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Biomedical subjects

F Berthoux

Publications and source records attributed to F Berthoux.

At least 73 records · Page 4Linked to original sources
PubMed1991

[IgA glomerulonephritis].

Primary IgA nephritis is the most frequent nephritis and represent half of the glomerular diseases. Its incidence is 2,7/10(5) inhabitants. The diagnosis is established on a renal biopsy, which shows typical IgA mesangial deposits: granular, predominant, and diffuse. A central pathogenic role is played by the IgA immune system, both from the mucosa and the bone marrow. The long term prognosis should no longer be considered as mild because, after 20 years of evolution, 1/3 of the patients are going into chronic renal failure, and 1/6 into end-stage renal disease. It is essential to delineate the risk factors predicting ultimate evolution towards chronic failure, to select patients who may benefit from aggressive treatment, such as high doses steroids. For all patients, it is essential to have a regular clinical and biological check up, and an adequate control of arterial hypertension, in order to avoid or delay progression.

Glomerulonephritis, IGA↗
PubMed1991

[Oncological complications after renal transplantation].

Oncological complications were studied in 420 renal transplantations performed in 389 patients. Seven patients with a history of neoplasia were transplanted, and 2 tumours were transmitted by the graft. However, the main problem was that of de novo tumours induced by immunosuppression: 26 patients developed such tumours which resulted in death for 7 of them. The risk of tumour seems to be relatively selective. Seven lymphoproliferative syndromes, 6 Kaposi's sarcomas and 4 spinocellular epitheliomas were observed and together accounted for 65.3 percent of de novo tumours. Excessive immunosuppression could be blamed in only one third of the patients. On the other hand, some geographical and/or ethnic factors seemed to facilitate tumour development, and infections with viruses of the herpes group were found in 76 percent of these subjects.

Adult↗
PubMed1991

Prognostic factors in mesangial IgA glomerulonephritis: an extensive study with univariate and multivariate analyses.

To clarify the risk factors for chronic renal failure in idiopathic IgA glomerulonephritis (IgA-GN), we performed a dual study on 282 patients using both standard univariate statistical methods and the multivariate regression model of Cox. During a follow-up ranging from 1 to 36 years, with a mean of 8 years, 18% of the patients (50/282) had gone into chronic renal failure (CRF), with 18 of them in end-stage renal disease (ESRD) (6%). The univariate comparison of patients with CRF versus patients without CRF showed multiple risk factors: mainly arterial hypertension, an amount of proteinuria, nephrotic syndrome, a high level of serum IgA, presence of HLA-B35 antigen, and the intensity of most pathological lesions on light microscopy. The actuarial survival rate for a normal renal function (serum creatinine less than 135 mumol/L [1.5 mg/dL]) was 84% at 10 years and 64% at 20 years. The multivariate study allowed the isolation of only four risk factors with a significant effect on survival rate. These were the amount of proteinuria, the global optical score on first renal biopsy, the presence of an initial hypertension, and the presence of the HLA-B35 antigen. From these results, the probability of renal survival for individual patients may be calculated and a high-risk subgroup defined. Our data confirm the greater usefulness of multivariate over univariate statistical analyses in finding risk factors for CRF in IgA-GN.

Adolescent↗
PubMed1991

Renal transplantation with a current T negative but historical T and/or B positive cross-match.

We report our experience of 36 renal transplanted patients against a current T negative allo-cross-match, but historical T and/or B positive allo-cross-matches, whatever the result of the current B cross-match. Additionally, we have determined the immunoglobulin class of the antibody directed against B and T lymphocytes. The graft survival rate did not differ between the 36 patients forming the study group, and the 229 patients transplanted within the same period with negative T and B, on current and historical sera, cross-matches. Within this study group there was no changes in graft survival rate for the following three subgroups, which were retrospectively defined: historical positive (14 patients) versus negative (22 patients) T cross-match, current positive (15 patients) versus negative (21 patients) B cross-match, and IgM (16 patients) versus IgG (20 patients) against B lymphocytes. In terms of transplant outcome, our policy was thus safe.

Adult↗
PubMed1990

[Phenotypic and functional study of natural killer lymphocytes in flow cytometry: application to renal transplantation].

In order to define the best appraisal of Natural Killer cells, the authors performed a dual study, including both phenotypes and functional activities, and all the analyses were achieved with flow cytometric techniques. Results were applied to renal transplantation. Among the numerous clusters of differenciation, only CD16 and CD56 appeared to be well correlated with the functional properties of Natural Killer cells, and especially for CD3- cells. On the other hand, CD57 should no longer be considered as a NK marker. Functional properties of Natural Killer cells were evaluated by cytotoxicity assays of peripheral lymphocytes against K562 and Daudi tumor cells, either spontaneously, or after a 3-day activation with Interleukin 2 (LAK). The authors use carboxyfluoro-diacetate to label viable cells and avoid radioisotopes. They confirm the Natural Killer cells deficiency in renal transplant recipients, and show that this impairment also involves the LAK cytotoxicity. Azathioprine appeared to be responsible of such deficiency. During viral infections, Natural Killer cells raised and reached the normal values, while they were incapable of any response to fight against cancer. They suggest that the Natural Killer deficiency could explain the high incidence of malignancies during renal transplantation.

