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Kaye M, Arredondo F, Anderson A, Williams L, Mak W. A study to compare the birth outcomes of infants conceived by intravaginal culture using the invocellTM device and conventional in vitro fertilization in traditional incubators. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.02.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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2
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Kroeker J, Keith J, Carruthers H, Hanna C, Qureshi N, Calic M, Kaye M, Solow M, Coey J, Sulaiman S. Investigating the time‐lapsed effects of rigid cervical collars on the dimensions of the internal jugular vein. Clin Anat 2019; 32:196-200. [DOI: 10.1002/ca.23264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 07/27/2018] [Accepted: 08/07/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Jenna Kroeker
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Jay Keith
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Hailey Carruthers
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Cherry Hanna
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Natasha Qureshi
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Masa Calic
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Meagan Kaye
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - Marissa Solow
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
| | - James Coey
- Keith B. Taylor Global Scholars Program at Northumbria UniversitySt. George's International School of Medicine Newcastle‐upon‐Tyne NE1 8ST UK
- Department of AnatomySt. George's University Grenada West Indies
| | - Sara Sulaiman
- Department of Applied SciencesNorthumbria University Newcastle‐upon‐Tyne NE1 8ST UK
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Aguilaniu B, Lancaster L, Conoscenti C, Iiowite J, Trampisch M, Moguikoc N, Homik L, Kaye M. Effet du nintédanib sur la capacité d’effort chez les patients atteints de fibrose pulmonaire idiopathique (FPI) : résultats d’un essai de phase IIIb. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Affiliation(s)
- M. Kaye
- Division of Nephrology, Montreal General Hospital, Montreal, Quebec - Canada
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Affiliation(s)
- M. Kaye
- Division of Nephrology Montreal General Hospital, Montreal, Quebec - Canada
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Abstract
Using a dialysate that contained no calcium, we studied the amount of calcium lost and the clearances of urea, creatinine, phosphate and calcium in fifteen different dialyzers at blood flow/min (QB) of 200 and 300. Five of these dialyzers, covering the functional range of the fifteen, were also tested at QB of 100, 150 and 400. The collection period was divided into the first twenty minutes and the remaining 220 minutes. Clearance was calculated using the initial twenty minutes and for all dialyzers the creatinine, phosphate and calcium clearances were linearly related to the measured urea clearnce, r = 0.946, 0.810 and 0.808 respectively. Calcium recovered in the dialysate varied, depending on the dialyzer and QB, however the amount found plateaued at QB 200 and did not increase further, unlike creatinine, phosphate and urea. Total dialysate calcium loss for a four-hour dialysis averaged 49.9 mmol (range 42.2 -63) or almost 2g of elemental calcium for QB of 200 ml/min and 48.9 mmol (range 31.1 -65.5) or 1.95 g of elemental calcium for a QB of 300 ml/min. Decreasing the calcium infusion replacement rate did not decrease the calcium dialysate loss in equal amounts as the blood to dialysate gradient falls leading to a smaller than expected dialysate loss. Measured urea clearance in these fifteen dialyzers was approximately 20% less than specified by the manufacturer and almost 30% less for creatinine and phosphate. This difference is probably due to in vivo measurements with blood whereas most of the specifications are obtained using saline in vitro. The data given provide a basis for calcium replacement when using a calcium free dialysis and a variety of dialyzers and blood flow rates.
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Affiliation(s)
- M. Kaye
- Division of Nephrology, Montreal General Hospital, Montreal - Canada
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Kreuter M, Crestani B, Quaresma M, Kaye M, Stansen W, Stowasser S. Long-term nintedanib treatment in idiopathic pulmonary fibrosis (IPF): new data from INPULSIS-ON. Pneumologie 2018. [DOI: 10.1055/s-0037-1619238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Kreuter
- Department of Pneumology, Thoraxklinik, University of Heidelberg, and Translational Lung Research Center Heidelberg; German Center for Lung Research
| | | | - M Quaresma
- Department of Pneumology, Thoraxklinik, University of Heidelberg, and Translational Lung Research Center Heidelberg; German Center for Lung Research; Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein
| | - M Kaye
- Minnesota Lung Center, Ltd., Minneapolis
| | - W Stansen
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein
| | - S Stowasser
- Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein
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8
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Kreuter M, Crestani B, Quaresma M, Kaye M, Stansen W, Stowasser S. Long-term treatment with nintedanib in patients with IPF: an update from INPULSIS-ON. Pneumologie 2017. [DOI: 10.1055/s-0037-1598507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Kreuter
- Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (Tlrc), Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
| | - B Crestani
- Hôpital Bichat, Pneumologie, Paris, France
| | - M Quaresma
- Boehringer Ingelheim Pharma GmbH & Co. Kg, Ingelheim am Rhein, Germany
| | - M Kaye
- Minnesota Lung Center, Ltd., Minneapolis, Minnesota, USA
| | - W Stansen
- Boehringer Ingelheim Pharma GmbH & Co. Kg, Ingelheim am Rhein, Germany
| | - S Stowasser
- Boehringer Ingelheim Pharma GmbH & Co. Kg, Ingelheim am Rhein, Germany
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Owen M, Jorgensen F, Willis C, McLauchlin J, Elviss N, Aird H, Fox A, Kaye M, Lane C, de Pinna E. The occurrence of Salmonella spp. in duck eggs on sale at retail or from catering in England. Lett Appl Microbiol 2016; 63:335-339. [PMID: 27561893 DOI: 10.1111/lam.12660] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/15/2016] [Accepted: 08/22/2016] [Indexed: 11/28/2022]
Abstract
Since 2010, human salmonellosis outbreaks in the UK have been detected as associated with the consumption of duck eggs. Little data are available on the rate of occurrence of Salmonella in duck eggs. The aim of this study was to investigate the occurrence of Salmonella spp. in duck eggs on sale and from catering in England during 2011, particularly those from small-scale production. All samples were collected independently of human salmonellosis outbreak investigations. Composite samples of 6-10 eggs (shells and contents were examined separately) were examined for the presence of Salmonella spp. using the ISO 6579:2002 method. Salmonella spp. was recovered from two of 145 samples (1·4%). In one sample, Salmonella Typhimurium DT 8 was isolated from the shells while Salm. Typhimurium DT 8 and Salm. Typhimurium DT30 were isolated from the contents. Salmonella Typhimurium DT8 was isolated from the egg shells only in the second contaminated sample. This study provides baseline data for risk assessors, regulators and the food industry and may be helpful in communicating risks associated with the consumption of this product as well as evaluating risk management options to control food safety including vaccination of ducks. SIGNIFICANCE AND IMPACT OF THE STUDY Human salmonellosis outbreaks in England and Northern Ireland due to Salmonella enterica serovar Typhimurium definitive phage type (DT) 8 have been identified as associated with the consumption of duck eggs since 2010. This study has shown that Salmonella spp. was detected in 1·4% of ducks egg samples providing baseline data for risk assessors, regulators and the food industry. This may be helpful in communicating risks associated with the consumption of this product as well as evaluating risk management options to control food safety including vaccination of ducks.
