Anthony W. Czerwinski

Relief of Idiopathic Generalized Pruritus in Dialysis Patients Treated with Activated Oral Charcoal

The effect of oral charcoal on idiopathic generalized pruritus in 11 stable patients undergoing maintenance hemodialysis was compared to that of placebo dextrose in a controlled, double-blind, cross-over study. Contrasted to placebo, charcoal, 6 g daily for 8 weeks, relieved pruritus subjectively in all but one patient (P = 0.01). Symptomatic relief from pruritus coincided with objective resolutions of active, scratch-induced skin lesions (P = 0.03). No significant alterations were noted in the serum concentrations of standard laboratory variables, including lipids, alkaline phosphatase, phosphorus, or calcium, during treatment with either charcoal or placebo. No adverse effects from the charcoal were noted during the study.

Chronic renal failure, dialysis, and neuropsychological function.

Hemodialysis patients, nondialyzed azotemic patients and control subjects with chronic physical disabilities were tested in psychometric measures of attention, memory, and visuomotor speed and coordination. There was relatively little difference between the performance of dialysis patients and controls and no significant correlations were found between years of dialysis treatment and performance on any task. In contrast, nondialyzed azotemic patients were impaired on 9 of 14 tasks relative to controls and/or dialysis patients. Measured levels of blood urea nitrogen (BUN) and serum creatinine were significantly correlated with the performance of nondialyzed azotemic patients on several tasks. These results demonstrate a relationship between degree of renal failure and cognitive and perceptual-motor functioning. The mild impairments evident in dialysis patients do not seem to be directly attributable to dialysis treatments. Rather, the onset of hemodialysis appears to have beneficial effects on neuropsychological function.

Effects of a single, large, intravenous iniection of dexamethasone

In a double‐blind study, 60 normal adult volunteers were infused with 2.0 mg. per kilogram of dexamethasone disodium phosphate or an equal amount of the diluent. The men and women receiving dexamethasone complained within 2 minutes of itching, burning, or tingling, all of which were most intense in the anogenital area, and which subsided within minutes. Prolonging the infusion time minimized or prevented this complaint.

Case report: acute pancreatitis following corticosteroid and azathioprine therapy.

Several drugs have been implicated as causes of acute pancreatitis. This report presents four patients, three with lupus nephritis and one with membranous glomerulopathy, who developed acute pancreatitis while being treated with corticosteroids alone or in combination with azathioprine. Two of the reported patients died with a hemorrhagic pancreatitis and one of the patients developed a pancreatic pseudocyst. The pathogenesis of corticosteroid and/or azathioprine-induced pancreatitis is discussed.

Familial absorptive hypercalciuria and renal tubular acidosis

Hypercalciuria was considered as a secondary condition when associated with familial renal tubular acidosis. Later studies suggested that hypercalciuria could lead to renal tubular acidosis and nephrocalcinosis. Selected members of a family spanning five generations were studied. Renal tubular acidosis was present in eight subjects in three consecutive generations. Increased 24-hour urinary calcium excretion was present in nine subjects in three consecutive generations, alone in the younger generation, and in combination with renal tubular acidosis and nephrocalcinosis in the older generation. Calcium loading tests showed the absorptive nature of hypercalciuria in nine of 18 subjects studied. This report suggests that in this family the absorptive hypercalciuria is an autosomal dominant genetic defect with complete penetrance and variable expressivity which leads to renal tubular acidosis and nephrocalcinosis.

Cefazolin Plasma Concentrations and Urinary Excretion in Patients with Renal Impairment

C EFAZOLIN is a new 7-aminocephalosporanic acid antibiotic active against various Gram-negative and Grampositive bacteria. Previous studies in man and animals without renal impairment demonstrated that the drug is primarily excreted by the kidneys, although approximately 3 per cent of the drug is excreted in bile.1’2 This study was performed to determine the effect of declining renal function on cefazolin plasma concentration, half-life, and urinary excretion. In addition, the effect of hemodialysis on plasma concentration and half-life was measured.

Safety and efficacy of zinc sulfate in geriatric patients

Using a double‐blind design, 30 geriatric patients with the diagnosis of senile dementia were treated with zinc sulfate, 220 mg three times daily, or with an identical‐appearing placebo for 24 weeks. Diarrhea occurred in 6 of 16 zinc‐treated patients and in one of 14 placebo patients. In zinc‐treated patients, plasma zinc concentrations increased during the first 4 weeks of study and thereafter stabilized at approximately 150 µg/dl. Psychometric and behavioral evaluations did not demonstrate a statistically significant difference between placebo and zinc‐treated patients. Some behavioral tests did illdicate that zinc‐treated subjects deteriorated less rapidly thall concurrent placebo subjects.

Effects of mebutamate on the electroencephalographic sleep profile

This study evaluated the effect of mebutamate (600 mg) on the electroencephalographic sleep profile in 10 healthy, noninsomniac normal males. Placebo was administered on nights 1–4, mebutamate on nights 5–7, and placebo on nights 8 and 9. The results demonstrated that mebutamate significantly altered the electroencephalographic sleep profile. REM sleep was significantly depressed but was not associated with rebound. A low‐amplitude, high‐frequency (18–28 cps) beta rhythm emerged with the administration of mebutamate. There was a significant increase in stages 2 and 4 sleep patterns, the latter being in the range of 100%.