PubMed Health⌕ Search

Biomedical subjects

M Papadimitriou

Publications and source records attributed to M Papadimitriou.

At least 55 records · Page 3Linked to original sources
PubMed1987

Idiopathic retroperitoneal fibrosis: a long-term follow-up study.

Eleven patients (8 male) with idiopathic retroperitoneal fibrosis (IRPF) were reviewed. The mean age of the patients was 44 years. Five patients (group 1) who had moderate obstruction were treated only by steroids. Six patients (group 2) who presented with severe obstructive uropathy (and/or serious metabolic disturbances) were treated with a combination of surgery and steroid administration. Unilateral or bilateral ureterolysis was performed in 5 patients. It was associated with nephrostomy in 2 cases and intraperitoneal disposition of the ureters in 1 case. Left nephrostomy without ureterolysis was performed in 1 patient. The mean follow-up period was 5.5 years (5 months to 20 years). All patients of group 1 now have normal renal function. In 5 patients of group 2, renal function improved significantly after operation; one of them was started on regular dialysis 16 years later. In another patient, IRPF recurred in the ureter of a living related renal graft 6 months after transplantation. In conclusion, steroid treatment alone offers a long-term survival in patients with IRPF of moderate severity. Combined treatment must be recommended for patients who present with severe obstruction and advanced uremia.

Acute Kidney Injury↗
PubMed1986

Cancer in renal transplant recipients.

The incidence of cutaneous malignancies and non-Hodgkin lymphomas is higher in transplant recipients than in the general population. From 1968 to 1984, 200 kidney grafts were transplanted to 180 patients with end-stage renal disease. All patients were on azathioprine (Aza) and prednisolone. In selected cases ALG and/or small doses of CsA were added. Six patients developed malignant tumors (two Kaposi sarcoma, one squamous cell and one squamous plus basal cell skin cancers, one reticulosarcoma, and one glioma). Mean age of patients was 43 years (range 35-53 years), and mean time of appearance of the tumor after transplantation was 62 months (range 24-98 months). Treatment consisted of reduction of the dosage of Aza, surgical removal or local irradiation of the tumor, and chemotherapy in case of systemic involvement (two cases). Three patients died (one Kaposi sarcoma, one reticulosarcoma, and one glioma) 3 to 6 months after diagnosis, and all three had previously been on high doses of Aza. The remaining three cases (one Kaposi) were cured by stopping or decreasing Aza, by excision, and/or local irradiation of the tumor. It seems that late diagnosis and Aza in high dosage are the main factors leading to the rapid dissemination of the initially localized tumor.

Adult↗
PubMed1985

Changes in left ventricular anatomy during haemodialysis, continuous ambulatory peritoneal dialysis and after renal transplantation.

The changes in left ventricular anatomy in 30 patients with end-stage renal disease and stable cardiac function, undergoing regular haemodialysis (10 patients), continuous ambulatory peritoneal dialysis (10 patients) and after successful renal transplantation (10 patients) were evaluated by M-mode echocardiography. Initially all had evidence of left ventricular hypertrophy and dilatation. Reevaluation after a mean follow-up of 22 months on each mode of treatment showed that in the haemodialysis group the left ventricular mass and volume were increased, while in continuous ambulatory peritoneal dialysis (CAPD) and, especially renal transplantation, the hypertrophy and dilatation were reversed. This improvement was probably due to a reduction of cardiac workload.

Adult↗
PubMed1985

Urinary tract infections after renal transplantation.

From 1980 to 1983, 69 patients (36 male) with end-stage renal disease underwent kidney transplantation (11 from cadaveric donors). Twenty-six out of 69 (17 male) with a mean age of 37 years (range 16-50 years) developed 69 UTI episodes. The standard immunosuppressive regimen consisted of prednisolone and azathioprine and, in selected cases, antilymphocyte globulin or cyclosporin A were given for a short period of time. Thirty-five episodes (50%) occurred within two months of the operation. The most commonly isolated bacteria were E. coli (28 cases), Ps. aeruginosa (16) and Proteus mirabilis (9). Kidney graft dysfunction, diabetes mellitus, urological complications and antirejection treatment were the main predisposal factors. Recurrence or reinfections were finally diagnosed in 19/26 patients (73%). Thirteen patients presented with asymptomatic bacteriuria (55% of episodes). Aminoglycosides, ureidopenicillins and third-generation cephalosporins were found to be very effective for treating severely ill, febrile patients. In addition, trimethoprim/sulphamethoxazole and mecillinam were useful for patients on long-term chemotherapy. There were no deaths or impairment of the renal graft function directly attributable to the urinary infection. In conclusion, UTIs are a very common cause of morbidity in kidney graft recipients, with the highest incidence in the early post-transplant period. Recurrences or reinfections occur often and asymptomatic bacteriuria is a common finding which needs not be treated aggressively in the absence of symptoms or obstructive uropathy. Patient and graft survival in the long term remain unaffected by the presence of the urinary infection.

