PubMed Health⌕ Search

Biomedical subjects

J A Traver

Publications and source records attributed to J A Traver.

At least 19 recordsLinked to original sources
PubMed2001

Prevalence of hepatitis B, hepatitis C, GB virus C/hepatitis G and TT viruses in predialysis and hemodialysis patients.

Patients with chronic renal failure on hemodialysis have a high risk of infections with viruses such as hepatitis B (HBV), hepatitis C (HCV), GB virus C/hepatitis G (GBV-C/HGV) and TT (TTV) viruses. The prevalence of HBV, HCV, GBV-C/HGV and TTV in patients with chronic renal failure who are on conservative management before entering into a hemodialysis program (predialysis) in comparison with hemodialyzed patients was studied to elucidate whether the high prevalence of these viruses is influenced by that observed in the predialysis stage. The presence of hepatitis B virus surface antigen (HBsAg), HCV RNA, GBV-C/HGV RNA and TTV DNA was analyzed in sera from 80 patients with chronic renal failure (35 on predialysis and 45 on hemodialysis). HBsAg, HCV RNA, GBV-C/HGV RNA and TTV DNA were detected in one (2.8%), six (17.1%), eight (22.5%) and 16 (45.7%) of the 35 patients on predialysis. Two (5.7%) of these patients were coinfected with HCV and GBV-C/HGV, whereas six (17.1%) had GBV-C/HGV and TTV coinfection. In the 45 hemodialyzed patients, HBsAg, HCV RNA, GBV-C/HGV RNA and TTV DNA were detected in one (2.2%), two (4.4%), seven (15.5%) and 26 (57.7%). One (2.2%) patient had HBV and TTV coinfection, two (4.4%) HCV and TTV coinfection whereas four (8.8%) were coinfected with GBV-C/HGV and TTV. No differences regarding age, gender, previous surgery and number of transfusions were found between infected and uninfected patients within and between both groups. In conclusion, the prevalence of the viruses studied in predialysis may influence their prevalence in dialysis units.

Aged↗
PubMed2000

Autoclaving eliminates hepatitis C virus from a hemodialysis monitor contaminated artificially.

Nosocomial transmission of the hepatitis C virus (HCV) has become the principal cause of HCV infection in hemodialysis units. Because HCV particles may pass through dialysis membranes and backfiltration occurs with high performance membranes, HCV transmission from contaminated dialysis monitors is likely. Thus it is important to have effective measures to disinfect hemodialysis monitors. In this study, autoclaving dialysate circuits were examined to establish an effective method to eliminate HCV particles from a monitor contaminated artificially. The dialysis monitor was contaminated in 2 different experiments with a 1/10 and 1/5 dilution of a serum pool containing 1.2 +/- 0.3 x 10(6) HCV genome copies/ml. During perfusion 2 samples were taken from the drainage tube at 5 and 10 minutes. After perfusion, the dialysate circuit was autoclaved at 120 degrees C for 20 minutes. Four samples were then taken from the autoclaved circuits and another from the drainage, which had not been autoclaved. The viral titer in the samples from the drainage before sterilization was similar to that of the serum dilution, showing the homogeneous distribution of the serum dilution in the dialysis circuits. After autoclaving, HCV RNA was not detectable in the samples obtained from the autoclaved circuits, whereas it was positive in the sample from the drainage. These results show that autoclaving is an effective method to eliminate HCV particles from contaminated hemodialysis monitors.

Cross Infection↗
PubMed1998

[Acute renal failure in the allogeneic transplantation of hemopoietic progenitors. The clinical characteristics in a series of 92 patients].

BACKGROUND: Analysis of clinical characteristics of acute renal failure (ARF) after allogeneic bone marrow transplantation (BMT). PATIENTS AND METHODS: Analysis of 92 patients who developed ARF of 260 patients following BMT. RESULTS: ARF incidence was 35.4%. Sixty three percent of ARF occurred before day 20 after BMT. Duration of ARF was less of 10 days in 72.8%. ARF was non oliguric in the 80.4% of cases. Most common ARF etiologies were: multifactorial (37%), nephrotoxicity (NPH) (33.7%) and veno-occlusive disease of the liver (VOD) (14.1%). ARF secondary to VOD was the most severe: and the longest, where the secondary to NPH was less lever and shorter. Hemodialysis (HD) was necessary in 22.8% of ARF. Mortality in ARF group was 45.6%, higher in HD group (80.9%) than in non-HD group (35.2%) (p < 0.0002). CONCLUSIONS: ARF is a frequent complication following BMT. It occurs early, has short duration, is non oliguric, mainly hemodynamic and carries a whose prognosis.

Acute Kidney Injury↗
PubMed1998

Eradication and follow-up of Helicobacter pylori infection in hemodialysis patients.

