Search PubMed⌕ Search

Biomedical subjects

J S Robson

Publications and source records attributed to J S Robson.

At least 37 records · Page 2Linked to original sources
PubMed1977

The effect of dialysate calcium concentration on 1alpha-hydroxyvitamin D3 on skeletal calcium loss and hyperparathyroidism in haemodialysis patients.

The response of hyperparathyroidism and skeletal calcium loss in haemodialysis patients to treatment with 1alpha-hydroxyvitamin D3 and a dialysate calcium concentration of 1.375 mmol/l was compared with the response to treatment with a dialysate calcium concentration of 1.375 or 1.75 mmol/l alone over a 6 month period. In patients treated with 1alpha-hydroxyvitamin D3 there was a significant rise in plasma calcium associated with a significant fall in plasma alkaline phosphatase and plasma parathyroid hormone as well as resolution of sub-periosteal erosions. In these patients there was a significant rise in the calcium content of the forearm assessed by neutron activation analysis in comparison to patients treated with a dialysate calcium concentration of 1.75 or 1.375 mmol/l alone. In patients treated with a dialysate calcium concentration of 1.375 or 1.75 mmol/l alone there was no significant change in the plasma calcium, alkaline phosphatase or parathyroid hormone after 6 months and in these patients subperiosteal erosions either did not change or became worse. No significant difference in the response in these two groups was observed. This study indicates that treatment of haemodialysis patients with 1alpha-hydroxyvitamin D3 is significantly more effective than treatment with a dialysate calcium concentration of 1.375 or 1.75 mmol/l alone in preventing progression of hyperparathyroidism and skeletal calcium loss.

Adult↗
PubMed1977

Oral or parenteral iron therapy in haemodialysis patients?

In 28 haemodialysis patients, in whom there was a high incidence of depleted marrow iron stores, a significant rise in Hb, and Hct, occasionally to a normal level, was achieved as effectively with oral as with i.v. iron supplements. There was a variable response to iron in individuals which could not be predicted from the initial iron status. No patient in whom marrow iron stores were reassessed after iron therapy developed increased marrow iron stores. Routine iron supplements are recommended in haemodialysis patients with regular monitoring of body iron stores.

Administration, Oral↗
PubMed1976

Significance of urinary C3 excretion in glomerulonephritis.

The third component of complement (C3) was measured in the urine of 98 patients with a variety of renal diseases. Renal biopsy was performed on 83 of the patients and examined by light, electron, and immunofluorescence microscopy. Urinary C3 was detected in cases of membranous glomerulonephritis, mesangiocapillary glomerulonephritis, rapidly progressive glomerulonephritis, and renal amuloidosis. It was not detected in minimal lesion glomerulonephritis; in cases of proliferative glomerulonephritis it was detected only in those showing histological evidence of a progressive lesion. Concentrations were low or undetectable in cases of non-immunological renal diseases. There was a good correlation between urinary C3 concentrations and the deposition of C3 in glomerular capillary walls, as seen by immunofluorescence microscopy, and there was no correlation with the degree or selectivity of proteinuria. Urinary C3 excretion appears to be an accurate indicator of continuing activity of disease. It is suggested that the presence of C3 in urine is due to complement fixation by immune complexes in glomerular capillary walls, and that urinary C3 estimations have potential applications in the study of glomerulonephritis.

Biopsy↗
PubMed1976

Proteinuria and the renal lesion in preeclampsia and abruptio placentae.

