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T Busch

Publications and source records attributed to T Busch.

78 records · Page 5Linked to original sources
PubMed1988

Elimination of absorbed aluminum in patients undergoing continuous ambulatory peritoneal dialysis.

Intestinal absorption of aluminum (Al) from the phosphate binder aluminum-hydroxide-chloride (PhosphonormR) and successive renal and peritoneal Al elimination were studied in 11 patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Al was measured by atomic absorption spectrometry in serum, urine, and dialysis fluid. Al levels in serum of all patients increased in average from 28.6 micrograms/l immediately before to a peak level of 41.6 microgramsWl 4 h after intake of 342 mg Al. After 24 h serum Al (34.0 micrograms/l) was still increased. Elimination across the peritoneum increased from 5.6 micrograms Al during the first 4 h to peak levels of 12.9 micrograms between hour 8 and 12 and decreased to 8.1 micrograms during the last 12 h. The Al clearance of the peritoneum was 0.43 ml/min. In the 6 patients with residual diuresis the renal Al excretion was higher than the peritoneal removal (48.1 micrograms/24 h vs. 24.8 micrograms/24 h). The renal Al clearance amounted to 1.6 ml/min. Assuming a gastrointestinal absorption quotient of 0.1% it is concluded that Al removal by CAPD in patients receiving 342 mg Al/day is not sufficient to prevent Al accumulation. In patients with remaining diuresis, the renal Al elimination exceeds the Al removal by the peritoneum.

Administration, Oral↗
PubMedDate not supplied

[Intraoperative coronary angioscopy after unsuccessful percutaneous dilatation angioplasty and the implantation of an intracoronary stent].

In all coronary arteries after failed PTCA with subsequent stent insertion the stenosed and dilated part of the vessels were inspected. We found dissections in 17/25 coronary lesions as well as thrombus adherent to the wall of the vessels in 8/25 cases. The morphology of the coronary stenosis was compared with the preoperative cine-angiogram. The angioscopic images after failed PTCA and subsequent stent-insertion showed severe wall dissections which were located beyond the inserted stent. In none of the cases was stent-implantation the sufficient treatment of coronary lesions. In all patients we performed coronary artery bypass grafting (CABG). Every coronary incision was used for peripheral anastomosis of the bypass grafts.

Aged↗
PubMedDate not supplied

Oral versus intraperitoneal application of clindamycin in tunnel infections: a prospective, randomized study in CAPD patients.

OBJECTIVE: To evaluate the potential superiority of either oral or intraperitoneal treatment of catheter tunnel infections (TI), using clindamycin as a first-line antibiotic and ultrasound as a diagnostic tool. DESIGN: This was a prospective, randomized study in continuous ambulatory peritoneal dialysis patients. From August 1993 until August 1995, 16 clinically- and ultrasound-proven episodes of TI were randomly assigned to either an oral or an intraperitoneal (IP) treatment (100 patients, 1414 patient-months). Main criteria for TI diagnosis were purulent drainage from the exit site and/or a positive ultrasound (pericatheter fluid collection of at least 2 mm, 7.5 MHz transducer). Initially, clindamycin (20 mg/kg body weight) was given via the oral (three times per day) or intraperitoneal route (four times per day). In the case of incompatibility or resistance to clindamycin, either oxacillin or ciprofloxacin were used orally or IP. RESULTS: Based on ultrasound criteria, the mean time until a > or = 50% reduction of pericatheter abscess diameter was 26 days (median) (range: 8-28 days) in the oral, and 15 days (8-27 days) in the IP group (p < or = 0.05). Showing no significant difference of pericatheter fluid at study entry with 4 mm (median) (range: 2-6 mm) in the oral group and 4 mm (2-4 mm) in the IP group, the IP treatment resulted in a decrease to 0 mm (0-2 mm) after 28 days (p < 0.05), while the diameter was still 2 mm (0-10 mm) (NS) in the oral group. Disappearance of exit-site infection was also somewhat earlier in the intraperitoneal group (51 vs 15 days, NS). Catheter removal had to be done once in the IP group and twice in the oral group within 6 months after study entry. CONCLUSIONS: The results give evidence for greater efficacy of the IP application of clindamycin as a first-line antibiotic compared to the oral route for the treatment of tunnel infections.

Abscess↗
PubMedDate not supplied

[Myocardial revascularization interventions].

UNLABELLED: Elective coronary artery bypass surgery (CABG) can be performed with low operative mortality. There is a controversial discussion whether short- and long-term results of CABG can justify this procedure even in elderly patients. MATERIAL AND METHODS: We retrospectively evaluated the clinical profile, operative procedure, postoperative short- and long-term results of 1127 patients over 70 years of age who underwent myocardial revascularization between January 1985 and December 1996. RESULTS: Mean age was 73.9 years. In 1996, septuagenarians represented 21.5% of our operated coronary patients, when compared with 6.4% in 1985. Analysis of risk factors showed an increasing prevalence of renal failure, obesity, hyperuricemia and a history of smoking. Preoperatively 87% of our patients were in NYHA-class III and IV. The percentage of emergent operations decreased over the observed period by 10.3%. Internal mammary artery was used with increasing frequency (44.8% in 1985-92 vs. 61.5% in 1993-96). The number of simultaneous valve replacements increased, too. Postoperatively, we noted rising incidence of respiratory failure (17.1%) and neurological disorders (13.7%). On the other hand, the need for intraaortic balloon pumping and hemofiltration declined by 6.6% and 2.9%. Perioperative mortality (< or = 24 h) was 3.65%, hospital mortality (< or = 30 days) was 9.64%. Actuarial 1 year at was 82% (+/- 4.3%), and 65.7% (+/- 3.8%) at 5 years. CONCLUSIONS: Our data suggest that CABG can be performed in septuagenarians with an acceptable operative risk. Since the large majority of patients improve symptomatically, surgery is the recommendable option for a growing number of elderly patients suffering from severe angina.

Age Factors↗