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Biomedical subjects

C Jacobs

Publications and source records attributed to C Jacobs.

At least 325 records · Page 18Linked to original sources
PubMed1981

Management of the pregnant patient with Hodgkin's disease.

Fifteen pregnant women with Hodgkin's disease were followed. Five patients had irradiation, 1000 to 3000 rad to the neck, mediastinum, or both, during the second or third trimester with normal outcome of pregnancy. One patient had a spontaneous abortion in the first trimester after radiotherapy of 4400 rad to the breast, an estimated fetal dose of 9 rad. One patient who received chlorambucil throughout pregnancy delivered a normal infant. Six patients had therapeutic abortions; one had early induction of labor. In one patient previously treated for supradiaphragmatic Hodgkin's disease, detection of a supradiaphragmatic relapse was delayed because of pregnancy. We recommend abortion for patients who develop Hodgkin's disease early in pregnancy or who have received chemotherapy or irradiation during the first trimester. During the latter half of pregnancy, asymptomatic disease may be closely followed but early delivery is recommended. Supradiaphragmatic, symptomatic disease can be treated with modified irradiation. For subdiaphragmatic, symptomatic, or extranodal disease, single-agent chemotherapy may be preferable. Treatment requires individualization to insure that the patient will be cured and the fetus protected.

Abortion, Therapeutic↗
PubMed1981

Carbohydrate content of middle molecular weight substances (MMWS) in uraemic patients: preliminary results.

MMWS (between 500 and 10,000 daltons) have been isolated from peritoneal dialysis fluid. Materials were fractionated according to a procedure previously applied to urine in healthy controls and in patients with various glycoproteins. Successive use of ion-exchange, charcoal-Celite and paper chromatography leads to the isolation of 20 oligosaccharidic fractions whose MW range between 400 and 2000 daltons. Glucuronoconjugates were also identified by this technique. Preliminary studies show that this carbohydrate material is very similar to the one found in normal urine. The origin and the signification of these oligosaccharides will be discussed in regard with our present knowledges on the structure, catabolism, and function of glycoproteins.

Carbohydrates↗
PubMed1980

[Acute renal failure during indomethacin treatment. 6 cases (author's transl)].

Acute renal failure (ARF) was observed in 6 patients under indomethacin treatment. Before receiving the drug 3 patients had normal, and the other 3 slightly elevated plasma creatinine levels. All patients were also treated with diuretics. ARF developed within the first 48 hours of therapy. Four patients had clear-cut oliguria. The renal disorders proved completely and rapidly reversible after treatment was discontinued, except in one female patient who had to undergo peritoneal dialysis for 12 days and in whom moderate aggravation of the pre-existing renal insufficiency persisted on follow up. The ARF was attributed to a sudden fall in renal blood flow due to the inhibitory effect of indomethacin on prostaglandin synthetase. This complication occurs exclusively in patients with renal hypoperfusion secondary to hypovolaemia, with cardiac insufficiency or with intrarenal vascular lesions. Sodium depletion induced by previous or concomitant diuretic treatment increases the risks. The possibility of ARF warrants careful monitoring of urinary output and renal function at the onset of non-steroidal anti-inflammatory therapy in patients with altered or precarious haemodynamics.

Acute Kidney Injury↗
PubMed1980

[Cerebral venous thrombosis, complication of the nephrotic syndrome (author's transl)].

The occurence of arterial and, more frequently, venous thrombosis in patients with the nephrotic syndrome is well documented. Several factors are involved among which the fall in plasma albumin, the rise of several coagulation factors, platelet hyperreactivity, decrease of antithrombin III. We report here the first case, to our knowledge, of a dural sinus thrombosis, complicating a nephrotic syndrome with minimal glomerular changes. The difficulties of such a diagnosis and the key value of carotid angiography to establish it are emphasized. The use of anticoagulants can prevent this complication.

Cerebral Angiography↗
PubMed1980

Visual function can be preserved in insulin-dependent diabetic patients treated by maintenance haemodialysis.