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Affiliation(s)
- M Owen
- Food Water and Environmental Microbiology Laboratory Porton, Public Health England, Salisbury, UK
| | - F Jorgensen
- Food Water and Environmental Microbiology Laboratory Porton, Public Health England, Salisbury, UK.
| | - C Willis
- Food Water and Environmental Microbiology Laboratory Porton, Public Health England, Salisbury, UK
| | - J McLauchlin
- Food Water and Environmental Microbiology Services, Public Health England, London, UK.,University of Liverpool, Institute of Infection and Global Health, Liverpool, UK
| | - N Elviss
- Food Water and Environmental Microbiology Services, Public Health England, London, UK
| | - H Aird
- Food Water and Environmental Microbiology Laboratory York, Public Health England, National Agri-Food Innovation Campus, York, UK
| | - A Fox
- Food Water and Environmental Microbiology Laboratory Preston, Public Health England, Royal Preston Hospital, Preston, UK
| | - M Kaye
- Food Water and Environmental Microbiology Laboratory Birmingham, Public Health England, Good Hope Hospital, Sutton Coldfield, UK
| | - C Lane
- Gastrointestinal Emerging and Zoonotic Infections Department, Public Health England, London, UK
| | - E de Pinna
- Gastrointestinal Bacteria Reference Unit, Public Health England, London, UK
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Kreuter M, Crestani B, Ogura T, Pelling K, Coeck C, Quaresma M, Kaye M. Interim analysis of nintedanib in an open-label extension of the INPULSIS® trials (INPULSIS®-ON). Pneumologie 2016. [DOI: 10.1055/s-0036-1571997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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11
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Sadler-Reeves L, Aird H, de Pinna E, Elviss N, Fox A, Kaye M, Jorgensen F, Lane C, Willis C, McLauchlin J. The occurrence of Salmonella
in raw and ready-to-eat bean sprouts and sprouted seeds on retail sale in England and Northern Ireland. Lett Appl Microbiol 2016; 62:126-9. [DOI: 10.1111/lam.12530] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/13/2015] [Accepted: 11/19/2015] [Indexed: 11/30/2022]
Affiliation(s)
- L. Sadler-Reeves
- Public Health England Food Water and Environmental Microbiology Laboratory Porton; Porton Down; Salisbury UK
| | - H. Aird
- Public Health England Food Water and Environmental Microbiology Laboratory York; York UK
| | - E. de Pinna
- Public Health England Gastrointestinal Bacteria Reference Unit; Public Health England, Colindale; London UK
| | - N. Elviss
- Public Health England Food Water and Environmental Microbiology Laboratory London; London UK
| | - A. Fox
- Public Health England Food Water and Environmental Microbiology Laboratory Preston; Royal Preston Hospital; Preston UK
| | - M. Kaye
- Public Health England Food Water and Environmental Microbiology Laboratory Birmingham; Good Hope Hospital; Sutton Coldfield UK
| | - F. Jorgensen
- Public Health England Food Water and Environmental Microbiology Laboratory Porton; Porton Down; Salisbury UK
| | - C. Lane
- Gastrointestinal, Emerging and Zoonotic Infections Department; Public Health England, Colindale; London UK
| | - C. Willis
- Public Health England Food Water and Environmental Microbiology Laboratory Porton; Porton Down; Salisbury UK
| | - J. McLauchlin
- Food Water and Environmental Microbiology Services; Public Health England; London UK
- Institute of Infection and Global Health; University of Liverpool; Liverpool UK
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Crestani B, Ogura T, Pelling K, Coeck C, Quaresma M, Kreuter M, Kaye M. Étude d’extension en ouvert des essais Inpulsis® (Inpulsis®–ON) sur le nintédanib dans la fibrose pulmonaire idiopathique : analyse intermédiaire. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Crestani B, Ogura T, Pelling K, Coeck C, Quaresma M, Kreuter M, Kaye M. P7 Interim analysis of nintedanib in an open-label extension of the INPULSIS® trials (INPULSIS®-ON). Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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14
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Willis C, Sadler-Reeves L, Elviss N, Aird H, Fox A, Kaye M, de Pinna E, Lane C, McLauchlin J. An assessment of the microbiological safety of fresh whole-leaf herbs from retail premises in the United Kingdom with a focus on Salmonella spp. J Appl Microbiol 2015; 119:827-33. [PMID: 26010515 DOI: 10.1111/jam.12855] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/08/2015] [Accepted: 05/17/2015] [Indexed: 11/29/2022]
Abstract
AIMS Fresh herbs have been associated with a number of outbreaks in recent years, in the United Kingdom and elsewhere. A study of fresh herbs was carried out to assess their microbiological safety in relation to Salmonella contamination and levels of Escherichia coli. METHODS AND RESULTS Between January and March 2014, 774 samples of ready-to-eat, fresh, whole-leaf herbs were collected from retail premises in the United Kingdom. Overall, Salmonella was detected in nine samples (1·2%). Of these, five were curry leaves. Other herbs contaminated with Salmonella were basil (two samples), walleria (1) and coriander (1). Escherichia coli was detected in 13% of samples, with 11% containing unsatisfactory levels (≥10(2) g(-1)). CONCLUSIONS Whilst 88% of samples in this study were of an acceptable microbiological quality, the presence of Salmonella and/or elevated E. coli levels in 12% is a cause for concern. Curry leaves, in particular, had significantly higher rates of contamination with both Salmonella and E. coli than other herbs. SIGNIFICANCE AND IMPACT OF THE STUDY This study highlights the potential public health risk associated with the consumption of certain ready-to-eat fresh herbs, and the need for good hygiene practices and effective decontamination procedures during the growth, harvesting and subsequent handling of these products.
