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Biomedical subjects

G Magnusson

Publications and source records attributed to G Magnusson.

At least 145 records · Page 8Linked to original sources
PubMed1981

Further experience with antihuman lymphocyte globulin (Behring): no effect on cadaveric renal graft survival.

In 1977 we reported that 1 year cadaveric renal graft survival was improved in patients treated with high dose anti-human lymphocyte globulin (AHLG) (Behring). Such a beneficial effect of this agent was not confirmed in the present study with an enlarged series of patients and with a longer follow-up time. Nor was there any gain in respect of renal function or any steroid sparing effect. The only indication of an immunosuppressive effect is that the rejection episodes possibly occurred later in the patients given the high dose AHLG.

Antilymphocyte Serum↗
PubMed1981

The influence of HLA-D matching on the outcome of intrafamilial kidney transplantation with special emphasis on the predictive value of the relative response in MLC.

One hundred and three recipients of kidney transplants from living related donors were analyzed for the influence of HLA-D matching on graft survival. Sixty-two donors were parents and 41 brothers or sisters. Twenty-two of the siblings were HLA-A, B identical. The degree of HLA-D compatibility was measured in a mixed lymphocyte culture reaction. Whereas nonresponsiveness was found with HLA-A, B identical sibling donors, the haploidentical donors were found to initiate varying degrees of stimulation. The stimulation was, calculated as the relative response (RR) to the donor in relation to an unrelated individual or to lymphocytes pooled from a number of individuals. It was found that RR values above 55% predicted a graft survival that was significantly inferior to the group with values less than 20% (p less than 0.01) and also to the group with RR values between 20% and 55% (p less than 0.05).

Actuarial Analysis↗
PubMed1981

Reduced steroid doses in cadaveric renal transplantation.

Commencing 1978, we reduced the initial dose of prednisolone to 40 mg/day against a former 120-200 mg/day for cadaver kidney recipients aged 60 years and above. The patient and graft survivals at 1 year which earlier had been 59 and 47% is 69 and 46% after the change (NS). From August 1980, we reduced the initial prednisolone dose to 30 mg/day for all recipients of cadaver kidneys. From the same time, all patients were given 5 units of leukocyte poor blood prior to the transplantation, and in addition, RATG (Stanford) was given during 2 weeks immediately following the transplantation. Preceding the reduction the patient and graft survivals at 6 months were 91 and 62% while they were 88 and 88% after the reduction (NS). The intravenous dose of methylprednisolone, which is used for the treatment of acute rejection, was reduced twice in this period, first from 6 to 3 g, and then to 1.75 g total dose. The proportion of rejections, successfully treated, had remained unchanged. Our preliminary results support the notion that it is possible to use lower steroid doses than previously in conjunction with cadaveric kidney transplantations. However, we have introduced other alterations of the routines which could have influenced the results.

Animals↗
PubMed1981

Fulminating anti-A autoimmune hemolysis with anuria in a renal transplant recipient: a therapeutic role of plasma exchange.

In this communication we present a case of fulminating anti-A autoimmune hemolysis with anuria occurring during the postoperative course after a successful renal transplantation. The patient was treated with repeated plasma exchange in an effort to remove antibodies directed against the red cells and also to eliminate the products of hemolysis known to cause acute renal failure. Subsequently the hemolysis receded and the patient regained graft function. Repeated plasma exchange, in addition to immunosuppression, appeared to have contributed to the ultimate recovery of the patient.

Acute Kidney Injury↗
PubMed1980

Cadaveric renal transplantation in patients of 60 years and above.

Between 1971 and 1977, 34 patients aged 60 years and above were treated with cadaveric renal transplantation in Stockholm. The survival figures were nearly the same as for patients of the same age group that had undergone long-term dialysis, with 2-year survival rates of 49 and 45%, respectively. Comparison with a younger group of transplant patients, ages 16 to 49, showed poorer patient and graft survival figures for the older patients, with 49 and 38%, respectively, after 2 years against 70 and 56% for the younger group. Complications were more frequent among the older patients, especially in regard to serious infections, heart conditions, and steroid diabetes. Irreversible rejection, on the other hand, was less common in the older group. On the basis of these findings, we intend continuing to offer renal transplantation to patients of 60 years and above. It would, moreover, seem worthwhile to try to reduce the dose of prednisolone in these patients.

Adolescent↗
PubMed1980

Utilization of a hospital emergency department in Stockholm. The effects of age, sex and marital status.

Utilization of hospital emergency departments in Stockholm increased by 30% between 1973 and 1977. One of the five health districts, the southwest (SW) district had the highest visiting rates, 40% above average. The Huddinge Hospital, a new university hospital, was opened in the SW district in 1972. Utilization of the Huddinge emergency department was studied over 15 months for a representative sample (17004 people) from the population. By record linkage, information from Stockholm County's Medical Information System was used together with specially collected data from the emergency department. The demographic profile of the catchment area for the Huddinge hospital differs in several respects from the average for Stockholm County. The present work is an attempt to evaluate the influence of three predisposing factors: age, sex and marital status, on the utilization of the emergency department. Compared with non-users the following groups were found to be overrepresented at the emergency department: women aged 15-34, children to unmarried parents, and divorced and widowed men and women.

