[The use of the HLA phenotype for predicting the outcome of acute glomerulonephritis in adults].
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Biomedical subjects
Publications and source records attributed to L A Pyrig.
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A positive dynamics of the course of glomerulonephritis under the effect of pathogenetic therapy evaluated in 140 patients was accompanied by a statistically valid reduction of glycoseaminoglycanes in the urine. This allows to use these indices as adjunctive criteria of treatment efficiency, especially in patients with chronic forms of the disease.
Urinary and blood lipid metabolism was examined during pregnancy complicated by different forms of nephropathies. The pregnant with primary nephropathy and with chronic pyelonephritis showed a significant increase of lipid peroxidation products in erythrocytes while the pregnant with chronic glomerulonephritis showed high-molecular lipoproteids in the urine. A relationship was found of metabolic disorders and indices characterizing the degree of renal lesions in the pregnant.
The authors evaluated data of expertise of the quality of observations on 1056 pregnant women with renal diseases (primary nephropathy, chronic glomerulonephritis, acute and chronic pyelonephritis, acute and chronic pyelonephritis, associated nephropathies) as well as data on the dynamic observation of 300 patients carried out according to special methods. On the basis of these findings the authors worked out the strategy, tactics and individual program of dispensarization with consideration of regularities of evolution of renal diseases, risk factors in the course of onset and progression of the disease. An organizational model was worked out of graded dispensarization with the participation of obstetricians, nephrologists, therapists, urologists.
It was shown that prednisolone and its combination with azathioprine++ increased contamination of the patients with yeast-like fungi and promoted development of candidiasis in them to a greater extent than cyclophosphamide. In the patients treated with the immunodepressants there was observed a carrier state in regard to various yeast-like fungi: 12 species belonging to 6 genera were isolated from the pathological materials. Determination of sensitivity to antifungal drugs in 200 Candida strains revealed that amphotericin B was the most active agent. Then followed mycoheptin, nystatin and nitroxolin. Levorin was the least active drug. The MICs of the drugs for the majority of the cultures were 0.5, 4-8, 8-16 and 32-64 micrograms/ml respectively. Candida resistant strains (mainly to levorin and mycoheptin) were isolated only from recipients of kidney transplants during the early postoperative period when the patients were subjected to intensive immunodepressive and prophylactic antifungal therapy. Among the fungi of the Candida genus C. guillermondii and C. parapsilosis proved to be the most resistant. Under the hospital conditions and in vitro studies it was found that cyclophosphamide and combinations of prednisolone with cytostatics increased resistance of Candida to the antifungal drugs. Rapid increasing of the fungi resistance to levorin and mycoheptin was observed. The increase in the resistance to amphotericin B was somewhat lower and that to nitroxolin and nystatin was extremely low. The study of the combined effect of the immunodepressants and antifungal drugs demonstrated that the immunodepressants increased the antifungal activity of amphotericin B, levorin and nitroxolin.(ABSTRACT TRUNCATED AT 250 WORDS)
Among bacterial infections arising in glomerulonephritis and complicating its course Mycoplasma infection (M. hominis) is not a rare finding as shown by microbiological and serological examinations. Good therapeutic results achieved in patients treated with prednisolone and cyclophosphamide suggest inhibiting action of glucocorticoids on Mycoplasma infection.
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Causes of the numerous changes found in kidney biopsy specimens and the absence of their commonly accepted classification are revealed. Principles of clinical morphology underlying nephrology have been formulated which emphasize the need to study the qualitative and quantitative characteristics of all renal structures, maintenance of the nosological independence of primary glomerulonephritis whose diagnosis must be supplemented by the morphological characteristics of kidney biopsy specimens. Kidney affection in different diseases should be designated by the term "nephropathy" specifying the causative factor and the character of affection of renal structures.
The authors analyze the immediate and long-term results of 48-day health resort treatment at the Southern Coast of the Crimea of three groups of patients with chronic glomerulonephritis (150 patients in each) depending on the place of their permanent residency: "north", "middle" and "south" climatic zones. Treatment efficacy was higher in the group of patient inhabiting the "middle zone" (latitude 57.5 degrees-42.5 degrees North). These findings make it possible to improve the organization of selection of this contingent of patients for climatotherapy as well as to study the processes of their adaptation to new climatic conditions.
Authors have worked out the methodology of functional diagnosis in nephrologic clinic--strategy, tactics and individual programme--on the basis of their own experience. The strategy is based on the natural functions of excretory and incretory renal function and quantitative and qualitative characteristics of indices. The tactics is based on the natural functions of evolution of renal diseases and probable exogenic and endogenic influences. The individual program involves standardization of conditions, complex usage of methods and integration of the results obtained. The interrelation between the methodologic foundations and their components is presented.
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A study was made of the nature of secondary immuno-deficiency, peculiarities of disordered function of regulatory T-lymphocytes (helpers and suppressors), and their interrelationships in different clinical variants of chronic glomerulonephritis (CGN). Altogether 94 CGN patients were examined, of them 34 were with urinary syndrome and 60 with nephrotic syndrome. With relation to a clinical variant of disease the absolute amount of T-lymphocytes was significantly lowered, the amount and function of B-lymphocytes showed a tendency to an increase. Function of nonspecific Concanavalin A-induced T-suppressors using PHA as a mitogenic indicator (T-T-suppression) was insignificantly raised, and when lipopolysaccharide (T-B-suppression) was used it was considerably suppressed. T-lymphocyte helper activity in CGN patients was on an increase.
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