PubMed Health⌕ Search

Biomedical subjects

D A Jenkins

Publications and source records attributed to D A Jenkins.

At least 19 recordsLinked to original sources
PubMed2001

Recurrence of dialysis shunt pseudoaneurysm following percutaneous thrombin embolization.

We report an unusual case of a 58-year-old woman on maintenance hemodialysis who presented with an iatrogenic radial artery pseudoaneurysm proximal to a Cimino-Brescia fistula. The pseudoaneurysm was not amenable to ultrasonographic compression due to the vascular anatomy. The pseudoaneurysm recurred despite initial successful response to two direct injections of thrombin on separate occasions. We highlight the role of ultrasound and thrombin injection in the treatment of pseudoaneurysm and emphasize the need for follow-up ultrasound examination to monitor recurrence.

Administration, Cutaneous↗
PubMed1998

Nuts and plasma lipids: an almond-based diet lowers LDL-C while preserving HDL-C.

OBJECTIVE: To compare lipid-altering effects of an almond-based diet with an olive oil-based diet, against a cheese and butter-based control diet. METHODS: Forty-five free-living hyperlipidemic men (n = 12) and women (n = 33) with a mean plasma total cholesterol (TC) of 251 +/- 30 mg/dL followed one of three diets; almond-based, olive oil-based, or dairy-based for 4 weeks. Total fat in each diet was matched, and the study-provided sources of fat comprised the major portion of fat intake. RESULTS: Reductions in TC and low-density lipoprotein-cholesterol (LDL-C) between the three groups were significantly different from the almond group (both p < 0.001). Within group analysis revealed that the almond-based diet induced significant reductions in TC (p < 0.05), LDL-C (p < 0.001), and the TC:HDL ratio (p < 0.001), while HDL-C levels were preserved. TC and HDL-C in the control diet were significantly increased from baseline (both p < 0.05), while the olive oil-based diet resulted in no significant changes over the study period. Weight did not change significantly. CONCLUSION: Results suggest that the more favorable lipid-altering effects induced by the almond group may be due to interactive or additive effects of the numerous bioactive constituents found in almonds.

Adult↗
PubMed1996

Ki-ras mutations in adenomas: a characteristic of cancer-bearing colorectal mucosa.

Activating mutations in the Ki-ras2 oncogene are frequently observed in sporadic colorectal adenomas and their incidence is reported to rise in large and tubulovillous adenomas to values close to those in carcinomas. This study shows that this property is a feature of adenomas growing in large bowel that has already demonstrated its propensity to engender malignant tumours: i.e., bowel in which there is a synchronous carcinoma. Adenomas from cancer-free bowel do not share this high incidence of Ki-ras mutations. This difference in mutation incidence between adenomas from cancer-free and cancer-bearing patients does not appear to derive from sampling bias relative to adenoma size, site, or patient age, nor is it found in another gene (APC) known to be of importance in adenoma formation. Large, dysplastic adenomas from cancer-bearing bowel, however, are particularly liable to carry Ki-ras mutations when they arise in patients over 70 years old. The observations suggest that the role of Ki-ras mutations may be more subtle than merely enhancing adenoma growth. Adenoma cells of cancer-prone individuals may suffer more mutational events than those in persons selected as cancer-free.

Adenoma↗
PubMed1996

Nurse education consultancy: a new role.

Market philosophy is transforming nurse education, an arena where alternative values and beliefs have been important. Such philosophy challenges nurse teachers to rethink their roles and consider what they might have to offer the profession either working within an institution or independently. This paper will explore the role of the nurse education consultant, examining what is implied by the term 'consultation' and what this might mean within a consultation process. Consultancy may be used to help colleges to market effectively and ethically, when the benefits of long term investment in education may not otherwise be apparent.

Consultants↗
PubMed1995

Renal expression of interleukin-2 receptor mRNA in patients with crescentic glomerulonephritis.

