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  • Hypertension  (2)
  • Acute phase proteins  (1)
  • Anti-N-artige Antikörper  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Influence of antihypertensive therapy on renal function (1992)
    Springer
    Journal of molecular medicine 70 (1992), S. S120 
    Details
    ISSN: 1432-1440
    Keywords: Hypertension ; Kidney ; Antihypertensive drugs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Antihypertensive therapy influences kidney function by different mechanisms depending on the mode of action of the drug used. The GFR is improved by calcium entry blockers and ACE inhibitors, unaffected by vasodilators, α-blockers and centrally acting sympatholytics and impaired by β-blockers. The same is true for renal blood flow and is due to changes of renal vascular resistance. Renal sodium excretion is impaired mostly by vasodilators, by α-blockers, sympatholytics and β-blockers; in contrast, calcium entry blockers and ACE inhibitors acutely induce natriuresis. The RAAS is stimulated by vasodilators, unaffected by α-blockers and sympatholytics and suppressed by β-blockers. Plasma catecholamines are stimulated by vasodilators and suppressed by centrally acting sympatholytics and unaffected by the others. Induction of acute renal functional impairment is reported for ACE inhibitors under conditions of compromised renal perfusion pressure such as in renal artery stenosis. These data from the literature reviewed are supported by our own experimental data on sodium balance under different drugs and micropuncture data in experimental renal artery stenosis. To achieve effective antihypertensive treatment with a low profile of side effects, careful monitoring of renal function seems to be mandatory.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00207622
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  • 2
    Electronic Resource
    Electronic Resource
    Haemolysis due to formaldehyde-induced anti-N-like antibodies in haemodialysis patients (1979)
    Springer
    Journal of molecular medicine 57 (1979), S. 673-679 
    Details
    ISSN: 1432-1440
    Keywords: Formaldehyd ; Anti-N-artige Antikörper ; Immunhämolyse ; Hämodialyse ; renale Anämie ; Formaldehyde ; Anti-N-like antibodies ; Immunohaemolysis ; Haemodialysis ; Renal anaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary During reuse of formaldehyde sterilized Kiil-dialysers, red cell survival, measured by means of51Cr t/2, was significantly reduced (p〈0.001) in 16 patients with anti-N-like positive sera, when compared with 19 antibody negative control patients (Mean±SD: 16.5±2.7 versus 22.4±3.1 days.) In antibody negative patients (n=10) replacement of form-aldehyde sterilized dialysers by ethylene-oxide sterilized disposable dialysers resulted in a significant increase (p〈0.002) of51Cr t/2 (Mean±SD, days: Kiil-dialyser 16.3±1.9; disposable dialyser 20.3±3.5). This improvement took place, although antibody titres persisted during the51Cr-measurements and declined thereafter only slowly. In antibody negative patients (n=6) red cell survival did not increase, when formaldehyde as a sterilant was avoided. In antibody positive patients mean haematocrit rose significantly (p〈0.05), whereas in none of the antibody negative patients a definite change of haematocrit occurred. The data demonstrate, that formaldehyde sterilisation of dialysers may cause antibody-mediated haemolysis contributing to the extent of renal anaemia. This immunohaemolysis may be corrected, in spite of continuing antibody persistance, when formaldehyde exposure is totally avoided, or possibly when minimized.
    Notes: Zusammenfassung Während der Wiederverwendung Formaldehyd-sterilisierter Kiil-Dialysatoren war die mit51Cr bestimmte Erythrocytenüberlebenszeit bei 16 Patienten mit Anti-N-artigen Antikörpern significant (p〈0,001) kürzer als bei 19 Antikörper-negativen Kontrollpatienten (MW±SD: 16,5±2,7 bzw. 22,4±3,1 Tage). Bei Antikörper-positiven Patienten (n=10) führte das Umsetzen von Formaldehyd-sterilisierten Kiil-Dialysatoren auf Ethylenoxid-sterilisierte Einmaldialysatoren vergleichbarer Effektivität zu einem sofortigen, signifikanten (p〈0,002) Anstieg der Erythrocytenüberlebenszeit (MW±SD: 16,3±1,9 Tage, Kiil-Dialysator; 20,3±3,5 Tage Einmaldialysator). Die Antikörper-Titer blieben während der Messung der Erythrocytenüberlebenszeit unverändert, danach fielen sie im Verlauf von Monaten langsam ab. Bei Antikörper-negativen Kontrollpatienten (n=6) führte das Umsetzen von Formaldehyd-sterilisierten Kiil-Dialysatoren auf die Ethylenoxid-sterilisierten Einmaldialysatoren nicht zum Anstieg der Erythrocytenüberlebenszeit. Bei den Antikörper-positiven Patienten stieg der mittlere Hämatokritwert nach dem Umsetzen signifikant (p〈0,05) an, dagegen kam es nach dem Umsetzen bei keinem der Antikörper-negativen Patienten zu einer gerichteten Veränderung der Hämatokritwerte. Die Untersuchungen belegen, daß die Formaldehyd-Sterilisation von Dialysatoren zu einer Antikörper-vermittelten Hämolyse führen kann, die zum Ausmaß der renalen Anämie dieser Patienten beiträgt. Diese Immunhämolyse kann, auch bei Persistenz der Anti-N-artigen Antikörper, zumindest teilweise verhindert werden, wenn eine weitere Formaldehyd-Exposition des Patienten vermieden wird.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01477668