Adolescent↗
PubMed1980

The hospital emergency department as the primary source of medical care.

The role of hospital emergency departments has gradually changed, particularly in large urban areas, where these departments have increasingly become outpatient clinics for everyday ailments rather than centres for the treatment of injuries and emergencies. The main objectives for the present study were: (1) to compare the utilization of district general practitioners and the hospital emergency department by a defined population; (2) estimate how many of the visits to the hospital emergency department are general practitioner-type visits. The results demonstrate the pattern of medical care usage in an area with hospital emergency department services which provide a 24-hour availability and open access, while the primary care services are available only during office hours, are understaffed and have limited access. The study is based pm a 1/30 sample (1032 individuals) from the population in the catchment area of a health centre in Stockholm. During the study period (15 months) 30% of the population visited the hospital emergency department, while 15% consulted district general practitioners. Of the visits to the hospital emergency department, 17 per cent were for injuries and between 39 and 64% were general practice-type visits, according to the criteria used in the study.

Adolescent↗
PubMed1980

Steroid diabetes--a sign of overtreatment with steroids in the renal graft recipient?

The development of steroid diabetes was studied in a consecutive series of 114 patients receiving a cadaveric renal graft. All were first-time transplantations. For acceptance in the series the graft should have functioned for at least 2 weeks after the transplant operation. The median age of the patients was 52 years. The follow-up period was at least one year. The criterion for a diagnosis of steroid diabetes was an elevated fasting blood glucose concentration of more than 8 mmoles/l. Fifty-two of the patients (46 per cent) developed steroid diabetes. Thirty-four (65 per cent) of them required insulin therapy or peroral anti-diabetic drugs. The mean age of these patients was higher than for those not afflicted by this complication. The first-year mortality was significantly higher, 42 against 13 per cent, respectively (p less than 0.01). The level of significance was not notably affected by correction for age at transplantation. Severe infection was the cause of a large proportion of the deaths in the diabetes group. The findings suggest that the development of steroid diabetes can serve as a warning signal for excessive dosage of corticosteroids, and help to identify patients that are particularly sensitive to immunosuppressive therapy with large doses of steroids.

Adolescent↗
PubMed1980

The significance of HLA-A, -B matching for the survival of cadaveric kidney transplants performed in Stockholm in 1970-78.

Of the 320 cadaveric renal transplantations carried out between 1970 and 1978 in Stockholm 308 were analysed with respect to dependence of graft survival on HLA-A, -B matching. From November, 1973, kidneys with 3 or 4 HLA-A, -B incompatibilities were accepted much more often than had previously been the case. All but 7 of the 90 grafts with 3 or 4 incompatibilities were transplanted during that period. In order to obtain as homogeneous a group as possible the transplantations performed during this period were analysed separately, and transplantation performed on diabetic patients and retransplantations were excluded. This material comprising 141 transplantations was examined also with respect to other factors that may have a bearing on graft survival. As regards the factors mean age, pre-transplantation dialysis and blood transfusions, primary diuresis at transplantation and high-dose ALG therapy there was no essential difference between the recipients of kidneys from donors with 1 or 2 HLA-A, -B incompatibilities and the 3 or 4 incompatibility group. Thirteen of the 141 transplantations were fully compatible but because this group was small it was not included in the statistical analysis. After 2 years the group with 3 or 4 HLA-A, -B incompatibilities displayed a significantly poorer graft survival than the one with 1 or 2 incompatibilities (p less than 0.05).

Graft Survival↗
PubMed1979

Hepatic effects of xylidine isomers in rats.

The effect of repeated (4 weeks) oral administration of 2,4-, 2,5- or 2,6-xylidine (at dose levels of 400--500 mg/kg/day) on the morphology and microsomal drug metabolising enzyme activity of the liver was studied in rats. All 3 isomers caused hepatomegaly which was considered to be due to proliferation of the smooth endoplasmic reticulum. Decreases in glycogen content and glucose-6-phosphatase activity were demonstrated histochemically. Biochemical investigations showed increases in microsomal protein and cytochrome P-450 content in rats dosed with 2,4- or 2,5-xylidine and in glucuronyltransferase activity in rats given 2,4-, 2,5- or 2,6-xylidine. Aniline hydroxylase activity was increased in all treated rats except males dosed with 2,6-xylidine. The results of the study indicate that all isomes of xylidine can be inducers of microsomal drug-metabolising enzyme activity, that they may be metabolised by oxidation and that the xylidine molecule may be eliminated as a conjugate with glucuronic acid.

Aniline Compounds↗