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R Oulès

Publications and source records attributed to R Oulès.

At least 19 recordsLinked to original sources
PubMed2000

[Shock? Stop!].

Explore the source record for details and available documents.

Adrenal Gland Neoplasms↗
PubMed1997

Continuous administration of intravenous iron during haemodialysis.

A simple, safe and potentially cost effective method of giving intravenous iron to patients receiving regular haemodialysis therapy is described. The heparin and iron are mixed in normal saline and given as a continuous infusion via the syringe pump present on the modern dialysis machine. No pharmacological incompatibility was observed between iron polymaltose and Heparin Choay or Heparin Roche. No adverse reactions attributable to i.v. iron were observed in over 400 patients and more than 30,000 dialyses.

Anaphylaxis↗
PubMed1992

Autoantibody to plasma fibrinopeptide A in a patient with a severe acquired haemorrhagic syndrome.

We describe a 50-year-old man with a severe acquired haemorrhagic syndrome. He had slightly prolonged clotting times using bovine thrombin, human thrombin and reptilase. His plasma contained a polyclonal IgG which interfered with the generation of fibrin monomers without inhibiting the aggregation of preformed monomers. The inhibitor delayed thrombin-induced fibrinopeptide A release. The IgG bound to insolubilized synthetic fibrinopeptide A (one binding site per molecule) and, with higher affinity, to fibrinogen (two binding sites per molecule). It did not bind to insolubilized fibrin monomers. The IgG did not impair the catalytic activity of thrombin toward a small synthetic substrate but inhibited the binding of thrombin to fibrinogen without binding to thrombin. The binding of the anti-fibrinopeptide A autoantibody to fibrinogen might have impaired thrombin-induced fibrinogen to fibrin conversion in vivo. This may have favoured the reported haemorrhagic syndrome which was associated with severe chronic renal insufficiency.

Autoantibodies↗
PubMed1991

[A severe epidemic of Streptococcus group G infection in hemodialysis: epidemiologic survey by molecular biology and preventive measures].

An outbreak of group G streptococci infection affected 6 patients of an hemodialysis unit. Group G streptococci were isolated from patients and from numerous atmospheric specimens, different parts of two dialysis machines, and two blankets, but from only one nurse on the hospital staff. Typing of group G streptococci by an improved method of DNA fingerprinting showed that the isolates from one patient, the nurse and the two blankets differed from one another. The group G streptococci were probably transmitted to patients by dialysis machines with defective microporous filters. No further case of group G streptococci infection was reported three years later since microporous guard filters were systematically doubled.

Adult↗
PubMed1988

Case-control study to determine the cause of sclerosing peritoneal disease.

This paper presents the results of a case control study based on 55 patients identified with sclerosing peritoneal disease through the 1984 centre questionnaire. For each case with a confirmed finding of small bowel enclosed in a bag or 'cocoon' of thickened peritoneum, three controls were selected from the main EDTA Registry patient file. Questionnaires were sent out on cases and controls in order to compare exposure to a number of factors implicated in the aetiology of sclerosing peritoneal disease. These included a history of peritonitis, use of agents to sterilise the tubing connection, use of bacterial filters and buffers, drugs added to the dialysate, and history of medication with beta-blockers. Questionnaires were returned for 82% of cases and 74% of controls. Analysis of the returns using McNemar's test showed a significantly higher exposure to chlorhexidine in cases compared with controls. On the basis of this strong association, it seems advisable that the use of chlorhexidine to sterilise tubing connections for peritoneal dialysis patients should be halted.

Chlorhexidine↗
PubMed1988

Survival on renal replacement therapy: data from the EDTA Registry.

Extensive survival data are presented from the EDTA Registry's files for patients who started renal replacement therapy in 1970-1974 compared to 1980-1984. The contribution of the different treatment modalities (haemodialysis, continuous peritoneal dialysis, and transplantation) to the survival of patients according to geographical region is also shown. Survival on renal replacement therapy, irrespective of treatment modality and of primary renal disease, was best in the 10-14-year-old patients, with 58% at 10 years and 52% at 15 years, and decreased with rising age to 28% at 10 years and 16% at 15 years in patients aged 45-54 when they commenced therapy in 1970-1974. When comparing the 0-4-year-old with the 10-14-year-old cohort of the paediatric patients, 5-year survival rates for patients starting renal replacement therapy in the early eighties declined from 85% to 70% with decreasing age. Treatment policy, as reflected by the proportion of patients on different modes of therapy, varied markedly between European regions but affected survival to a small extent only. The large population with diabetic nephropathy incurred annual mortality rates 2-3 times greater than those observed in patients with 'standard' primary renal diseases. Haemodialysis and continuous peritoneal dialysis, although not comparable because of important differences in selection policy, yielded similar survival rates. Patients and graft survival rates have improved markedly when comparing patients starting renal replacement therapy in the early seventies with the eighties; particularly for cadaveric transplantation. Patient survival after second grafting was similar to that after first grafting, with 83% at 5 years after second cadaveric grafting in the 15-44-year-old cohort, vs 85% after first cadaver transplantation in 1980-1984. Second cadaveric graft survival was superior to average first-graft survival for those recipients whose first graft had been functioning for more than 1 year. However, second-graft survival in rapid rejectors of a first graft as well as third cadaveric graft survival were curtailed by the large number of early losses, with only 52% of third grafts functioning at 1 year. For living related donor transplantation, parents were mostly used in children whilst identical siblings predominated in adults older than 45. In the early eighties, patient survival was 92% at 5 years for recipients younger than 15, 87% for the 15-45 year old cohort and 72% for those aged 45 or older.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1985

Mycobacterium haemophilum and mycobacterium xenopi associated infection in a renal transplant patient.

