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Biomedical subjects

A W Asscher

Publications and source records attributed to A W Asscher.

At least 19 recordsLinked to original sources
PubMed1991

The yellow card: mark II.

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Drug-Related Side Effects and Adverse Reactions↗
PubMed1991

Covert bacteriuria: long term follow up.

In a longitudinal prospective study 58 schoolgirls with covert bacteriuria were followed up for an average of 11.2 years (range 8.8 to 13.5 years). Intravenous urography was carried out at the start of the study (aged 4 to 11 years) and after completion of the follow up period (aged 14.8 to 22.3 years). After random allocation 27 of these girls received intermittent treatment for covert bacteriuria for the first four years and the control group received no treatment. The effect of covert bacteriuria, treatment, vesicoureteric reflux, and reflux nephropathy at presentation on the final renal length, progression of scarring, and development of new scars was analysed. No new scars were found in girls with bilaterally normal kidneys. In girls with reflux nephropathy, three kidneys showed progression of existing scars and two kidneys developed new scars. It was shown that final renal length was not influenced by vesicoureteric reflux or treatment, but reduced renal length at final assessment was associated with the presence of kidney scarring at initial assessment.

Bacteriuria↗
PubMed1989

Hypercalcaemia as a manifestation of malignant urothelial change in analgesic nephropathy.

We report two cases of patients with analgesic nephropathy presenting with the symptoms of hypercalcaemia, and who were found to have transitional cell carcinomas of the renal pelvis. On removal of the tumours, calcium levels fell to normal, indicating that a humoral factor produced by the tumour caused the hypercalcaemia. We suggest that hypercalcaemia in a patient with analgesic nephropathy may indicate a malignant change, and that serum calcium should be assessed when such patients are reviewed.

Analgesics↗
PubMed1987

Effect of symptomless bacteriuria in childhood on subsequent pregnancy.

The outcome of 52 pregnancies in 34 women who had had bacteriuria in childhood was compared with that of normal control pregnancies. The prevalence of bacteriuria at the first antenatal visit was significantly higher (p less than 0.001) in previously bacteriuric women (35%) than in controls (5%), and acute pyelonephritis developed in 10% compared with 4% of controls. Pre-eclampsia (arterial pressure above 140/90 mm Hg with proteinuria above ++) developed in 4 of 12 previously bacteriuric women known to have renal scarring (5 of 16 pregnancies), in only 1 of 22 previously bacteriuric women without scars (1 of 36 pregnancies), and in 1 of 52 controls (p less than 0.001). Women with renal scars were also more likely to undergo induction of labour (44% of pregnancies) and operative delivery (57% of pregnancies) than previously bacteriuric mothers without scars (17%, 22%) or control mothers (16%, 20%). The infants of previously bacteriuric mothers were not significantly smaller than those of healthy control mothers, but Apgar scores were lower among offspring of previously bacteriuric mothers with scarred or normal kidneys (p less than 0.001). Fetal outcome was, however, satisfactory in all cases.

Adult↗
PubMed1986

Pharmacokinetics of ciprofloxacin in healthy volunteers and patients with impaired kidney function.

The pharmacokinetics of ciprofloxacin were studied, in six healthy controls and in 18 patients with varying degrees of renal impairment, after administration of a single 100 mg intravenous dose. Pharmacokinetic parameters were calculated on a two compartment open model. The mean distribution volume was 2.1 (+/- 0.6) l/kg of ideal body weight; it did not correlate significantly with renal function. In the healthy volunteers 57 (+/- 9)% of the drug was eliminated by the kidney and 43% by other pathways. The renal clearance of ciprofloxacin correlated with creatinine clearance (rs = 0.93, P less than 0.001), and urinary excretion of the drug was markedly reduced in patients with the most severe degrees of renal impairment. Plasma clearance correlated with creatinine clearance (rs = 0.50, P less than 0.02). This together with the lack of correlation between non-renal clearance and renal function enables us to suggest an intravenous dosage schedule for patients with renal impairment.

Adult↗
PubMed1986

Progression of chronic pyelonephritis in the rat.

