Search PubMed⌕ Search

Biomedical subjects

S Meijer

Publications and source records attributed to S Meijer.

At least 217 records · Page 12Linked to original sources
PubMed1986

The effect of low-dose dopamine on renal haemodynamics in patients with type 1 (insulin-dependent) diabetes does not differ from normal individuals.

It is well known that patients with Type 1 (insulin-dependent) diabetes exhibit both increased glomerular filtration rate and effective renal plasma flow, which can be found even when these patients are well controlled. Usually this is attributed to a decrease in renal vascular resistance and/or to enlarged kidney size and glomerular volume. Among the factors which govern glomerular filtration rate, renal plasma flow is most important. Renal plasma flow increases if renal vascular resistance decreases. The latter might exist in insulin-dependent diabetes mellitus because of either a predominantly afferent or a predominantly efferent vasodilatation. Dopamine is an agent which causes predominantly efferent vasodilatation. Therefore, the effects of infusing a low dose of dopamine on glomerular filtration rate and effective renal plasma flow in 12 well-controlled patients with Type 1 (insulin-dependent) diabetes and 28 healthy volunteers were compared to investigate whether the increased glomerular filtration rate in Type 1 diabetes is caused by an efferent vasodilatation. The median increase in glomerular filtration rate during dopamine infusion amounted to 13.0% in diabetic patients and 12.5% in healthy control subjects (n.s.). It is concluded that the elevated glomerular filtration rate in well-controlled Type 1 diabetes is not caused by a predominantly efferent vasodilatation.

Adult↗
PubMed1986

The determination of oxalate in haemodialysate and plasma: a means to detect and study 'hyperoxaluria' in haemodialysed patients.

In order to find out whether hyperoxaluria can be demonstrated in patients on chronic (twice a week) haemodialysis, a group of 13 patients was investigated. These included one patient with proven primary hyperoxaluria, one suspected of having this disease and 11 patients in whom no information was available as to their oxalate metabolism. Oxalate concentrations in haemodialysate fractions and blood samples, taken before and after dialysis, were determined. The patient with primary hyperoxaluria had a plasma oxalate concentration before dialysis above 100 mumol/l and after dialysis above 25 mumol/l, while the oxalate concentration in haemodialysate at the start of dialysis was above 25 mumol/l and at the end above 10 mumol/l. The patient suspected of hyperoxaluria had similar values. Of the remaining 11 patients, one was shown to exhibit a transient hyperoxaluria, but the others showed a normal oxalate metabolism. A plasma oxalate/creatinine concentration ratio exceeding 0.1, and the calculated total quantity of oxalate removed by dialysis exceeding 2 mmol, also enabled a diagnosis of hyperoxaluria to be made. Hyperoxaluria can still be demonstrated in patients, who because of renal failure are subjected to haemodialysis. Measurements of oxalate in haemodialysate and plasma are valuable in cases where kidney transplantations are considered, especially when the particular patient exhibits hyperoxaluria.

Adolescent↗
PubMed1986

Effect of partial ileal bypass on ileum morphology in cholesterol-fed pigs.

We have studied ileum morphology in pigs 3.5 months after partial ileal bypass (PIB) surgery. PIB caused a reduction in the length of the bypassed ileum by 60%, while the circumference was decreased by about 70%. We did not find evidence for dilatation of the functional, neo-terminal ileum. These results in pigs are contrary to those found earlier in rabbits. This may be of importance concerning the choice of animal model to study the effects of PIB.

Animals↗
PubMed1986

Leiomyoblastoma of the gastric wall.

A patient with leiomyoblastoma of the gastric wall is reported. The manifestations of the tumor are described and guidelines for therapy and prognosis are provided, based on a review of literature.

Adult↗
PubMed1985

Cisplatin: a review of clinical applications and renal toxicity.

In reviewing the literature about the clinical application of cis-diamminedichloroplatinum(II) (cisplatin) it can be concluded that the availability of cisplatin has been an important advance in cancer chemotherapy; especially in patients with disseminated testicular carcinoma and ovarian cancer cisplatin-based combinations are the first choice treatment. Our own investigations of the nature of the main form of toxicity of cisplatin, the nephrotoxicity, are mentioned and methods of its prevention are summarized.

Cisplatin↗
PubMed1985

The effect of captopril on renal function in patients during the first cis-diamminedichloroplatinum II infusion.

On the assumption that hemodynamic changes in renal blood flow are the initial expression of cis-diamminedichloroplatinum (CDDP)-related nephrotoxicity, we treated patients with metastatic non-seminomatous testicular carcinoma during CDDP infusion with captopril. This angiotensin-converting enzyme inhibitor significantly attenuated the initial decrease in effective renal plasma flow and can probably be used to protect the kidneys against CDDP-induced nephrotoxicity.

Adolescent↗
PubMed1985

Nephrotoxicity of 1,1-diaminomethylcyclohexane sulphato platinum II (spiroplatin; TNO-6).

