Search PubMed⌕ Search

Biomedical subjects

J Traeger

Publications and source records attributed to J Traeger.

At least 55 records · Page 3Linked to original sources
PubMed1987

Malignant lymphoproliferative disorders of viral origin in transplant patients undergoing immunosuppressive therapy.

Although no case of lymphoproliferative syndrome occurred among our first 680 transplant patients, 13 cases developed in a subsequent series of 170 patients. This severe condition involved a proliferation of B cells and/or plasma cells that invaded a number of organs, resulting in the deaths of eight patients. Early tapering off of immunosuppressive therapy enabled five patients to recover without loss of the transplant. The factors likely to be involved in the occurrence of malignant lymphoproliferation are immunosuppressive drugs, and introduction of allogeneic EBV-infected cells or reactivation of EBV.

Humans↗
PubMed1987

[Lecithin cholesterol acyltransferase (LCAT) and lipid cardiovascular risk factors in hemodialysis patients].

In order to study the reliability of plasma LCAT activity as a marker of cardiovascular risk, we compared 66 chronic hemodialysis patients with a control group (n = 72) and a coronary artery disease (CAD) patients group (n = 46). The decrease of LCAT activity (measured by the Nagasaki method) did not appear as a marker of CAD risk; if this activity was effectively lower in 51 of the hemodialysis patients (p less than 0.001) than in the patients of the control group, it was higher in CAD patients (p less than 0.001). In the remaining 15 hemodialysis patients, we found an almost undetectable LCAT activity, not accompanied by a change in esterification percentage when compared with the other hemodialysis patients; the mixing of these serums with control group restored an enzymatic activity and excludes the presence of an inhibitor. The only risk factors common to hemodialysis and CAD patients was the decrease of HDL cholesterol and the high frequency of combined hyperlipoproteinemia.

Cholesterol↗
PubMed1987

Evolution of renal function under chronic oral administration of labetalol.

The glomerular filtration rate (GFR, inulin clearance) and renal plasma flow (RPF, PAH clearance) were measured in 35 hypertensive patients during chronic administration of an alpha-beta-blocker, labetalol. No significant changes in GFR occurred but RPF increased significantly. The increase in RPF was positively correlated with the decrease in mean arterial blood pressure. Patients with renal failure showed changes similar to patients with normal renal function. Thus chronic treatment with labetalol, unlike most beta-blockers, can increase RPF, an effect which could be related to the alpha-blocking activity of the drug.

Administration, Oral↗
PubMed1987

[Plasma levels of cyclosporin 6 hours after its oral administration, T6: key to the surveillance of the treatment].

Clinical evolution and CsA monitoring of 65 transplanted patients (55 kidneys and 10 kidneys and pancreas) treated with CsA were analysed, retrospectively (45 patients) and prospectively (34 patients). The aim of the study was: To show that nephrotoxicity is not uncommon with low trough plasma levels of CsA, and to indicate the value of CsA pharmacokinetic studies in individual cases. To suggest that the T6 value of a CsA pharmacokinetic plasma curve (6 hours after oral drug administration) is a valid expression of a full pharmacokinetics study. To show the results in a prospective study utilizing the T6 as a monitoring tool and with dose adjustments disregarding concomitant serum creatinine levels, with the aim of maintaining a therapeutic T6 (range 150-250 ng/ml). Patients with permanent Therapeutic T6 during the follow-up period (without dose adjustments) showed a creatinine serum level of 144 +/- 6 mumol/l. Serum creatinine levels decreased when CsA dose adjustments were made related to the presence of Toxic (greater than 350 ng/ml) or under-therapeutic (less than 100 ng/ml) T6 (p less than 0.01). Kidney and pancreas patients showed a tendency to under-therapeutic T6 and required a dose of 14 +/- 0.7 mg/kg to maintain a therapeutic T6. The CsA dose of kidney grafted patients through the T6 therapeutic period was 7.03 +/- 0.5 mg/kg. During the T6 toxic period, kidney patients received 8.85 +/- 0.3 mg/kg of CsA (p less than 0.02). Kidneys and graft survival is 97.6% at 6 months follow up in the prospective study. Current serum creatinine of all patients is 180.2 +/- 8 mumol/l. No patient was switched to conventional treatment. T6 is more useful than trough plasma levels for CsA monitoring. Nephrotoxicity and CsA under-treatment can be avoided. This new monitoring tool may allow the utilization of lower doses of CsA and thus contribute to improved graft function at long term follow-up.

Administration, Oral↗
PubMed1986

[Desferrioxamine treatment of osteomalacia caused by aluminum poisoning].

Three haemodialyzed chronic renal failure patients with histologically proven osteomalacia due to aluminium toxicity were treated with repeated injections of desferrioxamine, a potent chelator of aluminium. The drug, in doses of 3 or 6 g, was administered intravenously once a week for 5 to 11 months, at the end of a dialysis session. Treatment was well tolerated. Dramatic clinical improvement was observed, with rapid regression of pain and functional impairment. There was a 65% increase in alkaline phosphatase and a rise of immunoreactive parathyroid hormone (terminal C fragment). Healing of fractures was confirmed by radiology, and a second bone biopsy in the 3 patients after double tetracycline labelling showed regression of morphological and dynamic signs of osteomalacia, considerable reduction in stainable aluminium deposits and strong increase in bone remodelling compatible with the development of hyperparathyroidism. It is concluded that a moderate dose of desferrioxamine administered once a week is effective against osteomalacia due to aluminium toxicity.

