PubMed Health⌕ Search

Biomedical subjects

F J Dagher

Publications and source records attributed to F J Dagher.

At least 37 records · Page 2Linked to original sources
PubMed1984

The effects of bilateral renal transplantation on pelvic hemodynamics and sexual function.

Sexual function and internal iliac artery (IIA) patency were determined in 24 patients who had received at least two renal transplants, one in each iliac fossa, at the University of Maryland and Johns Hopkins Hospitals from 1975 to 1979. The pelvic hemodynamics of each patient were assessed with a penile/brachial blood pressure index (PBI). The rate of sexual dysfunction, as determined by questionnaires and personal interviews, was 46% (11 of 24 patients) compared with only 21% (five of 24 patients) after a single transplant. Nine of the 11 patients who were impotent had bilateral IIA occlusion and four of these nine had a PBI less than 0.70. One of the four patients regained full sexual function after a revascularization procedure, which confirmed that this impotence had a vascular etiology. Results of this study show that vascular insufficiency, but not necessarily vasculogenic impotence, was present in at least four of the 11 patients who were impotent (36%) and may have been avoidable by sparing at least one IIA during renal transplant procedures.

Adult↗
PubMed1984

The vascular steal phenomenon: an experimental model.

A model for the vascular steal phenomenon was designed and evaluated in 10 mongrel dogs in which the aortic bifurcation was used to represent a parent artery with two distal vascular beds. Right lower extremity flow was increased with a femoral arteriovenous fistula, and progressively greater stenoses were applied to the distal abdominal aorta. Significant decreases in left lower extremity flow (a steal) occurred only when the stenosis of the aorta exceeded 60%. There was a direct relationship between the pressure drop across the aortic stenosis and the degree of steal from the left lower extremity. The stenosis required for a steal phenomenon to occur is analogous to a critical arterial stenosis for a given velocity of flow and the specific cross-sectional area of the distal arterial bed.

Animals↗
PubMed1983

Migration of Kim-Ray Greenfield umbrella to the heart.

We have described a case of migration of a Kim-Ray Greenfield umbrella from the inferior vena cava to the heart for unknown reason. The umbrella was surgically removed and the patient recovered fully. This complication has not been previously reported. Despite this complication, we believe that the Kim-Ray Greenfield umbrella, when placed with particular attention to technique, effectively prevents pulmonary emboli and offers minimal associated morbidity.

Aged↗
PubMed1983

The correction of cerebrovascular insufficiency by transluminal dilatation: a preliminary report.

Transluminal angioplasty is being extensively utilized to dilate arteriosclerotic lesions. However, this technique has not been widely used for the treatment of cerebrovascular insufficiency. This report describes the application of transluminal angioplasty to relieve cerebral ischemia secondary to extracranial arterial stenosis. A total of 10 patients presented with symptoms of vertebrobasilar insufficiency. Bilateral upper extremity pressures were measured prior to the performance of arteriography on all patients. Significant stenoses were found in the subclavian artery (9) and in the innominate artery (1). Dilating catheters were passed retrograde through surgically exposed brachial and common carotid arteries. Transluminal angioplasty under fluoroscopic control was attempted. Anatomic correction of all lesions was achieved without hemorrhagic or embolic complications. The mean increase in brachial systolic pressure was 38.2 mm Hg postdilatation. Initial symptomatic relief was total in seven patients, partial in two, and absent in one. It is believed that associated small vessel brain stem disease accounted for the less than total relief of symptoms of these three patients. Average follow-up for all patients was 13 months with one recurrent subclavian artery stenosis occurring at three months postangioplasty. Preliminary results suggest that some patients with cerebral ischemia secondary to extracranial arterial stenosis can be treated safely by transluminal angioplasty.

Aged↗
PubMed1983

Patient profile and effect of dietary therapy on post-transplant hyperlipidemia.

The effect of dietary therapy on the serum lipid profile was examined in 32 post-transplant patients. Patients were transplanted more than 4 months before the study and had stable renal function and no other condition affecting lipid metabolism. Serum lipid profiles were determined on two serum samples obtained after a 12-hour fast. Seventeen patients who had pre-transplant hyperlipidemia (HLP) had similar HLP after transplantation. Of the 14 patients with normal pre-transplant profiles, 9 remained normal and 5 developed HLP. Twelve patients with HLP received out-patient dietary therapy providing less than 500 mg of cholesterol, less than 35% of calories from fat, less than 50% of calories from carbohydrate, and a P:S ratio greater than 1. Maintenance calories were based on the Harris-Benedict standard except for 9 overweight patients who were given less. After 3 months of therapy, serum cholesterol and triglycerides decreased to normal in 8 of 9 patients in whom both were elevated before dietary treatment and were unchanged in one patient. In 3 patients who had normal triglyceride but elevated cholesterol levels before therapy, cholesterol decreased but remained above normal; triglyceride increased in one patient and remained normal in two. High-density lipoprotein cholesterol (HDL-C) increased in all 12 patients and became normal in 11. Body weight fell in 11 of 12 patients receiving dietary therapy. Cholesterol, triglyceride, and HDL-C remained unchanged in 11 patients who did not undergo dietary treatment. Dietary therapy is a safe and effective way to treat post-transplant HLP.

