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Biomedical subjects

M L Owens

Publications and source records attributed to M L Owens.

12 recordsLinked to original sources
PubMed1978

Legionnaires' disease in renal-transplant recipients.

Legionnaires' disease is reported in five renal-transplant recipients. All had febrile respiratory illnesses with pulmonary infiltrates and one died. The diagnosis was made on clinical features and by indirect fluorescent antibody titres. Symptoms started after maximum immunosuppressive therapy.

Adult↗
PubMed1977

Treatment of peptic ulcer disease in the renal transplant patient.

This study reviews previous reports of peptic ulcer disease in kidney transplant recipients and includes our own experience. Between 1968-1976, 12 transplant centers reported on gastrointestinal complications occurring in 1853 renal transplant recipients. Among these are 52 patients in whom peptic ulcers developed before trnasplantation and 72 patients in whom peptic ulcers developed after transplantation. Included are 21 patients with peptic ulcer from 115 renal transplant recipients at VA Wadsworth Hospital. Patients who were operated upon for peptic ulcer before trnasplant were compared to patients with peptic ulcer before transplant but who were not operated upon. Ulcer recurrence was significantly lower in the operated group p less than .0003. Following transplantation 59 of 68 patients with peptic ulcer disease presented with bleeding or perforation. Mortality was high: 31 deaths in 72 patients (43%). Symptoms usually occurred early, 74% in 6 months, but 19% occurred after one year. The mortality from duodenal, gastric, combined gastric and duodenal and recurrent ulcers did not differ significantly. Elective surgery is indicated for peptic ulcer when demonstrated before or after kidney transplantation.

Gastrectomy↗
PubMed1976

Gastrointestinal complications after renal transplantation: predictive factors and morbidity.

In a ten-year study involving 109 renal transplant patients, 37 (34%) developed gastrointestinal complications. The immediate mortality from these complications was 27%. Three of four patients with erosive gastritis died. Five deaths occurred among 17 patients who developed ulcers after transplantation. Emergency surgery for ulcers resulted in two deaths. Patients with peptic ulcer disease, esophagitis, or bleeding before transplantation were much more likely to develop recurrences that patients not so affected. Peptic ulcer occurred notably more often in recipients whose kidneys came from cadavers than from related donors. Experience with gastrointestinal bleeding or its absence during a first transplant is a useful predictor of the results after a second transplant. The high recurrence rate and high mortality suggest that patients with ulcer disease demonstrated before kidney transplantation should either undergo elective surgery for ulcer disease or not be accepted for transplantation. Patients in whom ulcer disease develops after a kidney transplant shoud undergo early elective surgery.

Adult↗
PubMed1976

Aortocolic fistula, a lethal cause of lower gastrointestinal bleeding: report of a case.

Aortocolic fistula occurs with spontaneous rupture of aortic and iliac aneurysms into the sigmoid colon, or due to involvement of the aneurysmal wall by acute diverticulitis. In the eight cases reviewed, this complication proved uniformly lethal, although sufficient clinical findings were present for diagnosis, and adequate time was available for a planned therapeutic approach. Lower gastrointestinal bleeding in the patient who has an aortic aneurysm and left-lower-quadrant inflammation suggests the presence of an aortocolic fistual. Angiography should be performed during a bleeding episode to confirm the diagnosis. Surgical correction consists of an axillofemoral by pass graft, excision of the aortic aneurysm, and a Hartmann procedure.

Aged↗
PubMed1976

Femoral neuropathy complicating anticoagulant therapy.

A twenty-six year old white male on long-term sodium warfarin (Coumadin therapy for recurrent thrombophlebitis had sudden onset of severe groin pain, right iliac hematoma, and a femoral nerve palsy. A review of the twelve previously reported cases of this hemorrhagic complication indicates that immediate surgical decompression may be necessary to prevent residual disability.

Adult↗
PubMed1975

Discontinuance of immunosuprression in renal transplant patients.

Immunosuppressive therapy was discontinued in six patients for an average of 27 months. In these six patients, only two rejections have occurred. A survey of other transplant centers showed that in such patients rejection was often delayed weeks or months after therapy was stopped. Once immunosuppressive therapy has been stopped, for whatever reason, and rejection has not occurred, consideration should be given to not resuming therapy unless signs of rejection appear.

Graft Rejection↗