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Biomedical subjects

S Lamas

Publications and source records attributed to S Lamas.

At least 73 records · Page 4Linked to original sources

Hemodialysis with low-temperature dialysate: a long-term experience.

The effect of cool dialysate in hemodialysis (HD)-induced symptoms was studied in a group of 8 patients, neither diabetic nor anephric, with a high incidence of HD-induced hypotension (20-90%). Patients were studied during two consecutive periods of 6 months, the first one with dialysate at 37 degrees C (598 sessions) and the second one at 35 degrees C (599 sessions). Dialysis at low temperature was associated with a decrease in symptomatic hypotension (SH) (47.4 vs. 33.9%, p less than 0.001), a greater loss of weight during HD (1.52 +/- 0.03 vs. 1.71 +/- 0.03 kg, p less than 0.001) and stabilization of predialysis systolic blood pressure (SBP) at a lower level (144 +/- 0.69 vs. 139 +/- 0.98 mm Hg, p less than 0.001). At 37 degrees C, SH was associated with a higher ultrafiltration (1.71 +/- 0.05 vs. 1.32 +/- 0.05 kg, p less than 0.001). There was an improvement of symptoms both taken as a whole (55.6 vs. 45.8%, p less than 0.01) or one by one, cramps were the only exception as they increased at 35 degrees C (2.7 vs. 10.9%, p less than 0.001) being related with a greater weight loss at both temperatures (1.47 +/- 0.04 vs. 2.04 +/- 0.25 kg at 37 degrees C, p less than 0.001; 1.76 +/- 0.03 kg vs. 2.23 = 0.10 kg at 35 degrees C, p less than 0.001). In spite of the increase in the frequency of cramps, 7 out of 8 patients experienced some amelioration of dialysis symptoms (range between 7 and 21.4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Lupus-like in vitro anticoagulant activity in end-stage renal disease.

Lupus-like anticoagulant is diagnosed by a prolonged activated plasma thromboplastin time not corrected after incubation with normal plasma, prolongation of diluted tissue thromboplastin time and of diluted Russel's viper venom time, excluding factor deficiencies or specific coagulation inhibitors. We studied the presence of this 'lupus-like anticoagulant' in 100 patients with end-stage renal disease, 56 on hemodialysis and 44 on conservative treatment. 'Lupus-like anticoagulant' activity was found in vitro in the blood of 22 patients (22%) being a significantly higher prevalence than that found in 125 patients with systemic lupus erythematosus (15%) and in 50 healthy controls (0%). Hemodialysis patients showed 'lupus-like anticoagulant' activity in 30% cases, compared to 11% patients on conservative treatment. The presence of 'lupus-like anticoagulant' was unrelated with primary disease or medication received. The incidence of thrombosis in patients with this in vitro anticoagulant was higher than in patients without it (23 vs. 13%), although this difference is not significant. We conclude that prevalence of 'lupus-like anticoagulant' is high in patients with end-stage renal disease, a previously unreported observation. Its clinical and pathogenetic significance should be studied further.

Adolescent↗

Hypertension in primary chronic glomerulonephritis: analysis of 288 biopsied patients.

The prevalence of hypertension in 288 patients with primary chronic glomerulonephritis was compared with that observed in a control group of 3,477 subjects from the same geographic area. 23.3% of the patients and 12.8% of the general population were hypertensive (p less than 0.01). However, if only patients with normal renal function were considered, prevalence of hypertension (12.7%) was not higher than in the control group. Hypertension was more frequent in focal segmental sclerosis (30%) and in membranous glomerulonephritis (26%) than in IgA nephropathy (9%), membranoproliferative glomerulonephritis (11%) and IgM mesangial glomerulonephritis (12%). Five years after renal biopsy, 92% of normotensive and 47% of hypertensive patients remained with normal renal function (p less than 0.001). These findings suggest that the high prevalence of hypertension in chronic glomerulonephritis is related to the declining renal function. On the other hand, hypertension appears to represent a bad prognostic sign.

Age Factors↗

HLA antigens and serum ferritin in hemodialysis patients.

The evolution of serum ferritin levels in 111 chronic-hemodialysis patients is prospectively studied. Patients were classified in two groups according to the presence or absence of 'hemochromatosis antigens' (HLA A3, B7 or B14) in their HLA typing. Levels of serum ferritin were similar in both groups before they started dialysis and during the first year. On the contrary, in the second and third hemodialysis years serum ferritin was higher in the group carrying 'hemochromatosis antigens'. These differences were observed in patients treated with parenteral iron either in the form of transfusions or as intravenous dextran-iron but not in patients receiving oral iron. We conclude that the risk of developing iron overload is greater in hemodialysis patients with HLA A3, B7 or B14. Nevertheless, this potential risk can be minimized with a restrictive policy on the use of parenteral iron (transfusions, intravenous dextran-iron).

Anemia, Hypochromic↗

Os penis in a hemodialysis patient.

A case of os penis in a patient on chronic hemodialysis is described for the first time. Bilateral involvement of the corpora cavernosa was present, covered by an ossification plate.

Calcinosis↗

Variance analysis by use of a low cost desk top calculator.

A simple program for an HP-97 desk top calculator, which can be adapted to an HP-67, is presented. This program detects the presence of an added component of variance in any series classified with a unique criterion. Each series can be formed by any number of data. The program supplies additional information about this component. A brief theoretical description and a practical example are also included.

Analysis of Variance↗

Spontaneous regression of renal transplant artery stenosis: a new case.

Stenosis of the renal graft artery is a relatively common complication in renal transplantation. Therapy consists of either transluminal angioplasty or surgical correction. Nevertheless some untreated cases show good spontaneous evolution. We describe a well-documented case of graft artery stenosis causing severe hypertension with declining renal function which experienced spontaneous resolution.

Adult↗

Hemodialysis associated hypotension and dialysate temperature.

Incidence of intradialytic symptomatic hypotension was significantly reduced by lowering dialysate temperature from 37 degrees C to 35 degrees C. This improvement seems not to be mediated by temperature-induced changes in membrane biocompatibility, since leukocytes, platelets and complement activation were similar in both situations.

Aged↗

High prevalence of lupus anticoagulant in hemodialysis patients.

Coagulation studies were performed in 47 hemodialysis patients in order to assess abnormalities predisposing to thrombosis. A very high incidence of Lupus Anticoagulant was detected, a finding not previously described. This work is a preliminary report of this association and of its possible clinical implications.

Adult↗