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Affiliation(s)
- C Willis
- Public Health England, Food Water and Environmental Microbiology Laboratory Porton, Porton Down, Salisbury, UK
| | - L Sadler-Reeves
- Public Health England, Food Water and Environmental Microbiology Laboratory Porton, Porton Down, Salisbury, UK
| | - N Elviss
- Public Health England, Food Water and Environmental Microbiology Laboratory London, Colindale, London, UK
| | - H Aird
- Public Health England, Food Water and Environmental Microbiology Laboratory York, FERA, York, UK
| | - A Fox
- Public Health England, Food Water and Environmental Microbiology Laboratory Preston, Royal Preston Hospital, Preston, UK
| | - M Kaye
- Public Health England, Food Water and Environmental Microbiology Laboratory Birmingham, Good Hope Hospital, Sutton Coldfield, UK
| | - E de Pinna
- Gastrointestinal Bacteria Reference Unit, Public Health England, Colindale, London, UK
| | - C Lane
- Gastrointestinal, Emerging and Zoonotic Infections Department, Public Health England, Colindale, London, UK
| | - J McLauchlin
- Public Health England, Food Water and Environmental Microbiology Laboratory London, Colindale, London, UK.,University of Liverpool, Institute of Infection and Global Health, Liverpool, UK
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Pfeifer M, Cottin V, Taniguchi H, Richeldi L, Collard HR, Kaye M, Hansell DM, Bailes Z, Schlenker-Herceg R, Raghu G. Effect of baseline emphysema on reduction in FVC decline with nintedanib in the INPULSIS™ trials. Pneumologie 2015. [DOI: 10.1055/s-0035-1544834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abbott IJ, Papadakis G, Kaye M, Opdam H, Hutton H, Angus PW, Johnson PDR, Kanellis J, Westall G, Druce J, Catton M. Laboratory identification of donor-derived coxsackievirus b3 transmission. Am J Transplant 2015; 15:555-9. [PMID: 25582147 DOI: 10.1111/ajt.12986] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 08/04/2014] [Accepted: 08/19/2014] [Indexed: 01/25/2023]
Abstract
Unexpected donor-to-recipient infectious disease transmission is an important, albeit rare, complication of solid organ transplantation. Greater work and understanding about the epidemiology of these donor-derived transmissions is continually required to further mitigate this risk. Herein we present the first reported case of proven donor-derived transmission of coxsackievirus serogroup-3, an enterovirus, following solid organ transplant. Swift and effective communication between the organ donation agency, treating physicians, laboratory testing and notification ensured a coordinated approach. The resulting clinical syndromes in the organ recipients were mild. This case highlights the requirement for ongoing surveillance over a broad range of infecting pathogens that may present as a donor-derived infection.
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Affiliation(s)
- I J Abbott
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
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Cottin V, Crestani B, Taniguchi H, Richeldi L, Collard H, Kaye M, Hansell D, Bailes Z, Schlenker-Herceg R, Raghu G. Effet de l’emphysème sur la réduction du déclin de la CVF avec le nintédanib dans les études INPULSIS™. Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2014.11.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Puncreobutr C, Lee PD, Kaye M, Balint D, Farrugia D, Connolley T, Lin J. Quantifying damage accumulation during the hot deformation of free-cutting steels using ultra-fast synchrotron tomography. ACTA ACUST UNITED AC 2012. [DOI: 10.1088/1757-899x/33/1/012038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Skidmore S, Kaye M, Bayliss D, Devendra S. Validation of COBAS Taqman CT for the detection of Chlamydia trachomatis in vulvo-vaginal swabs. Sex Transm Infect 2008; 84:277-8; discussion 278-9. [PMID: 18305120 DOI: 10.1136/sti.2007.029587] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Vulvo-vaginal swabs (VVSs) are not validated for use by the manufacturers of two widely used nucleic acid amplification tests (NAAT) for the detection of Chlamydia trachomatis. However, there is evidence that this type of swab is suitable for diagnosis. OBJECTIVE To validate the Cobas Taqman CT assay for the detection of C trachomatis in VVS. METHOD Women aged 18-24 years attending a genitourinary medicine clinic were invited to take part in the study. Participants provided a self-taken VVS and the results obtained with these samples were compared with those obtained with an endocervical swab collected by a healthcare worker. A total of 267 women took part. RESULTS 255/267 (96%; 95% CI 92 to 98%) sets of samples gave concordant results. 12/267 (4.5%) VVSs were invalid/inhibitory and so no result was available for these samples. This compared with 2/267 (0.7%) for endocervical swabs. CONCLUSION VVS are suitable samples for detecting C trachomatis.
