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Biomedical subjects

A Sulima-Gillow

Publications and source records attributed to A Sulima-Gillow.

9 recordsLinked to original sources
PubMed1996

[Oral calcitriol pulse therapy in treatment of secondary hyperparathyroidism in patients with long term hemodialysis].

Oral calcitriol pulse therapy slowly becomes a method of choice in the treatment of secondary hyperparathyroidism in hemodialysis patients. It appears to be equally effective and simultaneously significantly cheaper than an intravenous therapy. In last year we have applied such a treatment to 12 hemodialysis patients with severe secondary hyperparathyroidism (iPTH range: 447-1228 pg/ml). All of them were hemodialysed 3 times a week with dialysate Ca+2 level 1.25-1.75 mM/l. Calcium carbonate was administered to maintain serum Ca level between 9.0-11.0 mg/dl and phosphate below 6.0 mg/dl. The patients were given calcitriol at dose 0.1 microgram/kg once a week, but it was obligatory to take a drug at bedtime, at least two hours after the last meal, a day before hemodialysis. During the treatment we divided the patients into two groups: I-patients who responded to our treatment (7/12); II-treatment was unsuccessful (5/12). In this group we decided to increase the dose of calcitriol to 0.075 micrograms/kg twice a week after 6 months use of a previous one. We have achieved statistically significant decrease of parathormone (p < 0.001) and alkaline phosphatase (p < 0.02) in group I and after the increase the dose of calcitriol there occurred the decrease of parathormone (p < 0.05) and alkaline phosphatase (p < 0.002) in group II. Simultaneously we have observed a great clinical improvement. Our results confirm the fact that even severe secondary hyperparathyroidism can be successfully treated with oral calcitriol pulse therapy. Administering of high doses of calcitriol at bedtime increases safety of this procedure-we have not observed any case of hypercalcemia.

Adult↗
PubMed1995

[Bacterial endocarditis in patients treated with maintenance hemodialysis].

UNLABELLED: Bacterial endocarditis (BE) is one of the most severe complications of hemodialysis (HD). The aim of the study was to analyse frequency and severity of BE in patients treated with HD in our dialysis unit. During the period 1969-1993276 patients were treated with HD in Gdańsk. In 23 cases (9F, 14M) HD treatment was complicated with BE. Patients were divided into two groups on basis of diagnostic criteria: I-13 patients (5F,8M) with BE diagnosed by means of clinical picture and positive blood culture.; II-10 (4F, 10M) with diagnosis additionally confirmed by echocardiography. In patients from group I BE was observed more often during the first 2 years of HD. In group II during 3-5 years of dialysis therapy, gram negative microorganisms were the most frequent etiological factors. The mean period of antibiotic therapy was 35 days. In all patients from group II changes in the bicuspid valve, in 60% of them additionally in aortic valve and in one patient also in the tricuspid valve were observed. In five patients changes in the parietal endocardium were also present. Development of organic valvular changes was observed in nine patients. Seven of 22 patients died during the acute phase of BE and two others from complications connected with BE. The longest survival of patients after BE was over 10 years. CONCLUSIONS: 1. The threat of BE in patients treated with HD decreased between 1987 and 1993 in comparison with the initial period of our HD station operations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Tuberculosis--an increasing risk for patients treated with long-term hemodialysis].

UNLABELLED: In the recent years an increase in the incidence of tuberculosis (TB) has been observed world-wide, including Poland. In the Department of Nephrology of Gdańsk School of Medicine, an increase in the incidence of TB has been observed among patients undergoing maintenance hemodialysis (HD). The aim of this work was to analyse the natural history of TB infection in this group of patients. Over the last seven years TB was diagnosed in 9 patients (5 female, 4 male) out of 171 patients on HD (5.2%). Seven of those were diagnosed in the last three years. The average age of patients with TB was 47.2 years. In three patients the clinical symptoms of TB has appeared during the first year of hemodialysis treatment (average 5.6 months), in the rest the mean period of dialysis before the TB diagnosis was 60 months. The TB was extrapulmonary (lymph nodes, pericardium and bones) in 5 patients. In most cases the clinical symptoms of TB were present, however, one patient was asymptomatic. Four cases were confirmed microbiologically and/or histopathologically. All patients treated with antituberculous drugs showed clinical recovery or cure, however in six patients the anti TB treatment was complicated by adverse drug reactions. One patient died and TB was diagnosed post mortem. In two patients who had had lymph nodal TB 2 and 6 years earlier, we now observed pulmonary TB. There were no cases of TB among hemodialysis unit staff. CONCLUSIONS: There is a increasing incidence of TB in population of HD patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Bone tuberculosis in a hemodialyzed patient--a difficult diagnostic problem].

Recent observations indicate quite high incidence of tuberculosis (tbc) in haemodialysis population. But there are really only few reports of arthritis the infection. Mycobacterial process in this location may imitate many other pathological states. Our report refers to 45-year-old man with right knee the infection and the peri-arthritic tissue, which developed after 8 years of renal replacement treatment. No evidence of the was noted before. Chronic pain, swelling and instability of the knee led finally to surgical extraction of diagnostic material, which contributed to final diagnosis. We consider this report to be important because of only few reported cases of the arthritis. Additionally unnecessary delay in commencement of treatment may lead to bone destruction.

Humans↗
PubMedDate not supplied

[Clinical estimation of 1-alpha-hydroxycholecalciferol in treatment of patients with chronic renal failure].

31 adult patients (15 male and 16 female) with chronic renal failure were treated for 6 months with 1-alfa-hydroxycholecalciferol on a dose 0.25-2.0 micrograms/24 h. 15 patients with not very advanced renal failure (serum creatinine level 176.8-442 mumol/l) received conservative therapy (group I), 16 patients with serum creatinine value 884-1326 mumol/l were treated by intermittent hemodialysis (group II). The statistically significant decrease of serum alkaline phosphatase activity in group I and II (p < 0.01), the rise of serum calcium level in group I (p < 0.005) were determined. Half of the patients from both the groups stated the relief or disappearance of bone and joint pains and muscle weakness. Besides in group I significant decrease of creatinine clearance (p < 0.001) and increase of serum urea and creatinine value (p < 0.01) were noticed. On the basis of these results we can conclude that the treatment with 1-alfa-hydroxycholecalciferol, produced by "Polfa", ought to be introduced gradually with increasing doses and frequent monitoring of calcium-phosphate metabolism and renal function parameters.

Adult↗
PubMedDate not supplied

[Retrospective studies of urinary infections in the elderly].

Retrospective analysis of the urinary infection course involved 55 elderly patients. The patients were divided into groups basing on the clinical diagnosis. These groups included patients with obstructive chronic pyelonephritis and the patients with lower urinary infections. It was found that reinfections occur in the elderly patients with both upper and lower urinary infections while recurrence is seen in case of the upper urinary infections. Bacteriuria is significantly more frequent in the obstructive chronic pyelonephritis than in other urinary infections. This form of bacteriuria is frequently accompanied by exacerbations than in bacteriuria of periodic origin. Arterial blood hypertension is frequent in the elderly with urinary infections but its incidence does not correlate with the localization of the infection. Decompensated renal failure in the course of the urinary infections in the elderly is nearly always combined with arterial blood hypertension.

Aged↗