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  • 3
    Electronic Resource
    Electronic Resource
    Kinetics and characteristics of an acute phase response following cardiac arrest (1999)
    Springer
    Intensive care medicine 25 (1999), S. 1386-1394 
    Details
    ISSN: 1432-1238
    Keywords: Key words Hypoxia ; Ischemia ; Acute phase proteins ; Cardiac arrest ; Infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Inflammation and hypoxia are frequently associated, but their interaction is poorly understood. In vitro studies have shown that hypoxia stimulates the genes of acute phase proteins (APP) and cytokines known to induce APP. We decided to determine kinetics and potential determinants of an acute phase response after cardiac arrest and to assess whether isolated moderate hypoxia can induce APP in humans in vivo. Design: Prospective, observational study in patients and human experiment. Setting: Tertiary care university hospital. Patients and participants: 22 patients after primarily successful cardiopulmonary resuscitation (CPR) and 7 healthy volunteers. Interventions: None in patients; exposure of volunteers to simulated altitude (460 torr/6 h). Results: Following CPR, type-1 APP (C-reactive protein, α1-acidglycoprotein, serum amyloid A) and type-2 APP (haptoglobin, α1-antitrypsin) increased consistently within 1–2 days and the ’negative' APP transferrin was downregulated. This APP response occurred irrespective of the cause of arrest, the estimated time of anoxia, clinical course or patient outcome and was not different in patients with and without infectious complications. Exposure of healthy volunteers to less severe but more prolonged hypoxia did not induce APP, although a time dependent increase of serum erythropoietin (EPO) was measurable under these conditions, indicating the activation of oxygen dependent gene expression. Conclusions: (i) A marked acute phase response occurs regularly after cardiac arrest, but within the complexity of this situation the severity of hypoxia is not a predominant determinant of this response. (ii) Despite in vitro evidence for similarities in the oxygen dependent regulation of APP and EPO production, the oxygen sensitivity of these proteins in vivo is different. (iii) Measurements of APP are not revealing regarding infectious complications in the early phase after CPR.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051086
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  • 4
    Electronic Resource
    Electronic Resource
    Erythropoietin und Hypertonie (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 914-919 
    Details
    ISSN: 1432-1440
    Keywords: Erythropoietin ; Hypertension ; Erythropoietin ; Hypertonie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Wirksamkeit von rekombinantem humanem Erythropoietin (rhEpo) bei der Korrektur der Anämie des terminal niereninsuffizienten dialysepflichtigen Patienten ist in mehreren Studien belegt. Eine deutliche Verbesserung der physischen Leistungsfähigkeit konnte durch ergometrische Untersuchungen dokumentiert werden. Neben seltenen Shunt-Thrombosen ist die einzige relevante unerwünschte Wirkung von rhEpo die Entwicklung oder Aggravierung einer Hypertonie bei etwa 30% der behandelten Patienten. Bei ca. 2% der Patienten kam es zur hypertensiven Enzephalopathie mit zentralnervöser Symptomatik. Als Ursache für diese Hypertonie-Entwicklung ist ein Anstieg des peripheren Widerstands anzunehmen. Belege dafür sind Messungen des regionalen Blutflusses mit Plethysmographie vor und nach Anämie-Korrektur mit rhEpo. Ursache für den Widerstandsanstieg wiederum dürfte eine Zunahme der Vollblutviskosität und eine Abnahme der peripheren hypoxiebedingten Vasodilatation sein. Zur Prävention der hypertensiven Komplikationen bei rhEpo-Therapie werden eine langsame Hämatokrit-Korrektur über 12–16 Wochen und eine Begrenzung des Ziel-Hämatokrits auf 30–35 Vol. % bei strikter Blutdruck- und Volumenkontrolle empfohlen.
    Notes: Summary Recombinant human erythropoietin (rhEpo) has been demonstrated in several studies to be effective in correcting the anemia of regular dialysis patients. This was accompanied by a significant improvement of the physical work capacity shown by exercise testing. The main side effect of rhEpo treatment has been the development or aggravation of hypertension in approximately 30% of the treated patients. In 2% hypertensive encephalopathy and convulsions occured. Data obtained by measurements of regional blood flow indicate the peripheral resistance did increase probably due to rise of blood viscosity and reversal of preexisting hypoxic vasodilatation. To avoid hypertensive complications anemia should be corrected slowly over a period of 12–16 weeks. Target hematocrit should not exceed 30–35 vol. %. Blood pressure and volume status should be monitored closely.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01728954
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