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Biomedical subjects

M Walravens

Publications and source records attributed to M Walravens.

14 recordsLinked to original sources
PubMed2005

Preservation of renal function after heart transplantation: initial single-center experience with sirolimus.

BACKGROUND: Long-term survivors of heart transplantation are often confronted with chronic kidney disease, by definition related to the intake of calcineurin-inhibitors. Sirolimus is increasingly proposed as an alternative immunosuppressive agent due to its absence of nephrotoxicity. METHODS: Between November 2002 and November 2003, 9 adult heart transplant candidates with moderate to severe chronic renal disease were switched from cyclosporine to sirolimus. The conversion scheme consisted of an immediate stop of cyclosporine and an 8-mg loading dose of sirolimus, followed by 3 mg/d; after 1 week, the sirolimus dose was adjusted to maintain trough levels between 5 and 15 microg/L. The majority of patients were on corticosteroids, and on either azathioprine or mycophenolate mofetil. At conversion, the mean serum creatinine level was 2.11 (+/-0.4) mg/dL and the mean glomerular filtration rate (GFR) was 32 (+/-7) mL/min/1.73 m(2). Prior to conversion, the renal dysfunction was predominantly stable. RESULTS: After conversion, there were 7 dropouts (75%) due to several side effects related to sirolimus: edema (n = 2), general discomfort (n = 2), delayed wound healing (n = 1), cardiac thrombus (n = 1), and diarrhea (n = 1). The median treatment time with Sirolimus, therefore, was only 4.0 months. While on sirolimus, the renal function of all patients remained unchanged or showed even some improvement. Retrospective nephrological review revealed severe renal artery stenoses in 2 patients and serious generalized abdominal and renal atheromatosis in 7 patients. No cardiac dysfunction was seen. CONCLUSION: Conversion from cyclosporine to sirolimus was problematic due to sirolimus side effects, occurring at any time after the switch. One should also question whether chronic kidney disease after heart transplantation is routinely caused by the administration of calcineurin-inhibitors, in view of the generalized renal and abdominal atheromatosis.

Aged↗
PubMed2000

Suprascapular neuropathy in volleyball players.

BACKGROUND: Suprascapular nerve entrapment with isolated paralysis of the infraspinatus muscle is uncommon. However, this pathology has been reported in volleyball players. Despite a lack of scientific evidence, excessive strain on the nerve is often cited as a possible cause of this syndrome. Previous research has shown a close association between shoulder range of motion and strain on the suprascapular nerve. No clinical studies have so far been designed to examine the association between excessive shoulder mobility and the presence of this pathology. AIM: To study the possible association between the range of motion of the shoulder joint and the presence of suprascapular neuropathy by clinically examining the Belgian male volleyball team with respect to several parameters. METHODS: An electromyographic investigation, a clinical shoulder examination, shoulder range of motion measurements, and an isokinetic concentric peak torque shoulder internal/external rotation strength test were performed in 16 professional players. RESULTS: The electrodiagnostic study showed a severe suprascapular neuropathy in four players which affected only the infraspinatus muscle. In each of these four players, suprascapular nerve entrapment was present on the dominant side. Except for the hypotrophy of the infraspinatus muscle, no significant differences between the affected and non-affected players were observed on clinical examination. Significant differences between the affected and non-affected players were found for range of motion measurements of external rotation, horizontal flexion and forward flexion, and for flexion of the shoulder girdle (protraction); all were found to be higher in the affected players than the non-affected players. CONCLUSIONS: This study suggests an association between increased range of motion of the shoulder joint and the presence of isolated paralysis of the infraspinatus muscle in volleyball players. However, the small number of patients in this study prevents definite conclusions from being drawn.

Adult↗
PubMed1991

Diagnostic significance of antinuclear antibodies in neurologic patients.

