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Biomedical subjects

R O Berkseth

Publications and source records attributed to R O Berkseth.

7 recordsLinked to original sources
PubMed1999

Human granulocytic ehrlichiosis presenting with acute renal failure and mimicking thrombotic thrombocytopenic purpura. A case report and review.

We present the case of an elderly female patient presenting with recurrent acute renal failure, fever, altered mental status, abdominal pain, thrombocytopenia and a small number of fragmented red cells on peripheral smear mimicking recurrent thrombotic thrombocytopenic purpura (TTP). Eventually, however, she was diagnosed to have human granulocytic ehrlichiosis (HGE), and after treatment for HGE her clinical and laboratory abnormalities resolved. Ehrlichiosis mimicking TTP, diagnosed at postmortem examination, has been described in a single prior case. As illustrated in this case, there are potential difficulties in diagnosing HGE after plasma exchange, blood transfusion and immunosuppressive therapy. Ehrlichiosis, a potentially curable disease, should be considered in the differential diagnosis of thrombotic microangiopathic disorders.

Acute Kidney Injury↗
PubMed1990

Sensitivity of erythrocytes to oxidant stress in uremia.

The erythrocytes from 19 chronic hemodialysis patients were examined for Heinz bodies and their sensitivity to oxidant stress. Heinz bodies were found in 63% of patients and an elevated level of oxidized hemoglobin in 36%. When exposed to acetylphenhydrazine oxidant stress, 84% had a normal response and 95% had stable reduced glutathione levels. Ascorbic-acid-induced oxidant stress was tolerated by 84%. The activities of enzymes associated with the hexose monophosphate shunt were examined and found to be intact. This study demonstrates an increased number of Heinz bodies in hemodialysis patients. However, this is not due to an increased sensitivity to oxidant stress. Other mechanisms must be sought to explain the presence of Heinz bodies in these patients.

Adult↗
PubMed1987

Aminoglycoside redistribution phenomenon after hemodialysis: netilmicin and tobramycin.

The serum concentration time profile of netilmicin and tobramycin before, during, and after hemodialysis was assessed in 5 noninfected adult chronic hemodialysis patients. The pharmacokinetic profile was biexponential for both agents in the pre-hemodialysis period. The total body clearance of netilmicin was significantly greater than that of tobramycin (5.32 +/- 0.75 ml/min vs 3.66 +/- 1.00 ml/min; p less than 0.05). The hemodialysis clearances of netilmicin and tobramycin were similar (60.8 +/- 16.6 ml/min and 54.7 +/- 18.8 ml/min, respectively). Netilmicin and tobramycin serum concentrations increased significantly 10 minutes after cessation of hemodialysis and maximally rebounded to 38.3 +/- 16.2% and 18.3 +/- 3.0% at 1.7 +/- 0.3 hours and 1.9 +/- 0.7 hours, respectively. This phenomenon may be a primary contributor to the marked variability observed in the clinical pharmacokinetics of these agents in hemodialysis patients. These data suggest that clinical serum concentrations should not be drawn until two hours after hemodialysis.

Adult↗
PubMed1984

Radiologic contrast-induced nephropathy.

Contrast nephropathy is the third most common cause of hospital-acquired renal insufficiency. While its exact pathogenesis is unclear, patients with existing renal disease are now known to be at increased risk for developing this complication. Identification of these patients by determination of serum creatinine levels may enable avoidance of contrast exposure or initiation of suitable therapy to minimize this complication if exposure to contrast is unavoidable.

Absorption↗
PubMed1978

Jejunoileal bypass surgery and granulomatous disease of the kidney and liver.

A 26-year-old woman, who had undergone jejunoileal bypass surgery six years previously for obesity, had symptoms of intermittent fever, myalgia, polyarthralgia, and aseptic joint swelling. These symptoms commenced one year after her surgery and gradually grew in intensity and frequency of occurrence. The patient, observed to have moderately decreased renal function, hyperoxaluria, and circulating cryoglobulins, underwent liver and renal biopsies. Both organ specimens demonstrated granulomatous involvement, but the kidneys exhibited no evidence of oxalate deposition. The findings of circulating cryoglobulins and suppression of symptoms with doxycycline, taken collectively with the circumstances surrounding this case, suggest that the observed granulomatous disease may be due to systematically adsorbed bacterial antigen(s).

Adult↗
PubMedDate not supplied

A simplified approach to monitoring in vivo therapy prescription.

The urea kinetic model has been used to individualize therapy prescription. Because the urea kinetic model is complex, the modeling approach to therapy monitoring is not widely practiced. Presented here is a simplified approach to therapy prescription monitoring that is based on the full-fledged urea kinetic model. A Kt/V-PCR domain map (K: clearance, t: time and V: volume of urea distribution; PCR: protein catabolic rate) has been developed with the predialysis urea nitrogen concentration on the abscissa and the post/pre dialysis urea concentration ratio on the ordinate. On this domain map, the therapy index Kt/V is represented by a family of horizontal lines and the PCR is represented by a family of curved lines. In this simplified approach, mid-week measurements of the pre (C1) and post (C2) dialysis urea nitrogen concentrations are plotted on the domain map. The position of the plotted point allows one to read off the Kt/V index and the PCR to determine whether therapy index, diet, or both need to be modified.

Blood Urea Nitrogen↗