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Biomedical subjects

M Elisaf

Publications and source records attributed to M Elisaf.

At least 109 records · Page 6Linked to original sources
PubMed1995

Pathogenetic mechanisms of hypomagnesemia in alcoholic patients.

The aim of our study was to describe the possible pathophysiologic mechanisms of hypomagnesemia in alcoholic patients. A total of 127 chronic alcoholic patients admitted to our university hospital for causes related to alcohol abuse were studied. Hypomagnesemia was the most common electrolyte disturbance observed in 38 patients (29.9%). In 18 of them inappropriate magnesiuria was evident, possibly due to hypophosphatemia, to metabolic acidosis or to a direct magnesiuric effect of acute alcohol consumption. The causes of hypomagnesemia in the remaining 20 patients were alcohol withdrawal syndrome and diarrhea. Respiratory alkalosis was evident in 10 hypomagnesemic patients and could have played a role in the development of hypomagnesemia. A decreased magnesium intake could also have contributed to the hypomagnesemia, especially in malnourished alcoholic patients. Hypomagnesemic patients more frequently had other acid-base and electrolyte abnormalities, such as hypophosphatemia, hypokalemia, hypocalcemia, and respiratory alkalosis, as compared with the normomagnesemic patients. Moreover, in hypomagnesemic patients serum magnesium levels were correlated with the indices of potassium and phosphorus excretion, suggesting that serum magnesium levels play a central role in the homeostasis of the other electrolytes. In conclusion, hypomagnesemia is the most common electrolyte abnormality observed in alcoholic patients, as a result of various pathophysiologic mechanisms.

Acid-Base Imbalance↗
PubMed1995

Prevalence of antibodies to human T-lymphotropic virus types I and II in volunteer blood donors and high-risk groups in northwestern Greece.

BACKGROUND: In addition to human immunodeficiency virus, human T-lymphotropic virus types I and II (HTLV-I/II) is prevalent among blood donors in the United States. In Greece, there are no epidemiologic data regarding the prevalence of HTLV-I/II among volunteer blood donors and high-risk groups. STUDY DESIGN AND METHODS: To determine the prevalence of HTLV-I/II infections in northwestern Greece, a seroepidemiologic study was conducted among volunteer blood donors, multiply transfused patients, heroin addicts, and chronic hemodialysis patients. The subjects were tested for serologic evidence of HTLV-I/II infection by enzyme immunoassays and specific protein immunoblot confirmatory test. RESULTS: None of the volunteer blood donors and heroin addicts had detectable antibodies to HTLV-I/II. Only 1 (1.45%) of the 69 multiply transfused patients had indeterminate results, while 2 (1.2%) of 163 hemodialysis patients were positive. CONCLUSION: In northwestern Greece, routine screening for HTLV-I and HTLV-II infections does not appear to be required. However, the finding of seropositivity among hemodialysis patients requires further evaluation of the origin of the infection, as its zero prevalence in this population seems to exclude transfusion transmission.

Adult↗
PubMed1995

Fractional excretion of potassium in normal subjects and in patients with hypokalaemia.

The aim of our study was the determination of fractional excretion of potassium (FEK+) in both normal subjects and hypokalaemic patients. Three hundred and twelve normal subjects aged 21-69 years and 84 hypokalaemic patients aged 36-72 years were studied. The mean FEK+ in normal subjects was 8% (range 4-16%). FEK+ was positively correlated with serum potassium (r = 0.74, p < 0.0001) and inversely with serum creatinine (r = -0.51, p < 0.001). The mean FEK+ in patients with hypokalaemia of external origin was 2.8% (range 1.5-6.4%). On the contrary, the mean FEK+ in hypokalaemic patients in whom renal potassium loss was the main aetiologic factor for the pathogenesis of hypokalaemia was 15% (range 9.5-24%).

Adult↗
PubMed1995

Successful treatment of hyponatremia with angiotensin-converting enzyme inhibitors in patients with congestive heart failure.

