Arvin B. Weinstein

Effects of exercise training during hemodialysis

Fourteen maintenance hemodialysis patients volunteered to participate in a 6-month program of exercise training. The exercise was performed on a stationary bicycle during the hemodialysis treatment. Six maintenance hemodialysis patients served as control without exercise training. Exercising patients participated in 91% of all possible exercise sessions. The exercise group showed a significant (23%) increase in maximal oxygen consumption over the 6 months. No change in exercise capacity resulted in the control group. Five of eight hypertensive patients in the exercise group decreased or discontinued antihypertensive medications. No changes occurred in hematocrit or lipid profiles in either group. We conclude that exercise training during the hemodialysis treatment is technically feasible and safe for appropriately screened patients and will increase exercise capacity, and in some patients improve blood pressure control. Exercise during dialysis also improves compliance to regular exercise and facilitates supervised exercise sessions, which are desirable in this patient group.

Superior vena cava draining into left atrium; another cause for left ventricular hypertrophy with cyanotic congenital heart disease.

Abstract A case of cyanotic congenital heart disease with left ventricular hypertrophy is described. Cardiac catheterization revealed a superior vena cava which drained into the left atrium. No other cardiovascular abnormality was present. The diagnosis was confirmed by operation and postmortem examination.

Allopurinol-induced interstitial nephritis.

Excerpt Four previous reports implicate allopurinol as a cause of acute renal failure in six patients (1-4). However, the renal histology in three autopsied patients was so variable that the existe...

The Physiologic Effect of Contrast Media Used for Angiocardiography

The deaths from angiocardiography at Wisconsin General Hospital were reviewed and found to be two per cent of 249 patients. These 5 deaths are reported briefly. Investigation was carried out to determine the hemodynamic effects of contrast substances on 12 dogs. In general, there was a temporary increase in right atrial and pulmonary arterial pressure followed by a rather marked decrease in systemic arterial pressure and tachycardia. The significance of these findings is discussed in relation to shunts within the heart or between the aorta and pulmonary artery.

The Suitability of Fixed-Bed Sorbers as Artificial Kidneys

Experimental and theoretical evaluations of fixed beds of granular dextran beads for the purification of uremic lymph are described. This work was inspired by reported success in treatment of chronic uremia by repeated collection, purification, and reinfusion of thoracic duct lymph. The experimental program demonstrated that a rapid and essentially complete separation of low molecular weight metabolites from lymph proteins in a gel bed is possible, but tJ:lat the protein-rich effluent is somewhat diluted by the occurrence of viscous flow instabilities in the trailing protein boundary. A complete theoretical description of the system which gave excellent agreement with observed behavior was achieved using a longitudinal dispersian model and parameters evaluated from available dispersion and mass transfer coefficient correlations and from analysis of some of the experimental data. The model and parameters were then used to investigate the effects of