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Biomedical subjects

C Jacobs

Publications and source records attributed to C Jacobs.

At least 253 records · Page 14Linked to original sources
PubMed1989

[The role of continuous ambulatory peritoneal dialysis in the treatment of chronic end-stage uremia. Registration Committee of the European Dialysis and Transplant Association-European Renal Association].

By the end of 1986, about 9% of the patients with TU submitted in Europe to maintenance dialysis therapy (MDT) were treated with CAPD. According to data collected by the EDTA Registry in 6 Western European Countries, the proportion of dialysis centres which in each country developed an active CAPD program has remained virtually unchanged from 1981 through 1986. In all countries CAPD is used preferably in diabetics and in patients aged more than 65 years. The 3 year technical survival is higher for the patients who started CAPD in 1983 than for those who did so in 1981 and is heavily influenced by an overall treatment strategy of TU which integrates a CAPD-renal transplantation program. In several countries the slow development of CAPD can be mainly accounted for by a weak motivation of nephrologists for implementing this efficient mode of RRT.

Adult↗
PubMed1988

In vivo treatment with IL-1 reduces the severity and duration of antigen-induced arthritis in rats.

IL-1 has been implicated in the pathogenesis of arthritis. Although IL-1 injected in vivo into normal joints results in a transient inflammatory reaction, we have shown that three weekly repetitive injections of IL-1 do not produce a progressive inflammatory condition suggestive of chronic arthritis. In fact, priming normal joints with three weekly IL-1 intraarticular injections results in a significant reduction in joint swelling and diminished histopathologic alterations/lesions caused by subsequent methylated BSA-induced arthritis. Similarly, post treatment with IL-1 intraarticular injection after arthritis induction reduced arthritic swelling and joint injury if IL-1 was given during the developing stage of arthritis. Our results suggest that IL-1 might limit arthritic inflammation and progressive cartilage destruction through an, as yet, undetermined mechanism(s). Further in vivo investigations are required to determine the therapeutic utility of IL-1 in reducing early arthritic inflammation.

Animals↗
PubMed1988

[Comparison between treatments of severe forms of familial hypercholesterolemia by total plasma exchange and selective removal of low density lipoproteins (LDLapheresis)].

A plasma exchange program for familial hypercholesterolaemia was started in 1982. Ten patients aged from 7 to 58 years were progressively included: 3 had an heterozygous form of the disease with ischaemic heart disease; 3 had an homozygous form with defective low density lipoprotein receptor activity, 4 had a receptor-negative homozygous familial hypercholesterolaemia and had previously undergone portacaval shunt. During total plasma exchange against human albumin (470 sessions in 9 patients) low density lipoprotein cholesterol values, but also high density lipoprotein cholesterol values, decreased by 40 per cent. More recently, 5 patients had selective low density lipoprotein absorption on dextran sulfate column (Liposorber); 90 exchanges were performed. High density lipoprotein cholesterol values decreased by 55 per cent and high density lipoprotein cholesterol values by only 27 per cent. The patients' attitude to treatment was excellent, with less fatigue and better compliance.

Adult↗
PubMed1988

[Prevention of peritonitis during continuous ambulatory peritoneal dialysis. Value of disconnectable systems].

Peritonitis remains the major obstacle to the acceptance of continuous ambulatory peritoneal dialysis as a long-term dialysis technique. In January, 1985, Y connectors were introduced into our continuous ambulatory peritoneal dialysis programme, and a two-year prospective randomized trial for all new patients was initiated in which the Y connection system was compared with the conventional technique in the prevention of peritonitis (group I). At the same time, 16 patients (group II), with a high incidence of peritonitis episodes were switched from the conventional technique to the Y connection system, while 55 patients (group III), remained on the conventional technique. Group IA patients (27 new patients using the Y connection system), developed peritonitis every 23 patient-months. Group IB patients (28 new patients using the conventional technique), developed peritonitis every 12.2 patient-months. The difference between these two sub-groups was statistically significant (P less than 0.02). Before their transfer to the Y connection system, group II patients developed peritonitis every 10 patient-months and thereafter one every 24 patient-months (P less than 0.001). Group III patients were divided into 12 continuous cyclic peritoneal dialysis patients with peritonitis every 24 patients-months, and 43 continuous ambulatory peritoneal dialysis patients with peritonitis every 11.7 patient-months. The Y connector therefore proved to be a simple and safe procedure effective in reducing the peritonitis rate in patients on continuous ambulatory peritoneal dialysis.

Adult↗
PubMed1988

Vegetarian children: appropriate and inappropriate diets.

Acceptable and appropriate vegetarian diets fulfill the Recommended Dietary Allowances and other authoritative dietary guidelines dealing with balance, variety, moderation, and developmental appropriateness of diets for children. Vegetarian regimes currently fed to infants and children are evaluated using these criteria. Vegan-like diets, fed early in infancy and childhood, pose special problems with respect to sufficiency of certain nutrients, energy, and bulk, especially if they are unplanned and unaccompanied by ongoing health supervision. Lactovegetarian, lactoovovegetarian, and semivegetarian patterns are more likely to be satisfactory. They conform closely with the pediatric recommendations for promoting health and reducing risks of chronic degenerative diseases, are sufficient without being excessive in nutrients, are low in bulk, and are developmentally appropriate.

