scholarly journals Immunosuppressive Drugs and Kidney Post-transplant Diabetes Mellitus

2019 ◽  
Vol 4 (2) ◽  
pp. 50-56
Author(s):  
Ismael Bilal Ismael ◽  
Sarhang Hasan Azeez

Background: As the rate of renal transplantation increases, more immunosuppressive drugs such as cyclosporine A (CsA) are consumed, particularly during the early months following transplantation, leading to post-transplant diabetes mellitus (PTDM) which can cause death. Objective: The present study examined the role of CsA in causing PTDM and other effective factors among patients with chronic kidney disease (CKD) who had undergone renal replacement therapy. Methods: The present investigation was a quantitative case-control study carried out on 30 CKD patients who had undergone renal transplantation and 30 healthy individuals. A questionnaire was utilized to gather their demographic information, and direct interviews were conducted with the subjects. To examine random blood sugar (RBS), white blood cell (WBC) count, creatinine level, and blood urea nitrogen (BUN), blood samples were obtained from the subjects. The mentioned parameters were analyzed using SPSS 22.0. Results: According to the results, the groups were homogenous in age, body mass index (BMI), and male-to-female ratio. However, there were significant differences between the two groups in RBS (P=0.011), WBC count (P=0.031), creatinine level (P=0.001), and BUN (P=0.001). Conclusion: Failure of allograft survival of renal transplantation was found to be a leading cause of death, which has been reportedly been treated by the consumption of immunosuppressive drugs such as CsA. However, this drug can increase the patient’s chances of developing PTDM. PTDM development can be reduced by applying a dosage of 10 mg/kg/d during the first week and 8-9 mg/kg/day during weeks 2-5 following transplantation.

Nephron ◽  
2021 ◽  
pp. 1-13
Author(s):  
Ana Elena Rodríguez-Rodríguez ◽  
Esteban Porrini ◽  
Mads Hornum ◽  
Javier Donate-Correa ◽  
Raúl Morales-Febles ◽  
...  

Post-transplant diabetes mellitus (PTDM) is a frequent and relevant complication after renal transplantation: it affects 20–30% of renal transplant recipients and increases the risk for cardiovascular and infectious events. Thus, understanding pathogenesis of PTDM would help limiting its consequences. In this review, we analyse novel aspects of PTDM, based on studies of the last decade, such as the clinical evolution of PTDM, early and late, the reversibility rate, diagnostic criteria, risk factors, including pre-transplant metabolic syndrome and insulin resistance (IR) and the interaction between these factors and immunosuppressive medications. Also, we discuss novel pathogenic factors, in particular the role of β-cell function in an environment of IR and common pathways between pre-existing cell damage and tacrolimus-induced toxicity. The relevant role of prediabetes in the pathogenesis of PTDM and cardiovascular disease is also addressed. Finally, current evidence on PTDM treatment is discussed.


2021 ◽  
Vol 27 (4) ◽  
pp. 46
Author(s):  
Inès Legeard ◽  
Marc-Antoine Chevrollier ◽  
Gérard Bader

Introduction: Post-transplant lymphoproliferations (PTL) are a severe complication of solid organ transplants. Their locations can be extra-nodal. Observation: The diagnosis and management of a non-Hodgkin's plasmablastic lymphoma of mandibular localization affecting a 66-year-old kidney transplanted patient are reported here. Comment: The main risk factors for non-Hodgkin lymphoma are immunosuppression and infection with Epstein-Barr virus. Clinical and radiographic examinations, which are not specific, must be supplemented by a histological examination. Treatment which is not consensual will most often consist of a reduction in immunosuppression coupled with chemotherapy. Conclusion: Despite a constant evolution in the incidence and clinical picture of post-transplant lymphomas, the role of the dentist remains essential in the early detection of lesions.


2020 ◽  
Vol 8 (1) ◽  
pp. 93-99
Author(s):  
Balaji Varaprasad Mallula ◽  
Jithender Reddy Chintala ◽  
Srinadh Boppanna ◽  
S. Annapurna

Background: Stroke is the second single most common cause of death in the world causing approximately 6.7 million deaths each year. It has a greater disability impact on an individual than any other chronic disease. The aim of the study is to review the value of CTA in detection and evaluation of non-traumatic cervicocerebral vascular disease (stroke). Subjects & Methods: A prospective observational study conducted in the Department of Radiodiagnosis, Kamineni Hospitals, L.B. Nagar, Hyderabad over 60 patients during April 2016 to May 2017. Results: Out of 60 patients, 35(58.3%) patients had ischemic stroke, 25(41.6%) had hemorrhagic stroke. Overall stroke was seen mostly in the age group of 61-70 (28.3%) years, with a Male to female ratio of 3:2. Conclusion: Hypertension was the most common risk factor associated with this disease, followed by diabetes. CTA helps in accurate diagnosis, risk stratification and planning management protocols.


