Search PubMed⌕ Search

Biomedical subjects

D G Oreopoulos

Publications and source records attributed to D G Oreopoulos.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

What is our impact?

Explore the source record for details and available documents.

Humans↗
PubMedDate not supplied

Continuous ambulatory peritoneal dialysis in end-stage renal disease due to multiple myeloma.

OBJECTIVE: To evaluate (1) the disease course, (2) the response to recombinant human erythropoietin (rHuEPO), and (3) the morbidity and mortality of patients with end-stage renal disease (ESRD) due to multiple myeloma (MM) who were treated with continuous ambulatory peritoneal dialysis (CAPD) DESIGN: Retrospective study. SETTING: Tertiary teaching hospital--The Toronto Hospital, Toronto, Ontario, Canada. PATIENTS: Seven patients with ESRD due to MM who were treated with CAPD. RESULTS: Mean age of the patients was 77.2 years (median 80 years, range 65-88 years). Two were in stage IB, 1 was in stage IIB, and the remaining 4 were in stage IIIB, according to Durie and Salmon's staging. Three patients received rHuEPO; 2 of these also were receiving chemotherapy for myeloma. The mean rHuEPO requirement was 277 U/kg/wk, which was more than other ESRD patients' requirements. Mean duration of CAPD was 20.6 months (6-58 months). The peritonitis rate was one episode in 14.4 months. The frequency of hospitalization was once in 5.6 months, and the mean number of days spent in hospital was 20 days per year. Quality of life did not get worse and, if anything, improved marginally while they were on CAPD. Three patients died after a mean survival of 32.7 months, and the remaining 4 patients are still alive. CONCLUSIONS: Myeloma patients with ESRD do fairly well on CAPD without deterioration in their quality of life and with an acceptable peritonitis rate.

Aged↗
PubMedDate not supplied

Answers to all your questions about peritoneal urea clearance and nutrition in CAPD patients.

In summary, SA and a number of other indices related to nutritional status have been identified as being strongly predictive of outcome in CAPD patients. Evidence connecting these indices to KT/V urea, or even to protein intake, remains limited, however. Increased dialytic dose may well increase protein intake, but neither of these parameters have been shown prospectively to raise SA, total body nitrogen, or SGA status on a consistent basis. Studies addressing this issue, however, have been few and small, and more data are required. For now, we will likely continue to deal with malnutrition by attempting to raise small solute clearance and protein intake, but we should be aware that such measures will frequently be unsuccessful, and we must pay attention to other factors, particularly comorbidity. It is clear from this review that there are many unanswered questions relating to this topic and that, in particular, the effect of prospective increases in the dialytic dose needs to be further elucidated.

Humans↗
PubMedDate not supplied

Synthesis of hyaluronic acid by human peritoneal mesothelial cells: effect of cytokines and dialysate.

OBJECTIVE: To assess effects of the inflammatory cytokines (IL-1-beta, TNF-alpha, TGF-beta 1) and dialysate effluent on synthesis of hyaluronic acid by human peritoneal mesothelial cells (HMC) in in vitro culture. METHODS: Dialysate effluent was collected after the overnight dwell of Dianeal 1.5% from patients during CAPD training. HMC were obtained from omentum from nonuremic donors or were harvested from the dialysate effluent from CAPD patients. Synthesis of hyaluronic acid was studied on monolayers of HMC, which were deprived of serum 48 hours prior to experiment. Effects of cytokines were tested in a medium with low serum concentration (0.1%) or in medium mixed (1:1 v/v) with the autologous dialysate. Hyaluronic acid level in medium was measured with radioimmunoassay. RESULTS: Cytokines enhanced synthesis of hyaluronic acid by HMC, and the strongest effect was induced by IL-1. Effluent dialysate stimulates synthesis of hyaluronic acid stronger than 10% FCS. Effluent dialysate and IL-1 synergistically enhance synthesis of hyaluronic acid by HMC. CONCLUSION: Effluent dialysate from CAPD patients stimulates production of hyaluronic acid by HMC and acts synergistically with cytokines.

Cells, Cultured↗
PubMedDate not supplied

Biocompatibility of silver-coated peritoneal dialysis catheter in a porcine model.

OBJECTIVE: Previous studies have shown that silver formulations coated onto implantable materials retard bacterial colonization and reduce the incidence of catheter-related infections. The objective of this study was to assess the histologic effects of sputter-coated silver/ silicone implants on host tissue. DESIGN: Sputter silver-coated silicone peritoneal dialysis catheter segments with and without Dacron cuffs were implanted in the subcutaneous fat and muscle in 4 pigs. Noncoated implants served as controls. The specimens were retrieved at 1, 2, 3, 4, 7, 8, 9, 10, 12, and 27 weeks. EXPERIMENTAL ANIMALS: Four 6-week-old male Yorkshire-Landrace pigs (5-6 kg) were used. MAIN OUTCOME MEASURES: Histologic parameters evaluated included the degree of inflammation, the number of giant cells, the extent of silver particulate inclusions, and the thickness of the capsules. All specimens were evaluated by a single blinded pathologist. Microbiologic analyses were also performed. RESULTS: The silver-coated catheters were associated with less inflammation than were the noncoated catheters, both in fat and muscle (p = 0.04). The number of giant cells was also lower around the silver-coated than the non-coated catheters, which were implanted in subcutaneous fat (p < 0.05). Particulate inclusions compatible with silver or silver oxide were observed only in tissue around silver-coated implants (p < 0.0001). The thickness of the capsules and the extent of the inflammatory zones were not significantly different. There was no evidence of infection-related changes. CONCLUSIONS: These data suggest that the sputter silver coating does not act as a significant tissue irritant.

Animals↗