The case is presented of a renal-transplant patient in Europe with a Mycobacterium haemophilum infection in association with M. xenopi infection. Clinical signs suggested the diagnosis of mycobacteriosis, which was confirmed by a skin biopsy. Despite antitubercular treatment which rapidly eliminated M. xenopi, the patient's condition did not improve until M. haemophilum was identified. Minimal inhibitory concentrations of various antimicrobial compounds showed a lack of efficacy of isoniazid, and rifampin had no clinical effect. The patient recovered only after careful surgical drainage of the lesions and the administration of minocycline. The pathogenesis of such mycobacterioses is discussed, with focus on the immunodepressive status which in our patient may have been partially induced by a cytomegalovirus reinfection.

Anti-Bacterial Agents↗
PubMed1985

Blood lines should be considered in studies of biocompatibility during acetate haemodialysis.

In this one-year prospective study, the biocompatibility of blood lines used for acetate haemodialysis treatment was evaluated in 12 patients. These blood lines, polyvinyl chloride (PVC) and polyurethane extruded PVC (PE) respectively were compared in a schedule of four alternating three-month periods of treatment: PVC/PE/PVC/PE. White blood cell count, complement, IgE and thromboxane values were recorded monthly. A reduction in white blood cell and polymorphonuclear counts after 30 minutes of dialysis was significantly less during period 2 than period 1. Pre-dialysis eosinophil counts varied in a seasonally dependent pattern. We conclude that in spite of their small area, blood lines have some effect on biocompatibility and that the season of the year has to be considered in biocompatibility studies involving eosinophils.

Acetates↗
PubMed1983

[Hypoxemia in hemodialysis: hemodynamic mechanism? Hemodynamic and spirometric study using acetate and bicarbonate buffers].

The background of this study is the occurrence during acetate hemodialysis (HDA) of arterial hypoxemia associated with well described vasodilatator hemodynamic changes. Our aim was to evaluate the relationship between these 2 phenomena. Eleven patients (7 males, 4 females, mean age 54 years) were compared in a protocol of HDA and bicarbonate hemodialysis (HDB) as regards their cardiac output measured by the dye dilution method, blood gases and respiratory gas measurements made at the bedside. The results show significant hypoxemia with hypocapnia as soon as the 30th minute of HDA and no significant variation of cardiac index. No significant variation of respiratory response was noted. Arterial prostaglandin levels rose significantly higher during HDA (+ 302%) than HDB (+ 163%; 2 alpha less than 0,05). The absence of a correlation between arterial hypoxemia and hemodynamic changes in HDA compared to HDB suggests that the phenomena are not interdependent. The importance of increased thromboxane activation in HDA will require further investigation.

Acetates↗
PubMed1981

Middle molecule accumulation in uremia: an "extra uremic factor".

To evaluate middle molecule (MM) accumulation in relation with patients' well-being, plasma MM were analyzed in 115 uremic patients by using the two-step chromatographic technique described by Fürst et al. Unexpectedly, most of the patients exhibited small or undetectable subpeaks 7a, 7b, 7c, 7d. However, patients on regular dialysis treatment tend to present higher MM concentrations when a complication, such as infection, hyperparathyroidism, symptomatic neuropathy, or intercurrent disease occurs and peak 7d was very prominent after radio-contrast media administration. No correlation was found between plasma MM and small molecule accumulation (urea, creatinine, and uric acid) or residual renal function or hematocrit. An unexpected correlation was found between some MM fractions and serum PTH. These results indicate that MM do not accumulate in plasma only as a result of impaired renal function. This suggests considerable variations in their generation rates may be due to unknown misleading artifacts, PTH breakdown products, or other factors.

Adolescent↗
PubMed1979

Removal of endogenous middle molecules by hemoperfusion.

In four regular dialysis patients, the removal of uremic middle molecules was studied during a three-hour hemoperfusion using a column containing 300 gm of activated carbon encapsulated with cellulose. Middle molecules in plasma were determined by high-speed gel filtration followed by gradient elution chromatography. Different adsorption characteristics were shown for the four middle molecule fractions measured. The initial clearances for middle molecule fractions were about 120 ml/min; clearances were 20-50 ml/min after two hours, and less than 25 ml/min, with release of some middle molecule fractions from the column, after three hours. The findings suggest that saturation of the column occurs after two to three hours of perfusion. Thus, prolongation of the perfusion time beyond two hours appears to be of little benefit. The reduction of middle molecules in plasma by a three-hour hemoperfusion was in magnitude, similar to that obtained by three-hour dialysis with a large surface area dialyzer or high-flux membrane.

Capsules↗