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Biomedical subjects

B Eklund

Publications and source records attributed to B Eklund.

At least 37 records · Page 2Linked to original sources
PubMed1994

Thirty years of renal transplantation in Helsinki.

During triple-drug immunosuppression, consisting of azathioprine, steroids, and cyclosporine, the number of acute rejections was low. Close monitoring of the patient and the graft during the early posttransplant weeks with regular cytological and histological analyses was the cornerstone of early diagnosis and a favorable outcome of acute rejection. Genetic homogeneity of our patient population, third-party transfusion program, and use of well HLA-matched kidney grafts may have been additional factors behind the low rate of acute rejection. Acute rejection within the first three postoperative months did not predispose the renal graft to chronic rejection in the long term. The histologically determined allograft damage index was a reliable predictor of future graft survival. Recipients with systemic diseases such as diabetes and amyloidosis, as well as elderly patients, could be transplanted safely with results only slightly inferior to those achieved with primary kidney disease. Results in diabetic recipients have steadily improved, encouraging the continuation of critical evaluation of the patients' pretransplant status and the preference for cadaveric transplants. Renal transplantation in small children yielded superior patient and graft survival rates. We consider the use of living donors justifiable in these cases. The five million population of Finland offers an ideal size for a transplant center. Continuous education of medical personnel and the general public is crucial for the cadaver transplant program.

Adolescent↗
PubMed1994

[Cancer following organ transplantation].

Organ transplantation is followed by an increased risk of cancer. Analysis of series of transplanted, and thus immunosuppressed patients, enables the risk factors associated with this treatment to be identified, and oncogenic mechanisms in general to be investigated. In most recent cancer studies where correct epidemiological methods have been used, the incidence of cancer among transplanted patients was found to be 3-5 times that in the general population. This was the case for most types of tumours, though the distribution was uneven with an over-representation of lip, cervical, vulvar, urological and skin cancer and lympho-proliferative disorders, most of which appear early after transplantation, except for skin cancer which appears later but increases in incidence with time. The increase in the incidence of cancer appears to apply to all kinds of organ transplantation, though so too does our knowledge of possible risk factors and oncogenic mechanisms in general. For many of the tumour types there would appear to be a connexion with virus infection, which opens up avenues of research regarding prophylaxis and treatment.

Humans↗
PubMed1992

Late histopathological findings in renal allografts with four immunosuppressive regimens.

The histological changes in renal allografts are usually studied when graft function has already deteriorated. The early results of renal allografts have improved dramatically during the last two decades, but the half-life of renal cadaveric allografts has remained unchanged at approximately 7 years. The mechanism of chronic rejection, and how to prevent it, is not known. We studied the histology of renal allografts under four different immunosuppressive regimens 2 years after transplantation. The aim of this study was to investigate whether histopathological changes exist in the renal allografts with relatively good and stable graft function. We also investigated whether there were differences in allograft histology between four immunosuppressive treatment groups 2 years after transplantation.

Azathioprine↗
PubMed1992

Leishmaniasis diagnosed from bronchoalveolar lavage.

A 51-year-old renal transplant patient, whose spleen had been removed 11 years ago, was admitted to hospital for elective surgery, which was cancelled as she developed spiking fever and nonproductive cough and her general condition deteriorated. After 2 weeks, leishmaniasis was unexpectedly diagnosed from a bronchoalveolar lavage specimen, which had been subjected to parasitological examination under the suspicion of pneumocystosis. Isoenzyme typing identified the parasite as Leishmania infantum. The patient had visited Malaga, Spain, twice a year, the last trip taking place 1 month before admission. Specific treatment was followed by rapid recovery without relapse during 1.5 years. Splenectomy and immunosuppressive medication obscured the clinical suspicion of leishmaniasis. The case is a reminder of the interstitial pneumonitis in leishmaniasis and emphasizes the value of broad-spectrum methods detecting a variety of parasites.

