Male infertility. 2. Treatment.
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Female↗
Biomedical subjects
R Swartz
Publications and source records attributed to R Swartz.
Radiologic features of a pyrophosphate-like arthropathy associated with long-term dialysis.
In a series of 28 long-term dialysis patients with musculoskeletal complaints, the radiologic findings in six cases resembled those occurring in the arthropathy of idiopathic calcium pyrophosphate dihydrate deposition (CPPD) disease. These findings included osteophytes, subchondral cysts, and cartilage loss in the metacarpophalangeal joints, patellofemoral joints, wrists, and shoulders. Chondrocalcinosis was present in three of the six cases. There were no significant differences in renal function or levels of serum calcium, phosphorus, iron, ferritin, aluminum, or parathormone between these patients and a control group matched for sex and age. Long-term dialysis may be associated with a metabolic arthritis similar to the arthritis which occurs in CPPD deposition disease. The etiology may include deposition of CPPD crystals, hydroxyapatite, or other calcium-containing substances in joints, or it may be related to a number of dialysis-induced metabolic abnormalities.
Arthritis↗
Microcytic anemia in dialysis patients: reversible marker of aluminum toxicity.
Improvement of microcytic anemia after deferoxamine treatment is described in eight long-term dialysis patients with high serum aluminum concentration and other clinical signs of aluminum toxicity. Hematocrit increase of 3 to 19 vol% was associated with correction of microcytosis, significant reduction in abnormal levels of free erythrocyte protoporphyrins, and amelioration of the bone-related symptoms and neurologic signs of aluminum intoxication. Increase in hematocrit, reversal of microcytosis, and reduction in protoporphyrin levels all correlated with the aluminum burden as indicated by the pretreatment serum aluminum levels and by the peak serum aluminum levels during mobilization with deferoxamine. Furthermore, deferoxamine resulted in marked improvement in anemia despite significant reduction in serum ferritin levels. This reversal of microcytosis with deferoxamine provides objective evidence verifying the toxicity of aluminum, and suggests that microcytosis may be an easily detected marker for both clinical diagnosis as well as response to treatment in some cases of aluminum intoxication.
Adult↗
Bacteriophage typing of Staphylococcus aureus strains isolated from Bloemfontein dairy herds.
Bacteriophage typing was performed on 88 coagulase positive Staphylococcus aureus strains isolated during a survey of subclinical mastitis in Bloemfontein dairy herds. Phage typing was performed using two basic international phage typing sets, i.e. the human isolate phage set (HPS) and the bovine isolate phage set (BPS). The results clearly indicated that the BPS could be successfully applied for the phage typing of bovine mastitis S. aureus strains. The majority of the strains was typed as BPS phage group IV (78,4%) and HPS group III (47,7%). The high prevalence of BPS group IV strains is in agreement with other studies. The prevalence of non-typable strains was 3,4% for BPS and 28,4% for HPS. Phages 102, 117, 107, 81, 47, and 6 had high lytic activity. BPS group IV patterns (102/107/117 and 102/117) dominated. The incidence of unique phage patterns was 12,5% for BPS and 26,0% for HPS. A relatively high proportion (71,3%) of the strains was typable with the HPS. As these strains were of possible human origin it indicated the possibility of mutual human-animal transfer of the pathogens. No relationship could be found between phage groups on the one hand and multiple antibiotic resistance on the other, and no phage groups dominated within herds.
Animals↗
Antibiotic susceptibility patterns of mastitis pathogens isolated from Bloemfontein dairy herds.
The antibiotic susceptibility patterns of bacteria associated with subclinical mastitis in Bloemfontein fresh milk dairy herds were determined. A total of 141 bacterial strains tested, consisted of Staphylococcus aureus (93 strains), coagulase negative staphylococci (17), streptococci (12), Corynebacterium bovis (8), Pseudomonas aeruginosa (7) and enterobacteria (4). Antibiotic susceptibility was determined qualitatively using the Kirby-Bauer disc diffusion method and quantitatively by determining the minimal inhibitory concentrations using the agar dilution method. The utilization of commercial intramammary antibiotic preparations on the dairy farms is also discussed. The Gram-positive bacteria were generally not exceptionally resistant to the antibiotics tested. S. aureus susceptibility figures for penicillin G were 66% and for methicillin (or cloxacillin) 100%. The coagulase negative staphylocci in contrast were relatively more resistant than the coagulase positive staphylococci. The enterobacteria and particularly the P. aeruginosa strains, were extremely resistant to all antibiotics tested. In the latter case even carbenicillin and gentamicin susceptibility figures were low. A general mastitis control programme is discussed.
Animals↗
Prevalence and types of bacteria associated with subclinical mastitis in Bloemfontein dairy herds.