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Affiliation(s)
- S Skidmore
- Department of Microbiology, Princess Royal Hospital, Telford TF1 1TF, UK.
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Kaye M, Skidmore S, Howells K, Spencer-Jones R, McGeoch C, Gregson P, Graham N, Warren R. The use of a real time PCR for diagnosis of hip and knee prosthetic infection: method development and comparison with histology and bacterial culture. J Infect 2007. [DOI: 10.1016/j.jinf.2007.04.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kaye M, Skidmore S, Osman H, Weinbren M, Warren R. Surveillance of respiratory virus infections in adult hospital admissions using rapid methods. Epidemiol Infect 2006; 134:792-8. [PMID: 16388686 PMCID: PMC2870437 DOI: 10.1017/s0950268805005364] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2005] [Indexed: 11/07/2022] Open
Abstract
Both influenza and respiratory syncytial virus (RSV) cause epidemics of respiratory illness of variable severity during the winter season. Influenza in particular has been blamed for hospital winter bed pressures, although it is thought that RSV may also play a role. Human metapneumovirus (hMPV) is a new respiratory virus reported to be important in children; only a limited number of studies are available for adult populations. We aimed to determine initially the burden of virologically confirmed infections, i.e. influenza, RSV and hMPV using polymerase chain reaction (PCR) technology and, in addition, to assess the feasibility of this approach as a surveillance tool for these respiratory viruses. Adult patients admitted to hospital in the previous 24 hours with onset of acute respiratory symptoms in the last 14 days were asked to participate. Informed written consent was obtained and nose and throat swabs taken. Multiplex PCR for influenza A (H1N1 and H3N2), influenza B and RSV A and B were carried out together with a separate PCR for hMPV. A total of 219 patients in 2001-2002 and 216 in 2002-2003 were tested and the combined results for both seasons were: 8 positive for influenza A/H1N1, 14 for influenza A/H3N2, 2 for influenza B, 14 for RSV A and 6 for RSV B. Most patients (261/435) were >65 years and most positives (30/44) were found within this age group. A number of patients aged >65 years who were positive for influenza (12/15) reported having had vaccine. In total, 373 samples were tested for hMPV and 20 were found positive across all age groups except the 45-54 years age group. As influenza activity was low during the study period the impact of infection on admissions could not be assessed. Nevertheless the viruses studied accounted for 15% of hospital admissions for respiratory infection. Most patients were aged >65 years, as expected. In the two years studied RSV and hMPV were each responsible for as many hospitalized cases of respiratory infection as influenza. Influenza infection must be considered even in those who give a history of vaccination. The molecular methods used in this study showed that surveillance of these respiratory viruses can be conducted and may help in the management of patients.
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Affiliation(s)
- M Kaye
- Microbiology Department, The Shrewsbury and Telford Hospital NHS Trust, Telford, Shropshire, UK.
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Kaye M, Skidmore S, Howells K, McGeoch C, Gregson P, Spencer-Jones R, Graham N, Warren R. P19.02 The Use of a Real Time PCR for Diagnosis of Hip and Knee Prosthetic Infection: Method Development and Comparison with Histology and Bacterial Culture. J Hosp Infect 2006. [DOI: 10.1016/s0195-6701(06)60358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
The declining incidence of AIDS-related opportunistic diseases among people with HIV infection has shifted the focus of clinical management to prevention and treatment of comorbidities such as chronic liver disease. The increased risk of hepatitis C virus (HCV)-related advanced liver disease in people with HIV infection makes early HCV diagnosis a priority. To assess HCV prevalence and predictors of HIV/HCV coinfection, we have conducted a retrospective analysis of people enrolled in the CAESAR (Canada, Australia, Europe, South Africa) study, a multinational randomized placebo-controlled study of the addition of lamivudine to background antiretroviral therapy. The impact of HCV on HIV disease progression was also examined. Anti-HCV antibody testing on 1649 CAESAR study participants demonstrated a HIV/HCV coinfection prevalence of 16.1%, which varied from 1.9% in South Africa to 48.6% in Italy. The strongest predictor of HIV/HCV coinfection was HIV exposure category (P<0.0001), with odds ratios (ORs) compared to homosexual as follows: injecting drug use (IDU), 365 [95% confidence interval (CI): 179-742]; transfusion or blood products, 32.2 (95% CI: 15.2-67.6); homosexual and IDU, 22.9 (95% CI: 8.5-62.1). The prevalence of HIV/HCV was low (3.7%) among homosexual men without reported IDU. Other predictors of HIV/HCV coinfection were alanine aminotransferase (ALT), country of residence, ethnicity and stage of HIV disease. A history of IDU or ALT > or =40 U/L at baseline had a positive predictive value (PPV) of 35%, negative predictive value (NPV) of 96%, sensitivity of 82% and specificity of 71% for HIV/HCV coinfection. HIV disease progression was similar in HIV monoinfected and HIV/HCV coinfected patients. People with HIV and a history of IDU or elevated liver function tests should be targeted for HCV testing. The low prevalence of HIV/HCV coinfection among homosexual men without a history of IDU suggests low efficiency of sexual HCV transmission.
