thermore, retinopathy was diagnosed by fluorescein angiography in only 60% of patients with biops... more thermore, retinopathy was diagnosed by fluorescein angiography in only 60% of patients with biopsy-proved Reply from the author diabetic nephropathy. This finding, as well as those from a recent Japanese study, suggests that the concordance The data referred to by Dr. Nzerue in his letter are between retinopathy and nephropathy in patients with not published and it is therefore impossible for us to type II diabetes is not as close as that observed in patients comment on the results. However, the results concerning with type I diabetes mellitus, at least in non-Caucasian the prevalence of nondiabetic renal disease and the prevpopulations [3]. In our series, we also found focal seg- alence of retinopathy in patients with diabetic glomerumental glomerulosclerosis in 50% of type II diabetics losclerosis are in agreement with most of the other unbiwho had no biopsy evidence of diabetic nephropathy. ased studies, including our own previously published The possibility that early focal segmental glomeruloscle- studies. rosis may explain albuminuria in patients with type II Per K. Christensen for the authors diabetes mellitus with normal histology should be consid
Acute renal failure is a serious complication of pregnancy. Over the past few decades, the overal... more Acute renal failure is a serious complication of pregnancy. Over the past few decades, the overall incidence of acute renal failure in pregnancy has decreased in Western societies. In less developed countries, the incidence of acute renal failure in pregnancy has remained high. This retrospective study examined the incidence, morbidity, fetomaternal mortality, and renal prognosis among pregnant inner-city patients. Serum creatinine levels of all pregnant patients seen at an inner-city hospital from January 1986 to December 1996 were reviewed. Twenty-one consecutive cases of acute renal failure were identified for an incidence of 2 in 10,000 pregnancies. Maternal mortality was high (15.7%) as was morbidity, with a tendency toward a high rate of intrauterine fetal growth retardation. These results suggest that the outlook for acute renal failure in inner-city patients is dismal in sharp contrast to the prognosis for other patient groups with acute renal failure in pregnancy in Western societies. Preventive strategies should be aimed at this subpopulation with a view to improving early prenatal care as well as enhancing overall access to the health-care system.
Rhodococcus equi is a facultatively-aerobic, gram-positive and intracellular bacteria that causes... more Rhodococcus equi is a facultatively-aerobic, gram-positive and intracellular bacteria that causes pulmonary and disseminated infections in immuno-compromised patients. It is a common agent that causes pneumonia in farm animals and only rarely is transmitted to man. I report a case of pneumonia caused by this agent in a patient with AIDS who had been misdiagnosed as tuberculosis and treated as such for five months before the correct diagnosis was made. The diagnosis should be suspected on clinical and radiologic grounds as treatment is considerably different from other opportunistic pathogens in AIDS.
The International Journal of Artificial Organs, 2003
A diabetic patient with chronic renal failure who developed recurrent and prolonged episodes of h... more A diabetic patient with chronic renal failure who developed recurrent and prolonged episodes of hypoglycemia associated with use of sulfonylurea agent is presented here. This patient was hospitalized with neuroglycopenic symptoms of hypoglycemia that persisted in spite of large doses of parenteral glucose replacement. On administration of somatostatin analogue octreotide, hypoglycemia resolved and, blood glucose levels were maintained even after cessation of parenteral glucose. The patient received 2 subcutaneous doses of octreotide 12 hours apart, and made a complete recovery. Our experience suggests that use of octerotide to treat refractory or prolonged sulfonylurea-included hypoglycemia in renal failure patients is safe and effective; large prospective studies would be needed to validate these findings.