Adult↗
PubMed1982

Surgical correction of vasculogenic impotence in a patient after bilateral renal transplantation.

This article documents a vascular cause of erectile dysfunction in a patient with ligation of both internal iliac arteries after bilateral renal transplantation. The diagnosis was made by the noninvasive measurement of the penile arterial systolic pressure and confirmed by pelvic arteriography. Correction of the patient's impotence was accomplished by restoration of penile blood flow by a saphenous vein bypass graft between the external iliac and internal iliac arteries.

Adult↗
PubMed1981

Transluminal angioplasty during vascular reconstructive procedures: a preliminary report.

A total of 16 isolated arterial lesions were dilated intraoperatively in conjunction with primary vascular reconstructive procedures. Of these, eight involved the iliac vessels and eight the femoropopliteal segment. All angioplasties were successful and no catheter-related complications were noted. Hemodynamic improvement was confirmed by intraoperative pressure measurements and/or noninvasive Doppler segmental pressures.

Catheterization↗
PubMed1980

Infectious complications in renal transplant recipients.

Infections complicated the course of 59 of 111 renal transplantations (53%) performed on 93 patients at the University of Maryland Hospital. Infections and resultant deaths were more common among the patients with cadaver transplants. The transplant wound and the urinary tract were the most common sites of infection, occurring in 33% and 24% respectively. Septicemia developed in 11 patients (10%), secondary to urinary tract infection in six and to surgical wound infection in three. Opportunistic viral, fungal, and actinomycotic infections occurred in ten patients (9%). A total of nine patients (8%) died as a result of infection. This experience with sepsis and mortality, substantially lower than previously reported, may have resulted from (1) rigorous screening and detailed histories of recipients and donors for infection at the time of transplantation, as well as bacteriologic and serologic studies; (2) discontinuation of azathioprine whenever the WBC fell to less than 5,000/cu mm; (3) aggressive surveillance and early management of infections; and (4) prompt removal of a nonviable kidney when detected by radionuclide scan and percutaneous renal biopsy.

Adolescent↗
PubMed1980

Erythrocytosis after renal allotransplantation: treatment by removal of the native kidneys.

A patient with end-stage renal disease had erythrocytosis after kidney transplantation, with a hematocrit level that ranged between 52 and 60%. Selective catheterization of venous blood from his native kidneys and the transplanted kidney revealed a threefold increase of erythropoietin activity in blood from his own kidney over systemic blood and blood from the transplanted kidney. Bilateral nephrectomy cured the condition. Postoperative hematocrit and erythropoietin levels were within normal limits.

Adult↗
PubMed1979

Episodic hypertension caused by recurrent renal artery lesions following transplantation: a case report.

A kidney transplant patient developed recurrent hypertension on two successive occasions associated with lesions of the renal artery. The first episode of hypertension was caused by renal artery stenosis and was surgically corrected; the second was caused by a sizable pseudoaneurysm at the site of arterial anastomosis which was resected, and arterial continuity was successfully re-established.

Adult↗
PubMed1979

Are the native kidneys responsible for erythrocytosis in renal allorecipients?

The development of erythrocytosis following renal transplantation has been reported to be caused by a number of factors. These include acute and chronic rejection, hydronephrosis and renal artery stenosis. In this study, seven patients were noted to have erythrocytosis with hematocrits ranging between 53.5 and 66%. Serum erythropoietin levels were elevated and ranged between 11 and 60 mU/ml with a mean of 31.9 mU/ml in six of seven patients. Selective catheterization of veins of native and transplanted kidneys in three patients revealed mean serum levels of 40.9 and 13.0 mU/ml, respectively. This suggests that excess erythropoietin is being produced from the diseased native kidneys. Bilateral nephrectomy in one patient cured erythrocytosis and dropped systemic levels of erythropoietin (EP) to 6.1 mU/ml. In four of the remaining five patients, hematocrits came down spontaneously to within normal over a 1- to 3-year period. Consequently, it appears that in a number of transplant patients the retained diseased kidneys, having lost all excretory and concentrating function, may remain capable of functioning as endocrine erythropoietin-producing organs.

Erythropoietin↗
PubMed1978

Skin protothecosis in a patient with renal allograft.

The case history of a 30-year-old male kidney transplant patient who developed cutaneous protothecosis is presented. The lesions, initially located over the forearm and around the site of previous AV shunt, consisted of maculopapular areas which opened spontaneously and drained purulent sanguineous material. Culutre of drainage grew Prototheca wickerhamii. Other virulent organisms, ie. Klebsiella pneumoniae and Pseudomonas aeruginosa, were also grown. The patient died of Klebsiella septicemia and shock. Protothecosis is an uncommon algal infection in man. This is the first report of the disease among recipients of a renal transplant.

Adult↗