Adult↗
PubMed1990

[Ureteral stenosis in kidney transplantation].

The authors report 13 cases of ureteral or periureteral sclerosis in a series of 330 cases of renal transplantation (3.9%): they occurred early, were asymptomatic (except for anuria); the renal cavities were always dilated, the renal function always deteriorated; the treatment was essentially surgical without mortality and with a low complication rate but 23% of the transplants were lost because of urological complications at 18 months. The authors compare their series with the literature.

Adult↗
PubMed1990

[Transplantation and tumors of the kidney].

The authors report the case of a woman who was transplanted with a cadaveric kidney. It was a cyst on the kidney; a biopsy was performed: it was a carcinoma. The transplanted kidney was removed. The second case was a man, transplanted with a cadaveric kidney, with a tumor at the lower pole: a tumorectomy was performed: it was a angiomyolipoma.

Acute Kidney Injury↗
PubMed1990

[Urinary fistula after renal transplantation].

Among 336 consecutive renal transplantations performed in our centre from March 1979 to December 1988, we have observed 26 cases of urinary leak in 25 patients. We have separated the ischemic and non-ischemic urinary leaks. The former (11 episodes) would have been prevented in most cases with better graft removal. The latter (15 episodes) were predominantly secondary to an anastomotic leak. We have treated surgically these urological complications. Only one patient died. The one-year graft survival rate was 67% in the 25 kidneys but the graft loss was directly due to the urinary leak in three cases.

Actuarial Analysis↗
PubMed1990

[Colonic perforation after renal transplantation].

Among surgical complications following kidney transplantation, the colonic perforation should be known. We reported a fatal case of perforation occurring on a colonic diverticulosis in the first month week post-transplantation. We emphasized on the difficulty to assess the diagnosis.

Aged↗
PubMed1989

Renal transplantation and Kock pouch: a case report.

We report on a young woman with anuric, terminal renal insufficiency whose bladder could not be used for renal transplantation. A Kock pouch was implanted during stage 1 of treatment and the capacity of the pouch was increased artificially with physiological saline solution. The patient subsequently underwent renal transplantation. Results were excellent with regard to continence and ease of catheterization. No complications due to infection were observed despite immunosuppression and electrolyte disorders were minor.

Adult↗
PubMed1989

Ganciclovir therapy of symptomatic cytomegalovirus infection in renal transplant recipients.

We used ganciclovir to treat 11 renal transplant recipients with symptomatic cytomegalovirus infection (seven primary), including one severe, five mild and five moderate cases. Two patients exhibited a non-mechanically ventilated pneumonitis and two others a gastrointestinal involvement. Ganciclovir was used intravenously according to a schedule which took into account renal function, for a median time of 14 days. All patients survived. Cytomegalovirus infection was cured in all patients but two: in the first an early clinical relapse required a second successful ganciclovir course; in the other graftectomy was needed to control infection. Graft was lost in an additional cured patient. Ganciclovir was well tolerated, especially with regard to haematological status. At the current follow-up of at least one month after the end of ganciclovir therapy, no further clinical relapse was observed; however, in one clinically cured patient cytomegalovirus was isolated from blood one week after ganciclovir cessation. These encouraging preliminary data suggest that ganciclovir therapy should be started as soon as cytomegalovirus infection is suspected, especially in cytomegalovirus seronegative recipients receiving a seropositive graft.

Adult↗
PubMed1989

[Effects of diltiazem on arterial pressure and renal function in renal transplanted and cyclosporin A treated subjects. Results after 3 months of a prospective study].

With the aim to improve renal graft function and to prevent hypertension, we used the calcium-antagonist diltiazem in a prospective randomized study in 30 consecutive cadaveric renal transplanted patients from september 1987 to may 1988. The diltiazem (D+) group comprised 14 patients receiving a loading dose of 0.3 mg/kg followed by a 2 micrograms/kg/d continuous IV infusion of D started as soon as possible after clamp on renal artery removal. D was then given orally (120-180 mg/d) throughout the study. 16 patients without D composed the D- group. Cyclosporine A (csa) was started either just before transplantation (15 mg/kg/d orally) in 18 patients (9 D+ and 9 D-) or after 2-3 weeks of poly or monoclonal antibodies (5 D+ and 7 D- at 10 mg/kg/d. In addition to the usual monitoring, inulin (for GFR) and PAH (for ERBF), clearances were performed 7 days and 3 months after transplantation. If hypertension (blood pressure greater than 160/90 mm Hg) occurred, all but calcium-antagonists antihypertensive agents were used in both groups. Between D+ and D-, the number of patients requiring haemodialysis during the first week was not different (7/14 vs 5/16) like the number of dialysis session per patient (1.4 vs 1.1) day 7 GFR (19 +/- 22 vs 23 +/- 20) and day 7 ERBF (146 +/- 147 vs 226 +/- 224) ml/mn/1.73 m2; at 3 months 13/14 (93 p. 100) vs 12/15 (80 p. 100) of the grafts are functioning (NS), GFR (34 +/- 17 vs 33 +/- 10) and ERBF (242 +/- 90 vs 236 +/- 117) are not different.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