Background There has been an increase in the use of central venous catheters for temporary hemodi... more Background There has been an increase in the use of central venous catheters for temporary hemodialysis access. In this report, we describe a case series of 12 patients on hemodialysis who developed intracardiac clots associated with the use of central venous catheters, their outcomes and review the literature on this syndrome. Methods Retrospective, single-center case series of 12 patients with right atrial thrombi associated with central venous catheter use for dialysis vascular access. These patients were treated between June 1, 2001 and June 30th 2002 at the three University of Rochester affiliated dialysis clinics. The medical records of these patients were reviewed to obtain information concerning demographics, dialysis history, dates of catheter insertion, catheter complications, identification and dimensions of intracardiac thrombi, echocardiographic data, and outcome of anticoagulant therapy. Results Right heart thrombi were identified in 12 patients in our hemodialysis pop...
Journal of the American Society of Nephrology, 1997
Hypertension is a common finding in non-insulin-dependent diabetes mellitus (NIDDM) nephropathy. ... more Hypertension is a common finding in non-insulin-dependent diabetes mellitus (NIDDM) nephropathy. African Americans have a high prevalence of NIDDM and hypertension, and are relatively resistant to the antihypertensive effects of converting enzyme inhibitors (CEI) but respond well to calcium channel blockers (CCB). In the long-term study presented here, the effects of isradipine, a dihydropyridine calcium antagonist, on the course of the nephropathy were investigated and compared with the effects of captopril in 31 African Americans with NIDDM and proteinuria (> or = 500 mg/day). The patients were stratified by levels of GFR and proteinuria, and they were randomized to receive isradipine (N = 16) or captopril (N = 15); doses were adjusted to maintain similar BP levels (< 140/90). At 6 months, mean arterial pressure was similar (102 +/- 3 and 104 +/- 3 mm Hg in the isradipine and captopril groups, respectively) and GFR was unchanged (delta = -4 +/- 3 and +1 +/- 3 ml/min/1.73 in ...
Numerous studies have documented the presence of racial disparities among Americans in health out... more Numerous studies have documented the presence of racial disparities among Americans in health outcomes with respect to cardiovascular disease, infant mortality, cancer, and kidney disease. With regard to kidney diseases, these disparities are more dramatic. African, Hispanic, and Native Americans have the highest risks of end-stage renal disease (ESRD). The incidence of ESRD is four times higher in African Americans than in whites. Diseases causing chronic kidney failure, such as diabetes mellitus, hypertension, systemic lupus erythematosus, and human immunodeficiency virus-associated nephropathy, are particularly prevalent among African-American patients. In addition to the higher prevalence, the morbidity associated with kidney complications of these diseases appears worse in African-American patients. African Americans also have worse outcomes and a relatively reduced access to kidney transplantation--the best therapy for ESRD. It is highly likely that social and environmental fa...
... Iyad Rashdan, MD. University of Oklahoma Health Sciences Center; Oklahoma City, OK 73104. Nex... more ... Iyad Rashdan, MD. University of Oklahoma Health Sciences Center; Oklahoma City, OK 73104. Next Section. ... In their excellent review [1], O'Meara and Dehmer mention that many drugs have been used to inhibit restenosis but that favorable effects were found only in some small ...
A biographic sketch of Hamilton Naki is presented here. He was a great self-taught surgeon whose ... more A biographic sketch of Hamilton Naki is presented here. He was a great self-taught surgeon whose contributions to the world of transplantation were largely ignored due to the apartheid system of South Africa. He assisted Christian Barnard in the first human heart transplant in 1967.
A patient with end-stage renal disease due to human immunodeficiency-associated nephropathy devel... more A patient with end-stage renal disease due to human immunodeficiency-associated nephropathy developed fever, cough and chest pain over a week's duration. He was diagnosed with lung abscess and started on antibiotic coverage. He underwent bronchoscopy because of progression of his illness and persistent fever and bronchoalveolar lavage culture isolated Legionella micdadei. In spite of appropriate antibiotic therapy, the patient remained febrile for 10 days, necessitating chest tube drainage. After a 6-week course of antibiotics and drainage, the patient made an uneventful recovery. Infections due to L. micdadei may be hard to diagnose because of difficulties in isolating this bacteria.