2008 ◽  
Vol 12 (6) ◽  
pp. 643-649 ◽  
Author(s):  
A. Prokai ◽  
A. Fekete ◽  
E. Kis ◽  
G. S. Reusz ◽  
P. Sallay ◽  
...  

Author(s):  
Srishti Sonwani ◽  
Sutakshee Sonwani

Background: Previous studies have reported the presence of diabetes ketoacidosis in patients of type 2 diabetes mellitus (T2DM). India reported that up to 30% of hospitalized DKA cases result in inpatient death. Aims and objectives of the study was to study the role of HbA1c and duration of diabetes in outcome of patients of diabetic ketoacidosis in type 2 diabetes mellitus.Methods: Hundred T2DM patients having DKA admitted in the Department of Medicine, Gandhi Medical College and Hamidia Hospital, Bhopal, were included. Data on demography (age, sex and diabetes duration, random blood sugar (RBS) and glycated hemoglobin (HbA1c) were recorded for each patients. Outcome was also recorded and compared with duration of diabetes and HbA1c level.Results: DKA was more common in age group of51-55 years (21%) with mean age of 56.10±10.40 years. Male preponderance was observed. Mean duration of diabetes, hemoglobin, random blood sugar (RBS) and HbA1c were 7.28±3.81 years, 9.8±1.42 gm%, 351.72±22.32 mg/dl, and 7.14±0.10 respectively. Mortality was higher among the patients with longer duration of diabetes (23.1%; p=0.012) and higher HbA1c (25%, p>0.05).Conclusions: Duration of diabetes play a significant role in deciding mortality in T2DM patients with DKA however HbA1c has no role in that.


2019 ◽  
Vol 6 (1) ◽  
pp. 71
Author(s):  
Kiran Grandhi ◽  
Jayasri Helen Gali ◽  
Kokiwar P. R.

Background: Tracheal strictures are known to recur after dilatation, so they need stenting to prevent recurrence. The objective was to study role of air way stenting (Duman- silica stent) in benign stricture trachea management.Methods: A hospital based prospective study was carried out among 15 cases (as these cases are very rare, author could study only 15 cases) presented with various clinical features suggestive of tracheal strictures. They were examined and managed by putting tracheal stent for up to eight months period. All cases were followed at regular intervals till 14months after the stent was placed. The outcome was studied.Results: The tracheal strictures have been found to be more in the age group of 25-30 years.  The male to female ratio was 4:1 i.e. for everyone female case there were four male cases. Thus, the tracheal strictures have been more common among the males compared to the females. All of the patients presented with severe stridor, breathing difficulty, and poor exercise tolerance. Most common cause of tracheal stricture was prolonged mechanical  ventilatory support >8 days due to organo phosphorus poisoning in past 3months and all of them were males.  All cases had good outcome at the end of 14months of follow up. All cases had normal findings. No one developed foreign body reaction, nor did no one develop granuloma formation at the stent site. After stent removal flexible bronchoscopy repeated after 3rd month and 6th month.Conclusions: Tracheal stenting is very useful procedure in the management of air way strictures.


2019 ◽  
Vol 22 (6) ◽  
pp. 59-68
Author(s):  
A. V. Arablinskiy ◽  
V. B. Rumer

Introduction.Acute abdomen is a complex condition that demands urgent diagnostics and treatment.The proposeof the study based on data we got in the Radiology Department of S.P. Botkin Municipal Clinical Hospital is to evaluate the role of computed tomography in acute abdomen diagnostics.Materials and methods. 637 acute abdomen patient`s data were retrospectively analyzed, provided in the term from January 2017 to January 2018. The average age was 53 years old, from 18 to 98 y.o. Male to female ratio was 1:1,51, male – 383, female – 254. Inclusion criteria was acute abdomen clinical presentation.Results.The most frequently seen conditions were ileus – 226 cases (35.5%), acute pancreatitis/pancreonecrosis – 185 cases (29%), ureteral occlusion with stones – 83 cases (13%), blunt abdominal trauma – 57 cases (9%), renal abscesses and inflammation diseases – 56 cases (9%). Liver abscesses – 13 cases (2%), mesenteric ischemia – 10 cases (1.5%), acute appendicitis – 4 (0,5%), aortic dissection – 2 cases (0,3%), hollow viscus perforation – 1 case (0.2%).Conclusion.CT with high accuracy and in a short time identify the reason of acute abdomen in all shown cases that highly improve the quality of medical management.


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