Bacteria associated with subclinical mastitis were isolated from machine-milked dairy herds in the Bloemfontein area supplying fresh milk during the period July to December 1980. The 151 quarter milk samples examined, were also subjected to somatic cell counts. Identification of the isolated bacterial strains showed that Staphylococcus aureus was the dominant mastitis-associated organism, constituting 66,4% of all bacteria isolated. Compared with other recent mastitis surveys a low prevalence of classical mastitis streptococci (0,7%) and of Gram-negative bacterial infections (6,3%) was encountered. The Gram-negative bacteria were almost invariably isolated from neglected herds in which the cows were generally in poor condition and the hygienic measures employed were totally inadequate. Other bacterial strains isolated included Corynebacterium bovis (6,3%) and the coagulase negative staphylococci (11,0%). The high somatic cell counts of the quarter milk samples yielding S. aureus, the mastitis streptococci and the Gram-negative bacteria suggested a major pathogenic role for these isolates. The frequent occurrence of C. bovis strains and coagulase negative staphylococci in samples with high somatic cell counts similarly suggested that these organisms were more pathogenic than is generally assumed.
Animals↗
Competition between different metabolic demands for oxygen consumption in the kidney.
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Absorption↗
Computed tomography: the cost-benefit dilemma.
Although cost-benefit analysis is used for most systems of health care planning, its use in evaluating CT scanning is not appropriate. The authors suggest that cost-effectiveness is a more reasonable approach to the economic analysis of CT installations. Cost effectiveness attempts to assure that disease is treated with the most effective means available which minimizes the cost of such treatment. This method involves such factors as the impact of CT on the existing health care system, health outcome of patients, and reduction of hospital occupancy.
Cost-Benefit Analysis↗
Extreme hypermagnesemia as a cause of refractory hypotension.
A 62-year-old woman with adequate renal function who consumed large quantities of magnesium citrate presented with lethargy and hypotension. The hypotension was refractory to all conventional therapy. Her serum magnesium was 12.5 meq/litre (normal, 1.5 to 2.5). She was found to have a perforated duodenal ulcer; peritoneal aspirate magnesium concentration was 12.2 meq/litre. Hypotension improved with intravenous calcium and peritoneal dialysis. This case shows that hypermagnesemia may be accompanied by severe refractory hypotension, and that intestinal disease may predispose to hypermagnesemia in patients ingesting large quantities of magnesium despite normal renal function. Dialysis removes excess magnesium and reverses its toxic effects.
Calcium↗
CT appearance of sclerosing peritonitis in patients on chronic ambulatory peritoneal dialysis.
PURPOSE: The purpose of this study was to describe the CT appearances of sclerosing peritonitis (SP) in patients on chronic ambulatory peritoneal dialysis (CAPD) and to compare these findings with the CT appearances in a control group of CAPD patients who did not develop SP. METHOD: The CT findings in 10 patients with SP were compared with those from a "control group" of 71 patients without SP who were on long-term CAPD and had also undergone at least one CT examination. Particular reference on CT examination was made to the appearance of the peritoneum and small bowel and the presence or absence of loculated fluid collections. RESULTS: Peritoneal abnormalities (calcification/thickening) were noted in 100%, loculated fluid collections in 90%, and small bowel abnormalities (tethering/dilatation) in 60% of the patients with SP. In the control group of patients, peritoneal abnormalities were noted in only 7%, loculated fluid collections in 15%, and small bowel dilatation in 5.7%. CONCLUSION: Peritoneal thickening, peritoneal calcification, loculated fluid collections, and tethering of the small bowel appear to be diagnostic of SP. In a small group of patients with follow-up CT scans, new, or progression of, CT findings correlated with the clinical severity of SP.
Adult↗
Biofilm formation on peritoneal catheters does not require the presence of infection.
The presence of biofilm is thought to accompany infection or colonization of chronic peritoneal dialysis (PD) catheters, and to be an important pathogenetic factor in the recurrence or persistence of peritonitis. In the current study, the characteristics of identifiable biofilm associated with the PD catheter were studied using scanning and transmission electron microscopy in six consecutive cases requiring catheter removal for a variety of indications. Biofilm characteristics in each case were rated in blinded fashion by three independent observers, and findings were then correlated with the clinical histories and microbiologic findings. Surprisingly, two of the three cases with the most severe biofilm formation occurred in patients with no history or microbiologic findings of recent infection, and the positive findings of leukocytes, macrophages, fibrillar matrix, and other structures on these catheters did not correlate with detectable infection. In addition, extracellular spherical lipoid structures and intracellular lipoid vacuoles in mesothelial-like cells were prominent in four of six cases, did not correspond to the presence of infection, and suggested possible mesothelialization of the catheter. The findings of this study do not necessarily controvert the microbial origin of some components of the biofilm, or the possible role of biofilm in some cases of persisting peritoneal infection. However, it is clear that many important components of the biofilm arise, not from microorganisms, but rather from host origin in the absence of detectable infection. Moreover, such "endogenous" biofilm production can result in extensive accumulation of catheter-associated matrix.
Adult↗
Continuous arteriovenous hemofiltration for acute renal failure.
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Acute Kidney Injury↗