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M M Nash

Publications and source records attributed to M M Nash.

8 recordsLinked to original sources
PubMed2005

Role of dietary salt intake in posttransplant hypertension with tacrolimus-based immunosuppression.

Dietary salt is an important contributor to hypertension in the general population. While its role in cyclosporine-induced hypertension is minimal, its role in tacrolimus-based immunosuppression has not been defined. We measured the 24-hour urine sodium excretion as an estimate of intake in a group of stable renal transplant recipients on tacrolimus (N = 143) who had serum creatinine fluctuations <20% during the preceding 3 months. Average clinic-measured blood pressure (BP) from before and after the 24-hour urine collection was computed. Patients with recent changes in antihypertensive medications were excluded. Average systolic BP was 126 +/- 14 and diastolic BP 76 +/- 7 mm Hg. Urine sodium was 162.6 +/- 70 mmol/d (range 50 to 351), and the sodium/creatinine ratio was 15.4 +/- 6.4. There was no correlation between urine sodium excretion and either systolic or diastolic BP (R = 0.07 and R = 0.05, P = NS) or the sodium/creatinine and systolic/diastolic BP (R = 0.13, R = 0.11, P = NS). By multiple linear regression only weight and urine protein were independently associated with both systolic BP (P < .0001 for each) and diastolic BP (P < .05 for each). In conclusion, there is no appreciable influence of dietary salt intake on BP under tacrolimus-based immunosuppression. Restricting dietary salt intake in these patients cannot be recommended at the current time.

Analysis of Variance↗
PubMed2001

Seasonal variation in outpatient blood pressure in stable renal transplant recipients.

Seasonal variation in blood pressure (BP) has been described in the general and dialysis populations, with higher recordings noted in the winter than in the summer. This difference has been attributed to changes in weight, ambient temperature, and length of daylight. In this study, we sought to determine whether such seasonal differences exist in renal transplant recipients, a group with a high prevalence of hypertension. We reviewed our outpatient population of 652 adult renal transplant recipients and identified primary allograft recipients with graft survival >1 year, stable renal function, on both cyclosporine and prednisone, and who had >1 pair of post-first year "winter" (defined as the months of January and February) plus "summer" (defined as the months of July and August) outpatient BP measurements from the same year. One hundred sixty-three patients met entry criteria, from whom 432 BP pairs were obtained. When the most recent pair from each patient was analyzed (n=163), diastolic and mean BP were found to be higher in winter than summer (by 2.5 and 2.3 mmHg, respectively, P<0.01 for each) by a paired Student t test. In a separate analysis using all BP pairs (n=432), systolic, diastolic, and mean BP were found to be significantly higher in winter (by 5.3, 2.7, and 3.5 mmHg, respectively, P<0.001 for each). An effect of season was confirmed in a multiple regression model of common predictors for hypertension, controlling for number of BP pairs per patient. In conclusion, renal transplant recipients demonstrate higher BP in the winter than in the summer. This effect is independent of known predictors of hypertension in this population and may be, at least, partly related to changes in length of daylight and temperature.

Adult↗
PubMed1998

Efficacy of azithromycin in the treatment of cyclosporine-induced gingival hyperplasia in renal transplant recipients.

BACKGROUND: Gingival hyperplasia (GH) is a common side effect of cyclosporine . Azithromycin (Zithromax; AZI) is a macrolide antibiotic reported in case studies to reduce cyclosporine-induced gingival hyperplasia (CIGH) in renal transplant recipients (RTR). METHODS: The efficacy of AZI to treat CIGH in RTR was examined in a double-blind, randomized crossover trial. Patients (n=17) with CIGH were randomized to receive AZI and a matching placebo in alternate order for 5 days, separated by a 2-week washout period. Follow-up visits were conducted at week 6 and week 12. Changes in GH were evaluated by measuring the clinical gingival sulcus depths, tooth length, and the length of the interdental papillae to the cementum-enamel junction of two teeth in each of the four quadrants. RESULTS: Significant improvements were observed in all three types of periodontal measurements, representing reductions of gingival tissue above the medial aspect of the tooth, of the gingival sulcus depth, and of the length of the interdental papillae. Patients reported an improvement in gum bleeding. AZI was well tolerated, and 67% of the patients reported that the treatment was at least somewhat useful. CONCLUSIONS: AZI should be considered for RTR with CIGH.

Adult↗
PubMed1993

Corneal Langerhans cell dynamics after herpes simplex virus reactivation.

PURPOSE: The authors investigated the progressive changes in the distribution of corneal Langerhans cells (LC) after reactivation of latent herpes simplex virus type 1 (HSV-1) in mice. METHODS: After corneal inoculation of National Institutes of Health inbred mice with HSV-1 and the establishment of latency, viral reactivation was induced by irradiating the ocular surface with 250 mJ/cm2 of ultraviolet B (UV-B) light. RESULTS: Subsequent viral replication in the cornea was followed by the migration of the LC toward the paracentral and central corneal epithelium. These areas are normally devoid of LC. The number of LC in the paracentral and central regions of the eye reached a peak at day 14 post-UV-B irradiation. After UV-B irradiation of mice latently infected with HSV-1, the development of corneal stromal opacification and neovascularization closely followed the migration of LC toward the central cornea and paralleled the influx of T-cells into the corneal stroma. This pattern was not observed in irradiated uninfected mice. CONCLUSIONS: LC migrate centrally in the corneal epithelium after viral reactivation. There is a direct correlation between the number of LC in the cornea and the degree of persistent stromal opacification.

Animals↗