Thirteen of 20 female Wistar rats developed perihilar kidney scars 6 weeks after ascending infection with Escherichia coli 078. After removal of the lesser scarred kidney from 6 of the animals, all animals were followed for 54 weeks. Proteinuria (greater than 18 mg/24 h) developed at 20 weeks in the uninephrectomised infected rats and at 34 weeks in the 2-kidney infected model. In 10 uninephrectomised controls significant proteinuria did not appear until 52 weeks. In 9 2-kidney controls proteinuria did not develop at all. The speed of onset and severity of proteinuria was related to the extent of the renal parenchymal loss. Pyelonephritic scars did not show macroscopic progression over the 54-week observation period, even though the original renal infection persisted. Uninephrectomised animals with infected scars developed a highly significant rise of creatinine/body weight (p less than 0.02) and of heart weight/body weight p less than 0.02) ratios compared with the non-infected controls. Their kidneys showed focal and segmental hyalinosis and sclerosis of the glomeruli adjacent to the scars. Immunofluorescent staining for serum proteins was negative, but mesangial deposits of Tamm-Horsfall protein were found in the glomeruli between the scars in animals with renal impairment. These findings establish that progressive renal impairment in rats with infected kidney scars is associated with the development of proteinuria and a glomerulopathy. The cause of the glomerulopathy is not clear, both glomerular hyperfiltration and deposition of Tamm-Horsfall protein in glomerular mesangial cells may be involved.

Animals↗
PubMed1986

Analysis of polymorphonuclear leukocyte respiratory burst activity in uremic patients using whole-blood chemiluminescence.

The respiratory burst activity of peripheral leukocytes from 17 patients with chronic renal failure and 12 healthy individuals was assessed using the technique of whole-blood chemiluminescence (CL). Luminol- and lucigenin-dependent CL was measured in two dilutions of venous blood following stimulation with serum-treated zymosan or phorbol myristate acetate, and the CL peaks associated with a polymorphonuclear leukocyte count of 10(4)/ml were calculated. The mean CL peaks for the patients were significantly higher than those for the controls in all experimental designs (p less than 0.05). This enhanced leukocyte respiratory burst activity was not associated with the underlying renal abnormality or with the type of dialysis treatment, but may have been related to the induction of tissue enzymes which is known to occur in uremia.

Acridines↗
PubMed1985

Serial measurement of renal plasma flow.

Effective renal plasma flow was measured two or three times in 1 h in 12 healthy volunteers. Radiohippuran (ortho-iodohippurate) was injected intravenously, and blood samples were obtained 8, 13 and 18 min post-administration. The problem of interference in succeeding measurements by activity from preceding injections was overcome by the use of three different radiolabels. These were, in order of use, 125I, 123I and 131I. The principal energies of gamma- and/or X-ray emission were 30, 160 and 365 KeV, respectively, allowing completely independent assay. A close correlation was observed between the results obtained for the three radionuclides over a wide range of renal plasma flow. The technique is relatively non-invasive and is presented as a suitable method for the important task of measuring renal plasma flow under the influence of drugs, especially of anaesthetics.

Adult↗
PubMed1985

A system for accurate immunolocalization of Tamm-Horsfall protein in renal biopsies.

The distribution of Tamm-Horsfall protein (THP) was studied in the human kidney using formalin-fixed, paraffin-embedded sections with a monoclonal antibody specific for human THP applied in conjunction with a modified dinitrophenyl hapten sandwich staining (DHSS) procedure. The method was found to be highly sensitive producing very strong specific staining at antibody dilutions up to 1 in 64 000. Counterstaining with Haematoxylin and Eosin was possible without significant masking of the specific staining. This provided excellent structural definition of the background tissue which proved especially important in the study of THP localization in randomly oriented biopsy material. THP was found in all segments of the thick ascending limbs of loops of Henle, most segments of distal convoluted tubules and occasionally in distended collecting ducts and in the glomerular capsular space. Maculae densae did not contain THP. The combination of the modified DHSS procedure and the human THP specific antibody represents a highly sensitive and reliable method for specific staining of the THP in kidney sections.

Antibodies, Monoclonal↗
PubMed1984

Pharmacokinetics of norfloxacin (MK 366) in patients with impaired kidney function--some preliminary results.

The concentration of norfloxacin in serum and urine was measured in five healthy volunteers and eleven patients with renal impairment following a 400 mg oral dose of norfloxacin. In impaired renal function the elimination rate of norfloxacin is decreased considerably whereupon the area under the curve (AUC) rises rapidly. The urinary concentration of norfloxacin decreases with renal function but therapeutic levels are still obtained for sensitive organisms. Patients with a glomerular filtration rate of less than 30 ml/min require dosage reduction and we would recommend a reduction to half the usual dosage.

Anti-Infective Agents, Urinary↗