We studied paraffin sections of renal biopsies from 7 patients with crescentic glomerulonephritis (CGN) by in situ hybridisation, to detect sites of interleukin-2 receptor (IL-2R) mRNA expression. Frozen sections from a further patient with CGN were studied by immunohistochemistry with a monoclonal antibody to CD25, to detect IL-2R protein. Positive control sections were taken from biopsies of acute cellular renal transplant rejection and negative controls from biopsies of membranous glomerulonephritis. No autoradiographic signal was detected in negative controls. IL-2R mRNA expression was seen in rejected transplants and in sections from 4 to 7 patients with CGN. Expression was seen in cortical interstitial cells, renal tubular epithelial cells, cells within glomerular crescents and in one glomerulus at the margin of Bowman's capsule. Tubular cell expression of IL-2R protein was confirmed by immunohistochemistry. We have confirmed that IL-2R mRNA expression occurs locally within the kidneys in CGN and have identified expression in tubular epithelial cells. The results suggest that local activation of immunocompetent cells occurs in the kidney and may be of significance in the pathogenesis of CGN.

Adult↗
PubMed1994

Expression of tissue kallikrein in human kidney.

1. We studied the distribution of human tissue kallikrein mRNA in normal and diseased kidney, using in situ hybridization, together with immunohistochemical localization of renal kallikrein protein. Materials studied were (a) normal tissue from kidneys removed because of localized renal carcinoma, (b) kidneys removed because of post-traumatic haemorrhage and (c) renal biopsy specimens from patients with membranous glomerulonephritis and nephrotic syndrome. 2. A 1.35 kb EcoRI fragment of human tissue kallikrein cDNA was labelled with [32P]dCTP using the random-primer technique, and used for in situ hybridization. A specific rabbit antibody to active human urinary kallikrein was employed for immunocytochemistry, using a peroxidase-antiperoxidase method. 3. By in situ hybridization, no tissue kallikrein gene expression was seen in the carcinoma nephrectomy specimens. Positive expression was seen in the trauma nephrectomy tissue, and in four of five nephrotic syndrome biopsies. In all kidneys, expression was confined to the renal cortex. The dominant site of gene expression was the distal tubule. Apart from one area of positive signal related to an epithelial cell of Bowman's capsule, expression was not observed in glomeruli. Expression was also seen in the walls of large- and medium-sized blood vessels. 4. By immunohistochemistry, the dominant site of immunoreactivity was the distal tubule. Dense staining was also seen in granular peripolar cells and in isolated parietal epithelial cells close to the vascular pole. Isolated immunoreactive cells were seen in the media of large- and medium-sized arteries. 5. The tissue kallikrein gene in the kidney may not be constitutively expressed, but is expressed in response to physiological or pathological stimuli.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Intrarenal localization of interleukin-1 beta mRNA in crescentic glomerulonephritis.

Il-1 beta is a potent proinflammatory peptide, and induces expression of other cytokines which are involved in the immune response. Kidney biopsies from nine patients with crescentic GN were studied by in-situ hybridization to determine the site of expression of Il-1 beta mRNA. Biopsies from nine patients with nonproliferative renal disease were studied as negative controls, and tonsillar tissue was studied as a positive control. An Il-1 beta cDNA probe was 32P-labelled by random primers and hybridized to paraffin-embedded tissue sections after de-waxing. Il-1 beta mRNA was expressed in tonsil, but not in negative controls. Positive mRNA expression was seen in four of the nine crescentic biopsies. This was observed in interstitial cells with morphological characteristics of macrophages adjacent to tubular cells, in cells within the glomerular tuft, and in tubular epithelial cells. Il-1 beta mRNA is expressed in renal tissue in crescentic GN. Tubular and interstitial expression of Il-1 beta mRNA appears of equal prominence to glomerular expression. Intrarenal cytokine synthesis may be involved in the pathogenesis of crescentic glomerulonephritis.

Adult↗
PubMed1993

Renal responses to nifedipine and captopril in hypertensive insulin-dependent diabetic men: a randomized cross-over study.

