Search PubMed⌕ Search

Biomedical subjects

A Wahlin

Publications and source records attributed to A Wahlin.

At least 91 records · Page 5Linked to original sources

Altered distribution of T lymphocyte subsets in lithium-treated patients.

37 lithium-treated patients, 6 prelithium patients and 12 healthy volunteers were studied regarding relative and absolute numbers of peripheral blood lymphocytes, T lymphocytes and T lymphocyte subsets defined with monoclonal antibodies (OKT4, OKT8). Prelithium patients did not differ significantly from healthy volunteers. The relative and absolute numbers of OKT4 cells were lower in lithium-treated patients than in the controls. The relative number of OKT8 cells increased with increasing duration of lithium therapy. Abnormally high as well as low OKT4/OKT8 ratios were found in lithium-treated patients. OKT4/OKT8 ratios were negatively correlated to the duration of lithium therapy. The urinary concentration capacity was significantly lower in patients with low OKT4/OKT8 ratio than in the other lithium-treated patients. It is concluded that lithium in therapeutic doses may have immunomodulatory effects.

Adult↗

Improved survival in multiple myeloma with combination chemotherapy and plasmapheresis.

The relation of different cytostatic regimens and plasmapheresis to survival time was studied in patients with stage III myeloma. The median survival time for 23 melphalan-prednisolone treated patients was 9 months. Nine melphalan-prednisolone treated patients, who were in addition treated with plasmapheresis survived longer (median 23 months), but the difference was not significant. Twenty-five patients, treated with plasmapheresis and cytostatic combination (melphalan, cyclophosphamide, BCNU, vincristine, prednisolone) survived significantly longer, for 61 months (median). Cytostatic combination therapy seems to prolong survival in stage III myeloma. Plasmapheresis may also have a favourable effect.

Adult↗

Melphalan-related leukemia in multiple myeloma.

Five patients with multiple myeloma ending in acute leukemia are described. The preleukemic phase was characterized by anemia, leukopenia and/or thrombocytopenia. The incidence of acute leukemia in myeloma was calculated to be 6%. Melphalan therapy for more than two years increased the incidence to 14%. All patients who developed leukemia had received a total melphalan dose of at least 1 100 mg.

Acute Disease↗

Urine microscopy as screening method for bacteriuria.

Fresh urine samples from 90 ambulatory patients with urological disorders were examined for leucocytes by counting the number of WBC/mm3 and per high power field (HPF) in sediment. Bacteria could be cultured in 20 samples, 18 of which contained greater than 8 WBC/mm3. Two (3%) of the 63 samples with less than or equal to 8 WBC/mm3 contained bacteria. Bacteriuria was found in two (3%) of 65 samples containing 0--1 WBC/HPF. Microscopic examination of the sediment might be used for the screening of patients with a high frequency and urgency of micturition for bacteriuria. A normal number of urinary leucocytes (less than or equal to 8/mm3) indicates that no bacteria will be found in culture. Leucocyturia indicates a high probability of bacteriuria.

Adult↗

Renal function in familial amyloidosis with polyneuropathy.

The renal function is assumed to be normal in most patients with familial amyloidosis with polyneuropathy (FAP) type 1. In the present study of 24 patients with FAP type 1, estimation of the urinary concentrating capacity and 51Cr-EDTA clearance demonstrated that the glomerular clearance and the concentrating capacity were imparied in most patients. The concentrating capacity was significantly correlated with the clearance values. Urine electrophoresis indicated a glomerular cause for the proteinuria. It is suggested that the renal dysfunction should be attributed to deposition of amyloid substance in the glomeruli.

Adolescent↗

Evaluation of serial bone X-ray examination in multiple myeloma.

Fifteen patients with multiple myeloma stage III were treated with a combination of cytostatics and plasmapheresis in a sequential trial running for 60 weeks. Thirteen patients showed clinical improvement and ten a reduction of their myeloma protein by at least 50%. Bone X-ray examination was performed every 15 weeks. Progression of bone lesions was seen in one patient, whereas the radiographic picture was unchanged in the others. It is concluded that bone X-ray, although essential in the diagnosis and staging of multiple myeloma, is not suitable for the monitoring of patients during treatment.