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Affiliation(s)
- J Amin
- National Centre in HIV Epidemiology and Clinical Research (NCHECR), The University of New South Wales, Level 2, 376 Victoria Street, Darlinghurst, Sydney 2010, Australia
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Gagnon RF, Mangel R, Kaye M. Metabolic acidosis during urinary retention in a patient with an enterovesical fistula. Clin Nephrol 2000; 54:73-7. [PMID: 10939761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
We report a patient known to have an enterovesical fistula who presented severe acute metabolic acidosis during an episode of urinary retention. The enterovesical fistula which had been intermittently symptomatic for 4 years, had developed after several intestinal surgical procedures and related intraperitoneal sepsis following resection of colon cancer 21 years previously. The patient who had a total colectomy and ileostomy, was admitted for hip replacement with the routine placement of a Foley bladder catheter. Three weeks post-operatively, the patient developed acute urinary retention following removal of the urinary catheter. The output from his ileostomy was immediately markedly increased, presumably from bladder urine diverted into the intestines through the enterovesical fistula. Within a few days he presented a normal anion gap metabolic acidosis with raised urea and stable creatinine; his clinical status deteriorated markedly with profound obtundation. These metabolic abnormalities were readily corrected by re-insertion of the Foley catheter with restoration of normal urine flow and immediate corresponding fall in the ileostomy output. Radiographic studies showed the presence of the enterovesical fistula originating from the jejunum. This is the first report of acute metabolic acidosis in association with an enterovesical fistula; the severe metabolic disturbances were triggered by the development of urinary retention resulting in the diversion of urine into the small bowel through the fistula.
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Affiliation(s)
- R F Gagnon
- Department of Medicine, Montreal General Hospital, Quebec, Canada
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Gagnon RF, Kintzen GM, Kaye M. Acquired cystic kidney disease: rapid progression from small to enlarged kidneys simulating adult polycystic kidney disease. Clin Nephrol 2000; 53:307-11. [PMID: 10809421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
A 57-year-old man on chronic hemodialysis presented marked bilateral renal enlargement due to acquired cystic kidney disease (ACKD). He had been on hemodialysis for less than 3 years only (14 months prior to receiving a functional renal transplant which lasted 8 years, followed by 18 additional months of dialysis), before the diagnosis of ACKD was made following an episode of flank pain with gross hematuria. The marked changes in kidney appearance during this 11-year period were documented by serial ultrasound examination showing the kidneys to be of near-normal size before the start of dialysis (> or =10 cm in 1986), then shrunken and contracted 5 years later while having a functioning renal transplant (<5 cm in 1991), and markedly enlarged reaching the size of adult polycystic kidney disease after returning to dialysis (>13 cm in 1997). Since the risk of ACKD increases with duration of dialysis, we sought additional predisposing factors in this unusual case and found that 2 years after renal transplantation, the patient was diagnosed with breast cancer for which he was treated with surgical excision and tamoxifen. Based on ultrasound evidence that the tamoxifen treatment preceeded the appearance of the renal cystic changes, we wonder whether this drug may have played a role in the rapid development of ACKD.
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Affiliation(s)
- R F Gagnon
- Department of Medicine, Montreal General Hospital, Quebec, Canada
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Kaye M. Overnight dialysis. CMAJ 2000; 162:633. [PMID: 10738446 PMCID: PMC1231212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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Kaye M, Vasilevsky M, Ketis M. The effect on blood pressure of an acute fall in ionized calcium during hemodialysis. A randomized study in two patients. Clin Nephrol 1998; 50:361-6. [PMID: 9877109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
AIM Elevating serum ionized calcium levels is known to stabilize blood pressure during and after a hemodialysis session. The data on lowering calcium levels is limited. SUBJECTS AND METHODS This study examined the responses to an acute drop in ionized calcium during a four hour hemodialysis session in two subjects who differed in the presence (patient 1) or absence (patient 2) of anti-hypertensive medication and average weight loss of 4 kg (patient 1) or 2 kgs (patient 2) with each dialysis. Parathyroid hormone (PTH) levels were normal (patient 1) or very high (patient 2). A calcium free dialysate was used and the calcium infusion rate distal to the dialyzer was varied to produce either no change in ionized calcium for 10 dialyses, or a fall of at least 0.2 mmol/l for 10 dialyses. The sequence was randomized and was blinded to the observers and patients. RESULTS The fall in ionized calcium was similar in each individual, 0.37 +/- 0.11 and 0.34 +/- 0.05 mmol/l. PTH rose from 8.6 +/- 1.6 to 24.2 +/- 6.6 pmol/l for patient 1 and 144.6 +/- 59.9 to 234.8 +/- 32.3 pmol/l for patient 2: patient 1 showed a fall in blood pressure after dialysis associated with the fall in calcium. This was most pronounced in the upright position whereas there was no change for Patient 2. For Patient 1 standing mean blood pressure post-dialysis was 104 +/- 6 mmHg when the calcium was stable and 94 +/- 10 mmHg with hypocalcemia p <0.01. Mean blood pressure during dialysis was also lower with hypocalcemia 100 +/- 7 versus 92 +/- 9 p <0.05. There were no significant changes in blood pressure for patient 2. Neither of the patients had any symptoms attributable to hypotension or hypocalcemia. CONCLUSION It was concluded that modest falls in ionized calcium were associated with a drop in standing blood pressure only when combined with other factors predisposing to vascular instability. Even so these decreases were small enough to be asymptomatic.