Adolescent↗
PubMed1983

The effect of preventive administration of verapamil on acute ischaemic renal failure in dogs.

In 15 healthy mongrel dogs the kidneys were exposed bilaterally, the renal pedicle was clamped on one side (control kidneys) and verapamil, 0.5 mg/kg body weight, was given intravenously. Ten minutes later the renal pedicle on the other side was clamped (verapamil group). At the end of a 60-minute ischaemic period, blood flow was re-established. The mean time to initiation of diuresis was shorter in the verapamil group and creatinine clearance was significantly higher. At the end of the two-hour experiment the mean fractional excretion of sodium and the mean urinary excretion of LDH were higher in the control group. CNa, CK, Cosm and Curea were significantly higher in the verapamil group during the two-hour period of study after revascularisation. On a statistical basis 60 minute acute ischaemic renal failure is significantly modified by the administration of verapamil.

Acute Kidney Injury↗
PubMed1983

Effect of hemodialysis on left ventricular performance.

Systolic time intervals (STI) and echocardiograms (Echo) were performed before and 30 min after hemodialysis (H) in 19 stable patients (pts) with chronic renal failure undergoing maintenance H. The % shortening of the internal diameter (% delta D), the mean velocity of circumferential fiber shortening (VCF), and the ratio of the pre-ejection period to the left ventricular (LV) ejection time (PEP/LVET) were used as indices of LV performance; the electromechanical systole corrected for heart rate (QS2I) was used as an index of adrenergic activity. After hemodialysis, LV function was improved in 9 pts, Group (GI) and decreased in 10 pts (GII). Changes due to H are shown. The % delta D and VCF before H were normal in GI but abnormal in GII (31.6 +/- 1.4 vs 24.5 +/- 1.4 and 1.07 +/- 0.06 vs 0.88 +/- 0.04, respectively). Systolic blood pressure remained unchanged in GI but decreased in GII (-9.5 +/- 4 mm Hg, p less than 0.01). Body weight decreased significantly (p less than 0.05) and equally in both Gs (-1.2 +/- 0.03 in GI and -1.6 +/- 0.03 in GII). Serum electrolytes, creatinine, and hemoglobin were identical in both Gs before and after H. LV performance improved in pts with LV dysfunction before H, but decreased in pts with normal LV function before H. The decreased afterload in GII and the different effect of alterations in preload and afterload in the failing and normal LV most likely account for these changes. STI and Echo provide simple techniques to assess changes in LV function due to H and one is complementary to the other.

Adult↗
PubMed1978

Effect of furosemide on acut ischaemic renal failure in the dog.

The effect of furosemide on the development of the acute ischaemic renal failure in the dog was studied. 11 canine kidneys were used as controls (group I) and 12 as a group where furosemide (6-8 mg/kg of body weight) was given (group II) immediately after releasing the clamps. Urine volume and sodium clearance were found significantly higher in the second group of kidneys during a period of 60 min after restoration of the blood flow to the kidney. Urea clearances remained low with no noted difference between the 2 groups. By the end of the first hour osmolar and potassium clearances were found to be significantly higher in the second group. The above findings suggest that furosemide given after an induction of acute ischaemic renal failure in the dog provides, up to the 1st hour after recirculation, some benefit in water and solute excretion but no benefit in urea clearance.

Acute Kidney Injury↗
PubMed1977

Haemoglobin oxygen dissociation curve in patients on regular haemodialysis.

Changes in the haemoglobin-oxygen dissociation curve (Hb-O2) and the factors which influence its position were studied before and after dialysis in 7 patients on regular haemodialysis during 20 dialyses. Seven normal subjects were used as controls. Haemoglobin showed a lower than normal affinity for O2 in uraemic patients before haemodialysis (p50in vivo = 33.09 +/- 0.92 mmHg and p507.4 = 31.51 +/- 0.73 mmHg, P less than 0.001), and this could be considered as a protection against tissue anoxia. After dialysis Hb-O2 affinity at the patient's pH (p50 in vivo = 27.97 +/- 0.57 mmHg, P less than 0.001). This probably eliminates the benefits of the predialysis balance of tissue oxygenation, producing a degree of hypoxia, and may play a role in the genesis of post-dialysis symptoms. Measures should be taken to improve oxygenation of high risk patients with latent heart failure or respiratory disturbances during and after dialysis.

Blood↗