The effects of nifedipine retard and captopril on renal haemodynamic parameters have been examined in a double blind randomised cross-over trial in 10 insulin-dependent diabetic males with hypertension (systolic pressure > 150 mmHg or diastolic pressure > 90 mmHg). The acute renal haemodynamic response to nifedipine retard 20 mg and captopril 25 mg was monitored at the start of therapy and again after 8 weeks treatment with nifedipine retard 20 mg b.d. and captopril 25 mg b.d. Blood pressure fell from 148/97 +/- 4/2 (SEM) during the run-in phase to 135/87 +/- 4/1.5 on nifedipine retard and to 131/83 +/- 5/1 on captopril. There was no difference between the initial renal response to the two agents; an increase in renal plasma flow and a non-significant decline in glomerular filtration rate resulted in similar decreases in filtration fraction. After 8 weeks therapy, neither drug had a significant effect on urinary albumin excretion. Baseline renal function did not differ and no acute changes in renal haemodynamics were seen after nifedipine. Following captopril there was no acute change in systemic blood pressure but RPF rose from 572 +/- 41 to 638 +/- 42 ml/min per 1.73 m2 (P < 0.05) and filtration fraction fell from 0.21 to 0.16 (P < 0.02). This sustained acute response of the renal circulation to angiotensin-converting enzyme (ACE) inhibition after chronic therapy may be relevant to the apparent renal protection afforded by ACE inhibitors in experimental nephropathies.

Adult↗
PubMed1992

Effect of treatment mode on the natural history of acquired cystic disease of the kidney in patients on renal replacement therapy.

The natural history of acquired cystic disease of the kidney has been investigated in a long-term follow-up study of patients on renal replacement therapy. A cohort of 145 end-stage renal failure patients was initially investigated with ultrasonography to determine the degree of cystic change. Seventy-three patients were available for follow up a minimum of 3 years later. The grade of cystic disease progressed in dialysis patients and progression was more marked in haemodialysis patients than patients maintained on CAPD. Patients with functioning renal transplants did not show progression of cystic change and in two patients regression was seen. Nine patients maintained on chronic dialysis at the time of initial ultrasound subsequently received renal grafts, and three of these patients had evidence of regression of cystic change on follow-up scanning. After 3 years follow-up a single haemodialysis patient had evidence of a solid lesion in a cystic kidney and this has not progressed during a further 12 months of follow-up. Acquired cystic disease of the kidney is a progressive disease in chronic dialysis patients. However, over a follow-up period of 3 years, patients with functioning renal grafts do not show similar progression. The incidence of solid renal tumours has been shown to be low.

Adult↗
PubMed1989

Evidence against a role for prostaglandins in sustaining renal hyperfiltration in type 1 diabetes mellitus.

The acute effect of inhibition of prostaglandin synthesis with indomethacin 50 mg by mouth on renal haemodynamics has been examined in 8 male Type 1 diabetic patients with elevated glomerular filtration rate who were free of diabetic complications. Renal plasma flow and glomerular filtration rate were measured by constant infusion of para-amino hippurate and polyfructosan, the patients being studied at normoglycaemia. Urinary excretion of prostaglandin E2 fell from 885 +/- 160 to 345 +/- 115 pg min-1, and excretion of 6-keto-prostaglandin F1 alpha fell from 489 +/- 77 to 283 +/- 50 pg min-1. There was no change in renal plasma flow or glomerular filtration rate following indomethacin. The results do not support the hypothesis that increased renal prostaglandin synthesis is a cause of hyperfiltration in diabetes mellitus.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

Can low-dosage aluminium hydroxide control the plasma phosphate without bone toxicity?

