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Biomedical subjects

R Bambauer

Publications and source records attributed to R Bambauer.

At least 55 records · Page 3Linked to original sources
PubMed1990

Raster-electron-microscopic investigations in large-bore catheters for extracorporeal detoxification.

Large bore catheters (n = 42, 31 patients) which remained in position for a period of between 2 to 73 days (mean = 26.8 days/patients) were investigated with raster electron-microscopy (scanning electron micrographic: SEM) and for bacterial colonisation. Microbiological findings indicated colonisation of the intravascular large bore catheters in 8 out of 42 catheters (19%). SEM morphological investigation showed bacterial colonisation in only 3 catheters (7%). The 3 different catheter materials had small deposits of fibrin and protein on the inner and outer surfaces after 2 days. This second layer covered the entire surface after 3 days and increased to a thickness of 3-60 microns in the following days. In this matrix erythrocytes, thrombocytes and granulocytes could also been seen.

Bacterial Adhesion↗
PubMed1990

[Status of plasmapheresis and cyclosporin A in the treatment of systemic lupus erythematosus].

We report the history of 2 teenagers suffering from systemic lupus erythematosus for more than 5 years. Both of them were treated with total plasma exchange (TPE) and Ciclosporin A. They responded well to this therapy and achieved remissions. Especially the 2nd patient showed a dramatic clinical improvement after a relapse caused by sun exposure. Both treatment modalities are discussed and the following conclusions are drawn: TPE is an important therapeutic element in treating patients with SLE, whereas Ciclosporin A is not recommended for therapy of first choice. Further prospective and controlled studies have to show, if there is a benefit of this therapy, especially in childhood.

Adolescent↗
PubMed1989

Subcutaneous injection of desmopressin (DDAVP): evaluation of a new, more concentrated preparation.

A more concentrated desmopressin (DDAVP) preparation (40 micrograms/ml), which required small injection volumes (less than 1 ml), was studied in a double-blind trial in 10 healthy volunteers, 12 patients with haemophilia A, and 8 patients with uraemic bleeding. DDAVP was administered by subcutaneous injection at a dose of 0.4 micrograms/kg body weight. In healthy subjects, peak levels of DDAVP ranging from 480 to 638 pg/ml were reached 1 h after the subcutaneous injection and DDAVP was eliminated with a mean half-life of 3.1 h. DDAVP produced a 2.5-fold (3.0-fold) increase of factor VIII:C (factor VIII:Ag) and a 1.9-fold (2.2-fold) increase of von Willebrand factor:Ag (ristocetin cofactor) over baseline levels. Additionally, a 2.1-fold increase of tissue-type plasminogen activator antigen was observed. Factor VIII and von Willebrand factor were rapidly eliminated with a half-life ranging from 1.3 to 5.7 h and from 1.1 to 11.4 h, respectively. In haemophilia A patients, DDAVP produced a 2.3-fold increase of factor VIII:C 1 h after the injection. DDAVP was given on 8 occasions for management of bleeding, and only in 1 patient did a wound haematoma (after herniotomia) occur. In 7 of the 8 patients with uraemia the bleeding time shortened, and in all patients an increase of platelet retention and a decrease of platelet count was observed (p less than 0.05). No serious local or systemic untoward side effects were observed.

Adult↗
PubMed1989

Indications of plasmapheresis and selection of different substitution solutions.

Substitution solutions used for plasmapheresis (PH) may be human albumin, serum protein conserves or plasma. 746 plasmapheresis carried out on 88 patients with a variety of diseases were examined and the side effects due to the substitution solutions were investigated. Side effects occurred in less than 10% of the cases where the four substitution solutions were used. The least side effects were observed in treatments using human albumin as substitution. Side effects increased for serum protein conserves, followed lyophilised plasma and were highest for fresh frozen plasma. In view of these possible side effects the criteria for PH should be strictly observed and the substitution solution should meet clinical requirements.

Albumins↗
PubMed1988

Nitrendipine in patients with end-stage renal disease and hypertension.

Calcium antagonists reduce the calcium uptake in vascular cells. The reduction of intracellular calcium leads to vasodilatation and lowering of the blood pressure. The cardiac output is increased, for example, by nitrendipine and related agents, so that the supply of blood to essential organs is improved. Despite the blood pressure decrease, the plasma renin activity increases only slightly and the plasma aldosterone concentration not at all after administration of nitrendipine. The effects of nitrendipine were examined in a study carried out over a period of 6 months on 10 patients suffering from renal hypertension and end-stage renal disease requiring compulsory dialysis. In all patients, adequate blood pressure control was achieved with, in some cases, low doses of nitrendipine combined with other antihypertensive medication. Nitrendipine was very well tolerated, and no side effects were observed.

Adult↗
PubMed1988

Hemofiltration and plasmapheresis in premature infants and newborns.