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Affiliation(s)
- M Kaye
- Division of Nephrology, Montreal General Hospital, Quebec, Canada
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Joo JS, Ehrenpreis ED, Gonzalez L, Kaye M, Breno S, Wexner SD, Zaitman D, Secrest K. Alterations in colonic anatomy induced by chronic stimulant laxatives: the cathartic colon revisited. J Clin Gastroenterol 1998; 26:283-6. [PMID: 9649012 DOI: 10.1097/00004836-199806000-00014] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Cathartic colon is a historic term for the anatomic alteration of the colon secondary to chronic stimulant laxative use. Because some have questioned whether this is a real entity, we investigated changes occurring on barium enema in patients ingesting stimulant laxatives. Our study consisted of two parts. In part 1, a retrospective review of consecutive barium enemas performed on two groups of patients with chronic constipation (group 1, stimulant laxative use [n=29]; group 2, no stimulant laxative use [n=26]) was presented to a radiologist who was blinded to the patient group. A data sheet containing classic descriptions of cathartic colon was completed for each study. Chronic stimulant laxative use was defined as stimulant laxative ingestion more than three times per week for 1 year or longer. To confirm the findings of the retrospective study, 18 consecutive patients who were chronic stimulant laxative users underwent barium enema examination, and data sheets for cathartic colon were completed by another radiologist (part 2). Colonic redundancy (group 1, 34.5%; group 2, 19.2%) and dilatation (group 1, 44.8%; group 2, 23.1%) were frequent radiographic findings in both patient groups and were not significantly different in the two groups. Loss of haustral folds, however, was a common finding in group 1 (27.6%) but was not seen in group 2 (p < 0.005). Loss of haustral markings occurred in 15 (40.5%) of the total stimulant laxative users in the two parts of the study and was seen in the left colon of 6 (40%) patients, in the right colon of 2 (13.3%) patients, in the transverse colon of 5 (33.3%) patients, and in the entire colon of 2 (13.3%) patients. Loss of haustra was seen in patients chronically ingesting bisacodyl, phenolpthalein, senna, and casanthranol. We conclude that long-term stimulant laxative use results in anatomic changes in the colon characterized by loss of haustral folds, a finding that suggests neuronal injury or damage to colonic longitudinal musculature caused by these agents.
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Affiliation(s)
- J S Joo
- Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale, USA
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Abstract
The case is described of a 29-year-old man with renal failure and recurrent hyperparathyroidism who 3 weeks postparathyroidectomy developed hypocalcemic tetany because he was taking one-half the prescribed dose of calcitriol. He interpreted his symptoms as those of potassium intoxication and self-administered almost 1,500 mEq sodium bicarbonate. The increase in plasma sodium and osmolarity led to increased fluid intake, and at presentation he had an ionized calcium of 0.50 mmol/L, K 5.3 mmol/L, Na 148 mmol/L, total CO2 52.6 mmol/L, pO2 51.2 mm Hg, and pH of 7.61. He had gained 7 kg in weight. All abnormalities were corrected by dialysis, using initially a calcium-free dialyzate with extra calcium infused. The case illustrates the effect of alkalosis in reducing the amount of calcium that exists in ionized form, and it is suggested that complexing of calcium as calcium bicarbonate together with the pH change contributed to the decrease in ionized calcium. It is also an example of the hazards of treating patients who devise their own therapeutic regimens.
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Affiliation(s)
- M Kaye
- Division of Nephrology, Montreal General Hospital, Quebec, Canada
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Abstract
It has often been noted that with repeated exposure to random-dot stereograms the time required to perceived depth decreases. Further, with extensive practice, stereoacuity thresholds have been shown to decrease. For both types of learning some researchers have reported specificity of the improvements to retinal location, and have thus suggested that the learning may be localised at early levels of visual processing, such as in primary visual cortex. However, these studies have not adequately ruled out the possibility that the specificity shown may be due to the operation of selective-spatial-attention mechanisms. In the present study this possibility was examined by training observers to judge the relative depth of a pair of stereograms presented equally often in two spatial locations, but stimuli were only presented with one direction of disparity (ie crossed or uncrossed) in any one location. Results indicated that, as expected, observers' judgements improved with practice. However, this improvement transferred completely to stimuli presented with the other direction of disparity in each location. Thus, it is argued that previous findings of retinal-location-specific improvements in stereoacuity may well be due to selective-spatial-attention mechanisms, rather than to learning localised at an early level of visual processing.
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Affiliation(s)
- P Sowden
- Department of Psychology, University of Surrey, Guildford, UK
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Affiliation(s)
- C J Ryan
- Department of Psychiatry, Westmead Hospital, Sydney, NSW, Australia
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Kaye M. Hypocalcemia after an acute phosphate load is secondary to reduced calcium efflux from bone: studies in patients with minimal renal function and varying parathyroid activity. J Am Soc Nephrol 1995; 6:273-80. [PMID: 7579096 DOI: 10.1681/asn.v62273] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Seven patients with severe hyperparathyroidism secondary to chronic renal failure, six patients with hypoparathyroidism after remote total parathyroidectomy also with chronic renal failure, and a miscellaneous group of three patients, some of whom were in the previous two groups, were studied on 24 occasions over a 6-h period. Each test consisted of a 2-h control period followed by a 4-h phosphate (Pi) infusion period. Radioactive calcium, 45Ca, had been administered the evening before. Samples were taken every 15 min throughout the 6-h study. In all tests, ionized and total calcium fell as Pi rose. Intact parathyroid hormone levels (PTH) rose, except in the hypoparathyroid patients, in whom there was no change. The decline in 45Ca activity was not affected by the Pi infusion, the fall being -0.131 +/- 0.057 cpm/min during the control period and -0.124 +/- 0.043 during the Pi infusion. There were no changes in pH, bicarbonate, electrolytes, or vitamin D metabolites during the procedure. The mean overall fall in total calcium was -0.118 mmol/mmol rise in Pi. For ionized calcium, it was -0.067 mmol/mmol Pi or 56.8% of the total calcium. This ratio was unchanged throughout the test period. With a steady flux of calcium from extracellular fluid (ECF) to bone as measured by 45Ca, the fall in ECF calcium has to be due to a decreased flux from bone to ECF. This could be produced by the reduced dissolution of a labile pool of a calcium salt such as brushite, CaHPO4.