thermore, retinopathy was diagnosed by fluorescein angiography in only 60% of patients with biops... more thermore, retinopathy was diagnosed by fluorescein angiography in only 60% of patients with biopsy-proved Reply from the author diabetic nephropathy. This finding, as well as those from a recent Japanese study, suggests that the concordance The data referred to by Dr. Nzerue in his letter are between retinopathy and nephropathy in patients with not published and it is therefore impossible for us to type II diabetes is not as close as that observed in patients comment on the results. However, the results concerning with type I diabetes mellitus, at least in non-Caucasian the prevalence of nondiabetic renal disease and the prevpopulations [3]. In our series, we also found focal seg- alence of retinopathy in patients with diabetic glomerumental glomerulosclerosis in 50% of type II diabetics losclerosis are in agreement with most of the other unbiwho had no biopsy evidence of diabetic nephropathy. ased studies, including our own previously published The possibility that early focal segmental glomeruloscle- studies. rosis may explain albuminuria in patients with type II Per K. Christensen for the authors diabetes mellitus with normal histology should be consid
Acute renal failure is a serious complication of pregnancy. Over the past few decades, the overal... more Acute renal failure is a serious complication of pregnancy. Over the past few decades, the overall incidence of acute renal failure in pregnancy has decreased in Western societies. In less developed countries, the incidence of acute renal failure in pregnancy has remained high. This retrospective study examined the incidence, morbidity, fetomaternal mortality, and renal prognosis among pregnant inner-city patients. Serum creatinine levels of all pregnant patients seen at an inner-city hospital from January 1986 to December 1996 were reviewed. Twenty-one consecutive cases of acute renal failure were identified for an incidence of 2 in 10,000 pregnancies. Maternal mortality was high (15.7%) as was morbidity, with a tendency toward a high rate of intrauterine fetal growth retardation. These results suggest that the outlook for acute renal failure in inner-city patients is dismal in sharp contrast to the prognosis for other patient groups with acute renal failure in pregnancy in Western societies. Preventive strategies should be aimed at this subpopulation with a view to improving early prenatal care as well as enhancing overall access to the health-care system.
Rhodococcus equi is a facultatively-aerobic, gram-positive and intracellular bacteria that causes... more Rhodococcus equi is a facultatively-aerobic, gram-positive and intracellular bacteria that causes pulmonary and disseminated infections in immuno-compromised patients. It is a common agent that causes pneumonia in farm animals and only rarely is transmitted to man. I report a case of pneumonia caused by this agent in a patient with AIDS who had been misdiagnosed as tuberculosis and treated as such for five months before the correct diagnosis was made. The diagnosis should be suspected on clinical and radiologic grounds as treatment is considerably different from other opportunistic pathogens in AIDS.
The International Journal of Artificial Organs, 2003
A diabetic patient with chronic renal failure who developed recurrent and prolonged episodes of h... more A diabetic patient with chronic renal failure who developed recurrent and prolonged episodes of hypoglycemia associated with use of sulfonylurea agent is presented here. This patient was hospitalized with neuroglycopenic symptoms of hypoglycemia that persisted in spite of large doses of parenteral glucose replacement. On administration of somatostatin analogue octreotide, hypoglycemia resolved and, blood glucose levels were maintained even after cessation of parenteral glucose. The patient received 2 subcutaneous doses of octreotide 12 hours apart, and made a complete recovery. Our experience suggests that use of octerotide to treat refractory or prolonged sulfonylurea-included hypoglycemia in renal failure patients is safe and effective; large prospective studies would be needed to validate these findings.
