PubMed Health⌕ Search

Biomedical subjects

C Ogg

Publications and source records attributed to C Ogg.

At least 19 recordsLinked to original sources

Renal function following pregnancy in renal transplant recipients.

We set out to analyse the effect of pregnancy and hypertension in renal transplant recipients and review serum creatinine levels as a marker of graft function, before, during and after pregnancy. The study was conducted at a major tertiary referral centre in London. This was a retrospective analysis of renal transplant patients who had achieved a successful pregnancy. During the period 1967-1998, there have been 272 women of childbearing age with successful renal transplants functioning for over 1 year. Within this population there have been 66 pregnancies in 41 patients resulting in 53 births. Among the pregnancies that progressed beyond 24 weeks, preterm delivery occurred in 32 (60.4%). The mean gestation was 35.7 (range 30-41), mean birth weight was 2365 grams (range 908-3430 grams) with 47%of infants weighing <2500 grams. There were vaginal deliveries in 14 (26%), the rest delivered by caesarean section. Patients that developed hypertension in late pregnancy tended to have higher pre-pregnancy creatinine levels and a deterioration of graft function postpartum. Serum creatinine levels greater than 130 micromol/l before pregnancy predict deteriorating renal function postpartum. Kaplan-Meier life survival analysis showed that the risk of subsequent graft loss is associated with increased serum creatinine levels (130-180 micromol/l) before pregnancy. Pregnancy figures in our unit are favourable compared to those reported in the literature. Poor pre-pregnancy renal function (creatinine 130-180 micromol/l) and previous hypertension is associated with a significant risk of graft failure. Creatinine levels currently deemed as being acceptable during the pregnancy of renal transplant recipients may need to be reappraised.

Journal Article↗

Adherence of Staphylococcus aureus to cultures of human peritoneal mesothelial cells.

Strains of Staphylococcus aureus, isolated from the effluent of patients with peritonitis on CAPD (continuous ambulatory peritoneal dialysis), adhered well to both cultured human mesothelial cells and to fibronectin, but not to laminin or gelatin. Mesothelial cells grown in medium M199 exhibited more surface fibronectin compared to cells grown in MEM-Dval and demonstrated higher levels of S. aureus adherence. Soluble fibronectin concentrations up to 10 micrograms/ml increased the adherence of S. aureus to cultured mesothelial cells. The dose-response curve was consistent with the binding of fibronectin to a saturable receptor of apparent dissociation constant (KD) = 1.7 x 10(-10) M. This corresponds closely to the KD (2 x 10(-10) M) of the staphylococcal fibronectin-binding protein. S. aureus adherence was increased following the preincubation of mesothelial cell monolayers with interleukin-1 and was maximal after 6 h preincubation. Treating mesothelial cells with interferon-gamma for 48-72 h reduced the adherence of S. aureus.

Bacterial Adhesion↗

Lipoxygenase inhibitors shift the yeast/mycelium dimorphism in Ceratocystis ulmi.

The yeast-mycelium dimorphism in Ceratocystis ulmi, the causative agent of Dutch elm disease, was switched by gossypol, nordihydroguaiaretic acid, and propylgallate. In each case the mycelial form was converted to the yeast form. These compounds are recognized lipoxygenase inhibitors. Inhibitors of cyclooxygenase and thromboxane synthetase did not cause mycelia to shift to the yeast form. We suggest the following two-part hypothesis: (i) that lipoxygenase is a target for antifungal antibiotics and (ii) that many phytoalexins (antimicrobial compounds of plant origin) are targeted toward fungal lipoxygenases. In addition, in a study to determine potential lipoxygenase substrates, a fatty acid analysis indicated that C. ulmi conidiospores contained high levels of oleic, linoleic, and linolenic acids but no arachidonic acid.

Ascomycota↗

Recurrence of focal segmental glomerulosclerosis in transplanted kidneys: analysis of incidence and risk factors in 59 allografts.

Fifty-nine allografts were placed in 43 patients with renal failure from focal segmental glomerulosclerosis (FSGS): 27 allografts were put into 16 children aged less than 15 years, and 32 allografts into 27 adolescents and adults. Recurrence of FSGS was noted histologically in 13 allografts, 10 in 8 children and 3 in adults. None of the 9 children and 24 adults who never developed an allograft nephrotic syndrome showed FSGS in their allograft biopsies. The age of onset was a strong risk factor for recurrence: recurrent FSGS developed in 8 of 16 children (50%) but only in 11% of adolescents and adults (3 of 27 patients). Although the time from apparent onset to renal replacement treatment was shorter in those with recurrence than those without in the children, there was no difference in the time spent on dialysis prior to transplantation. Mesangial prominence was observed in the original biopsy in 12 of 13 patients with recurrence, and recurrence rate was similar in living and cadaver donor allografts; class I MHC matching was similar in those with and without recurrence. Three allografts treated with cyclosporin A as well as 9 with azathioprine showed recurrence. Of 9 second or subsequent allografts placed in those with recurrence in the first allograft, only 3 showed further recurrence. In 3 re-grafted after 13, 11 and 5 years, normal function was seen.

Adolescent↗

Outcome in patients on continuous ambulatory peritoneal dialysis and haemodialysis: 4-year analysis of a prospective multicentre study.