Aged↗

Plasma proteins and anti-kidney antibodies in renal carcinoma.

Occurrence of the nephrotic syndrome in association with renal carcinoma has been reported earlier. There is a risk of masking of carcinoma due to symptoms of nephrotic syndrome/glomerulonephritis. In this study the serum protein profile in patients with renal carcinoma was found to be similar to that of patients with glomerulonephritis. However, increased levels of complement factors C3 and C4 were found, indicating low or none complement consumption. Patients with metastasis had higher blood ESR, orosomucoid, CRP, C3 and C4 but lower Hb and albumin than patients without evidence of metastasis. Immunofluorescence examination of kidneys and sera indicated the occurrence of antibodies against glomerular structures, IgG antibodies were demonstrated in most patients, IgA and IgM in some.

Aged↗

Response to busulphan treatment of paroxysmal nocturnal hemoglobinuria and myelofibrosis in one and the same patient.

Paroxysmal nocturnal hemoglobinuria (PNH) occurs occasionally in association with other blood disorders. This fact has led to the suspicion, that a mutation on the stem cell level may produce a dual defect of hematopoiesis, the PNH defect as well as other disturbances in blood formation. A patient with PNH and myelofibrosis appearing simultaneously is presented. Treatment with busulphan resulted in reduction of the hemolysis and improvement of the patient's condition. To our knowledge, this experience has not been described previously.

Blood Cell Count↗

Renal function and morphology in long-term lithium and combined lithium-neuroleptic treatment.

Ten patients on long-term lithium therapy and ten on lithium and neuroleptics (combination therapy) were examined with renal biopsy and tests of renal function. Patients on combination therapy had more pronounced histopathological changes and lower concentrating capacity than patients on lithium alone. Patients on combination therapy had received a larger total dose of lithium and had had higher maximum serum lithium levels than patients on lithium alone. Patients with large daily urine volumes had a low concentrating capacity. There was a negative correlation between degree of histopathological lesions and urinary concentrating capacity. Estimation of urinary concentrating capacity seems to be of value for the assessment of renal lesions in lithium treatment.

Adult↗

Renal concentrating capacity in long-term lithium treatment and after withdrawal of lithium.

The urinary concentrating capacity was estimated with the DDAVP test in 87 patients receiving lithium therapy, which was discontinued in all patients. The test was repeated three and eight weeks after withdrawal of lithium in 75 patients and one year after withdrawal in 27 patients. Of the 87 patients, 52 were also treated with neuroleptics, which treatment was continued throughout the study. Two control groups, consisting of 30 patients receiving only neuroleptics and 30 healthy subjects, were studied on one occasion with the DDAVP test. Lithium-treated patients had significantly lower concentrating capacity and higher serum creatinine than healthy subjects at all examinations. Small but statistically significant correlations were found between urinary osmolality and total dose of lithium, between urinary osmolality and duration of lithium treatment, between the highest serum lithium concentration recorded and urinary osmolality after withdrawal of lithium and between the daily dose of lithium and urinary osmolality, while patients were still on lithium. The concentrating capacity improved significantly during the first two months after withdrawal of lithium, but not later. One year after withdrawal of lithium, 17 of 27 patients still had a concentrating capacity below 800 mOsm/kg. Patients receiving lithium and neuroleptics had lower concentrating capacity than patients treated with lithium alone, and patients treated with neuroleptics alone had lower concentrating capacity than healthy subjects.

Adult↗

Kidney function in patients with affective disorders with and without lithium therapy.

The ability to concentrate the urine was estimated in healthy volunteers, patients with affective disorders who had never received lithium and lithium-treated patients. Patients with affective disorders who had never received lithium were found to have significantly lower concentrating capacity than healthy volunteers. However, lithium-treated patients had still lower concentrating capacity and differed significantly both from healthy volunteers and from patients who had never received lithium. Furthermore, in a subgroup of lithium-treated patients investigated twice with an interval of 6 months, a progressive decrease in concentrating capacity was found, indicating the importance of lithium therapy.

Adult↗