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Biomedical subjects

M Yaqoob

Publications and source records attributed to M Yaqoob.

At least 73 records · Page 4Linked to original sources
PubMed1992

Suppression of the renin-angiotensin-aldosterone axis with erythropoietin therapy by a negative feedback loop.

To investigate the pathophysiology of hypertension in patients receiving recombinant human erythropoietin (rHuEpo) we studied its effects on the renin-aldosterone axis of chronic haemodialysis (HD) patients not receiving antihypertensive drugs. Nine severely anaemic normotensive HD patients received rHuEpo 50 U/kg bodyweight, thrice weekly after each HD. The dose was increased by 25 U/kg bodyweight every 4 weeks to a maximum of 100 U/kg or until an increase of Hb or Hct of 2 g/dl or 7% was achieved. Blood samples were taken after 30 min supine rest and while seated 10 min later after gentle ambulation. Results expressed as mean +/- SEM: therapy in normotensive HD patients by a negative feedback loop, before the development of hypertension.

Adult↗
PubMed1992

Haemodialysis-related porphyria cutanea tarda and treatment by recombinant human erythropoietin.

Haemodialysis-related porphyria cutanea tarda is a rare, but serious and mutilating skin condition, resulting from extremely high plasma porphyrin levels because of their inadequate clearance by haemodialysis. The treatment is very difficult as chloroquine is ineffective and venesection, the conventional treatment of this disease, is not always an option because of anaemia of end-stage renal disease. We report a case of haemodialysis-related porphyria cutanea tarda and her successful management by recombinant human erythropoietin treatment.

Erythropoietin↗
PubMed1992

Phlebotomy for erythropoietin-induced malignant hypertension.

Four patients on regular dialysis treatment whose blood pressure was well controlled, developed malignant hypertension while receiving maintenance recombinant human erythropoietin (r-Hu-EPO). None of these patients had a haematocrit greater than 35% at any stage, and clinically, none had any evidence of fluid overload. Initially, they were all managed by stopping r-Hu-EPO and intensification of antihypertensive therapy. However, none of the patients responded, and venesection of 500 ml of blood was performed in each case with swift and sustained response.

Adult↗
PubMed1992

Urinary dopamine excretion in chronic renal disease.

We have measured unconjugated urinary dopamine and investigated its relationship to glomerular filtration rate in two groups of 22 patients with chronic renal failure matched for age and sex, one group with primary glomerular disease, the other with tubulo-interstitial disease. Urine dopamine excretion was similar in both glomerular and tubulo-interstitial disease groups, and correlated significantly with creatinine clearance. Although urinary protein excretion was significantly higher in glomerular disease, urinary sodium excretion, fractional sodium excretion, urine flow rate and free water clearance were similar in both groups and did not correlate with dopamine excretion. These results suggest that in patients with chronic renal disease, urinary dopamine excretion is mainly under the influence of the glomerular filtration rate, irrespective of the underlying pathology, and therefore interpretation of urinary dopamine excretion requires a knowledge of the patients' renal function.

Adult↗
PubMed1992

Prevention of bacterial infection and sepsis in acute severe pancreatitis.

Between 1984 and 1986 six patients with acute respiratory failure (requiring ventilation for at least 3 days) complicating acute pancreatitis were managed on the intensive care unit (median ventilation period 6 days; range 3-41 days). Between 1987 and 1989 nine similar patients were managed (median ventilation period 35 days, range 4-69 days), and a regimen of enteral tobramycin, polymyxin and amphotericin to selectively decontaminate the digestive tract (SDD) was introduced. Five of six patients treated before 1987 had serious infections (three Gram-negative, one fungal), compared with only one of nine patients treated with SDD (P < 0.05). Clinical signs of sepsis were evident for 62% of the pre-SDD period, compared with 39% of the period during SDD therapy (P < 0.001). Systemic antibiotic prescribing was reduced in the SDD group; however, mortality remained unaffected with only two patients surviving pre-SDD and three during SDD treatment. SDD reduces infection rates and sepsis in patients with acute pancreatitis and may help to improve the prognosis of this life-threatening condition.