Adult↗
PubMed1986

High bone turnover associated with an aluminum-induced impairment of bone mineralization.

A hemodialyzed patient showing x-ray and biochemical evidence of apparently pure severe hyperparathyroidism underwent a tetracycline-labeled transiliac bone biopsy. The bone biopsy not only confirmed the hyperparathyroid bone lesions but also revealed an impairment of bone mineralization induced by aluminum. This was demonstrated by a reduction of double-labeled osteoid surfaces, a significant increase in the osteoid seam thickness, and the presence of extensive aluminum deposits in bone. The planned parathyroidectomy was postponed, and deferoxamine (DFO) therapy, 2 g once a week, was initiated. A second bone biopsy, taken 6 months later, showed recovery of normal bone mineralization but the persistence of hyperparathyroid bone lesions. This was associated with a considerable reduction in the extent of aluminum deposits on trabecular bone surfaces. This observation shows that severe and apparently pure hyperparathyroidism can be associated with an impairment of bone mineralization induced by aluminum. This suggests that bone mineralization and aluminum overload should be evaluated in dialyzed patients who are being considered for parathyroidectomy.

Aluminum↗
PubMed1985

[Obstructive anuria with non-dilated cavities].

Four patients with no evidence of acute functional or organic renal failure suddenly developed anuria. Repeated ultrasonographic exploration failed to show any dilatation of the urinary tract. After 4, 5, 7 and 34 days of anuria respectively, an obstacle was detected, located and identified by ultrasonically guided antegrade pyelography, which led to immediate urine derivation by percutaneous nephrostomy. Three of these patients were cured by percutaneous techniques alone. These 4 cases represent a small but not negligible part of a series of 74 patients with obstructive anuria, 70 of whom had dilated renal cavities. They throw doubt not on the reliability of ultrasonography, but on the idea that all obstacles are associated with dilatation upstream. They also confirm that opacification of the urinary tract is the only way of making sure that an obstacle is present. Antegrade pyelography gives excellent contrast images and can be used as first stage of a percutaneous nephrostomy. The other diagnostic methods are fraught with a high proportion of inadequacy or failure.

Acute Kidney Injury↗
PubMed1985

Metabolic control of type I (insulin dependent) diabetes after pancreas transplantation.

A study was conducted of the circadian hormonal and metabolic patterns of 10 type I (insulin dependent) uraemic diabetic patients after pancreas and renal transplantation. A single 24 hour profile was obtained in each patient following as closely as possible his or her normal daily routine two to 15 months after transplantation. None of the patients were using insulin at the time of the study. Compared with a group of six normal subjects the transplant recipients had mildly raised blood glucose concentrations, hyperinsulinaemia between meals and at night, delayed postprandial insulin peaks, mild hyperketonaemia, and normal blood lactate and plasma glucagon concentrations. The findings showed that successful pancreas transplantation results in disappearance of the need for insulin and return to normal or near normal of the metabolic abnormalities of diabetes. The minor differences observed in comparison with normal hormonal and metabolic homoeostasis were probably due to intrinsic (reduced islet mass, denervation, peripheral hormone delivery) and environmental (immunosuppression, relatively impaired renal function) factors.

3-Hydroxybutyric Acid↗
PubMed1985

Effects of parathyroidectomy on bone formation and mineralization in hemodialyzed patients.

Undecalcified sections of doubly tetracycline-labeled transiliac bone biopsy specimens obtained from ten hemodialyzed patients before and 10 to 16 months after parathyroidectomy (PTX) were analyzed. Before parathyroidectomy (total PTX with autotransplant in six patients and subtotal PTX in four patients), all the patients demonstrated histological evidence of hyperparathyroidism with increased resorption parameters. A high bone formation rate (BFR) was noted in all patients but one who had both an increase in the osteoid seam thickness and a low calcification rate characteristic of osteomalacia. A significant correlation was found between immunoreactive parathyroid hormone (iPTH) levels and BFR at the tissue and at the basic multicellular unit (BMU) levels. Parathyroidectomy was associated with a dramatic drop in resorption surfaces and osteoclast number as well as in bone formation rate at the tissue, BMU, and cell-levels. After PTX, the bone formation rate at the tissue level was low or in the lower range of normal values in six patients. The thickness index of osteoid seams was significantly reduced and no evidence of osteomalacia was present even in the six patients showing bone aluminum deposits after PTX. One of the three patients, who had an iPTH level within the normal range after PTX, showed an osteoid excess associated with a low bone formation rate. These date demonstrate that increased PTH secretion is an important factor of bone formation in dialyzed patients and that excessive reduction of the PTH secretion leads to an inactive bone.

Adult↗