The defect in glomerular permeability that leads to proteinuria can be assessed by determining the relative clearance of macromolecules of known but different dimensions, that is, glomerular selectivity. Such estimates can be made using naturally occurring plasma proteins and dextran or polyvinylpyrrolidone injected into the circulation. In preeclampsia, protein and dextran selectivities show good concordance. The proteinuria is intermediate in its selectivity. These findings confirm that proteinuria is glomerular in origin and that the glomerular abnormality is uniform throughout the majority of functioning glomeruli. In abruptio, protein selectivity is very low and dextran selectivity is high. This pattern is seen also in acute ischemic renal failure and suggests that the true glomerular functional defect is actually less severe than in preeclampsia and that much of the protein in the urine in abruptio is postglomerular in origin. The structural lesion in preeclampsia is "characteristic" only in the sense that a number of individual components of glomerular injury, which are themselves commonly seen in other glomerular disorders, occur in a particular balance, and not because of any single unique or specific feature. The important components--that is, endothelial swelling, mesangial cytoplasmic activity, subendothelial deposits, and occational thrombosis of the afferent arterioles--all occur, albeit to a lesser degree, in abruptio placentae, as well as in other glomerular disorders in which intravascular coagulation is a primary cause or plays a major role.

Abruptio Placentae↗
PubMed1975

Periosteal new bone formation developing during haemodialysis for chronic renal failure.

Periosteal new bone formation in the pelvis is reported in five patients on maintenance haemodialysis for chronic renal failure. In two of the cases the shafts of long bones were also involved. The associated radiological and biochemical findings suggest that this unusual radiological feature may be a manifestation of secondary hyperparathyroidism. In one patient in whom the plasma phosphate and calcium X phosphate [Ca X P1] product were reduced there was partial incorporation of the periosteal new bone into the underlying cortex.

Adolescent↗
PubMed1973

The role of the mesangial cell in proliferative glomerulonephritis.

In 40 patients with a histological diagnosis of proliferative glomerulonephritis the deposition of immunoglobulins, complement (C(3)), and fibrin/fibrinogen has been assessed by immunofluorescence and electron microscopy. The results of such examinations have been correlated with the outcome of the illness. In minor or resolving disease there is usually minor functional impairment, a good response to therapy or spontaneous resolution, the deposition of small amounts of material in glomerular capillary walls, and active mesangial removal. In moderate to marked disease there is initially a moderately severe functional disorder, a good response to therapy, considerable deposition of material in glomerular capillary walls but with less active mesangial regions than in the previous group. In progressive glomerulonephritis there was initial severe functional disorder, poor response to therapy, large amounts of material deposited within capillary walls, and active mesangial regions which were greatly enlarged, containing numerous deposits. In the rapidly progressive group there was severe functional disorder with poor response to therapy, the deposition of only small amounts of material within capillary walls, the lack of any significant mesangial cell reaction, and the formation of epithelial crescents. The results of the study indicate that in proliferative glomerulonephritis following the deposition of material in glomerular capillary loops, the progression of the disease is, to some extent at least, dependent upon the ability of the mesangial cell to remove such material.

Adolescent↗
PubMed1972

Modification by drugs of urinary fibrin/fibrinogen degradation products in glomerulonephritis.

Treatment with indomethacin, aspirin, or prednisone has been shown to reduce urinary fibrin/fibrinogen degradation products (F.D.P.) in approximately two-thirds of patients with proliferative glomerulonephritis. This reduction which is dose-dependent for prednisone but not for indomethacin or aspirin in the range of doses used occurs within two to three days of beginning treatment and is thought to result from decreased intraglomerular fibrin deposition rather than alteration of glomerular permeability to F.D.P. In patients who responded in this manner treatment was associated with reductions in the degree of proteinuria and maintenance or improvement in renal function.

Adolescent↗
PubMed1972

Neuropathy associated with hepatitis in patients maintained on haemodialysis.

During a study of peripheral nerve function in chronic renal failure, 11 patients who were being treated by chronic intermittent haemodialysis developed serum hepatitis. Before the infection there was a trend towards improvement in nerve conduction velocities. A pronounced deterioration in the conduction velocities in motor fibres of peripheral nerves occurred in association with hepatitis. In the months after recovery from the infection there was again a trend towards improvement in conduction velocities. We suggest that this reflects the occurrence of a peripheral neuropathy which is at least in part demyelinating. The neuropathy is related to the serum hepatitis, but its pathogenesis is indeterminate.

Chronic Disease↗