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Biomedical subjects

F Ruzany

Publications and source records attributed to F Ruzany.

At least 19 recordsLinked to original sources
PubMed2004

Long-term outcome of renal transplantation at a university center in Rio de Janeiro between 1975 and 2000.

This study reports the 25-year experience of a single university center with respect to the impact of selected variables on long-term survival and half-life of 742 transplants. We calculated 1-, 5-, and 10-year Kaplan-Meier survival rates for grafts and patients, with separate analyses for HLA match and for each quinquennium. We also investigated the impact of cyclosporine administration and OKT3 induction. Global graft and patient survival rates were 85.2%, 61.0%, and 43.5% and 93.0%, 78.9%, and 66.6% for 1, 5, and 10 years, respectively. The half-life of 23.3 years for the 105 HLA-identical transplants was significantly better (P <.0001) than that for all other matches. Half-lives for 319 1-haplotype matched, 116 living-unrelated, and 153 cadaver grafts were 8.2, 5.7, and 5.6 years, respectively. No survival advantage was noted among these other matches. Introduction of cyclosporine in all non HLA-identical transplants and OKT3 induction for cadaver grafts conferred significant survival advantages compared with no use (P =.0002 and P =.009). There has been a continuous improvement in the long-term results in each quinquennium studied.

Brazil↗
PubMed2004

Is hepatitis C a risk factor to posttransplant diabetes mellitus after renal transplantation in patients using tacrolimus?

The objective of this study was to evaluate the association between previous hepatitis C virus (HCV) infection and the occurrence of posttransplant diabetes mellitus (PTDM) among patients undergoing kidney transplants using tacrolimus (FK). From August 1999 to January 2003, 66 patients (36.4 +/- 15.5 years) underwent kidney transplantation using an immunosuppressive regimen of tacrolimus, mycophenolate mofetil, or azathioprine and steroids. Thirty-four patients (52%) received kidneys from living donors and 32 (48%) from cadaveric donors. The diagnosis of diabetes mellitus was established after two consecutive ambulatory measurements of fasting glycemia > or = 126 mg/dL. Thirty-five percent of the patients (23/66) were HCV+ and 65% (43/66) HCV-. Of the 66 patients, 33% (22) developed PTDM, 19 (82%) from the HCV+ group and only 3 (7%) from the HCV- group. Among those who developed PDTM, the diagnosis was established in the first 2 posttransplant months in most cases (68.2%). The results showed a significant association between HCV and PTDM (P < or = .0001). In this group of patients HCV infection was strongly associated with the development of PTDM. Therefore, additional care is required regarding the immunosuppressive regimen among patients with chronic HCV infection.

Diabetes Complications↗
PubMed2000

Calcium acetate versus calcium carbonate in the control of hyperphosphatemia in hemodialysis patients.

CONTEXT: Hyperphosphatemia has an important role in the development of bone and mineral abnormalities in end-stage renal disease (ESRD). OBJECTIVE: To compare the phosphorus binding power and the hypercalcemic effect of calcium acetate and calcium carbonate in hemodialysis patients. TYPE OF STUDY: Crossover, randomized, double-blind study. PLACE: A private hospital dialysis center. PARTICIPANTS: Fifty-two patients who were undergoing regular hemodialysis three times a week ([Ca++] dialysate = 3.5 mEq/L). PROCEDURES: Half of the patients were started on 5.6 g/day of calcium acetate and, after a 2 week washout period, received 6.2 g/day of calcium carbonate. The other half followed an inverse protocol. MAIN MEASUREMENTS: Clinical interviews were conducted 3 times a week to monitor for side effects. Determinations of serum urea, calcium, phosphorus, hematocrit, Kt/V and blood gas analysis were obtained before and after each treatment. RESULTS: Twenty-three patients completed the study. A significant increase in calcium plasma levels was only observed after treatment with calcium carbonate [9.34 mg/dl (SD 0.91) vs. 9.91 mg/dl (SD 0.79), P < 0.01]. The drop in phosphorus levels was substantial and significant for both salts [5.64 mg/dl (SD 1.54) vs. 4.60 mg/dl (SD 1.32), P < 0.01 and 5.89 mg/dl (SD 1.71) vs. 4.56 mg/dl (SD 1.57), P < 0.01, for calcium acetate and calcium carbonate respectively]. The percentage reduction in serum phosphorus (at the end of the study) per milliequivalent of salt administered per day tended to be higher with calcium acetate but statistical significance was not found. CONCLUSION: Calcium acetate can be a good alternative to calcium carbonate in the handling of hyperphosphatemia in ESRD patients. When calcium acetate is used, control of hyperphosphatemia can be achieved with a lower administration of calcium, perhaps with a lower risk of hypercalcemia.

Acetates↗
PubMed1994

Thalidomide for the treatment of uremic pruritus: a crossover randomized double-blind trial.

Our observation that thalidomide administration to a dialysis patient with leprosy alleviated his pruritus led us to conduct this short-term study to assess the efficacy of the drug in this regard. From 210 hemodialysis patients, 29 cases of refractory uremic pruritus were entered into the study. Patients were instructed to score their symptoms from 0 to 3, three times a day and assigned to receive thalidomide or placebo at bed time for 7 days. After a washout period of 7 days, drugs were crossed over. Response was defined as a reduction of at least 50% in the pruritus scoring. Eighteen patients finished the study. In the first phase, 55% of patients responded showing a mean reduction in their pruritus scoring of 78% (p < 0.05 vs. placebo); no response to placebo was observed. A similar proportion of patients responded to thalidomide in the second phase with a mean reduction in their pruritus scoring of 81%. In conclusion, thalidomide can be a precious tool in the handling of uremic pruritus unresponsive to available therapy.

