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Biomedical subjects

M Olmer

Publications and source records attributed to M Olmer.

At least 55 records · Page 3Linked to original sources
PubMed1988

Aluminium overload of parathyroid glands in haemodialysed patients with hyperparathyroidism: effect on bone remodelling.

In the course of chronic renal failure, aluminium may deposit and accumulate in different tissues. The aluminium content of parathyroid glands was measured in 31 haemodialysis patients at the time of a parathyroidectomy. The values were compared with those obtained from ten control patients with primary hyperparathyroidism without renal failure, and were related to bone remodelling. Of the 31 patients, 27 had a bone biopsy after double tetracycline labelling, at the time of parathyroidectomy. Twenty-one patients had severe hyperparathyroidism, three patients had hyperparathyroidism associated with osteomalacia, three patients had mild hyperparathyroidism with reduced bone formation. Seven patients had bone aluminium deposits, associated with osteomalacia in one case. The parathyroid aluminium was 62 +/- 35.7 (mumol/g glandular dry weight) in haemodialysis patients and 14.3 +/- 6.3 in control patients (P less than 0.001). A significant positive correlation existed between parathyroid aluminium and serum aluminium (P less than 0.01). The parathyroid aluminium was not different in the patients with and without bone aluminium deposits. A weak correlation was found between parathyroid aluminium and plasma parathyroid hormone. A significant negative correlation existed between parathyroid aluminium and osteoblastic surfaces (P less than 0.05), but no correlation was found with bone formation rate at tissue and bone multicellular units levels. We conclude that aluminium accumulates in parathyroid glands of dialysed patients. Severe hyperparathyroidism may coexist with aluminium overload of parathyroid glands. A marked aluminium overload, however, may cut short the course of hyperparathyroidism and may decrease parathyroid function and cellular activity in bone.

Adult↗
PubMed1987

Clinical correlation between hypercoagulability and thrombo-embolic phenomena.

A study of the coagulolytic balance as well as platelet aggregation was carried out in 64 nephrotic patients. The data were correlated, in a prospective attempt, with the clinical demonstration of thrombo-embolic events. Activating factors (factors I, VIIIc, VIIIr:Ag) were increased as well as certain clotting inhibitors, alpha-1-antitrypsin and alpha-2-macroglobulin. There was a platelet hyperaggregability in 31.5% of our patients. Thrombo-embolic complications occurred in six subjects (9%). The data of these six patients were compared with that of the other patients; no significant correlation were found between clotting abnormalities and thrombosis. Low level of ATm (less than 0.8 U.Fr) and severe hypoalbuminemia (less than 20 g/liter) were of no predictive value for the occurrence of thrombo-embolic events.

Adult↗
PubMed1987

[Vasculorenal accidents in pregnancy. Prognostic value of renal biopsy].

Our study is an attempt to determine whether, after a vasculo-renal accident (VRA) in pregnancy, renal biopsy (RB) is of interest to determining the outcome specially of blood pressure. Starting from the 201 RB we systematically performed in such patients we may conclude: first, the onset of clinical and biological troubles do not allow to postulate the existing kidney lesions. Minimal changes observed in 31 women appeared early 9 times and during the last trimester 22 times. Most of the cases observed were preeclampsia (n = 108). The clinical or biological troubles were observed 44 times within the first months of the pregnancy and in 64 patients at the end of it. A specific group isolated concerns predominant vascular lesions (n = 44). Forward troubles were observed 16 times and 28 times during the third trimester. Second: a follow up has been possible for 1 to 5 years in 145 patients. A permanent hypertension occurred out of the 80 preeclamptic women, meanwhile among the 40 women with predominant vascular lesions, 60 p. 100 developed a permanent hypertension. Thus RB provides interesting data on renal lesions revealing sometimes (n = 18) a specific nephropathy (most of them were a glomerulopathy). Furthermore predominant vascular lesions suggest hypertension to recur in later pregnancy or become permanent.

Biopsy↗
PubMed1985

Predictive value of desferrioxamine infusion test for bone aluminium deposits in hemodialyzed patients.

A transiliac bone biopsy was performed in 16 hemodialyzed patients, and a staining procedure with Aluminon was used to reveal bone aluminium deposits. The baseline serum aluminium levels did not allow to predict the patients with aluminium deposits. In contrast, the peak of serum aluminium, 48 h after a desferrioxamine infusion, was much more reliable for the detection of patients with bone aluminium overload.

Adult↗
PubMed1984

[Plasma acetate and bicarbonate kinetics and intolerance to acetate during and after renal dialysis].

