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Biomedical subjects

C Tielemans

Publications and source records attributed to C Tielemans.

At least 55 records · Page 3Linked to original sources
PubMed1987

Effect of aluminum on porphyrin metabolism in hemodialyzed patients.

In patients with renal failure and on chronic hemodialysis, serum aluminum, serum delta-aminolevulinic acid, serum porphobilinogen and erythrocyte zinc protoporphyrin (ZPP) are significantly elevated, whereas erythrocyte delta-aminolevulinic acid dehydratase activity (ALAD, values in percent) is significantly reduced. The last two parameters (ZPP and ALAD) are statistically related to serum aluminum concentration (Al-S), but only the correlation between Al-S and ALAD remains statistically significant after standardization for the degree of renal insufficiency (expressed in terms of urea level). This study does not support the hypothesis that the retention of aluminum is responsible for the increase of ZPP in uremic patients on dialysis. The disturbances of porphyrin metabolism found in patients with renal failure and on chronic dialysis are not similar to those observed in porphyria cutanea tarda.

Adult↗
PubMed1985

Campylobacter fetus peritonitis followed by septicaemia in a patient on continuous ambulatory peritoneal dialysis.

A 62-year-old man being treated by continuous ambulatory peritoneal dialysis (CAPD) developed peritonitis due to Campylobacter fetus subspecies fetus (intestinalis), an organism seldom isolated in such circumstances. After appropriate and apparently effective antibiotic therapy, the patient relapsed 6 weeks later with septicaemia. Blood cultures yielded a similar organism, thereby suggesting a clinically silent metastatic infection during the episode of peritonitis, probably at an old arteriovenous fistula. Parenteral tobramycin followed by oral erythromycin achieved a complete cure of this unusual complication.

Campylobacter Infections↗
PubMed1985

Red blood cells indices and aluminium toxicity in haemodialysis patients.

Microcytic, hypochromic anaemia is a feature of aluminium toxicity. To detect the possible influence of aluminium on erythropoiesis in a general haemodialysis population we studied the evolution of red blood cell parameters and aluminium status in 30 patients (27 without aluminium toxicity symptoms). Aluminium status was assessed by serum aluminium measurements before (BAl) and after (PAl) a desferrioxamine infusion. The evolution with time (delta) of PAl and DAl (= PAl - BAl) during the prospective study inversely correlated with delta mean corpuscular volume (2 alpha less than 0.01) and delta mean corpuscular haemoglobin (2 alpha less than 0.001). Patients with DAl greater than 180 micrograms/L had lower mean corpuscular haemoglobin values (p less than 0.05). These findings suggest that aluminium inhibits haemoglobin synthesis even in haemodialysis patients free of aluminium toxicity symptoms.

Adult↗
PubMed1985

Bone scan in haemodialysis patients: relation to hyperparathyroidism and aluminium toxicity.

The influence of hyperparathyroidism and aluminium toxicity on bone scan scores (FS = Fogelman's score) was studied in 37 haemodialysis patients (group 1), of whom 24 had aluminium toxicity (group 2). FS, parathormone (iPTH) and aluminium status were assessed simultaneously, the latter by measuring serum aluminium before (BAl) and 48 hours after (PAl) a desferrioxamine infusion. FS correlated directly with iPTH in all groups, inversely with PAl and DAl (= PAl - BAl) in group 1; FS less than or equal to 2 was found in group 2 only (2 alpha less than 0.05). The time course of FS and aluminium concentration was also studied in 24 patients: a PAl increase was significantly associated with a FS decrease (2 alpha less than 0.001). In conclusion, hyperparathyroidism increases and aluminium toxicity decreases FS; FS less than or equal to 2 is very suggestive of aluminium toxicity.

Adult↗
PubMed1985

Improvement of anemia with deferoxamine in hemodialysis patients with aluminum-induced bone disease.

As microcytic anemia is a feature of aluminium intoxication, we prospectively studied the hematologic effects of deferoxamine in 10 hemodialysis patients with aluminum-induced bone disease. Comparing the mean monthly results of a 4 month period before and during deferoxamine therapy, we observed an important decrease of the transfusion needs (alpha less than 0.025) and an increase of hematocrit (p less than 0.02), hemoglobin (p less than 0.02), MCV (p less than 0.02) and MCH (p less than 0.05); the number of red blood cells remained unchanged. Our results show that deferoxamine treatment of dialysis patients with aluminum bone disease can markedly improve their anemia, even in the absence of recent aggravation, microcytosis and hypochromia. They also suggest that aluminum could participate in the anemia of dialysis patients even if it is normocytic.

Adult↗
PubMed1985

[Cutaneous vasculitis associated with chronic hepatitis: 2 cases].

2 cases of cutaneous vasculitis associated with chronic hepatitis and mixed cryoglobulinaemia are reported. Further studies revealed in the first case hypocomplementaemia and glomerulonephritis. The cutaneous lesions of this patient responded dramatically to plasma exchange whereas prednisolone 20 mg/day and azathioprine 50 mg/day for 10 months showed no effect. The second case (chronic active hepatitis with acute colitis) responded well to prednisolone and azathioprine. The cutaneous lesions (vascularitis) may be the only clinical symptom of a chronic hepatitis and the study of those cases sometimes allows an early diagnosis of renal failure to be made.

Azathioprine↗
PubMed1984

Pseudomonas paucimobilis peritonitis in patients treated by peritoneal dialysis.

Pseudomonas paucimobilis has rarely been reported as an opportunistic human pathogen. We report the isolation of this organism in two patients who developed peritonitis during the course of intermittent or continuous ambulatory peritoneal dialysis. The origin of the infection was related to contamination of the dialysate in the first patient but could not be determined in the second case.

Adult↗
PubMed1983

Haemodialysis, continuous ambulatory peritoneal dialysis and cellular immunity.

The cellular immunity of haemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patients was studied with regards to T-lymphocyte subsets and to suppressor T-cell function. The two groups of patients showed similar alterations: low proportions of suppressor-cytotoxic T-cells and low suppressive activity. In both groups there is a deterioration of this suppressive activity with time on dialysis.

Aged↗
PubMed1981

Predictive value of 99mTc pyrophosphate bone scintigraphy for vitamin D trials in uraemia.

The usefulness of 99mTc-Pyrophosphate (99mTc-PPi) bone scintigraphy was evaluated in the follow up of 21 haemodialysed patients without clinical or radiological evidence of osteodystrophy. 99mTc-PPi bone scintigraphy was semi-quantitatively analysed using Fogelman's score. Patients were randomised to receive vitamin D analogues (1 alpha hydroxyvitamin D3 or dihydrotachysterol, n = 12) or to serve as controls (n = 9), both groups being given oral calcium supplements. Bone scintigraphy deteriorated in patients only on calcium therapy but not in patients treated by vitamin D-analogues. Vitamin D therapy reduced secondary hyperparathyroidism in all cases but induced rapid intoxication with normal doses in 4 of the 12 treated patients. Since intoxicated patients had significantly lower Fogelman's score than the patients who tolerated the treatment well, 99mTc-PPi bone scintigraphy is proposed as a screening test before vitamin D-analogues trials.

Bone and Bones↗