Aged↗
PubMed1992

Hepatitis C virus in chronic hemodialysis patients with non-A, non-B hepatitis.

Sixteen of 110 hemodialysis (HD) patients fulfilling criteria of non-A, non B hepatitis (NANBH), i.e. alanine aminotransferase (ALT) greater than 50 U/ml in the absence of both serologic markers for acute HBV and HAV infections and clinical evidence of another cause of hepatitis, were tested for the presence of antibodies against hepatitis C virus (anti-HCV) by enzyme immunoassay (Ortho, Diagnostics). All (100%) were anti-HCV-positive. There were 5 patients with a monophasic (M) rise pattern (1 or 2 ALT rises), and 11 cases demonstrated a polyphasic (P) rise elevation pattern (more than 2). The mean ALT value of the M group was 202.3 +/- 209 U/ml and that of the P group was 116.6 +/- 39.1 U/ml. The patients received a mean of 19.1 +/- 16.2 units of packed red cells during the follow-up period (69.9 months). Only 1 patient received no blood transfusion. Six patients had a past HBV infection and 3 became HIV-infected in the course of this study. The high rate of infection of hemodialysis patients with hepatitis C virus in our setting points to the need for improved control measures.

Adult↗
PubMed1981

Histocompatibility antigens and insulin-dependent diabetes: a study of 20 Brazilian families.

1. The relationship between histocompatibility antigens (HLA) and insulin-dependent diabetes was examined. The relative frequency of HLA and the relative risk were determined for 20 families containing 82 individuals, 23 of whom had insulin-dependent diabetes. The control group contained 102 individuals. 2. The B8, B13, and B15 antigens had the highest relative frequency in the group of diabetic patients, whereas B5, B7 and B12 were lowest. A high relative frequency of histocompatibility antigens was found not only in the diabetic patients, but also in their parents and siblings. There was a predominance of A2B8, A2B15, and A9B15 haplotypes in the diabetic population. The diabetic siblings had identical haplotypes. 3. These data support previous reports suggesting genetic linkage between susceptibility to diabetes and the histocompatibility antigen system.

Brazil↗
PubMed1979

[Glomerular immunopathology: comparative study with immunofluorescence and immunoperoxidase (author's transl)].

In order to evaluate the reliability of immunoperoxidase technic (IP) for immuno-deposits in frozen renal tissue, a single blind study was done comparing it with immunofluorescent technic (IF). Fifty renal biopsies were studied. Ten there were no deposits by IF or IP. In 40 of them the results showed the same specificity and greater intensity for IP. There were 25 cases with IgG, 22 with IgM, 9 with IgA, 3 with Clq, 27 with C3 and 3 with HbsAg. We concluded that IP can be used in place of IF for detection of the immune deposits in renal biopsies and that it offers an easier observation than the later.

Complement C3↗
PubMed1975

The behavior of carbenicillin as a nonreabsorbable anion.

In order to study the mechanism of hypokalemic alkalosis which occurs in some patients being treated with disodium carbenicillin, renal clearance experiments were carried out in rats and observations were made on electrical changes in isolated toad bladders. In rats maintained on a sodium-free diet, intravenous infusion of carbenicillin at 40 mg. per hour resuited in an immediate diuresis characterized by a striking increase in K and NH4 excretion, and progressive acidification of the urine. In a control group of rats, also prepared with a sodium free diet, intravenous infusion of mannitol resulted in a comparable diuresis, but no significant changes in K and NH4 excretion, and no acidification of the urine. The urinary changes in the carbenicillin-treated rats could not be accounted for by any alterations in blood electrolytes, acid-base values, or glomerular filtration rate (GFR). Isonatric, isohydric substitution of carbenicillin for chloride in the mucosal bathing media of toad bladders mounted in Ussing chambers resulted in a reversible increase in electrical potential (PD) and resistance (R) without a comparable change in short-circuit current (SCC). Substitution in the serosal medium resulted in a reversal of polarity of PD and SCC in 4 of 9 experiments, a finding best explained by more rapid movement of chloride from M leads to S than carbenicillin movement from S leads to M (a chloride diffusion potential). The observations in both the rat and toad bladder experiments are consistent with the view that carbenicillin behaves as a nonreabsorbable anion. Hypokalemic alkalosis in patients receiving this drug can thus be attributed to increased electrical negativity of the distal nephron with subsequent enhancement of K and H secretion.

Acid-Base Equilibrium↗
PubMedDate not supplied

[Infectious endocarditis in patients on periodic hemodialysis].

Nineteen patients originating from four hemodialysis centers with infectious endocarditis (IE) were studied during the period of 1985-1989. It was observed high proportion of patients with apparent normal cardiac valves preceding the IE; in 68.42% (13 out of 19 cases) there was an association with vascular access infection, the dialysis treatment time had a variation from 5 days to 6 years (median 19.5 months) and the interval between the initial symptoms and the IE diagnosis was from 2 to 30 days with an average of 5 days. The echocardiogram showed vegetation in 18 cases studied. The mostly affected cardiac valves were mitral in 42.1% and aortic in 31.5%. The predominant organism was S. aureus (75%). In 8 cases the primary focus was identified as the hemodialysis catheter and in 6 others as the arteriovenous fistula, one patient presented infection in both access simultaneously. The outstanding clinical manifestations were embolic (12 out of 19 cases) neurological (13 out of 19) and of cardiac failure (13 out of 19). The median hospitalization time was 24 days (4-55 days) and the mortality rate was 68.4%, the majority of sepsis. The authors emphasize the large proportion of cases linked to hemodialysis catheters and propose an increase in the infectious preventive measurements in those patients.

Adolescent↗