Evolution of visual function was assessed in 43 insulin-dependent diabetic (IDD) patients treated by maintenance haemodialysis (MH) for a cumulative duration of 1248 patient-months. At start of MH, 23 patients (46 eyes) still had good vision, 20 patients (40 eyes) were blind. All 40 blind eyes had severe proliferative retinopathy (PR) with additional irreversible complications in 32. Of the 46 eyes with preserved vision, PR was present in 24 (52.2%) with only 2 additional severe complications. Restoration of sight was obtained either spontaneously or after ophthalmic surgery in 6 eyes (7%). Stabilisation was achieved in 74% of eyes which retained vision at the start of MH. Two patients with eyesight at start of MH became blind (8.7%). Aggravation of visual function is mainly related to development of PR and not to haemodialysis per se. Careful ophthalmic follow-up, together with close control of diabetes, blood-pressure and uraemia can ensure preservation of vision in most IDD patients treated by MH.

Adult↗
PubMed1980

Renal handling of cis-diamminedichloroplatinum(II).

The renal handling of cis-diamminedichloroplatinum(II) (cisplatin) was investigated by measuring the renal clearance of creatinine and free platinum (Pt). Free Pt clearance exceeded the glomerular filtration rate, indicating secretion of cisplatin or a metabolite. These results suggest that accumulation of Pt within renal tubular cells may be related to its nephrotoxicity.

Cisplatin↗
PubMed1980

Mechanism of cis-platinum nephrotoxicity: I. Effects of sulfhydryl groups in rat kidneys.

cis-Diamminedichloroplatinum (CP), an important chemotherapeutic agent, produces acute renal failure by an unknown mechanism. Other heavy metals, such as mercury, are thought to be nephrotoxic by reacting with sulfhydryl (SH) groups. To investigate the mechanism of CP nephrotoxicity, F344 rats were injected once with 6 mg of CP per kg. After 96 hr, the blood urea nitrogen rose to 140 mg/100 ml. The SH concentration in control kidneys was 20.4 +/- 0.1 muml/g wet weight. Total renal SH groups decreased to a maximum of 14% at 120 hr (P less than .01). The fall in SH groups was entirely due to a decrease of protein-bound SH groups. Cell fractionation studies showed that the greatest decline of SH groups occurred in the "mitochondrial" and "cytosol" fractions. These fractions also had the highest Pt concentrations. There was no stoichiometric relationship between Pt accumulation and the change in SH groups. Furthermore, in vitro studies demonstrated that CP does not directly interact with SH groups. To determine if the change in renal SH groups was nonspecific effect of acute injury, renal failure was induced with glycerol (5 g/kg i.m.). Total SH groups per kidney increased after glycerol. These results indicate that the decrease in renal SH groups produced by CP is not due to nonspecific tubular necrosis. The present findings suggest the possibility that the nephrotoxic effects of CP may be related to depletion of SH groups. However, a direct cause-effect relationship has not been established.

Animals↗
PubMed1980

Mechanism of cis-platinum nephrotoxicity: II. Morphologic observations.

Light microscopy, transmission electron microscopy and scanning electron microscopy were used to characterize the morphologic alterations and to localize the site of injury within the kidney 1, 2, 3, 5 and 7 days after the intraperitoneal injection of cis-diamminedichloroplatinum. Pathologic alterations were evident 3 days after the injection of the drug and were localized to the S3 segment of the proximal tubule situated in the outer stripe of the outer medulla. A spectrum of changes was seen in this S3 segment which included a thinning or focal loss of brush border, cellular swelling, condensation of the nuclear chromatin and focal areas of necrosis. After 5 days, widespread tubular necrosis of the S3 segment in the outer stripe was the predominant finding. Necrotic tubular epithelial cells could be seen detaching from the basal lamina and being sloughed into the tubular lumen. Only a bare basal lamina remained in many areas. Regeneration of the S3 segment was seen after 7 days and was characterized by tubules with widely dilated lumens which were lined by many low-lying epithelial cells. The observation that cis-diamminedichloroplatinum exerts its nephrotoxic effect on the S3 segment of the proximal tubule located in the outer stripe of the outer medulla demonstrates that the pattern of injury produced by this antitumor drug is similar to that associated with other nephrotoxic and ischemic models of acute renal failure.

Animals↗
PubMed1980

Risk factors in chronic haemodialysis.

A survival analysis was performed in 1,453 patients treated by chronic haemodialysis and prospectively followed up in the computerised French Diaphane Dialysis Registry. Risk factors found for overall and cardiovascular mortality are age, male sex, high systolic of diastolic blood pressure, low body mass index and low predialysis values of cholesterol, triglycerides, haematocrit, urea, creatinine and potassium. These results confirm the importance of optimal blood pressure control. They indicate that the nutritional state may play a more vital role than certain cardio-vascular risk factors found in the general population.

Adolescent↗