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Biomedical subjects

M Bewick

Publications and source records attributed to M Bewick.

At least 109 records · Page 6Linked to original sources
PubMed1978

Cimetidine: prophylaxis against upper gastrointestinal haemorrhage after renal transplantation.

The incidence of upper gastrointestinal haemorrhage within four months of renal transplantation was studied in two groups of patients. Thirty patients who received prophylactic cimetidine suffered no episodes of upper gastrointestinal haemorrhage, while six of the 33 patients who did not receive cimetidine suffered haemorrhages and one of them died as a result. The difference between the groups was significant. The results suggest that the prophylactic use of cimetidine in patients receiving renal transplants is worth while.

Adolescent↗
PubMed1978

Focal segmental glomerulosclerosis with rapid decline in renal function ("malignant FSGS").

We describe 11 patients whose renal biopsies showed minimal changes with focal segmental glomerulosclerosis. These patients, in contrast to the majority of patients with similar renal histology, went into renal failure within 2 1/2 years of clinical onset. All were young, severely nephrotic, most hypertensive, with microscopic hematuria, non-selective proteinuria and extreme hypercholesterolemia. Treatment with corticosteroids and cytotoxic drugs was without effect in any patient. Despite rapid decline in renal function, profuse proteinuria and a nephrotic syndrome persisted into terminal uremia and continued even after dialysis had begun. Seven patients were given nine allografts; four grafts failed because of immediate vascular complications, and a persistant nephrotic syndrome was evident in two of the five surviving grafts. This did not, however, lead to graft failure. Two patients died on dialysis because of myocardial problems. These patients with rapid decline in renal function constitute a distinct clinical subgroup amongst those with focal and segmental glomerulosclerosis; it is possible that they have a different primarily vascular pathogenesis in contrast to other patients with similar renal biopsy appearances.

Adolescent↗
PubMed1977

[Guy's Hospital home dialysis program (author's transl)].

The first home dialysis was carried out from Guy's Hospital in London in 1968. Since then, 141 patients have been treated in this manner. The age of the patients ranged from 4 to 64 years. 24 patients have died (cerebrovascular accidents, myocardial infarction, pulmonary edema, sepsis, peritonitis, hyperkalemia etc.). Some of the deaths were due to a slackening of discipline on the part of the patients and nursing staff during the years of constant dialysis. Of 60 adults 52 were able to start work again; full rehabilitation still seems possible in 6 cases. Nevertheless, many patients cannot lead a normal life because their social and sexual activity is greatly restricted. The present economic crisis led to financial limitations in the National Health Service. In future, home dialysis may have to be reduced and more transplantations performed.

Adolescent↗
PubMed1976

Transformation of lymphocytes from patients awaiting cadaver renal transplants.

The response of lymphocytes from prospective kidney transplant recipients to inactivated donor lymphocytes (one-way mixed-lymphocyte reaction (M.L.R.)) and to phytohaemagglutinin (P.H.A. response) was measured before transplantation of cadaver kidney allografts in 78 and 75 cases respectively. M.L.R. results from patients whose grafts had failed within 3 or 6 months compared with M.L.R. results from patients whose grafts continued to function at the same times showed only slight differences irrespective of whether the data was expressed as a relative response or a mitotic index. Because of the large overlap in values, it was concluded that the M.L.R. test was of limited value in predicting graft prognosis. Pretransplantation P.H.A. responses from patients whose grafts failed within 3 or 6 months were significantly different from those shown by patients whose grafts remained functioning at those times. It is suggested that lymphocyte responsiveness to P.H.A. before transplantation may be of value in predicting the fate of renal allografts.

Adolescent↗
PubMed1976

Immune response to HBsAg and the spectrum of liver lesions in HBsAg-positive patients with chronic renal disease.

Evidence of chronic hepatitis was found on histological examination in nine out of 15 patients positive for hepatitis-B surface antigen (HBsAg) who had either chronic renal failure or a functioning renal transplant. Cirrhosis had already developed in three of the patients, who deteriorated rapidly and died. Liver biopsies from the remaining 12 patients showed the features of chronic aggressive hepatitis in two, chronic persistent hepatitis in four, and minor histological lesions in six. The persistence of HBsAg in patients with renal failure or in those receiving immunosuppressive drugs after a transplant must indicate some impairment of the normal immune response to hepatitis-B viral antigens. Nevertheless, cellular or humoral immunity to HBsAg was detected in all eight patients with chronic hepatitis tested compared with only one out of five with minimal liver lesions, which suggests that the severity of the liver damage may be directly related to the degree of immunocompetence.

Adult↗
PubMed1976

Transplantation in mesangiocapillary glomerulonephritis with intramembranous dense "deposits": recurrence of disease.

Six patients with mesangiocapillary glomerulonephritis and intramembranous dense "deposits" developed terminal renal failure and were transplanted, three from living and three from cadaver donors. Eight renal biopsy specimens were obtained from five of the grafts, from 1 to 26 months following transplantation. All six biopsy specimens taken later than seven months following the graft showed recurrence of dense intramembranous "deposits" in the basement membranes of glomeruli, and of Bowman's capsule and tubular basement in five. Recurrence of "deposits" was associated with deposition of C3 on immunofluorescent study in all but one specimen; in addition, IgM was found in two specimens, but IgG and early complement components were absent. Only two patients, however, showed glomerular proliferation associated with profuse proteinuria. In the other subjects the recurrence of the "deposit" was not associated with clinical findings. Graft loss, which occurred in two patients, was predominantly from rejection.

Adult↗
PubMed1976

Avascular necrosis of bone in patients undergoing renal allotransplantation.

Five to forty-three months after renal allotranplantation, thirteen patients (9 male, 4 female) developed avascular necrosis of one or more joints. The dose of corticosteroids used as part of the immunosuppressive therapy was compared to that used in similar patients who did not develop avascular necrosis. No significant difference could be found.

Adolescent↗
PubMed1975

Short-term cadaver kidney preservation.

200 consecutive human cadaver kidneys were preserved using 6 different techniques. Some attempt was made in the clinical situation to assess donor pre-treatment and postoperative specific recipient treatment to encourage immediate renal function. Provided the warm time was less than 60 min and the cold time less than 12 hours, intraarterial flushing with a crystalloid or colloid solution combined with pre-treatment of the donor and postoperative fluid load/frusemide drive to the recipient gave the best results.

Cadaver↗