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Affiliation(s)
- M Kaye
- Division of Nephrology, Montreal General Hospital, Quebec, Canada
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38
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Abstract
Five strains of inbred mice were found to have variations in bone mass although they were similar in body weight. Two of these strains, C57BL/6J and A/J, were studied in greater detail and the former had more bone in both femur and tibia. The increased bone mass was associated with larger quadriceps muscles in the C57BL/6J animals when measured at 18 weeks of age. Activities of animals from these two strains were studied over 24 h periods using a cage with an ultrasonic movement detector and automatic counter. The C57BL/6J animals were more active than the A/J mice. The male C57BL/6J mice tended to have larger testicles and higher testosterone levels than the A/J animals, whereas the female A/J animals had larger ovaries and higher oestradiol levels. As both male and female C57BL/6J animals were more active, it was concluded that the sex hormone differences between the two strains was not responsible for either the changes in bone mass or physical activity. These findings indicate that in the mouse, activity is in part genetically determined. We have hypothesized that this, in turn, could affect muscle mass and secondarily, bone size and strength. If these results can be applied to humans, it would suggest that differences at birth between individuals are important for bone mass in later life and that muscle mass and activity are in part genetically influenced. If this was the case, then muscle mass and strength could be a factor in bone mass and one of the goals in prevention and treatment of osteoporosis should be directed toward preservation and/or augmentation of muscle strength.
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Affiliation(s)
- M Kaye
- Division of Nephrology and Geriatric Medicine, Montreal General Hospital, Canada
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39
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Kaye M. Dialysate calcium loss using a calcium free dialysate. Int J Artif Organs 1994; 17:365-72. [PMID: 7806422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Using a dialysate that contained no calcium, we studied the amount of calcium lost and the clearances of urea, creatinine, phosphate and calcium in fifteen different dialyzers at blood flow/min (QB) of 200 and 300. Five of these dialyzers, covering the functional range of the fifteen, were also tested at QB of 100, 150 and 400. The collection period was divided into the first twenty minutes and the remaining 220 minutes. Clearance was calculated using the initial twenty minutes and for all dialyzers the creatinine, phosphate and calcium clearances were linearly related to the measured urea clearance, r = 0.946, 0.810 and 0.808 respectively. Calcium recovered in the dialysate varied, depending on the dialyzer and QB, however the amount found plateaued at QB 200 and did not increase further, unlike creatinine, phosphate and urea. Total dialysate calcium loss for a four-hour dialysis averaged 49.9 mmol (range 42.2-63) or almost 2g of elemental calcium for QB of 200 ml/min and 48.9 mmol (range 31.1-65.5) or 1.95 g of elemental calcium for a QB of 300 ml/min. Decreasing the calcium infusion replacement rate did not decrease the calcium dialysate loss in equal amounts as the blood to dialysate gradient falls leading to a smaller than expected dialysate loss. Measured urea clearance in these fifteen dialyzers was approximately 20% less than specified by the manufacturer and almost 30% less for creatinine and phosphate. This difference is probably due to in vivo measurements with blood whereas most of the specifications are obtained using saline in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Kaye
- Division of Nephrology, Montreal General Hospital, Canada
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40
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Bonnardeaux A, Somerville P, Kaye M. A study on the reliability of dipstick urinalysis. Clin Nephrol 1994; 41:167-72. [PMID: 8187361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The objective of this study is to determine the reliability of the Ames automated method as a screening procedure for the detection of red blood cells and leukocytes. 5486 urines were analyzed by an automated dipstick technique. 3127 urines were completely negative on the stick and 2359 showed a positive finding. All 2359 dipstick positive urines and 456 of the 3127 dipstick negative urines (total of 2815) were read blindly by one of two nephrologists working on different days, 1743 by M. K. and 1072 by P. S. Red cells, leukocytes and casts were enumerated per high power field and compared to the dipstick findings. Urines that were negative by dipstick for protein, blood leukocytes, nitrites, glucose and ketones were generally negative on microscopic examination, with only 5.3% having any abnormality. Urines positive for one or more of these findings correlated poorly with the microscopic findings due to the number of false positive and false negative dipsticks for red cells and leukocytes. Sensitivities were 75.3% and 81.0% and specificities were 88.6% and 64.3%, for red cell and leukocytes, respectively. Increasing the dipstick cutoff point improved sensitivity but lowered specificity. Urines positive for glucose and ketones had lower sensitivities for the detection of leukocytes, but not urines positive for protein. Microscopic examination should be done on dipstick abnormal urines. This may not be necessary for negative urines unless specifically indicated for clinical reasons. Urines positive for ketones or glucose should be screened systematically since they give a larger proportion of false negatives for leukocytes.
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Affiliation(s)
- A Bonnardeaux
- Division of Nephrology, Montreal General Hospital, Quebec, Canada
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41
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Kaye M. Long-term studies using a calcium-free dialysate. Clin Nephrol 1993; 40:221-4. [PMID: 8261679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
In this prospective controlled study the purpose was to assess the long-term safety of calcium-free dialysate (O Ca) for hemodialysis and to determine the optimum calcium replacement. With this technique there is no calcium in the dialysate and calcium is infused into the drip chamber distal to the dialyzer. We compared the use of a standard bicarbonate dialysate with a calcium free dialysate in two groups of patients. One group (study 1) received 10 mmol/hour Ca replacement, the other (study 2) received 13.3 mmol/hour Ca during dialysis. Each O Ca period lasted six months. This experimental period was compared with the six months preceding and following in the same patient and as well, with a concurrent control group who received standard bicarbonate dialysis either with 1.5 mmol/l calcium in the dialysate in study 1 or 1.75 mmol/l in study 2. Each group had nine to eleven subjects. No adverse effects were seen in either of the studies. With 10 mmol/hour calcium replacement there was a small but not significant rise in the pre-dialysis intact parathyroid hormone level (PTH) whereas in all the other groups it remained the same or fell. There was significantly less rise in the post-dialysis calcium in the same group and this was associated with a small but not significant fall in both pre-dialysis total and ionized calcium. It was concluded that the O Ca technique can be used for long periods and that 13.3 mmol/hour is a satisfactory replacement using Discap 140 dialyzers or their equivalent.