In a combined retrospective and prospective study, we tried to define the prevalence of antinuclear antibodies (ANA) and its clinical relevance in neurological patients. Three hundred twenty-seven neurological patients who had ANA determined because of suspicion of connective tissue disease (CTD), were retrospectively studied. Thirty (9.2%) were ANA positive, 20 (66%) of whom had CTD. Of 327 consecutively admitted patients, prospectively studied, 18 (5.5%) were ANA positive, 5 (28%) of whom had evidence of CTD. Systemic lupus erythematosus (SLE) was the most frequently diagnosed CTD. In a prospective study of 48 multiple sclerosis (MS) patients, only 1 had detectable ANA at a dilution of 1:40. Lupus anticoagulant (LA) was prospectively detected in 2 patients but was not associated with a vascular or autoimmune systemic disease.

Adult↗
PubMed1981

Arteritis associated with hyperviscosity-like syndrome in rheumatoid arthritis, treated by intermittent plasma-exchange for 2.5 years.

A case is reported of a hyperviscosity-like syndrome in a 53-year-old male suffering from rheumatoid arthritis. The clinical presentation was an acute abdomen, peripheral neuritis, otovestibular areflexy, and central retinal vein thrombosis (papilloedema and retinopathy with venous engorgement, haemorrhages and exudates). Plasma viscosity was normal and whole blood viscosity, measured with an Oswald viscometer, was slightly elevated. The patient had markedly elevated rheumatoid factor tire and fibrinogen level. Histologically, there were no signs of arteritis in the mesentery. Intermittent plasma-exchange resulted in general improvement and no new vascular accidents after 2.5 years.

Arteritis↗
PubMed1978

Evaluation of sacro-iliitis: comparison of radiological and radionuclide techniques.

A 99mTc count profile of the sacro-iliac region was performed in 14 control subjects and in 50 patients with inflammatory pain of the sacro-iliac joints. In addition, 85mSr count profiles were recorded in 14 control subjects. The sacro-iliac/sacral uptake ratio was calculated. There was no significant difference between Sr and Tc count profiles. The uptake in patients with sacro-iliitis was not above the range for controls. The mean uptake ratio was significantly below that for controls, and was lower in cases with radiologically advanced changes than in those with few or no signs. This method was not useful for early diagnosis of sacro-iliitis.

Adolescent↗
PubMed1978

A systematic survey of the HLA B27 prevalence in inflammatory rheumatic diseases.

HLA B27 has been tested systematically in 246 patients attending a rheumatology clinic for chronic inflammatory arthritis or spondylitis. Patients were allocated to nine groups: typical ankylosing spondylitis, ankylosing spondylitis with moderate involvement without peripheral arthritis, ankylosing spondylitis with moderate involvement and with peripheral arthritis, juvenile chronic arthritis, Reiter's syndrome, Yersinia arthritis, arthropathies of inflammatory bowel disease, psoriatic arthritis, seronegative and seropositive rheumatoid arthritis. Except for seropositive rheumatoid arthritis, a significant association with HLA B27 antigen was found in all groups. In the seronegative rheumatoid arthritis group HLA B27 was present in 40% of the cases in contrast to 5.6% of the seropositive rheumatoid arthritis cases. These data confirm that a wide range of the so called "seronegative arthropathies" are associated with HLA B27 and suggest that sex and HLA B27 antigen are important factors in the manifestation of rheumatic disease. Women had less severe spondylitic changes but more peripheral arthritis of the small joints. Ankylosing spondylitis in its various forms had a comparable sex distribution despite relatively mild disease in females. The mean age of onset in the HLA B27 associated diseases was found to be significantly lower than in the seropositive rheumatoid arthritis group.

Arthritis, Juvenile↗
PubMedDate not supplied

HLA-B27, arthritis and Yersinia enterocolitica infection.

Over a 3 1/2-yr period 25 cases of Yersinia enterocolitica arthritis were observed. This is a frequency of about 1% of the new patients seen at our Rheumatology Clinic. The histocompatibility antigen HLA-B27 was found in 14 of the 25 patients with Yersinia arthritis (56%). There was no difference in duration of disease, joint symptoms or laboratory data between the HLA-B27 positive or negative group. Six cases had a disease course longer than 1 yr. Four of them had a disease onset before the age of 16 yr and all cases had knee joint involvement. Our findings are discussed in relation to reports from other centers.

Adolescent↗