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R Roland

Publications and source records attributed to R Roland.

16 recordsLinked to original sources
PubMed2005

A renal transplant patient with intractable hiccups and review of the literature.

Intractable hiccups in transplanted patients may be caused by various medical conditions including infections. We report a case of a 44-year-old man who suffered from intractable hiccups after cadaveric kidney transplantation. We identified 3 different hiccup periods with different causes: 1) steroid and anesthetics use, 2) severe ulcerose herpetic and mycotic esophagitis, and 3) pleuropneumonia caused by nosocomial methicillin-resistant Staphylococcus epidermidis and pulmonary abscess requiring thoracic surgery.

Adult↗
PubMed2002

[Gastrointestinal surgical complications after kidney transplantation].

BACKGROUND AND OBJECTIVE: Clinical spectrum of gastrointestinal (GI) complication in renal transplant recipients ranges from nonspecific signs of abdominal discomfort to life-threatening surgical emergencies. The manifestation of such complications is modified by antirejection therapy with resulting risk of diagnostic and therapeutic error. The present study analyses the incidence of serious GI complications after renal transplantation and their treatment. METHODS: Retrospective analysis in a university transplant center in years 1988-2000. There was 239 renal transplants performed in 234 patients (age 42 +/- 14). Male to female ratio was 140.99. Polycystic kidney disease patients comprised 9% (n = 22). RESULTS: Five serious GI complications resulting in death were recorded (2x upper GI bleed, 1x acute pancreatitis, 1x bowel obstruction in sclerotizing peritonitis, 1x diffuse purulent peritonitis of unknown origin). There was no case of diverticulitis. The average time onset of lethal GI complication was 2.8 +/- 1.4 years after renal transplantation. There was no statistically significant relation to underlying diagnosis of renal failure, warm and cold ischemia time, and time elapsed after transplantation. CONCLUSION: GI complications have increased incidence in patients after renal transplantation. The incidence of complications has no relationship to underlying diagnosis of renal failure, warm and cold ischemia time, and time elapsed after transplantation. Patients involved in transplant program should be carefully followed and thoroughly examined with any new GI symptomatology. Further studies are necessary to evaluate potential of pre-transplant screening programs.

Adult↗
PubMed1997

[Controlled clinical study of Consupren versus cyclophosphamide in chronic glomerulonephritis. II. Adverse effects].

BACKGROUND: The second part of the study was designed to assess Consupren side effects. METHODS AND RESULTS: The groups of patients studied were described in Part I. Side affects typical of Cy-A were evaluated only in the CS group. Gastrointestinal intolerance, only mild and temporary, was observed in 31%, neurotoxicity in 44%, hypertrichosis in 37%, nephrotoxicity in 25%, and gingival hypertrophy in 19%. Mean values of systolic and diastolic blood pressure did not change significantly in the course of treatment. When changes in blood pressure were individually investigated in particular patients, they were found in 31% in the CS group and in none in the K group. Mean values of uric acid non-significantly increased in the CS group and, on individual investigation, hyperuricaemia was observed in 31%. Mean values of serum potassium did not alter significantly. Signs of possible hepatotoxicity were found in 37% patients of the CS group. In this group, there was a significant decrease in haemoglobin mean values and a decrease in haemoglobin of more than 25 g/l was observed in 44% of CS group patients. In the K group significant decrease in mean leukocyte count was noted, but no patient developed real leukopenia. CONCLUSIONS: The occurrence of side effects was comparable to data known from the literature.

Chronic Disease↗
PubMed1997

[A controlled clinical trial of Consupren versus cyclophosphamide in chronic glomerulonephritis].

BACKGROUND: Experience gained from recent studies shows, that Cyclosporine-A (Cy-A) may decrease proteinuria (PU) in some forms of chronic glomerulonephritis (GN) with the nephrotic syndrome. The aim of this study was to test the efficacy of Czech-made Cy-A, Consupren. METHODS AND RESULTS: 30 patients with chronic GN, confirmed by biopsy and PU higher than 3 g/d, corticodependent or corticoresistant, were randomized according to the month of birth to either therapy with Consupren at an initial dose of 5 mg/kg/d (CS group, after dropout of 3 patients who did not finish the treatment, n = 16) or Cyclophosphamide at a dose of 1.5 mg/kg/d (K group, n = 11), and prednisone maintained at the original dose in both groups. The treatment was stopped after six months or after achieving remission. The main criterion of efficacy was PU. The decrease in mean values, statistically evaluated by Holm's procedure was highly significant in the CS group and non-significant in the K group. A similar evaluation of PU corrected by glomerular filtration rate was significant in both groups. Partial or complete remission was reached in 50% of CS group patients and in 34% of K group patients (NS). In the CS group a significant increase in the mean values of albumin and gama-globulin, and a decrease in cholesterol levels were observed. In the K group, these changes were non-significant. CONCLUSIONS: In patients with chronic GN and the nephrotic syndrome, the efficacy of Consupren treatment gives comparable, or even better results versus treatment with Cyclophosphamide.

Adult↗
PubMed1993

Type IV renal tubular acidosis associated with Alport's syndrome.

A case of hereditary nephritis with mild reduction of renal function associated with renal tubular acidosis type IV is described. The patient was admitted with life-threatening hyperkalaemia. To our knowledge, type IV renal tubular acidosis has not been reported previously in association with Alport's syndrome in an adult patient.

Acidosis, Renal Tubular↗
PubMed1993

Spirometric alterations in patients with reduced renal function.