Hyponatremia commonly complicates the clinical course of patients with congestive heart failure (CHF) and seems to be an ominous prognostic factor. Angiotensin-converting enzyme (ACE) inhibitors improve the symptomatology of CHF patients. Moreover, it has been reported that these drugs can raise serum sodium in hyponatremic patients. The aim of this prospective work was to study the mechanisms involved in the correction of hyponatremia in 6 patients aged 52-69 years with CHF and hyponatremia (serum sodium 125-128 mmol/l) who were receiving digitalis and furosemide. In these patients, captopril was introduced in progressively increasing doses. The drug induced significant clinical improvement. Additionally, a statistically significant increase in serum sodium was observed which was correlated to a rise in the diluting ability of the kidney (increase in CeH2O). A slight increase in creatinine clearance was also found, which could have contributed to the improvement in hyponatremia. Therefore, we conclude that ACE inhibitors can improve hyponatremia in CHF patients by increasing the urinary diluting ability.

Aged↗
PubMed1994

Primary lymphoma of the pericardium: report on a "cured" case and review of the literature.

This report describes a 62-year-old man with a primary diffuse, immunohistochemically proven B-cell lymphoma of large non-cleaved cell (centroblastic) type of the pericardium. The patient responded completely to systemic chemotherapy and remains free of disease 30 months after diagnosis. The use of non-cardiotoxic drugs in divided doses as initial treatment is emphasized. In addition, the authors reviewed the literature of the last decade regarding the management and outcome of patients with primary cardiac lymphomas.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

The value of alpha-amylase and isoamylase determination in chronic renal failure patients.

Hyperamylasemia is a common finding in chronic renal failure (CRF) patients. It has been suggested that the diagnosis of acute pancreatitis in these patients is confirmed when serum amylase activities are greater than three times the upper normal limits. In order to evaluate the frequency, the type, and the hyperamylasemia levels in patients with various degree of chronic renal failure, the total serum amylase (Ta), the pancreatic (Pa) and salivary (Sa) types of serum isoamylases, as well as the urine isoamylases (Tu, Pu, Su, respectively) have been determined by the Phadebas method. Moreover, the levels of serum electrolytes and triglycerides were determined in order to study any relationship between serum electrolytes as well as triglycerides and alpha-amylase activities. We studied 102 patients of whom 33 (group A) had CRF with serum creatinine levels 8.5 +/- 3.1 mg/dL (mean +/- SD), 59 (group B) were receiving chronic hemodialysis, and 10 (group C) were on continuous ambulatory peritoneal dialysis as well as 47 normal individuals. None of the subjects studied had any clinical manifestation of acute pancreatitis. Our results showed that the Ta, Pa and Sa levels of groups A, B, and C were significantly elevated compared to normal subjects. Eighteen patients had Pa activities greater than three times the upper normal limits. In the present study, no relationship between serum electrolytes as well as triglycerides and alpha-amylases was found. In conclusion, hyperamylasemia was a much more common finding in CRF patients than previously reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1994

Effect of an acute oral protein load on microalbuminuria in uninephrectomized patients in relation to the time since nephrectomy.