Adolescent↗
PubMed1988

Acute renal failure induced by foscarnet: 4 cases.

Foscarnet (FC) is a new antiviral agent which has been recently proposed for the treatment of severe cytomegalovirus (CMV) infections in immunocompromised patients. When used intravenously (i.v.), main adverse effects of FC are a fall in hemoglobin, and an increase in liver enzymes and serum calcium. Although increased serum creatinine have been noted in several patients, deterioration of renal function is often accounted for by the concomitant use of other nephrotoxic drugs, the severity of underlying disease or the presence of graft rejection. Consequently FC is often considered as a non or poorly nephrotoxic drug. We report 4 cases of acute renal failure (ARF) which can be exclusively attributed to FC. FC was used for CMV chorioretinitis in 3 AIDS patients and in one non-immunocompromised patient. ARF was diagnosed between the 6th and 15th day of treatment, with oligoanuria in two patients (one of whom required two hemodialysis periods). ARF was most likely secondary to acute toxic tubulopathy. Three patients did not receive any other nephrotoxic drug. The fourth patient received concomitantly sulfadiazine but renal function returned to baseline value after FC completion although sulfadiazine was continued. In conclusion, our 4 observations suggest that FC may be responsible for acute tubulopathy. We suggest that in these patients renal function should be carefully monitored and dehydration promptly corrected to limit the risk of nephrotoxicity.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Functional renal effects of cyclosporin. Physiopathological mechanisms].

Animals and humans undergoing a treatment with cyclosporin (CsA) show a reversible increase in renal vascular resistance and decrease in glomerular filtration rate. The causes of these abnormalities have not yet been established. In animals potential mechanisms for CsA induced renal functional impairment are an increase in urinary thromboxane A2 excretion, plasma renin activity and renal sympathetic nervous system activity and an enhancement of vasopressin stimulated Ca++ mobilisation and cell contraction in vascular smooth muscle cells. In human, the problem is far less clear. CsA induces an inhibition in PRA and urinary prostaglandins excretion. Furthermore CsA does not modify urinary and plasma levels of catecholamines. Whatever the mechanism underlying the vasoconstriction induced by CsA, the inhibition of PGI2 synthesis and angiotensin II formation may participate in the decrease in renal blood flow and glomerular filtration rate which is observed in patients receiving CsA.

Animals↗
PubMed1988

[Clinical aspects of continuous ambulatory peritoneal dialysis in diabetics].

The treatment of end stage renal diabetic nephropathy remains a challenge. A large experience allows us to clearly outline the advantages and the drawbacks of continuous ambulatory peritoneal dialysis (CAPD). 81 patients, mean age 51.3 years, were treated over the past nine years by CAPD-CCPD. Extrarenal complications, mainly vascular lesions, account for qualifying these patients as a high risk population. The technique was modified in order to inject insulin intraperitoneally, four times per day, to control blood glucose level. Peripheral vascular disease was prospectively studied in 19 patients. Actuarial survival was 92% at one year, 50% at four years mainly influenced by age: 85% survival at two years in 35 patients aged less than 50 years and 62% at two years in 46 patients aged more than 50 years. The main causes of death were of cardiovascular origin: arteritis, myocardial infarction, stroke. The main causes for transfer to an alternative method of treatment were technical complications. Peritonitis rate was one episode ever 14 months. Satisfactory control of blood pressure, blood glucose levels, main biological parameters, visual status were the clear advantages of the method. Peripheral vascular disease is not influenced by the technique. CAPD can be the technique of first choice in young diabetics awaiting a kidney transplant and the reference technique for home dialysis.

Adult↗
PubMed1988

Effects of nifedipine on cisplatinum-induced nephrotoxicity in rats.

The effects of calcium channel blockade with nifedipine (N) on cis-diammine dichloroplatinum II (CDDP)-induced nephrotoxicity were tested in male Sprague-Dawley rats. Renal function was evaluated before and five days after CDDP administration (5 mg/kg). The rats were treated with various doses of N (0.1; 0.3; 0.6 mg/kg/day) 2 days before CDDP administration and throughout the study. The severity of CDDP-induced acute renal failure was markedly modified in N-treated animals according to the daily dosage of N. At 0.3 and 0.6 mg/kg BW/day, N enhanced CDDP nephrotoxicity. Serum creatinine was 637 +/- 45 and 611 +/- 71 mumoles/liter, respectively, 5 days after CDDP administration (vs. 313 +/- 24 mumoles in animals treated with CDDP alone; p less than 0.05). In these animals the plasma potassium level was significantly elevated at day 7 when compared with CDDP-treated and control rats. In contrast, at the dose of 0.1 mg/kg BW/day N attenuated CDDP nephrotoxicity with a serum creatinine of 214 +/- 35 mumoles at the end of the study. The pathologic changes were also more severe in the groups receiving 0.3 and 0.6 mg/kg of nifedipine. We postulate that at the higher doses (0.3 and 0.6 mg/kg) the systemic hemodynamic effects of nifedipine may override the potentially beneficial intrarenal effect which may account for the favorable results recorded with a dosage of 0.1 mg/kg.

Acute Kidney Injury↗