Sixteen patients treated exclusively by haemodialysis using reverse osmosis water treatment for up to 7 years (mean 49.3 +/- 17 months) were assessed for evidence of bone aluminium accumulation and toxicity. All patients were treated with aluminium hydroxide phosphate binders for the duration of dialysis but the dosage was restricted to a maximum of 2.85 g daily (mean daily dose 2.6 +/- 0.8 g). The mean plasma phosphate over the 12 months prior to the study was 1.68 +/- 0.42 mmol/l and in only three patients was adequate control of the plasma phosphate not achieved. No patient had evidence of fracturing bone disease. Bone aluminium staining was present in only two patients but was seen at the calcification front in only one of these. Three patients had histological evidence of osteomalacia, but in none was aluminium staining present. Mean bone aluminium was moderately high at 36.67 +/- 31 micrograms/g and in only three patients exceeded 40 micrograms/g. This study indicates that adequate control of the plasma phosphate can be achieved with low dosage of aluminium hydroxide, and in the medium term is not associated with evidence of bone aluminium toxicity.

Aged↗
PubMed1988

The acute renal haemodynamic and endocrine response to felodipine in normal man.

Felodipine (0.075 mg/kg p.o.), a calcium antagonist, was given to 9 male volunteers, with and without indomethacin pretreatment. Diuresis and natriuresis occurred after felodipine without significant change in effective renal plasma flow or glomerular filtration rate. There was no significant change in urinary 6 keto PGF 1 alpha or urinary kallikrein excretion and indomethacin did not inhibit the natriuretic or diuretic response to felodipine. The felodipine induced diuresis and natriuresis appears most likely to be mediated by an action of the drug on renal tubules.

Adult↗
PubMed1988

Mefenamic acid nephropathy: an interstitial and mesangial lesion.

Six cases of acute renal failure associated with mefenamic acid therapy are described. Five patients were non-oliguric and five patients had clinical features of salt and water depletion. In these patients the presenting symptoms were abdominal pain, diarrhoea and vomiting. Renal biopsy in five patients showed interstitial nephritis and mesangial proliferation. All patients recovered without specific therapy after withdrawal of the drug, but in four patients mild renal impairment persisted. These findings indicate that both interstitial and mesangial changes are common features of acute renal failure due to mefenamic acid therapy.

Adult↗
PubMed1987

Symphysis-fundus height, maternal height, labor pattern, and mode of delivery.

Fetal growth was monitored with use of symphysis-fundus charts in 920 consecutive term singleton pregnancies with cephalic presentation. There were 402 primigravid and 518 multigravid patients. The symphysis-fundus charts were divided into four zones and the patients allocated into groups according to the zone of the last symphysis-fundus height measurement before the onset of labor. A highly significant increase was noted in the incidence of abnormal labor and operative delivery in group A primigravid women (symphysis-fundus height above the ninetieth centile), which was even more pronounced when the effect of epidural analgesia was excluded. Conversely, there was a significant progressive increase in the proportion of operative deliveries for fetal distress from group A through group D (symphysis-fundus height below the tenth centile). Similar trends were significant but less pronounced among multigravid women. The relationship between maternal height, symphysis-fundus height, and operative delivery for dystocia in primigravid women was examined. High operative delivery rates were present in group A primigravid patients regardless of maternal height. In groups B and C, however, increased maternal height was associated with lower operative delivery rates.

Body Height↗
PubMed1986

Acquired cystic disease of the kidney in patients with end-stage chronic renal failure: a study of prevalence and aetiology.

Renal ultrasound scanning was performed in 100 patients with end-stage renal failure treated by both haemodialysis and continuous ambulatory peritoneal dialysis (CAPD). Each kidney was assessed for the presence of acquired cystic disease and solid lesions. The appearances were divided into five grades from grade 0 (no cysts detected) to grade 4 (greater than 15 cysts per kidney). Other intra-abdominal organs were also scanned for the presence of cysts. The findings were then correlated with possible aetiological factors, including the type of dialysis used. Sixty-three percent of all the patients had acquired cystic disease of the kidney (ACDK). No solid lesions were found and no cysts were detectable in other organs. The presence and grade of ACDK did not correlate with the age or sex of the patient, the nature of the underlying renal disease, or the duration of chronic renal failure. There was a significant correlation between the grade of ACDK and the duration of both haemodialysis (P less than 0.001) and CAPD (P less than 0.01). The presence of residual renal function did not influence the development of cysts. ACDK had no effect on haemoglobin or other laboratory parameters measured.

Adult↗