To evaluate the effect of an acute oral protein load (OPL) on urinary albumin excretion (UAE) in uninephrectomized subjects with a negative Albustix test, in relation to the time since nephrectomy, the UAE was determined by a double-antibody 125I radioimmunoassay in 3-hour urine collections before and after 150 g OPL under conditions of moderate physical activity in 18 subjects who underwent unilateral nephrectomy more than 10 years (346.5 +/- 178.60 months) before evaluation and had a mean basal creatinine clearance (CCr) of 45.3 +/- 14 ml/min (group 1), in 21 subjects who underwent unilateral nephrectomy less than 10 years (31.5 +/- 28 months) before evaluation and had a mean basal CCr of 76.0 +/- 22 ml/min (group 2), and in 16 normal volunteers (controls) with a mean basal CCr of 103.1 +/- 12 ml/min. The UAE was higher in group 1 as compared with either group 2 or controls at both basal state (90.8 +/- 65, 19.6 +/- 17, and 11.0 +/- 5 micrograms/min/100 CCr for groups 1 and 2 and controls, respectively; p < 0.001) and after OPL (92.0 +/- 65, 43.6 +/- 24, and 12.0 +/- 5 micrograms/min/100 CCr for groups 1 and 2 and controls, respectively; p < 0.001). However, the increase in UAE following OPL was significant (p < 0.001) only in group 2 patients. In all patients, the basal UAE was negatively correlated with basal CCr (r = 0.63; p < 0.001) and positively correlated with the time since nephrectomy (r = 0.73; p < 0.001) and with both systolic (r = 0.57; p < 0.001) and diastolic blood pressures (r = 0.69; p < 0.001). CCr calculated using 3-hour urine collections increased more in controls (11.2 +/- 44.2%) than in patient groups 1 (1.6 +/- 0.89) and 2 (7.7 +/- 3.7%; p < 0.001). Basal CCr calculated using 24-hour urine collections the day before the test was negatively correlated with the time since nephrectomy in group 1 (r = -0.69; p < 0.001) and positively correlated with the time since nephrectomy in group 2 (r = 0.89; p < 0.001). Multiple regression analysis revealed that the relationship between CCr and duration of uninephric state was independent of age or systolic and diastolic blood pressures in both patient groups. These results suggest that UAE increase significantly after an OPL in subjects who have been nephrectomized less than 10 years before the study and have basal CCr values higher than 50% of normal.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1994

Lipid parameters including Lp(a) in hemodialysis patients.

Chronic hemodialysis (CHD) patients have a high incidence and prevalence of atherosclerotic disease which may be related to numerous atherosclerotic risk factors. Among them dyslipidemia plays a significant role. Elevated Lp(a) levels, which are strongly associated with atherosclerosis, have been reported recently in uremic patients. The aim of our study was the determination of the levels of lipid parameters including Lp(a) in 151 CHD patients (76 male) aged 57 (12-81) years, who were on hemodialysis for a mean of 44.3 (range 1 to 189) months. Eighty-four normal individuals age and sex matched were used as controls. The median serum Lp(a) concentration in hemodialysis patients was 13 mg/dL compared with 6.5 mg/dL in healthy controls, p < 0.001 by distribution-free Mann-Whitney test. The prevalence of subjects with Lp(a) levels above 25 mg/dL was significantly higher in CHD patients compared to normal subjects (30% vs. 8%, p < 0.001). Even if CHD patients were matched for fasting lipid levels, they showed Lp(a) levels significantly higher than controls. No significant correlation was found between Lp(a) levels and either the age of the patients or the duration of hemodialysis. The etiology of primary renal disease did not influence the Lp(a) levels.

Arteriosclerosis↗
PubMed1994

Acid-base and electrolyte abnormalities in alcoholic patients.

This study was undertaken to analyze the acid-base and electrolyte abnormalities and the pathogenetic mechanisms involved in alcoholic patients admitted to our department for causes related to alcohol abuse. We studied 79 alcoholic patients aged 31-78 years. None had any other disease or was receiving drugs influencing acid-base balance and electrolyte parameters. On their admission and before any therapeutic intervention laboratory investigation of the acid-base status and electrolyte parameters in both sera and urine was carried out. Thirty-two patients (40.5%) had acid-base disturbances. Ten patients (12.6%) had pure respiratory alkalosis, 2 patients (2.5%) pure metabolic alkalosis, while 20 patients (25.3%) had the so-called syndrome of alcoholic ketoacidosis. Forty-one patients (52%) had electrolyte abnormalities. Eighteen patients (22.8%) had hyponatremia. However, 5 patients had pseudohyponatremia due to alcohol-induced hypertriglyceridemia. Two patients (2.5%) with increased insensible losses had hypernatremia. Hypokalemia was found in 10 patients (12.6%), hypomagnesemia in 25 patients (31.6%), hypophosphatemia in 23 patients (29.1%), hyperphosphatemia in 2 patients (2.5%), and hypocalcemia in 17 patients (21.5%). However, only 7 patients had true hypocalcemia. In conclusion, alcoholic patients develop a series of acid-base and electrolyte disturbances owing to various pathogenetic mechanisms.

Acid-Base Imbalance↗
PubMed1993

Effect of intravenous calcium infusion on indices of activity of the parathyroid glands and on urinary calcium and sodium excretion in normotensive and hypertensive subjects.

