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Biomedical subjects

S I Vas

Publications and source records attributed to S I Vas.

At least 19 recordsLinked to original sources
PubMed1994

Renaissance of tuberculosis in the 1990s: lessons for the nephrologist.

OBJECTIVE: To call attention to the worldwide increase in tuberculosis and to review the disease in peritoneal dialysis patients. DATA SOURCES: Recent epidemiological publications. DATA EXTRACTION: Epidemiological data summarized in tables and diagnostic and therapeutic recommendations reviewed. CONCLUSIONS: Tuberculosis is on the rise worldwide. Multiple drug-resistant strains are emerging, causing therapeutic problems. The role of atypical mycobacterial infections in continuous ambulatory peritoneal dialysis (CAPD) is reviewed. Early diagnosis of cases and thorough chemotherapy are advocated.

Humans↗
PubMed1993

Single daily dose of aminoglycosides in the treatment of continuous ambulatory peritoneal dialysis peritonitis.

Toxicity of aminoglycosides is a major concern in the treatment of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. The relatively high blood levels and prolonged and repeated usage may all be contributory. The recognition of the so-called postantibiotic effect, together with the increased phagocytosis of antibiotic-treated cells, may introduce a new mode of therapy with once-daily dosage. Intermittent therapy with vancomycin is already generally accepted. The extension of this modality to antibiotic therapy is discussed.

Administration, Oral↗
PubMed1991

Primary and secondary role of viruses in chronic renal failure.

Viruses may be the cause of renal disease. This effect may be direct, affecting the renal parenchyma, or may be indirect, usually through immune complex damage. The classification and potential role of viruses involved in renal damage is discussed.

Animals↗
PubMed1990

Successful treatment of systemic blastomycosis with high-dose ketoconazole in a renal transplant recipient.

A case of disseminated blastomycosis in a male renal transplant recipient is presented. Discontinuation of immunosuppressive therapy and treatment with high-dose ketoconazole was successful in treating the patient's cutaneous and pulmonary disease initially. Ketoconazole was discontinued after 12 months of chronic therapy, but 2 weeks after discontinuation, blastomycosis recurred. High-dose ketoconazole was again effective; the patient remains asymptomatic presently on chronic suppressive therapy with ketoconazole.

Aged↗
PubMed1989

Subcapsular steatonecrosis in response to peritoneal insulin delivery: a clue to the pathogenesis of steatonecrosis in obesity.

Hepatic steatosis and steatonecrosis occur in nonalcoholic individuals, usually in a setting of obesity, type II diabetes mellitus, and after jejunoileal bypass. We propose an hypothesis for the pathogenesis of these hepatic lesions based on an observation in peritoneal dialysis patients. Hepatic histology was examined at autopsy in 11 patients with type I diabetes mellitus and renal failure who had received i.p. insulin in conjunction with continuous ambulatory peritoneal dialysis (CAPD). Steatosis in a unique subcapsular distribution occurred in 10 of 11 patients treated with i.p. insulin and in 0 of 9 controls receiving CAPD without insulin. Three of the 11 had steatonecrosis, 2 of whom had Mallory bodies. We suggest that insulin has an important role in the pathogenesis of steatosis and steatonecrosis. In CAPD patients the lesions occurred only under the capsule where concentrations of insulin are high secondary to its i.p. administration. In obese patients the lesions occur throughout the liver where insulin concentrations are high because of elevated levels in the portal vein. Free fatty acids (FFA) are oxidized in the liver by a pathway that is blocked by insulin. In the presence of insulin, FFA are preferentially esterified into triglycerides which accumulate in large quantities leading to steatosis; small amounts of FFA escaping local control may lead to membrane injury and steatonecrosis. Steatosis and/or steatonecrosis will occur when there is insulin secretion sufficient to block FFA oxidation but not sufficient to block FFA mobilization from adipose tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Infections of continuous ambulatory peritoneal dialysis catheters.

In the last several years we have reached a certain plateau in the frequency of peritonitis seen in patients. Consequently, a peritonitis rate of one every two patient years may be acceptable. Further reduction of this peritonitis rate will require large efforts on all fronts. One will have to consider what the acceptable cost/risk of peritonitis is in peritoneal dialysis patients. New developments in catheter technology, improved connections, better understanding of patient selection and training programs, improved diagnostic and therapeutic methods in the management of peritonitis, and an understanding of the infectious and immune processes are eagerly awaited.

Humans↗
PubMed1988

Slow continuous hemodialysis for the management of complicated acute renal failure in an intensive care unit.

This paper describes a simple system for the performance of slow continuous hemodialysis (SCHD) as a means of treating difficult and complicated cases of oliguric acute renal failure. The method, which employs access to the circulation via a double-lumen central venous catheter and a BSM 22 blood systems module, can be performed safely in the intensive care unit of a general hospital if closely supervised by a trained nephrologist. The results of treating 16 consecutive cases of complicated acute renal failure in a large general hospital without a hemodialysis unit are described. The method, whose simplicity makes it suitable for intensive care unit nurses without previous hemodialysis training, was not associated with any serious accidents or complications, and was tolerated well by even the most critically ill and hemodynamically unstable patients. The advantages of this approach over more traditional continuous arteriovenous hemofiltration (CAVH) are discussed.

Acute Kidney Injury↗
PubMed1986

In vitro cytotoxicity and antibiotic activity of polymyxin B nonapeptide.

Polymyxin B nonapeptide, prepared by enzymic removal of the fatty acyl diaminobutyric acid side chain from polymyxin B, was about 100-fold less toxic to K562 cells than polymyxin B. MICs of polymyxin B nonapeptide against a test panel of bacteria were 2- to 64-fold lower than those of polymyxin B.

Bacteria↗
PubMed1985

Microbiological diagnosis of peritonitis in patients on continuous ambulatory peritoneal dialysis.

The fast and accurate etiological diagnosis of peritonitis in patients on continuous ambulatory peritoneal dialysis is essential. The concentration of larger volumes of peritoneal fluids may yield more isolates than conventional methods. The removal of antibiotics present in the fluids as a consequence of therapy by washing or using antibiotic-removing resins increases the yield considerably. The use of anaerobic culture media is justified if fecal organisms are suspected as the cause of the infection.

Bacteriological Techniques↗
PubMed1984

Continuous ambulatory peritoneal dialysis: no longer experimental.

Many patients with end-stage renal disease have now been maintained for 5 years or more with continuous ambulatory peritoneal dialysis (CAPD). Viewed initially as an experimental alternative to be used only when hemodialysis was not feasible, CAPD is now seen as the treatment of choice in an increasing number of situations. CAPD is suitable for self-care. The main concern in the early years--peritonitis--is now less frightening and less frequent (one episode occurring every 18 patient-months as compared with every 8 initially), and this has allowed chronic complications of CAPD, such as malnutrition and loss of the peritoneum's capacity for ultrafiltration, to come to light. As would be expected, among patients of advanced age and those who have heart disease or diabetes, survival rates tend to be lower than among other CAPD patients. However, hypertension seems to be more easily controlled, pre-existing anemia can be significantly ameliorated, and young children grow more normally than they do with hemodialysis. Diabetes-related changes in vision stabilize in most CAPD patients, and control of the blood glucose level is good; insulin is administered intraperitoneally. CAPD is thus showing itself to be a feasible form of long-term treatment for end-stage renal disease.

Adolescent↗