Acute Disease↗
PubMed1992

Primary glomerulonephritis and hydrocarbon exposure: a case-control study and literature review.

A case-control study was undertaken to investigate the possible role of chronic hydrocarbon exposure and tobacco and alcohol consumption in the causation of primary glomerulonephritis. Exposure to hydrocarbons and the consumption of tobacco and alcohol were assessed blindly by telephone interview and questionnaire in 55 patients with end-stage renal disease due to biopsy-proven primary glomerulonephritis in whom there had been no evidence of systemic disease. This was compared with 55 normal subjects matched for age, sex, social class and residential area and a comparable internal control group of 45 patients with end-stage renal disease secondary to systemic disease, diabetic nephropathy or chronic pyelonephritis. Hydrocarbon exposure scores derived from the results of the questionnaires were significantly higher (p < 0.001) in the patients with primary glomerulonephritis than in the normal subjects and the internal control group. Moreover, more detailed assessment of the type of hydrocarbon exposure showed significantly greater exposure of patients with glomerulonephritis to petroleum products (p < 0.001), greasing/degreasing agents (p < 0.01) and paints/glue (p < 0.05), and a resulting estimated relative risk of developing glomerulonephritis with each type of hydrocarbon exposure of 15.5, 5.3 and 2.0. Those patients with heavy hydrocarbon exposure (hydrocarbon score > 25,000) had a significantly higher serum creatinine at presentation than those with mild to moderate exposure, suggestive of more advanced renal disease. However, there was no significant difference in tobacco and alcohol consumption among subjects in different groups. We conclude that occupational exposure to hydrocarbon is likely to play a role in the pathogenesis of primary glomerulonephritis and that the risk of developing glomerulonephritis is greatest in those subjects exposed to petroleum products.

Adult↗
PubMed1991

Low-dose desferrioxamine test for the diagnosis of aluminium-related bone disease in patients on regular haemodialysis.

Bone biopsy in an invasive method of diagnosing aluminium related bone disease (ABD). Toxic side-effects have been reported with the currently used 'high-dose Desferrioxamine (DFO) tests.' A low-dose DFO test was evaluated for the diagnosis of ABD in 28 symptomatic patients (13 male) on regular haemodialysis treatment. DFO 0.5 g diluted in 100 ml of 0.9% sodium chloride was given intravenously during the first 2 h of dialysis. Aluminium estimation before (t1) and 48 h after DFO challenge (t2) were made by DC plasma emission spectrometry. Following the DFO test bone biopsy was performed and the specimen stained for aluminium using soluchrome zurine. The DFO test was considered positive if the t2 concentration was 150 micrograms/l or treble the amount of t1. Nineteen patients (8 male) fell into this group and all except two had ABD. Of the nine remaining patients (5 male) who had a negative DFO test none had ABD. We conclude that ABD can be diagnosed safely in the majority of patients using a low-dose DFO test, thereby avoiding toxic side-effects.

Adult↗
PubMed1991

Delayed recovery of renal function in patients with acute renal failure due to accelerated hypertension.

Five patients with acute renal failure due to accelerated hypertension required regular dialysis treatment for 2-12 months (mean 8.8), before recovering sufficient renal function for dialysis to be withdrawn. Two patients who had prior evidence of chronic renal impairment remained off dialysis for 20 and 27 months before decompensating again to require regular dialysis treatment. Two patients with no prior history of renal disease have remained independent of dialysis for 32 and 48 months. The fifth patient was lost to follow-up after a 7 month dialysis-free period. Delayed recovery of renal function following accelerated hypertension is a distinct possibility and should be considered in such patients before contemplating long term strategies such as renal transplantation.

Acute Kidney Injury↗
PubMed1990

Multiple organ failure--a role for plasma exchange?

Two patients with multiple organ failure, septicaemia and a deteriorating clinical course were treated by plasma exchange in addition to standard supportive measures. Dramatic improvements were seen in cardio-respiratory (patient 1), neurological and renal parameters (patient 2) which were attributable to the exchanges. Plasma exchange might be of value as adjunctive therapy where overwhelming septicaemia occurs with multiple organ failure.

Adult↗