The effect of an intravenous calcium gluconate load (10 mg/kg over 5 min) on plasma ionized calcium concentration, parathyroid hormone (PTH), and the rate of urinary excretion of calcium, sodium, and nephrogenous cyclic adenosine monophosphate (NcAMP) was examined in 26 patients with essential hypertension and 27 age- and sex-matched normotensive subjects. Prior to calcium administration hypertensives had lower plasma ionized calcium concentration (P < .01) and higher PTH levels (P < .001) and excreted more calcium (P < .05) and NcAMP (P < .001) in the urine compared to normotensives. Following calcium infusion, plasma ionized calcium did not differ significantly between the two groups, but PTH levels remained higher in the hypertensive subjects at both 60 min (P < .001), and at 120 min (P = .02) post-load. Post-load values for both urinary calcium excretion and urinary sodium excretion were significantly higher in the hypertensive subjects than in the control group. Both before and after calcium infusion, urinary calcium excretion was positively correlated with urinary sodium excretion in each of the two groups, but for the same level of sodium excretion, hypertensives excreted more calcium in the urine, compared to normotensives, both before (P < .05) and after calcium infusion (P < .001). A positive correlation between basal plasma renin activity (PRA) values and plasma ionized calcium values obtained before (r = 0.42, P = .03) or at 60 min (r = 0.41, P = .03) and 120 min (r = 0.42, P = .03) after calcium infusion existed only in the hypertensive subject group. Post-load urinary sodium excretion values were negatively correlated to basal PRA values in both groups (r = -0.55, P < .01 and r = -0.58, P < .01 for hypertensives and normotensives, respectively), but a similar negative correlation between post-load urinary calcium excretion values and basal PRA values existed only in the hypertensive subject group (r = -0.50, P < .01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Liver involvement in hemorrhagic fever with renal syndrome.

Hemorrhagic fever with renal syndrome is an acute febrile nephropathy caused by several viruses of the genus Hantavirus of the family Bunyaviridae. During the past 8 years, 32 cases of hemorrhagic fever with renal syndrome have been diagnosed. Nine out of the 32 patients (28%) had raised (twofold upper normal limits) transaminases during hospitalization. Four out of the nine patients (44%) died. In contrast, only three out of the 23 patients (13%) without raised transaminases died. Five patients had slightly increased serum alkaline phosphatase and gamma-glutamyl-transpeptidase, whereas six patients had prolonged prothrombin time. Liver histology showed midzonal necrosis in hepatic lobules with extravasation of red cells and mild mononuclear infiltrate. Liver involvement seems to be an ominous prognostic factor in such patients and is correlated with severe renal failure and thrombocytopenia.

Alanine Transaminase↗
PubMed1993

High frequency of antibodies to Hantaan virus and hepatitis C virus in chronic haemodialysis patients. Coincidence or cross-reaction?

OBJECTIVES: To address the question of whether there is any coincidence or cross-reaction between hepatitis C virus (HCV) and Hantaan virus (both RNA arboviruses), as well as to assess the frequency of antibodies to the above viruses amongst chronic haemodialysis patients in our region. DESIGN: Collection of serum samples from consecutive unselected chronic haemodialysis patients. SETTING: A tertiary referral center (University Hospital). SUBJECTS: One hundred and fourteen chronic haemodialysis patients were investigated for the presence of antibodies to HCV (anti-HCV) and Hantaan virus disease (anti-HVD). Eleven unselected non-haemodialysis patients with well-defined haemorrhagic fever with renal syndrome (HFRS) were also investigated for the anti-HCV antibodies comprising the disease control group. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The utility of an anti-HVD positive test in chronic haemodialysis patients. RESULTS: Seventeen patients (14.9% 95% confidence interval [CI] 8.4-21.4%) were anti-HCV positive, whereas 15 (13.2%, 95% CI 6.9-19.3%) were anti-HVD positive. An anti-HCV positive test was confirmed by recombinant immunoblot assay (RIBA II) in 88.2%. The presence of anti-HCV antibodies was not associated with transfusions but with the longer duration of haemodialysis (62.8 +/- 29.8 vs. 31.2 +/- 29.3 months, P < 0.001). Anti-HVD antibodies were not associated with transfusions or with the duration of haemodialysis. Three patients were positive for both anti-HCV and anti-HVD antibodies. None of the 11 patients with well-defined HFRS had anti-HCV antibodies. CONCLUSIONS: Chronic haemodialysis patients are a high risk group for HCV infection in association with the duration of haemodialysis and, at least for our geographical area, these patients have to be examined for anti-HVD antibodies especially when a definite causative agent for chronic renal failure is not found. The HVD and HCV infection are not exceptional amongst haemodialysis patients in our region, whereas the possibility of a cross-reaction between these two RNA arboviruses is rather excluded as there was no evidence of HCV infection amongst the patients with well-defined HFRS.