Background There has been an increase in the use of central venous catheters for temporary hemodi... more Background There has been an increase in the use of central venous catheters for temporary hemodialysis access. In this report, we describe a case series of 12 patients on hemodialysis who developed intracardiac clots associated with the use of central venous catheters, their outcomes and review the literature on this syndrome. Methods Retrospective, single-center case series of 12 patients with right atrial thrombi associated with central venous catheter use for dialysis vascular access. These patients were treated between June 1, 2001 and June 30th 2002 at the three University of Rochester affiliated dialysis clinics. The medical records of these patients were reviewed to obtain information concerning demographics, dialysis history, dates of catheter insertion, catheter complications, identification and dimensions of intracardiac thrombi, echocardiographic data, and outcome of anticoagulant therapy. Results Right heart thrombi were identified in 12 patients in our hemodialysis pop...
Journal of the American Society of Nephrology, 1997
Hypertension is a common finding in non-insulin-dependent diabetes mellitus (NIDDM) nephropathy. ... more Hypertension is a common finding in non-insulin-dependent diabetes mellitus (NIDDM) nephropathy. African Americans have a high prevalence of NIDDM and hypertension, and are relatively resistant to the antihypertensive effects of converting enzyme inhibitors (CEI) but respond well to calcium channel blockers (CCB). In the long-term study presented here, the effects of isradipine, a dihydropyridine calcium antagonist, on the course of the nephropathy were investigated and compared with the effects of captopril in 31 African Americans with NIDDM and proteinuria (> or = 500 mg/day). The patients were stratified by levels of GFR and proteinuria, and they were randomized to receive isradipine (N = 16) or captopril (N = 15); doses were adjusted to maintain similar BP levels (< 140/90). At 6 months, mean arterial pressure was similar (102 +/- 3 and 104 +/- 3 mm Hg in the isradipine and captopril groups, respectively) and GFR was unchanged (delta = -4 +/- 3 and +1 +/- 3 ml/min/1.73 in ...
Numerous studies have documented the presence of racial disparities among Americans in health out... more Numerous studies have documented the presence of racial disparities among Americans in health outcomes with respect to cardiovascular disease, infant mortality, cancer, and kidney disease. With regard to kidney diseases, these disparities are more dramatic. African, Hispanic, and Native Americans have the highest risks of end-stage renal disease (ESRD). The incidence of ESRD is four times higher in African Americans than in whites. Diseases causing chronic kidney failure, such as diabetes mellitus, hypertension, systemic lupus erythematosus, and human immunodeficiency virus-associated nephropathy, are particularly prevalent among African-American patients. In addition to the higher prevalence, the morbidity associated with kidney complications of these diseases appears worse in African-American patients. African Americans also have worse outcomes and a relatively reduced access to kidney transplantation--the best therapy for ESRD. It is highly likely that social and environmental fa...
... Iyad Rashdan, MD. University of Oklahoma Health Sciences Center; Oklahoma City, OK 73104. Nex... more ... Iyad Rashdan, MD. University of Oklahoma Health Sciences Center; Oklahoma City, OK 73104. Next Section. ... In their excellent review [1], O'Meara and Dehmer mention that many drugs have been used to inhibit restenosis but that favorable effects were found only in some small ...
A biographic sketch of Hamilton Naki is presented here. He was a great self-taught surgeon whose ... more A biographic sketch of Hamilton Naki is presented here. He was a great self-taught surgeon whose contributions to the world of transplantation were largely ignored due to the apartheid system of South Africa. He assisted Christian Barnard in the first human heart transplant in 1967.
A patient with end-stage renal disease due to human immunodeficiency-associated nephropathy devel... more A patient with end-stage renal disease due to human immunodeficiency-associated nephropathy developed fever, cough and chest pain over a week's duration. He was diagnosed with lung abscess and started on antibiotic coverage. He underwent bronchoscopy because of progression of his illness and persistent fever and bronchoalveolar lavage culture isolated Legionella micdadei. In spite of appropriate antibiotic therapy, the patient remained febrile for 10 days, necessitating chest tube drainage. After a 6-week course of antibiotics and drainage, the patient made an uneventful recovery. Infections due to L. micdadei may be hard to diagnose because of difficulties in isolating this bacteria.
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Papers by Chike Nzerue