Drug Prescribing for Patients with Chronic Kidney Disease in General Practice: a Cross-Sectional Study

History and admission findings: A 35-year-old man was admitted to our hospital with chills, headache, pain in the calves for five days and a bloody sputum. The day before he had returned from a 4-week trip to the north of Thailand. There he had participated in hiking trips and walked sometimes over wet fields with small skin injuries on his feet. The admission examination was uneventful except fever as high as 39 degrees Celsius, particularly no rash, no conjunctivitis, no spleno- or hepatomegaly and no palpable lymph nodes could be noted.Diagnostic procedures: An x-ray of the chest showed confluent opacities, a bronchoscopy revealed diffuse alveolar hemorrhagy. Blood chemistry showed elevated liver enzymes, elevated kidney retention parameters and an increased C-reactive protein. An extended microbiological diagnostic procedure showed elevated antibody titers for leptospira and a PCR detected leptospira-DNA, representing acute leptospirosis.Treatment and outcome: After initiation of an antibiotic regimen including ceftriaxone and erythromycine the fever resolved immediately and the general condition improved. The patient could be discharged after two weeks in a good physical condition.Conclusion: The constellation of flu-like symptoms, hepatitis and nephritis, eventually escorted by bloody sputum, may suggest leptospirosis.

HISTORY AND ADMISSION FINDINGS:A 35-year-old man was admitted to our hospital with chills, headache, pain in the calves for five days and a bloody sputum. The day before he had returned from a 4-week trip to the north of Thailand. There he had participated in hiking trips and walked sometimes over wet fields with small skin injuries on his feet. The admission examination was uneventful except fever as high as 39 Celsius, particularly no rash, no conjunctivitis, no spleno- or hepatomegaly and no palpable lymph nodes could be noted.DIAGNOSTIC PROCEDURES:An x-ray of the chest showed confluent opacities, a bronchoscopy revealed diffuse alveolar hemorrhagy. Blood chemistry showed elevated liver enzymes, elevated kidney retention parameters and an increased C-reactive protein. An extended microbiological diagnostic procedure showed elevated antibody titers for leptospira and a PCR detected leptospira-DNA, representing acute leptospirosis.TREATMENT AND OUTCOME:After initiation of an antibiotic regimen including ceftriaxone and erythromycine the fever resolved immediately and the general condition improved. The patient could be discharged after two weeks in a good physical condition.CONCLUSION:The constellation of flu-like symptoms, hepatitis and nephritis, eventually escorted by bloody sputum, may suggest leptospirosis.

A 35-year-old man was admitted to our hospital with chills, headache, pain in the calves for five days and a bloody sputum. The day before he had returned from a 4-week trip to the north of Thailand. There he had participated in hiking trips and walked sometimes over wet fields with small skin injuries on his feet. The admission examination was uneventful except fever as high as 39 Celsius, particularly no rash, no conjunctivitis, no spleno- or hepatomegaly and no palpable lymph nodes could be noted.An x-ray of the chest showed confluent opacities, a bronchoscopy revealed diffuse alveolar hemorrhagy. Blood chemistry showed elevated liver enzymes, elevated kidney retention parameters and an increased C-reactive protein. An extended microbiological diagnostic procedure showed elevated antibody titers for leptospira and a PCR detected leptospira-DNA, representing acute leptospirosis.After initiation of an antibiotic regimen including ceftriaxone and erythromycine the fever resolved immediately and the general condition improved. The patient could be discharged after two weeks in a good physical condition.The constellation of flu-like symptoms, hepatitis and nephritis, eventually escorted by bloody sputum, may suggest leptospirosis.