1,1-Diaminomethylcyclohexane sulphato platinum II (spiroplatin; TNO-6) is a new platinum-containing analog used as an antitumor agent. Renal function studies were performed in eight patients treated with this drug (30 mg/m2). During and after the first spiroplatin infusion there was a decrease in effective renal plasma flow (ERPF:P less than 0.05) and an increase in filtration fraction (P less than 0.01) without changes in glomerular filtration rate (GFR), suggesting changes in renal hemodynamics. During the same period there was an increase in relative N-acetyl-beta-D-glucosaminidase excretion (P less than 0.01), pointing to tubular cell damage. Also, an increase in relative beta 2-microglobulin excretion was established during and after spiroplatin infusion. On day 21 a decrease in GFR was found (median 7.4%), together with a decrease in ERPF (median 11.8%).

Acetylglucosaminidase↗
PubMed1985

Serum beta 2-microglobulin: a real improvement in the management of multiple myeloma?

Beta 2-microglobulin (B2-m) determinations in serum have recently been introduced as a method of stratifying patients suffering from multiple myeloma. Conflicting results from several studies prompted us to study retrospectively the correlation of B2-m with presenting features and disease stage, as well as the prognostic value of B2-m, in 87 myeloma patients. Significant correlations were found between B2-m and presenting features such as haemoglobin level, serum calcium level and total body myeloma cell mass. The strongest correlation existed between B2-m and serum creatinine (r = 0.68). B2-m did not discriminate between the different disease stages as defined by Durie and Salmon, nor between myeloma Stage IA and monoclonal gammopathy of undetermined significance (MGUS). Considered alone, B2-m was found to have prognostic value in terms of survival. This correlation disappeared after correction for serum creatinine level and tumour load (multivariate analysis). Furthermore, changes in tumour load during therapy were not reflected in changes in B2-m levels, thereby rendering B2-m levels invalid as tumour marker. Our findings indicate no value for B2-m determinations in the staging and follow-up of myeloma patients.

Creatinine↗
PubMed1985

Influence of captopril on cis-diamminedichloroplatinum-induced renal toxicity.

Renal function studies were performed in 18 patients with nonseminomatous testicular cancer during four platinum-containing chemotherapy courses. The first 9 patients received chemotherapy alone, the second 9 also captopril, an angiotensin I converting enzyme inhibitor, in order to prevent cis-diamminedichloroplatinum-induced nephrotoxicity. In the first group a decrease in glomerular filtration rate, that was preceded by a fall in effective renal plasma flow, was observed. In the second group, captopril was able to prevent the initial decrease in effective renal plasma flow, but failed to prevent the ultimate decrease in glomerular filtration rate.

Adult↗
PubMed1985

The influence of verapamil on renal function in patients treated with cisplatin.

Nine patients with testicular cancer were treated with four platinum containing chemotherapy courses. In order to prevent cisplatin (CDDP)-induced nephrotoxicity, verapamil, a calcium entry blocker, was added to the chemotherapeutic regimen. Renal function studies, consisting of the measurement of the effective renal plasma flow (ERPF) and the glomerular filtration rate (GFR), were performed before, during and after the first dose of CDDP, at the end of the first course and at the end of the fourth course of chemotherapy. The results were compared with the results obtained previously in CDDP-treated patients not receiving verapamil. The initial decrease in ERPF during and after the first CDDP infusion was completely prevented by verapamil. Despite continuation of verapamil throughout all four courses, it failed to reduce the ultimate fall in GFR.

Adult↗
PubMed1985

Pneumatosis intestinalis in patients after cadaveric kidney transplantation: possible relationship with an active cytomegalovirus infection.

Four patients are presented with pneumatosis intestinalis following kidney transplantation, all with severe cytomegalovirus (CMV) infection. Two patients had a primary infection and two patients had CMV reactivation. One patient died because of disseminated CMV infection. Two patients had concomitantly an active, non-obstructive duodenal ulcer. In a control population of 17 patients who suffered from a duodenal ulcer post-transplant without any evidence of CMV infection, we could not demonstrate pneumatosis intestinalis. We suggest a possible relationship between pneumatosis intestinalis and active CMV infection. The possible mechanisms responsible for this relationship are discussed.

Adult↗
PubMed1985

Early protein restriction in chronic renal failure.

We performed a prospective randomised trial in 199 patients with various stages of renal failure. Stratified for sex, age and renal insufficiency, 105 patients were assigned to a protein (Pr)-restricted group (0.4-0.6g/kg/BW), and 94 to a control group. Pr-restriction led to a significant reduction in the excretion of urea, phosphate and protein. Survival of renal function was significantly better in Pr-restricted patients. Median serum creatinine concentration increased in the control group (p less than 0.05), but remained stable in Pr-restricted patients. We conclude that Pr-restriction retards, or even halts the progression of chronic renal failure.

Clinical Trials as Topic↗