lumbar spinal cord. There was no alteration in the contralateral dorsal horn or in either ventral horn. Furthermore, levels of ir-met-enkephalin (ME) and ir-leu-enkephalin (LE) were unaffected. There was no difference in the density of mu-, delta- or kappa-binding sites in any part of the lumbar cord, at either 24 h or 1 week, between ipsilateral and contralateral tissue. By 3 and 5 weeks postinoculation, the symptoms had spread to the contralateral hind limb and ir-DYN was elevated in the contralateral dorsal horn and the ipsilateral ventral horn. At 5 weeks, levels of ir-ME and ir-LE also were increased in the ipsilateral and contralateral dorsal horns, but not in the contralateral ventral horn. Furthermore, levels of ir-DYN were increased in the cervico-thoracic spinal cord, and rats displayed adrenal hypertrophy and a rise in plasma levels of ir-beta-endorphin (beta-EP). These data indicate: (1) Peripheral inflammation localized to a single limb selectively modifies levels of ir-DYN in ipsilateral dorsal horn. The effect is specific to DYN as compared to ME and LE. The density of mu-, delta-, or kappa-receptors in the lumbar spinal cord is unmodified. (2) The altered response to opioid agonists and antagonists shown by rats with an inflamed limb may be selective to the injured tissue. (3) Alterations in opioid systems associated with unilateral hind limb inflammation may not be exclusively chronic in nature: they appear very rapidly (within 24 h) of the induction of pain. With time, the contralateral limb becomes affected and, eventually, the effects resemble those seen with generalized polyarthritis.

Animals↗
PubMed1988

[Pathophysiologic and clinical relevance of atrial natriuretic factor in patients with cirrhosis of the liver].

Defects of the ANF system in cirrhosis have not been demonstrated in terms of absolute deficiency of plasma levels or by evidence of major abnormalities of processing in patients with cirrhosis. In the present study, the responsiveness of the ANF system to acute volume stimulation by water immersion and the diuretic and natriuretic effects of ANF infusion were examined. Stimulation of ANF release by 1-h immersion was significantly blunted in ten cirrhotic patients with ascites (increase of plasma ANF by 46 +/- 18%), whereas 11 cirrhotics without ascites showed a 104 +/- 16% increase, similar to the 117 +/- 29% stimulation in 25 healthy controls. Immersion increased urinary volume by 3.6 +/- 0.6/2.0 +/- 0.8/0.7 +/- 0.4 ml/min and urinary sodium excretion by 146 +/- 38/75 +/- 43/43 +/- 19 mumol/min in controls/cirrhotics without/cirrhotics with ascites. Infusion of ANF for 30 min prompted an increase in diuresis and natriuresis in seven cirrhotic patients, which was less marked in patients with ascites, as compared to patients without ascites. Thus, the stimulus response coupling for ANF may be impaired in patients with cirrhosis and ascites.

Ascites↗
PubMed1988

[Effect of an antacid on duodenal pH in severe excretory pancreatic insufficiency].

pH was measured continuously in the lower duodenum before and 90 min after a standard meal in 15 controls and 13 patient with severe pancreatic insufficiency (PI); gastric acid secretion was unimpaired in all of them. 7 out of the 13 pat. with PI received additionally 30 ml of an A-Mg-silicate preparation (MegalacR) 45 min after the meal. Mean pH dropped after the meal from 6.9 to 6.2 in the controls and from 7.1 to 4.9 in the pat. with PI. The overall time of pH-values below 5 amounted to 0.5% of the measuring period in the controls, in PI-pat. to 35%. In pat. with PI there were additionally pH-values below 4 during 11% of the postcibal period. Antacid administration increased duodenal pH significantly but only over 15 min; this transient effect had, however, no significant influence on the overall time of the pH-values below 5 and 4. Al-Mg-silicate has obviously no relevant effect on the postcibal duodenal pH in pat. with PI and can therefore not be regarded as a means to prevent inactivation of pancreatic enzymes in the duodenum.

Aluminum Compounds↗
PubMed1987

Diffuse gastric antral vascular ectasia: cause of chronic gastrointestinal blood loss.

In a patient with long-standing iron deficiency anemia, diffuse gastric antral vascular ectasia was found endoscopically. Diagnostic problems were the misinterpretation of the macroscopic finding as hemorrhagic inflammation and the microscopic confirmation of the diagnosis from small biopsy particles. Resection of the antrum resulted in a persistent normalization of hematologic parameters. Focal ischemia due to microthrombi in mucosal vessels might be the cause of the tendency of this vascular malformation to bleed.

Adult↗
PubMed1987

[Interdigestive and postprandial duodenal pH in healthy probands, in patients with ulcer and in chronic pancreatitis].

In patients with chronic pancreatitis (48), gastric ulcer (6), duodenal ulcer (6) and controls (12) duodenal pH was measured continuously by a glass electrode before and 90 minutes after a standard meal. The capacity of the stomach to secrete acid was known in all test persons, the degree of exocrine pancreatic insufficiency was determined according to the results of the S-CCK-test: 6 had no, 29 moderate and 13 severe pancreatic insufficiency. There were no significant differences between the mean interdigestive duodenal pH of the groups. After a meal, however, even patients with a normal pancreatic function but with hyperchlorhydria had a significantly lower pH (mean pH 5.5) than those with normo-chlorhydria (mean pH 6.1) and hypochlorhydria (mean pH 6.5). In patients with severe pancreatic insufficiency and normo-/hyperchlorhydria duodenal pH was much lower (mean pH 4.2) in some cases to pH 3.5, thus well below a level known as inactivating pancreatic enzymes. The total duration of the pH being less than 4.5 amounted to 12% of the postprandial measuring time (11 of 90 min). If, however, severe pancreatic insufficiency was combined with a-/hypochlorhydria duodenal pH did not differ from controls. Thus, reduced acid secretion of the stomach exerts beneficial effect on duodenal pH in patients with severe pancreatic insufficiency.

Acid-Base Equilibrium↗
PubMed1986

[Pure human pancreatic juice. Methodologic aspects of pancreatic juice collection and interpretation of findings].

A procedure to collect pure pancreatic juice endoscopically is described which allows an instant estimation of the protein content of the secretion by measuring its absorption at 280 nm. By this the kinetics of protein secretion can already be read from a curve during the collecting procedure, thus avoiding a multitude of small fractions otherwise necessary. Timing and size of the samples are adjusted individually according to the course of protein secretion and not to a rigid regimen. The method described is especially apt to investigations of pancreatic proteins and substances the secretion of which parallels that of protein; e. g. trypsinogen, calcium and zinc, however not sodium and potassium.

Cholecystokinin↗
PubMed1986

[Endoscopic perfusion manometry of the common bile duct in the post-cholecystectomy syndrome].

In 14 cholecystectomized patients with recurrent attacks of pain endoscopic manometry of the c.b.d. was carried through after thorough exclusion of organic diseases. Two different conspicuous types of pressure behaviour became evident: In 8 pat. the pressure in the c. b. d. increased steadily during perfusion and finally triggered pain, identical to the spontaneous one according to localization and character. In 6 pat. even after prolonged perfusion no pain emerged and the c. b. d.-pressure remained unchanged. As the increase in c. b. d.-pressure connected with provocation of pain was reproducible, perfusion manometry in the c. b. d. seems to be a mean of delimitating and objectifying functional disturbances of the bile duct.

Cholecystectomy↗