Background: Although small-cell lung cancer (SCLC) is a primarily highly chemosensitive malignancy, the majority of patients will ultimately relapse. As part of an ongoing effort to identify active new agents, the efficacy of treosulfan in patients with relapsed SCLC was examined in a monoinstitutional, phase II trial. Material and Methods: Between January 1995 and September 1996, 15 previously treated patients (limited; disease n = 1, extensive disease n = 14) with refractory (n = 1) or relapsed (n = 14) SCLC were included in this prospective phase II study. The patients received treosulfan 8 g/m(2) intravenously as a short infusion every 4 weeks. The application was terminated in case of disease progression. Results: 14 patients are evaluable for response and toxicity after receiving 1-6 courses of treosulfan. No complete or partial remissions were seen. Three patients achieved a stable disease lasting 2, 3 and 10 months, respectively. Eleven patients showed disease progression. The most common toxicities were thrombocytopenia (14% WHO grade 3-4) and leukocytopenia (5% WHO grade 3). Nonhematological toxicities, e.g. alopecia, nausea, vomiting, stomatitis and skin reactions, were moderate and mild. Conclusions: No major efficacy was seen using treosulfan as second-line therapy in patients with extensive disease SCLC. There are no sufficient data, however, on the effectiveness of treosulfan in front-line therapy.

A number of applications of battery energy storage in photovoltaic installations have been analyzed. The use of lead/acid batteries enhances the efficiency and reduces the cost. Some aspects of automatic charge/discharge control have been discussed. The rate of variation of the battery voltage can be used to determine the state-of-charge. This is based upon fundamental battery characteristics related to the kinetics of the lead/acid system. Although the cost of solar cells is still quite high, photovoltaic energy systems are competitive, not only in small remote installations, but also in large industrial applications. The wide range of working conditions necessitates precise evaluations of the solar array, but no particular problems appear to exist for the battery and the peripheral equipment.

ChemInformVolume 19, Issue 33 Physical Inorganic Chemistry ChemInform Abstract: Local and Cooperative Jahn-Teller Distortions of Ni2+ and Cu2+ in Tetrahedral Coordination. D. REINEN, D. REINEN Fachbereich Chem., Philipps-Univ., D-3550 MarburgSearch for more papers by this authorM. ATANASOV, M. ATANASOV Fachbereich Chem., Philipps-Univ., D-3550 MarburgSearch for more papers by this authorG. ST. NIKOLOV, G. ST. NIKOLOV Fachbereich Chem., Philipps-Univ., D-3550 MarburgSearch for more papers by this authorF. STEFFENS, F. STEFFENS Fachbereich Chem., Philipps-Univ., D-3550 MarburgSearch for more papers by this author D. REINEN, D. REINEN Fachbereich Chem., Philipps-Univ., D-3550 MarburgSearch for more papers by this authorM. ATANASOV, M. ATANASOV Fachbereich Chem., Philipps-Univ., D-3550 MarburgSearch for more papers by this authorG. ST. NIKOLOV, G. ST. NIKOLOV Fachbereich Chem., Philipps-Univ., D-3550 MarburgSearch for more papers by this authorF. STEFFENS, F. STEFFENS Fachbereich Chem., Philipps-Univ., D-3550 MarburgSearch for more papers by this author First published: August 16, 1988 https://doi.org/10.1002/chin.198833005Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume19, Issue33August 16, 1988 RelatedInformation

ADVERTISEMENT RETURN TO ISSUEPREVArticleNEXTLocal and cooperative Jahn-Teller distortions of nickel(2+) and copper (2+) in tetrahedral coordinationDirk Reinen, M. Atanasov, G. Nikolov, and Friedhelm SteffensCite this: Inorg. Chem. 1988, 27, 10, 1678–1686Publication Date (Print):May 1, 1988Publication History Published online1 May 2002Published inissue 1 May 1988https://pubs.acs.org/doi/10.1021/ic00283a005https://doi.org/10.1021/ic00283a005research-articleACS PublicationsRequest reuse permissionsArticle Views819Altmetric-Citations54LEARN ABOUT THESE METRICSArticle Views are the COUNTER-compliant sum of full text article downloads since November 2008 (both PDF and HTML) across all institutions and individuals. These metrics are regularly updated to reflect usage leading up to the last few days.Citations are the number of other articles citing this article, calculated by Crossref and updated daily. Find more information about Crossref citation counts.The Altmetric Attention Score is a quantitative measure of the attention that a research article has received online. Clicking on the donut icon will load a page at altmetric.com with additional details about the score and the social media presence for the given article. Find more information on the Altmetric Attention Score and how the score is calculated. Share Add toView InAdd Full Text with ReferenceAdd Description ExportRISCitationCitation and abstractCitation and referencesMore Options Share onFacebookTwitterWechatLinked InRedditEmail Other access optionsGet e-Alertsclose Get e-Alerts