Extracorporal detoxication methods in newborns are most unavailable, contraindicated because of technical problems. Herein are reported the experiences with a blood pump unit that was miniaturized for hemodialysis, hemofiltration, and plasmapheresis in newborns. In three premature infants with acute renal failure of different etiology (two newborns with severe Rh-erythroblastosis, 1 premature infant with hypoproteinemia) 13 single-needle hemofiltrations and 6 single-needle plasmaphereses were performed with double head pump, special tube systems, and small modules. The age of the patients ranged from 1 to 14 days, body weight was between 800 and 2,800 g. Four umbilical veins and two femoral veins were used as vascular access. The ultrafiltration rate during the treatment averaged 0.3 ml/min in single-needle hemofiltration and the plasma filtrate flow rate 1.3 ml/min in single-needle plasmapheresis. All treatments were well tolerated. Four patients died due to complications unrelated to the treatment, two patients recovered. These preliminary results show that both hemofiltration and plasmapheresis may be carried out without major problems in premature infants and newborns.

Acute Kidney Injury↗
PubMed1988

Plasma exchange and immunosuppression in rapidly progressive glomerulonephritis: a controlled, multi-center study.

In a randomized study of 26 patients with histologically confirmed rapidly progressive crescentic glomerulonephritis, 12 patients were treated with immunosuppressants alone (corticosteroids, cyclophosphamide and azathioprine) while the other 14 patients received not only the identical immunosuppressive treatment but also plasma exchange therapy for four weeks. No statistically significant difference was found between the two groups. After 8 weeks, 73% and 69% of the patients in each respective group showed recompensation of renal function; serum creatinine fell from initially 7.0 and 6.2 mg/dl mean to 2.7 and 2.3 mg/dl mean, and under continued immunosuppression did not rise in the following months. Thus, in non-autoantibody induced rapidly progressive glomerulonephritis, kidney function could be improved substantially by immunosuppressive therapy, but an advantage of supplementary plasma exchange could not be shown.

Adult↗
PubMed1986

Posttransfusion purpura. A survey of 13 cases.

Thirteen cases of posttransfusion purpura (PTP) which were diagnosed in Germany and Austria from 1977-1985 are described. All patients were women with a mean age of 58.6 years (range, 36-77 years). All but one had been pregnant and received blood transfusions 2 to 12 days prior to the onset of PTP. The thrombocytopenic purpura was always severe with a nadir of platelet counts below 10 X 10(9)/l and lasted between 3 and 60 days. All patients recovered from PTP. Optimal therapy consisted of administration of high-dose IgG. Twelve of the 13 patients had developed platelet-specific Zwa antibodies (eight of them together with HLA antibodies), in one Zwa positive individual only HLA antibodies were detectable. Five of six HLA-DR typed patients carried DR3 which is considered an immunogenetic risk factor in PTP. Clinical awareness of this rare, but serious iatrogenic transfusion complication is prerequisite for prompt diagnosis and improved therapy.

Adult↗
PubMed1985

[Therapeutic plasma exchange in severe tropical malaria].

Cases of malaria are being seen ever more frequently in the Federal Republic of Germany, presenting both diagnostic and therapeutic problems. Three recent cases of severe malignant falciparum malaria are presented, one ending fatally. In the other two, plasma exchange combined with haemodialysis led to a cure.

Adult↗
PubMed1985

Penicillamine-induced pemphigus foliaceus-like dermatosis. A case with unusual features, successfully treated by plasmapheresis.

A case of a severe, widespread bullous dermatosis clinically resembling pemphigus foliaceus occurred during treatment with penicillamine hydrochloride in a patient with rheumatoid arthritis. Histologically, the disease showed changes compatible with pemphigus vulgaris as well as with a bullous drug eruption. Treatment by plasmapheresis proved to be effective in controlling the disease.

Dermatitis, Exfoliative↗
PubMed1984

Drug-resistant bronchial asthma successfully treated with plasma exchange.

Two patients suffering from allergic bronchial asthma who showed no improvement despite six and four weeks, respectively, of drug therapy were successfully treated with therapeutic plasma exchange. The first patient had no attacks over a period of five months, and the other patient had none for over one year. Although this report only deals with single observations, we believe that therapeutic plasma exchange is of particular value for patients with severe allergic bronchial asthma because it eliminates in addition to immunocomplexes other substances, including antigens, rapidly from the blood. This means that it is possible to directly intervene in the pathomechanism. However, further investigations are necessary in order to corroborate this successful therapy.

Adult↗
PubMed1984

[Behavior of oxypolygelatine (Gelifundol) in patients with dialysis-dependent kidney failure].

Colloidal solutions are used with increasing frequency as plasma replacement, in addition to thrombosis prophylaxis, for treating disturbances of the microcirculation and hemodilution as well as for cases of decreases in blood pressure during hemodialysis and hemofiltration treatments. The effects of the dextran, hydroxyethyl amylum and gelatine preparations available very greatly, for example with regard to expander effect, half life, elimination etc. Gelatine solutions have a particularly short intravascular retention and therefore appeared to us to be especially suitable for treating decreases in blood pressure and states of shock during hemodialysis and hemofiltration. We examined the behaviour of 5,5% oxypolygelatine (OPG) in 11 patients during dialysis treatment (6 patients with a residual diuresis smaller than 500 ml/24 h, 5 patients with a residual diuresis larger than 500 ml/24 h). Before each of the 12 treatments 250 ml OPG was administered to all patients. 48 hours later 86-93% of the infused OPG had been eliminated. Despite repeated doses no remarkable OPG cumulation was registered.

Adult↗