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  • 1980-1984  (2)
  • Diagnose-Verfahren  (1)
  • Pressoreceptors
  • 1
    ISSN: 1432-2013
    Keywords: Blood pressure ; Kidney blood flow ; Autoregulation ; Renin release ; Pressoreceptors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract 1. The effect of varying renal artery pressure between 160 and 40 mm Hg on renal blood flow and renin release was studied in seven conscious foxhounds under β-adrenergic blockade receiving a normal sodium diet (4.1 mmol/kg/day). Pressure was either increased by bilateral common carotid occlusion or reduced in steps and maintained constant by a control-system using an inflatable renal artery cuff. Carotid occlusion itself had no influence on renal blood flow and renin release when renal artery pressure was kept constant and the β-receptors in the kidney were blocked. 2. Between 160 mm Hg and resting pressure there was no change in renal blood flow; between resting blood pressure and the lower limit of autoregulation (average 63.9 mm Hg) renal blood flow increased slightly (average 7%) indicating a high efficiency of renal blood flow autoregulation. 3. The relationship between renal artery pressure and renin release could be approximated by two linear sections:a low sensitivity to a pressure change (average slope: −0.69 ±0.26ng AI/min/mm Hg) was found above a threshold pressure (average: 89.8±3.3 mm Hg) and a high sensitivity to a pressure change (average slope: −64.4±20.8 ng AI/ min/mm Hg) was observed between threshold pressure and 60 mm Hg. There was no further increase of renin release between 60 and 40 mm Hg. 4. It is concluded that within the autoregulatory plateau the kidney of a conscious β-blocked dog receiving a normal sodium diet releases only negligible amounts of renin until renal artery pressure falls below a threshold pressure of 90 mm Hg which is close to the animals resting systemic pressure. Since beyond that a decrease of systemic pressure by as little as 1.3 mm Hg below threshold can raise resting renin release (84.8±29.8 ng/min) by 100%, it is suggested that systemic blood pressure tends to stabilize at a level at which renin release is minimal.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Langenbeck's archives of surgery 364 (1984), S. 371-380 
    ISSN: 1435-2451
    Keywords: Diagnostic procedures ; Risk-utility-relation ; Therapeutic decisions ; Diagnose-Verfahren ; Nutzen/Risiko-Relation ; Therapeutische Entscheidungen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Auch oder besonders in der Chirurgie ist die kausale Therapie an eine kausale Diagnose gebunden. Diese führt um so häufiger zu Irrtümern, je höher die Ansprüche an die Trennschärfe gestellt werden. Viele Ärzte beschränken sich auf symptomatische Maßnahmen, die über die Selbstheilung hinaus nutzlos sind oder zur Polypragmasie führen. Dazwischen stehen Diagnosen des „Als ob” oder probatorische Eingriffe. Die Diagnostik besteht aus logischen und psychologischen Elementen. Die Approximation erfolgt entweder von hypothetico-deduktiven Verfahren oder von den Prinzipien der Mustererkennung her. Anamnese und unmittelbare Mustererkennung führen in etwa 80% zu einer vorläufigen Diagnose. Diese muß mit naturwissenschaftlichen Methoden gesichert oder verworfen werden. Die endgültige Entscheidung wird bestimmt von der Theorie der Wahrscheinlichkeit und der Theorie des Nutzens. Sie werden an der Nützlichkeitsmatrix und an Entscheidungsbäumen demonstriert.
    Notes: Summary In surgery (as in other disciplines of medicine) a causal therapy is connected with a causal diagnosis. Many physicians confine themselves to symptomatic measures which are useless beyond self-healing or introduce some kind of polypragmasia. Sometimes between those extreme positions there is a need of deliberations “as if” or primarily diagnostic operations. Diagnostics as a whole consist of logical as well as of psychological elements. Approximation is made either by some kind of hypothetico-deductive calculations or using some kind of pattern recognition. Anamnesis and immediate personal examination yield a preliminary diagnosis in about 80%. Yet a diagnosis of this sort has to be verified or falsified by scientific methods. The final decision is a function of both the theory of probability and the theory of utility. The combination is demonstrated by the so-called decision matrix and the so-called decision tree, going from simple models to complicated ones.
    Type of Medium: Electronic Resource
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