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Biomedical subjects

R Bergner

Publications and source records attributed to R Bergner.

17 recordsLinked to original sources
PubMed2006

[Therapy of hypercalcemia with ibandronate in case of acute renal failure].

Hypercalcaemia is a common complication of malignancies associated with bone destruction. Besides, benign diseases as sarcoidosis or hyperparathyroidism may lead to hypercalcaemia. The main principles of modern therapy contain a forced diuresis as well as the application of bisphosphonates. Latter substances bear the danger of developing a renal insufficiency. Here, we report the case of a female patient, suffering from primary hyperparathyroidism with severe hypercalcaemia and calcium levels up to 6 mmol/l, who developed acute renal failure. We treated the patient with forced diuresis and repeated infusions of ibandronate (5 x 6 mg ibandronate). Even if lowering the serum levels of calcium only for a short time after each application, yet we could improve renal function by these means. Only after performing a parathyroidectomy, we could see a sustained decline of calcium levels. This case report supports the results of other publications, that have reported the missing nephrotoxic effect of ibandronate compared to other bisphosphonates.

Acute Kidney Injury↗
PubMed2005

High bone-binding capacity of ibandronate in hemodialysis patients.

Bisphosphonates are a potential therapy for osteoclast-mediated bone disease, such as renal osteodystrophy. This study evaluated ibandronate bone-binding in patients with secondary hyperparathyroidism and renal osteodystrophy and examined whether there is a correlation with bone metabolism parameters. Sixteen patients with end-stage renal disease and secondary hyperparathyroidism receiving regular hemodialysis were recruited to this 12-week trial. Intravenous ibandronate 2 mg was administered for 5 min every 4 weeks directly after hemodialysis. Ibandronate levels were measured 15 min after infusion and at trough levels before the next hemodialysis. Serological markers of bone metabolism were also measured. After the first infusion, the peak ibandronate level was 154 +/- 75.1 ng/ml and the trough level was 2.7 +/- 1.7 ng/ml. At week 12, peak and trough ibandronate levels were 164.8 +/- 89.9 ng/ml and 3.2 +/- 2.6 ng/ml, respectively. Ibandronate bone uptake was 98.0% at first application and 98.4% at week 12. In patients with remaining diuresis, ibandronate urine excretion was < 0.001% of the administered dose. There was no correlation of ibandronate bone-binding with parameters of osteoclast activity or parathyroid hormone (PTH). The correlation with markers of osteoblast activity was significant but weak. Ibandronate had a bone-binding capacity of approximately 98% in hemodialysis patients. After repeated dosing ibandronate bone-uptake remained stable and was independent of osteoclast activity or PTH levels. Due to the high bone-binding of ibandronate in these patients, a 2 mg dose of intravenous ibandronate is equivalent to a 4-5 mg dose of ibandronate in patients with normal renal function.

Adult↗
PubMed2004

Therapy of IgA nephropathy with mycophenolate mofetil--report of 3 cases.

Mycophenolate mofetil is an immunosuppressive agent in transplantation which inhibits the purin neogenesis. Proliferating lymphocytes are suppressed and antibody production is decreased. Many cases of successful therapy in different kidney diseases are reported, such as diffuse proliferative lupus nephritis, pauci-immune necrotizing glomerulonephritis, focal segmental glomerular sclerosis and IgA nephropathy. We report 3 patients with IgA nephropathy who were treated with mycophenolate mofetil for more than 1 year. In all patients, proteinuria decreased significantly and the renal function remained stable. In 2 patients, kidney biopsy was repeated after 12 months and 18 months, respectively. There were no histological signs of progression of the disease. Two patients developed infections during treatment. One patient had a pneumonia, and a second patient an infection with varizella zoster. Based on our data, mycophenolate mofetil can be a potential treatment of IgA nephropathy. Further controlled studys are warranted to investigate the role of mycophenolate mofetil in IgA nephropathy.

Adult↗
PubMed2001

[Cerebral vasculitis as the initial manifestation of systemic lupus erythematosus].

HISTORY AND CLINICAL FINDINGS: A 41-year-old man was admitted to the hospital because of a series of seizures. History revealed increasing weakness and generalized myalgia following a severe respiratory tract infection three months previously. The clinical examination was dominated by reduced alertness and cognitive impairment. INVESTIGATIONS: Positive ANA titres pointed to an autoimmune disease; further laboratory tests revealed an antiphospholipid syndrome. The clinical diagnosis of systemic lupus erythematosus was supported by renal biopsy. Transcranial Doppler sono-graphy and magnetic resonance imaging with angiography revealed cerebral vasculitis with multiple intracerebral grey and white matter lesions. TREATMENT AND COURSE: In addition to an immunosuppressive therapy with corticosteroids and intravenous pulses of high-dose cyclophosphamide, oral anticoagulation was given in order to prevent thromboembolic complications. Seizures were treated with valproate. A follow-up MRI revealed multiple glial cell reactions and reduced vasculitic changes. CONCLUSIONS: Initial neuropsychiatric symptoms and seizures prompted the diagnosis of systemic lupus erythematosus with cerebral vasculitis in a 41-year-old patient. Approximately 20 % of all lupus patients initially present with neuropsychiatric disorders. Central nervous system involvement and renal complications determine the course and prognosis of the disease as well as therapeutic decisions. Particularly in young patients with neuropsychiatric symptoms systemic lupus erythematosus should be excluded routinely.

Adult↗
PubMed1979

[The galactophoritis--a cytological symptom of mastopathy (author's transl)].

In cytological examinations of 7,739 women with nipple discharge 90 cases of galactophoritis were found. Additional diagnostic methods, especially galactography in 24 patients could classify the galactophoritis as a symptom of mastopathy. Cytophotometrical and bacteriological examinations of the galactophoritical discharge supported this. Based on enlarged galactographical-histological comparative investigations milk duct cysts and dilatations in the galactograms were shown to be typical roentgenmorphological signs of mastopathy. It was therefore possible to classify the cytological picture of the galactophoritis.

Breast↗
PubMed1977

[Direct fetal electrocardiography in umbilical cord complications and congenital heart abnormalities].

The modern obstetrics allows with help of electronical control a prenatale and intranatale state-diagnosis of the fetal heart. By use of direct fetal electrocardiography is it possible under consideration of QRS-deformations and ST-segment-depressions to add a suspicious diagnosis, so that can avoid dangerous complications of the umbilical cord or in case of absence of such complications can early detect congenital heart diseases.

Asphyxia Neonatorum↗
PubMed1977

[Comparative intranatal and postnatal electrocardiography in normal labor].

The comparison of intranatal and postnatal electrocardiograms shows, that in spite of the hemodynamic important transposition of the infant circulation are no remarkable differences in the electrocardiogram. Remarkable is also the resemblance of electrical axises in the intranatale and postnatale ECG, at which we report particularly on the estimation of the electrical axis of the fetal heart, introduced by Larks. The estimation of this axis in the fetal ECG and its position call the attention as additional diagnostical criterion in some cases to an intrauterine fetal distress or a congenital heart disease.

Electrocardiography↗