Adolescent↗
PubMed1993

Chronic renal dysfunction in hemorrhagic fever with renal syndrome patients.

During the last 9 years, 32 cases of hemorrhagic fever with renal syndrome (HFRS) have been diagnosed in our institution. Seven patients died. Twenty-three patients were discharged healthy while in another 2 some degree of renal dysfunction, which remained stable 12-15 months later, was evident. In 12 out of the 23 healthy individuals thorough examination of renal function was performed 1-5 years after their discharge. Three out of the 12 had renal tubular acidosis (RTA) type I (distal), complete or incomplete, and 2 (1 of whom also had incomplete RTA) had reduced urine concentrating ability. The development of chronic renal dysfunction was independent of the clinical severity of the acute illness.

Adult↗
PubMed1993

Atherosclerotic risk factors in female students of northwestern Greece.

The prevalence of predisposing atherosclerotic factors such as obesity, hypertension, hyperlipidaemia, smoking and consumption of animal fat in a cohort of all female students in the last class of high schools in Northwestern Greece was studied. A total of 590 students were included in the study. In all subjects body weight and height, SBP and DBP (in sitting position), total cholesterol and triglycerides (after 14 hours of fasting) were measured. Smoking and dietary habits were examined by a questionnaire. The results showed that 41.57% of the students were obese (Quetelet index > 22), 3.12% were considered as hypertensives (SBP > 140 mmHg and/or DBP > 90 mmHg), 14.19% had hypercholesterolaemia (total cholesterol > 5.439 mmol/l (210 mg/dl), 95th percentile in Greece), 4.7% had hypertriglyceridaemia (total triglycerides > 1.423 mmol/l (126 mg/dl) 95th percentile in Greece). Moreover, 22% consumed meat and 24% ate eggs at least four times per week. Only 13% of these students smoked habitually or occasionally. In conclusion, the prevalence of hyperlipidaemia and obesity in our cohort is significantly high and is correlated with nutritional factors. The detection of predisposing atherosclerotic factors in adolescents is of primary importance for early prevention of vascular damage.

Adolescent↗
PubMed1992

Renal tubular acidosis in primary Sjögren's syndrome.

Renal tubular acidosis (RTA) is a frequent extraglandular manifestation of Sjögren's syndrome; however, no distinction on the incidence of this renal tubular defect between primary and secondary Sjögren's syndrome has been reported. This study was undertaken in order to define the frequency of RTA and the possible pathogenetic mechanisms in a group of 21 randomly selected primary Sjögren's syndrome patients. RTA was found in 7 (33%) patients. The incomplete type of the disorder was the most frequent. It seems that the etiology of RTA is multifactorial. Renal excretion of monoclonal proteins and the immunologically-induced interstitial inflammation are the main possible factors of this renal tubular defect.

Acidosis, Renal Tubular↗
PubMed1992

Aprindine-induced hepatic granulomata.

Aprindine is a very effective antiarrhythmic agent with a narrow therapeutic ratio. We report a patient who suffered from granulomatous hepatitis probably due to the administration of aprindine. Evidence of hepatitis appeared within 6 weeks of initiating aprindine therapy and resolved rapidly when the drug was withdrawn. Six months later, fibrosis but no granulomata were found in the expanded portal tracts. Our observations suggest that granulomatous hepatitis can occur during aprindine therapy.

Aprindine↗