Plasma acetate kinetics, acid-base homeostasis and clinical tolerance were monitored in 7 patients with chronic renal failure during and after hemodialysis with standard conditions. In 6 patients, without severe clinical symptoms acetate levels became stable during the last hour of dialysis (4.86 +/- 0.44 mmol/l) and decreased according to first order kinetics (half-life (8.82 +/- 3.42 mn). Simultaneously bicarbonate levels significantly increased (p less than 0.005). At the opposite the 7th patient has been characterised by a continuous rise in acetate levels (12.3 mmol/l at the end of the dialysis), a slower elimination (half-life: 31.0 mn), a collapse of plasma bicarbonate and severe acetate intolerance. Moreover symptomatic patients were characterised by an increase of plasma levels and half-lives. Therefore it seems that during dialysis of comparable efficiency, an insufficient rate of acetate metabolism may be at the origin of a worsening of metabolic acidosis as well as an increase of acetate load, responsible for severe acetate intolerance.

Acetates↗
PubMed1984

[Respective effect of calcium and oxalate on calcium oxalate crystallization in the urine].

Our aim is to determine the respective role of calcium (Ca) and of oxalate (ox) in the formation of calcium oxalate (Caox) crystals. Two urine samples are mixed after increasing either the calcium concentration (Ca) in one sample or the oxalate concentration (ox) in the other. The crystals formed are identified by their habits or by x-ray. Similarly, urine from 37 hypercalciuric stone-formers is analysed. Caox crystallizes at an oversaturation beta greater than or equal to 13,5, critical beta. An almost linear relationship exists between beta and (ox), the critical beta being obtained at an (ox) approximately 0,26 mmol/l. No simple relationship links beta and (Ca). These results point out the predominant role of oxalate in the formation of Caox crystals.

Adult↗
PubMed1983

Absence of secondary hyperparathyroidism in most patients with renal hypercalciuria.

We examined parathyroid gland function in 47 patients with idiopathic hypercalciuria in an effort to determine whether serum levels of parathyroid hormone (PTH) and/or urinary excretion of cyclic adenosine monophosphate (cyclic AMP) can discriminate between the various forms of hypercalciuria. Although we could separate our 47 patients into two groups, 21 patients with renal hypercalciuria (RH) and 15 patients with absorptive hypercalciuria (AH), there remained a group of 11 patients who did not exactly correspond to either group. Basal serum PTH was normal in the two groups: for RH, 10.32 +/- 0.93; for AH, 11.43 +/- 1.10 microliter Eq/ml. Similarly, urinary cyclic AMP did not differ between the two groups: for RH, 4.88 +/- 0.5; for AH, 4.87 +/- 0.55 nmoles/dl/min GFR. Moreover, the response of the parathyroid glands to acute hypocalcemia produced by intravenous infusion of EDTA was not different among patients with AH, RH, and control subjects. Only one patient showed a marked increase of serum PTH in response to acute hypocalcemia, and the bone biopsy revealed increased osteoclastic resorption. In conclusion, our data show that serum levels of PTH and urinary cyclic AMP do not differentiate between the various forms of idiopathic hypercalciuria. The EDTA test demonstrated that secondary hyperparathyroidism is very uncommon in these patients.

Adult↗
PubMed1983

Factor VIII related antigen, coagulation tests and acute renal failure.

Coagulation factors were measured in 50 patients presenting with acute renal failure on the day of their admission (D1) and seven days later (D7). A number of changes were observed, particularly in those patients with a poor prognosis (decreased platelet counts and plasminogen concentrations and increased factor VIII related antigen concentrations). In the majority of cases it would appear that disseminated intravascular coagulation remains sub-clinical.

Acute Kidney Injury↗
PubMed1982

Parathyroid carcinoma, adenoma and hyperplasia in a case of chronic renal insufficiency on dialysis.

A 62 year-old female patient with polycystic disease and chronic renal insufficiency who had required dialysis for 3 years, presented with diffuse but predominantly lumbar bone pain associated with lassitude. Radiologic studies showed diffuse osteoporosis and destruction of the 4th lumbar vertebra. Calcium levels were normal (2.30-2.50 mmoles) with increased PTH levels (1820 microliter Eq/ml). The presence of a cervical mass suggested a diagnosis of hyperparathyroidism. A cervical exploration was performed with ablation of 4 parathyroid glands and autotransplantation of a portion of the left inferior gland into the arm. Pathological studies showed the existence of carcinoma in the right superior and inferior glands, adenoma of the left superior gland and hyperplasia of the left inferior gland. The association of hyperplasia, adenoma and carcinoma could be explained by an initial hyperplasia of the 4 glands due to renal insufficiency, with subsequent transformation of 3 into adenomas of which 2 became cancerous. The patient's status was significantly improved following surgery.

Adenoma↗