CuZrF6 and CrZrF6 undergo phase transitions between 100 and 450K, which are induced by crystal packing effects and changes from dynamical to static Jahn-Teller distortions of the Cu(Cr)F6 octahedra. We analyzed in particular the transitions of the Jahn-Teller type using 57Fe2+, doped into the Cu2+(Cr2+) sites, as a Mössbauer probe. The quadrupole splitting is large in the region of static distortions and essentially reflects the distortion symmetry of the host Cu(Cr)F6 polyhedra, while it vanishes in the case of a dynamical Jahn-Teller effect. Ligand field, EPR, and magnetic data are given in addition and are discussed with respect to the structures of the host compounds and the cooperative Jahn-Teller order of the tetragonally elongated Cu(Cr)F6 polyhedra in the low-temperature phases.

Abstract The structures of two modifications of CuZrF6 by means of neutron diffraction on powder samples in the temperature range from 298-560 K are reported. All modifications consist of octahedra, which share corners in three dimensions and which are centered alternately by Cu2+ or Zr4+. The high temperature α-modification crystallizes in space group Fm3 (No. 202) with α = 7.939 Å. There is experimental evidence, that the CuFe-octahedra are distorted by a static Jahn-Teller-effect. The space group P1̄ (No. 2) with Z = 2 is proposed for the low-temperature γ-modification.

FeZrF6 exhibits a phase transition from the trigonal LiSbF6 structure type to the cubic high-temperature modification with an ordered ReO3 lattice at 212.3°K. From the temperature dependence of the quadrupole splitting in the temperature range 212°K ⩽ T ⩽ 4.1°K an axial splitting parameter |Δ1| = 68 cm−1 could be deduced, which is valid for T < 50°K and decreases linearly to 27 cm−1 (210°K) with increasing temperature. There is structural evidence supporting this interpretation and identifying the axial ligand field component as being of trigonal symmetry. Ligand field and EPR spectroscopic results, however, prove the existence of an additional dynamic Jahn-Teller coupling of tetragonal symmetry, which is obviously not seen by Mössbauer spectroscopy.

AbstractEine Übersicht über die Strukturen aller bisher beschriebenen Verbindungen des Typs MIIMeIVF6 wird gegeben. Ist MII ein Übergangsmetallion der ersten Periode, so treten die kubische geordnete ReO3‐Struktur und der hexagonale LiSbF6‐ Typ auf. Bei einem Kation mit einem Jahn‐Teller‐instabilen Eg−Grundzustand (Cr2+, Cu2+) auf der MII ‐ Position werden zusätzlich niedrigersymmetrische tetragonale und trikline Varianten dieser beiden Strukturen beobachtet. In vielen Fällen konnten im zugänglichen Temperaturbereich 80 K < T < 800 K Phasenübergänge zwischen den verschiedenen Gittertypen gefunden werden. Die relativen Stabilitäten der hexagonalen Tieftemperatur‐ im Vergleich zu den kubischen Hochtemperatur‐Modifikationen werden auf der Grundlage geometrischer Parameter und der elektronischen Eigenschaften insbesondere der MeIV Ionen ausführlich diskutiert. Eine Anzahl von Verbindungen des Typs MIIMeIVF6 konnte erstmalig dargestellt und charakterisiert werden. Über die spektroskopischen Eigenschaften wird in einem zweiten Teil der Arbeit berichtet.