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Affiliation(s)
- M Kaye
- Division of Nephrology, Montreal General Hospital, Quebec, Canada
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Kaye M. Parathyroidectomy: whom, when, how? Int J Artif Organs 1993; 16:285. [PMID: 8354588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Kaye M, Rosenthall L, Hill RO, Tabah RJ. Long-term outcome following total parathyroidectomy in patients with end-stage renal disease. Clin Nephrol 1993; 39:192-7. [PMID: 8491048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Long-term follow up (mean 3.8 years), following elective total parathyroidectomy in thirteen patients with end-stage renal disease is described. Nine patients are alive and all except two have measurable levels of intact parathyroid hormone (PTH). One patient is mildly hyperparathyroid with PTH levels of 143 pg/ml (normal 10-65 pg/ml). All patients did well as far as their bone and mineral metabolism were concerned and there were no fractures, bone pain or metastatic soft tissue calcification. Lumbar spine bone mineral density (BMD) increased above the baseline value and femoral neck bone density was significantly greater than a matched control group of non-parathyroidectomized dialysis patients (1.097 +/- 0.140 versus 0.811 +/- 0.148 g/cm2, Z-score 1.98 +/- 1.64 versus -0.79 +/- 1.07, p < 0.001). Two of the nine patients have been transplanted, both have good allograft function and show increases in BMD. We believe that these findings justify the complete removal of all parathyroid tissue for selected patients with chronic renal failure where medical therapy has failed and aluminium bone disease has been excluded. They also raise the possibility that PTH is necessary for bone loss to occur.
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Affiliation(s)
- M Kaye
- Division of Nephrology, Montreal General Hospital, Canada
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Shennib H, Novick R, Mulder D, Menkis A, Morin JF, McKenzie N, Kaye M, Noirclerc M. Is lung retransplantation indicated? Report on four patients. Eur Respir J 1993; 6:354-7. [PMID: 8472825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
As more lung transplantations are performed, many patients will suffer graft failure and will be considered for retransplantation. This article reviews the case management reports of four patients who received lung or heart/lung retransplantation, with overall disappointing results. The pros and cons of lung retransplantation are discussed.
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Affiliation(s)
- H Shennib
- Joint Marseille-Montreal Lung Transplant Program, Marseille, France
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45
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Shennib H, Novick R, Mulder D, Menkis A, Morin JF, McKenzie N, Kaye M, Noirclerc M. Is lung retransplantation indicated? Report on four patients. Eur Respir J 1993. [DOI: 10.1183/09031936.93.06030354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As more lung transplantations are performed, many patients will suffer graft failure and will be considered for retransplantation. This article reviews the case management reports of four patients who received lung or heart/lung retransplantation, with overall disappointing results. The pros and cons of lung retransplantation are discussed.
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46
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Hadjis T, Grieff M, Lockhat D, Kaye M. Calcium metabolism in acute renal failure due to rhabdomyolysis. Clin Nephrol 1993; 39:22-7. [PMID: 8428403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
We report a patient with drug and hyperthermia induced rhabdomyolysis who developed acute renal failure. During the oliguric phase of 22 days, there was profound hypocalcemia (lowest ionized calcium of 0.34 mmol/l), associated with appropriately elevated intact PTH levels and high normal 1,25(OH)2D levels. Massive calcification in necrotic muscle occurred during this time. In the recovery phase, hypercalcemia was present lasting 33 days (maximum ionized calcium of 1.99 mmol/L), associated with suppression of PTH secretion, low 1,25(OH)2D3 levels, decreased bone resorption and mobilization of the muscle calcium deposits. This case report illustrates that the changes in serum calcium in rhabdomyolysis-associated acute renal failure are explicable by the deposition or removal of mineral into or from necrotic muscle with the parathyroid and vitamin D changes occurring secondarily.
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Affiliation(s)
- T Hadjis
- Medical Intensive Care Unit, Montreal General Hospital, McGill University, Quebec, Canada
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47
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Affiliation(s)
- M Kaye
- Division of Nephrology, Montreal General Hospital, Canada
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48
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Kaye M, Prichard SS. Assessing new technology. CMAJ 1991; 144:632, 637. [PMID: 1998913 PMCID: PMC1453033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Kaye M, Vasilevsky M, Barber E. Correction of hypophosphatemia in patients on hemodialysis using a calcium-free dialysate with added phosphate. Clin Nephrol 1991; 35:130-3. [PMID: 2032398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Three patients on long term hemodialysis were found to be hypophosphatemic. They were treated using a calcium-free dialysate to which phosphate was added to give a final concentration of 1 or 2 mmol/l. All corrected their low phosphates. Hypocalcemia developed in two patients when the calcium infusion rate was 15 ml/hour of 10% CaCl2. It is recommended that this should be increased to 20 ml/hour. Under these circumstances, correction of hypophosphatemia is possible with the transfer of approximately 30-35 mmol phosphate over a four-hour dialysis.
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Affiliation(s)
- M Kaye
- Division of Nephrology, Montreal General Hospital, Quebec, Canada
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50
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Kaye M. Parathyroid carcinoma in renal failure. Nephrol Dial Transplant 1991; 6:150. [PMID: 1857530 DOI: 10.1093/ndt/6.2.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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