Animals↗
PubMed1991

The association of HLA-DR antigens with acute steroid-resistant rejection and poor kidney graft survival.

The association of an early steroid-resistant rejection (SRR) with HLA-DR antigens was analyzed in 410 kidney transplantations. A severe SRR leading to a poor (45%) 1-year graft survival (GS) occurred in 22 transplantations (5%). An acute reversible rejection (ARR) with a GS of 94% was found in 80 transplantations (20%). For the 308 (75%) transplantations with no early rejection episodes the GS was 91%. HLA-DR5 and -DR8 present in the donor as incompatible antigens were strongly associated with SRR. Further, a mismatched DR1 from the kidney donor predicted a rejection, either reversible or irreversible. These findings may have practical implications for an early diagnosis of SRR and for considering of rescue therapy whenever transplantation with disparities in these loci has been performed.

Adult↗
PubMed1990

The effect of intravesically applied antibiotic solution in the prophylaxis of infectious complications of renal transplantation.

The effect of intravesically applied antibiotic solution in the prevention of infectious complications of renal transplantation was evaluated in a prospective, randomized study. The bladder was filled preoperatively with saline solution containing cephalotin in the test group, and with saline solution only in the controls. Both groups of patients received IV doses of cephamandole during, and once after, surgery. Two hundred consecutive patients were randomly allocated to the study groups. The overall incidence of urinary tract infection was 10.4% during the first 4 postoperative weeks; that of wound infections was 1.6% and of septicemia 3.3%. The addition of cephalotin to the bladder irrigation fluid did not have any effect on the overall incidence of infectious complications.

Administration, Intravesical↗
PubMed1990

The value of repeated renal retransplantations.

The outcome of 64 repeated renal retransplantations (50 third, 13 fourth, and 1 fifth) during a period of 25 years was retrospectively evaluated. The prognosis of third and subsequent grafting was greatly improved if cyclosporine was included in the induction immunosuppressive regimen (one-year graft survival 79.9%, compared with 32.4% if CsA was not used). The onset of graft function was not delayed by CsA and the proportion of never functioning grafts was significantly lower (5.3%) in patients treated with CsA than in those treated without it (43.2%). Survival of the previous grafts for longer than one year favorably influenced the outcome of the subsequent grafts.

Adult↗
PubMed1990

Seasonal mood variation: an epidemiological study in northern Norway.

In an epidemiological study carried out in the town of Tromsö in northern Norway an extensive questionnaire was sent twice, in summer and winter, to 1000 subjects to investigate the degree of symptoms of mood variation (depression or hypomania) during the polar winter night and midnight sun seasons. The results suggest that the general population north of the Arctic Circle shows a major seasonal mood variation. It is suggested that seasonal mood variation is a chronobiological mood disturbance related to and probably precipitated by extreme variations in light. The therapeutic implications and preventive measures are discussed.

Adult↗
PubMed1990

Reposition of a displaced peritoneal catheter: the Helsinki whiplash method.

Dialysate outflow obstruction caused by displacement of the catheter tip is a relatively common complication of peritoneal dialysis, occurring in up to 20% of implanted catheters and often requiring surgical intervention. We describe a simple method used to reposition straight, Tenckhoff-type catheters. The procedure is performed under fluoroscopic control using a 2 mm thick catheter guide, bent fo form a slight curve. The catheter guide is introduced near the tip of the migrated catheter and then rotated in order to bring the catheter to the pelvis. Experiences over the five-year period 84-89 are summarized. In more than 60% of the patients, the first displacement occurred within one month of insertion of the catheter, and 70% of the catheters migrated to the right. The procedure was used in 21 patients to treat 50 displacements. In 86% of the cases the procedure was successful. 52% of the patients needed only one reposition while 48% experienced two or more displacements and subsequent repositions. Five patients eventually needed replacement of the catheter or were permanently switched to hemodialysis. The reposition procedure was practically free of complications.

Catheterization↗