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Biomedical subjects

Z Varghese

Publications and source records attributed to Z Varghese.

At least 145 records · Page 8Linked to original sources
PubMed1978

Parenteral 1,25-dihydroxycholecalciferol in hepatic osteomalacia.

Despite regular long-term parenteral vitamin D2 treatment, four patients with biliary cirrhosis had multiple symptoms of bone disease and bone biopsy specimens showed osteomalacia without osteoporosis. Three patients also had a proximal myopathy. Plasma calcium values (after correction for albumin), phosphorus, magnesium, and serum 25-hydroxy-vitamin D were within normal limits. Treatment with 1,25-dihydroxy-cholecalciferol (1,25-(OH)2D3) relieved symptoms in three of the four patients and improved those in the fourth. Histological examination of bone showed improvement in all four patients, but serum and urinary biochemical changes were not pronounced. We conclude that 1,25-(0H)2D3 treatment has a beneficial effect on bone and muscle in hepatic osteomalacia, either because vitamin D 1-hydroxylation fails in biliary cirrhosis or because hepatic osteomalacia is resistant to vitamin D2 metabolites.

Aged↗
PubMed1978

Changes in ionized calcium and other plasma constituents associated with cardiopulmonary bypass.

Plasma concentrations of calcium fractions, proteins, phosphate and magnesium were measured before, during and after cardiopulmonary bypass in 15 patients undergoing cardiac surgery. When calcium chloride was added to a pump priming solution which contained little or no blood, the concentrations of all calcium fractions were significantly greater after bypass than before, with a mean ionized calcium concentration of 1.52 mmol litre-1 plasma water, 30 min after completion of bypass. This iatrogenic hypercalcaemia was increased significantly by the administration of more than 10 mg kg-1 calcium chloride in the first 30 min after bypass. Other plasma constituents showed the dilutional effect of the pump prime during bypass and only the magnesium concentration failed to return towards normal values after operation.

Adolescent↗
PubMed1978

Clinical, biochemical, and histological studies of osteomalacia, osteoporosis, and parathyroid function in chronic liver disease.

Twenty of 32 patients with either chronic cholestatic or hepatocellular liver disease had bone pain or recent fractures. On bone biopsy five patients had normal bone, 15 had osteomalacia, five had osteoporosis, and seven had a combination of osteomalacia and osteoporosis. In the presence of osteoporosis, osteomalacia was minimal or absent. There was no biochemical, radiological, or histological evidence of excess parathyroid activity. No significant correlations were demonstrated between the plasma and urinary biochemical findings and the presence of either osteoporosis or osteomalacia and bone biopsy was essential for correct diagnosis. There was no statistical relationship between low serum 25-hydroxy vitamin D values and the presence of osteomalacia. Bone disease was not prevented by regular intramuscular vitamin D2, although biochemical changes were improved. Drugs such as corticosteroids and cholestyramine may be important aetiological factors in hepatic osteodystrophy.

Adult↗
PubMed1977

Plasma lipoprotein patterns in patients receiving dialysis therapy for chronic renal failure.

A study is reported of the prevalence, nature and possible aetiology of the hyperlipidaemia found in a group of 74 patients receiving maintenance dialysis. Sixty patients were receiving haemodialysis and 14 peritoneal dialysis. Sixty-four per cent of the male and 83% of the female patients had a lipoprotein abnormality which was predominantly of the Type IV pattern, probably due to a combination of increased hepatic triglyceride synthesis and diminished peripheral clearance.

Adolescent↗
PubMed1977

Differences in the calcium concentration of serum and plasma initially and after storage.

Calcium concentrations of plasma and serum in glass and plastic containers initially and after storage for up to 8 months at--20 degrees C were compared. The mean initial calcium concentration of the plasma samples was 2.491 nnol/l and this was significantly higher than the mean serum concentration of 2.440 nnol/l. There were no significant differences in the mean calcium concentrations attributable to differences in glass or plastic as materials for storage containers for either serum or plasma. The mean calcium concentration of serum remained stable over the entire storage period, but that of the plasma samples fell significantly between one month and six months, with no further fall between six months and eight months.

Blood Preservation↗
PubMed1976

Persistent hypophosphataemia and osteomalacia in dialysis patients not on oral phosphate-binders: Response to dihydrotachysterol therapy.

Four patients who had been on regular haemodialysis for periods of 3 1/2 to 7 years became hypophosphataemic with plasma-phosphate concentrations of 2.5 mg/dl or less before dialysis. None of them had been taking oral phosphate-binders for 2 years or more. Histologically all the patients had an excess of osteoid on bone biopsy. Intestinal absorption of phosphate and calcium was impaired, despite normal or high serum-25-hydroxycholecaliferol concentrations. Treatment with oral dihydrotachysterol resulted in corrections of the phosphate malabsorption and increases in plasma-phosphate concentration. The initial low plasma-phosphate values in these patients before dialysis probably reflected a state of phosphate depletion caused by the combination of malabsorption, loss during dialysis, and a low dietary intake.

Adult↗
PubMed1975

Comparison of biochemical with radiological findings in renal osteodystrophy.

In a group of 121 adult patients with end-stage chronic renal failure who had been undergoing maintenance haemodialysis for up to 10 years a number of biochemical variables have been measured and related to a set of objective radiological changes in the same patients. The changes in plasma calcium, magnesium, phosphate, total protein, and albumin concentration did not distinguish the patients who were grouped on a radiological basis. Plasma alkaline phosphatase activity increased with the severity of the radiological findings but did not provide a sensitive discriminatory index between the different radiological groups. Plasma hydroxyproline concentration was found to be more sensitive than plasma alkaline phosphatase activity in detecting a radiological abnormality in some of the patients.

Adult↗
PubMed1974

Effects of age, sex, and polycystic disease on progressive bone disease of renal failure.

A study of 150 patients undergoing haemodialysis has shown that age had a striking effect on the radiological presentation of renal bone disease, erosions being common in the young and uncommon in older patients and vascular calcification showing opposite trends to this. Men aged 20 to 59 years had a greater tendency to develop erosions than did women in this age range. Examination of a group of 53 patients over a period of five years showed that the half time for the development of vascular calcification was 4.6 years, erosions 26.7 years, and fractures 6.9 years. Nine out of 16 polycystic patients matched for age and sex with 50 controls did not develop erosions and had consistently less vascular calcification than the controls when examined over a six-year period.

Adolescent↗
PubMed1973

Serum IgG and renal transplantation.

In 57 patients with renal allografts the prolonged administration of prednisolone >/= 1 mg/kg/day and azathioprine >/= 3 mg/kg/day caused a significant and persistent fall in serum IgG at all levels of creatinine clearance. The fall in IgG was more striking when creatinine clearance was below 25 ml/min. At lower doses of azathioprine and prednisolone serum IgG fell when the creatinine clearance was less than 35 ml/min, the degree of recovery towards normal being dependent on creatinine clearance and dosage. Post-transplant haemodialysis decreased the depression of IgG, and patients with immediately functioning grafts had minimal IgG depression. An inverse relation between IgG and IgM was observed in some patients. Severe infections and toxicity were associated with the greatest reduction in IgG; leucopenia and thrombocytopenia were not consistently reliable guides to toxicity. The deaths of four patients (7%) were associated with severe infections. Falls in IgG were not related to the rejection process. IgG measurement should be used as a guide to immunosuppression and toxicity in renal allograft patients.

Adult↗