It is currently accepted that Helicobacter pylori (Hp) infection is crucial in the pathogenesis of peptic ulcer. Therefore, we developed a prospective study to assess the prevalence of Hp infection by the 13C Urea Breath Test (13C UBT) in 52 hemodialysis patients, and we evaluated the efficacy of two consecutive eradication regimens in 23 positive patients with dyspepsia and/or on a transplantation list. The correlation between anti-Hp serology and 13C UBT results was also analyzed in 34 patients who were followed up during 18 months. The Hp prevalence by 13C UBT was 63.5% (33/52). The eradication rate after the first cycle of therapy (amoxicillin 500 mg/8 h and omeprazole 20 mg/12 h, 14 days) was 60.8% (14/23). After the second cycle (clarithromycin 500 mg/12 h plus omeprazole 20 mg/12 h, 14 days), the eradication rate reached 82.6% (19/23). The serological procedure showed a good correlation with 13C UBT (about 80% sensitive and specific) when very restrictive diagnostic and eradication criteria were adopted. We conclude that an eradication rate higher than 80% can be reached after two consecutive cycles of dual therapy in hemodialysis patients. Anti-Hp serological tests must be cautiously interpreted in these patients.

Aged↗
PubMed1996

Nephroprotective effect of cilastatin in allogeneic bone marrow transplantation. Results from a retrospective analysis.

Cilastatin, an inhibitor of the tubular brush border enzyme dehydropeptidase-I, is added in a fixed combination to imipenem. Cilastatin has been demonstrated in different animal models and in one clinical trial, to reduce the nephrotoxicity associated with cyclosporin A. To evaluate a possible nephroprotective effect of cilastatin following allogeneic BMT we conducted a retrospective analysis of 104 patients transplanted in our BMT Unit from January 1991 to January 1995. Imipenem/cilastatin (I/C) was used in a non-randomized manner in 64 patients during this period. Acute renal failure (ARF) was diagnosed in 32 patients (30%). ARF was not associated with gender, sepsis, conditioning regimen, underlying disease, bilirubin, or age. VOD occurred in 12/32 (37.5%) of patients with ARF whereas it occurred in only 7/72 (9.7%) of patients without ARF (P < 0.0007). ARF was not correlated with use of aminoglycosides, vancomycin, ciprofloxacine, ceftazidime or amphotericin-B. However, 13 patients of 64 exposed to I/C (20.3%) developed ARF vs 19 of 40 patients (47.5%) who were not exposed to I/C (P < 0.003; OR 0.28). Stratified analysis and multiple logistic regression confirmed the I/C nephroprotective action. The mean cyclosporin A levels in the I/C group were significantly decreased (208.6 +/- 64.9) vs the non-I/C group (265 +/- 118). We conclude that these results suggest I/C may counteract acute cyclosporin A nephrotoxicity following BMT and further prospective clinical trials are needed to confirm if routine administration of cilastatine confers benefit in the BMT setting.

Acute Kidney Injury↗
PubMed1995

Acute renal failure in patients following bone marrow transplantation: prevalence, risk factors and outcome.

To assess the prevalence, risk factors, clinical causes and outcome of acute renal failure (ARF) following bone marrow transplantation (BMT), a retrospective analysis of 275 patients was undertaken. ARF was diagnosed in 72 patients (26%) and occurred in 81.9% within the first month. The three main clinical causes were multifactorial (36%), nephrotoxic (29%), and veno-occlusive disease of the liver (VOD) 15%. The prevalence was higher in allogeneic BMT (36%) than in autologous BMT (6.5%). Risk factors related to the development of ARF wee preexisting VOD and age older than 25 years. Logistic regression in allogeneic BMT confirmed this association (VOD, odds ratio 3.8; age offer than 25, odds ratio 1.9). Underlying disease, graft-versus-host disease, sepsis, conditioning therapy, and sex were not associated with ARF. Seventeen cases of ARF required hemodialysis (24%) mainly in association with VOD (70.5%). The overall morality from ARF was 45.8%, the dialyzed group having the highest mortality (88%). Survival in the ARF group was continuously worse up to 3 months and the actuarial survival at 10 years was 29.7 versus 53.2%. We conclude that ARF is a common complication mainly in allogeneic BMT and carries a grave prognosis. VOD and age were risk factors for ARF.

Actuarial Analysis↗
PubMed1992

Development of systemic lupus erythematosus in a patient on hemodialysis.

A case of systemic lupus erythematosus (SLE) that developed 2 years after beginning hemodialysis is reported. The patient had not been given any drug implicated in the production of SLE. She had been treated with deferoxamine, an in vitro inhibitory of DNA synthesis. The difficulty of the diagnosis is emphasized. Clinical improvement after prednisone treatment was impressive. SLE may appear even in patients receiving hemodialysis, despite immunological depression derived from chronic uremia.

Adolescent↗
PubMed1992

Renal failure in temporal arteritis.

We report a case of biopsy-proven temporal arteritis and polymyalgia rheumatica with improved clinical symptoms with steroid treatment but with subsequent renal failure while on steroids. Kidney biopsy showed focal segmental necrotizing glomerulonephritis with crescents and small-vessel vasculitis. Treatment with methylprednisolone and cyclophosphamide achieved normalization of renal function. We emphasize the importance of kidney biopsy because of its therapeutic implications. The previous literature concerning renal disease in temporal arteritis is discussed.

Aged↗