Spirometric parameters were measured in 49 patients with reduced renal function. The patients were divided according to their glomerular filtration rate (GFR) into two groups: (A) GFR < 0.2 ml s-1-end stage renal failure; (B) GFR > or = 0.2 ml s-1. FEV1 and FEF25-75 were significantly lower in the end-stage renal failure group of patients. 80% of the patients with GFR < 0.2 ml s-1 and 31% of the patients with GFR > or = 0.2 ml s-1 had spirometric evidence of small airways dysfunction. In multiple stepwise regression analysis with ventilatory parameters as dependent variables and renal function, total protein, urea, creatinine, sodium, and hemoglobin levels, proteinuria, diuresis, and history of left ventricular failure as independent variables only GFR and total protein correlated significantly with FEV1 and FEF25. In conclusion, our study demonstrates that impairment of spirometric function in patients with renal insufficiency is continual, with reduction of GFR, and thus small airways dysfunction may be expected not only in patients with end-stage renal failure, but also in those with moderate GFR reduction.

Adult↗
PubMed1992

[Are dietetic and non-immunologic therapies becoming deciding factors in the treatment of autoimmune diseases?].

Authors call attention to non-immunological therapy and its determining role for fate and final prognosis in patients with autoimmune diseases. A stress importance of the timely and rigorous antihypertensive and antiinfectious treatment. From the dietary measures is best known favourable effect of the low protein diet and pharmacological limitation of the phosphorus supply. A new therapeutical aspect is the influence of the lipids on the autoimmune diseases activity and efficiency of the omega-3 unsaturated fatty acids. Non-immunological methods of the treatment are particularly valuable for the general practitioners and pediatricians, because enable them essentially to influence the course of the autoimmune diseases.

Autoimmune Diseases↗
PubMed1992

[New views on the pathophysiology of the nephrotic syndrome].

The authors draw attention to new pathophysiological aspects of some symptoms of the nephrotic syndrome (NS), in particular proteinuria, hypoalbuminaemia and oedema. In proteinuria they focus attention on the formation of a new population of heteropores in severe morphological forms of NS with penetration of high molecular proteins into urine. In hypoalbuminaemia the authors emphasize the importance of an inadequately increased albumin synthesis in the liver. In case of oedema in the majority of patients hypovolaemia is not present, as was assumed so far. In the pathogenesis of oedema primary Na retention in the kidneys is important caused by the glomerulonephritic process. New findings in the pathophysiology of NS lead to changes of several clinical approaches. The authors draw attention e.g. to the need of dietary protein restriction in NS, on altered effects of drugs in NS, new approaches to diuretic treatment etc.

Edema↗
PubMed1992

[Recombinant erythropoietin--a fundamental change in the treatment of anemia?].

The authors summarize in the submitted review recent findings on erythropoietin (EPO) and recombinant EPO (rHuEPO), a new therapeutic preparation which changed fundamentally the clinical picture of many diseases associated with anaemia. The authors discuss the physiology of EPO, regulation of its secretion, mechanism of action on bone marrow and its importance in the pathogenesis of polycythaemia and in particular anaemia. They emphasize in particular the use of rHuEPO in the treatment of different forms of anaemia. They analyze the pathogenesis of renal anaemia and the importance of treatment with rHuEPO for improvement of the haemogram as well as the general condition of the patients, their adaptability, improved psychic condition and reduced need of transfusions. The authors draw attention to the great importance of treatment with rHuEPO in the treatment of anaemias associated with inflammatory diseases (rheumatoid arthritis, AIDS, Crohn's disease and others), anaemia associated with malignancies, in the treatment of surgical diseases and in autotransfusions, in anaemias of premature infants and in some congenital heart diseases. The introduction of rHuEPO into the treatment of anaemia is a great advance of modern pharmacotherapy, which moreover opened new vistas on the role of anaemia in the clinical picture of many diseases.

Anemia↗
PubMed1992

[Personal experience with the use of human recombinant erythropoietin in the treatment of anemia in children with chronic renal insufficiency].

The authors analyze the course of treatment with human recombinant erythropoietin (rHuEPO) in five children in the preterminal stage of chronic renal insufficiency and one premature infant with a low birth weight and anaemia and acute renal insufficiency. rHuEPO was administered, 50-100 u./kg, by the s.c. route 2-3X per week. During the first month of treatment the haemoglobin rose from 7.0 dag/l to 8.2 dag/l and persisted at this level approximately to the third month of treatment. The haematocrit reached values of 0.30 during the 4th month of therapy when the authors observed also the maximum increase of reticulocytes (20%). The authors did not find a marked decline of iron and ferritin concentrations. In the child with a low birth weight treatment with rHuEPO was started at the age of six weeks and the age haemogram was favourably influenced already after four weeks of treatment with rHuEPO.

Anemia↗
PubMed1990

Grain quality characteristics of rice in Madagascar retail markets.

A survey of rice in retail markets of Madagascar with emphasis on the surplus regions of Marovoay and Lac Alaotra and the deficient area, Antananarivo City showed rices of Madagascar to be predominantly medium-long, medium-shaped, with high apparent amylose content, low gelatinization temperature, and soft, hard or medium gel consistency. Mean protein content was 7.5%. Percent white grains among red and white grains ranged from 0 to 100% (mean 56%), head rice 0-94%, translucency 6-66%, and Kett whiteness 12-48%.

Amylose↗
PubMed1979

[Axial osteosclerosis with autosomal dominant transmission: a new entity?].

The authors report on the case of a 26-year-old woman and three members of her family suffering from a benign condensing osteopathy, of dominant autosomic transmission, characterized mainly by a non homogenous hyperopacity of the spine and the pelvis, without alcaline hyperphosphatasemia, and which seems to them different from the condensing ostepathies described up to now.

Adult↗