In a study in seven large renal units in England, the morbidity and mortality of all patients starting continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis during 1983-85 were monitored prospectively over a 4-year period and related to reasons for choice of therapy and potential risk factors. 610 new patients (median age 52 years, range 3-80 years) started CAPD; 16% had diabetes mellitus and 21% cerebrovascular or cardiovascular disease. 329 patients (median age 48 years, range 5-77 years) started haemodialysis; 7% had diabetes mellitus and 17% cerebrovascular or cardiovascular disease. The Kaplan-Meier patient survival estimates at 4 years were 74% for haemodialysis and 62% for CAPD; technique survival figures for the same period were 91% for haemodialysis and 61% for CAPD. Cox's proportional hazards regression analysis showed that cerebrovascular/cardiovascular disease, age over 60 years, and diabetes mellitus were important predictors for survival in CAPD patients; there were no risk factors associated with permanent change to haemodialysis. In the haemodialysis group early change to CAPD was associated with presence of cerebrovascular or cardiovascular disease. The major cause of drop-out in both groups was transplantation. The mean length of hospital admission was 14.8 days per patient-year for CAPD and 12.4 days per patient-year for haemodialysis.

Adolescent↗

Multi-centre study on outcome of treatment in patients on continuous ambulatory peritoneal dialysis and haemodialysis.

In a multi-centre study by seven large renal units in the United Kingdom, the morbidity and mortality of all patients starting CAPD and haemodialysis during a 2-year period (1983-1984) has been monitored prospectively and related to reasons for choice of therapy and potential risk factors. Over this period 338 new patients (mean age 48; range 3-77 years) started CAPD; 17% had diabetes mellitus and 25% had cerebro/cardiovascular disease. One hundred and seventy-five patients (mean age 45; range 5-73 years) started haemodialysis; 6% had diabetes mellitus and 14% had cerebro/cardiovascular disease. The Kaplan-Meier actuarial patient survival estimates at 2 years were haemodialysis 84% and CAPD 83%, whilst technique survival figures for the same period were haemodialysis 92% and CAPD 80%. Cox's regression analysis showed that cerebro/cardiovascular disease and age greater than 60 years were most important predictors for survival in CAPD patients, in whom smoking appeared to be a significant risk factor, for permanent change of therapy to haemodialysis. The major cause of 'drop out' in both groups was transplantation, whilst hospitalisation was 14.9 days per patient year for CAPD and 12.8 for haemodialysis patients. Within the CAPD group a temporary change to haemodialysis (less than 2 months) occurred on 106 occasions (each of mean of 19 days duration), amounting to 10 days per patient year of therapy. CAPD was used twice as often as haemodialysis for managing new patients. After 2 years hospitalisation technique and patient survival were comparable in the two groups, with cerebro/cardiovascular disease, age, and smoking being significant predictors of outcome.

Adolescent↗

Adult-onset minimal change nephrotic syndrome: a long-term follow-up.

A series of 89 adult-onset nephrotic patients with minimal changes on renal biopsy was analyzed to compare the rate of response to corticosteroids and cytotoxic agents and the stability of remission or frequency of relapses at different ages. Severe hypertension and diminished renal function were more common in patients aged over 60 years, who formed 22.5% of the group. Seventy-five patients were given a first course of prednisolone in an initial dose of 60 mg/24 hr. After an eight week course of tapering doses of corticosteroids, only 45 of the 75 patients were in complete remission, 55 patients after 16 weeks and eventually 58 lost their proteinuria. The respective estimates of remission were 60%, 76% and 81%. Subsequently, of the 58 treated patients who responded, 24% never relapsed. Fifty-six percent of the patients relapsed on a single occasion or infrequently, and only 21% were frequent relapsers. Cyclophosphamide was used in 36 patients, in two as initial treatment, in 11 because of corticosteroid resistance, and in the remainder because of relapses. The time-course of loss of proteinuria was similar to that following treatment with corticosteroids, 25 (69%) losing proteinuria within 16 weeks. Only four patients failed to lose their nephrotic syndrome. Two of them had presented in acute renal failure and all four were over 60 years of age. The stability of remission after cyclophosphamide was better than that reported for children, only 13 of 36 showing relapses and 66% being in remission at five years, after which no further relapses were seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗

Renal transplantation in patients treated with haemodialysis and short term and long term continuous ambulatory peritoneal dialysis.

Forty two adult patients who had been treated with continuous ambulatory peritoneal dialysis for one to 142 weeks (mean (SD) 38 (36)) received a total of 44 allografted kidneys. Twenty one had been treated with continuous ambulatory peritoneal dialysis for less than 26 weeks (mean 11 (8)) and the other 21 for longer than 26 weeks (mean 64 (35)). These two groups were compared with 55 patients who had been treated with haemodialysis and received a total of 63 grafts. In the group of patients treated with continuous ambulatory peritoneal dialysis azathioprine and low dose prednisolone were used as the immunosuppressive regimen for 20 transplantations in 18 patients, and 24 patients receiving 24 grafts were treated with cyclosporin A and low dose prednisolone. In the group of patients treated with haemodialysis 38 patients receiving 43 grafts were treated with azathioprine and low dose prednisolone, and 20 patients receiving 20 grafts were treated with cyclosporin A and low dose prednisolone. Actuarial survival of patients and grafts at two years was 95% and 72%, respectively, in the continuous ambulatory peritoneal dialysis group compared with 89% and 58%, respectively, in the haemodialysis group. No difference was found in graft survival between short term treatment with continuous ambulatory peritoneal dialysis (72% graft survival) and long term treatment (65% graft survival). In conclusion, continuous ambulatory peritoneal dialysis is suitable treatment for patients awaiting renal transplantation.

Adolescent↗

Aluminium in bone from patients with renal failure.

Some samples of bone from patients with renal failure contained more aluminium than others, and the concentration tended to be highest in patients who had been uraemic or on dialysis longest. The significance of the association of raised concentrations of aluminium in bone with renal failure is discussed.

Activation Analysis↗