Peritonitis due to Brevibacterium otitidis in a patient undergoing continuous ambulatory peritoneal dialysis.

Brevibacterium otitidis is a coryneform rod and, as far as is known, is isolated only from infected ears. We report the first known case of peritonitis caused by B. otitidis in a patient undergoing continuous ambulatory peritoneal dialysis.

Three cases of opportunistic infection caused by propionic acid producing Corynebacterium minutissimum.

Propionic acid producing strains of Corynebacterium minutissimum were isolated from three patients with opportunistic infections. One neutropenic patient was undergoing chemotherapy for prolymphocytic leukemia; the other two patients were undergoing hemodialysis and peritoneal dialysis respectively. An unusual feature of these three strains was their resistance to several antibiotics, which is seldom seen in diphtheroids other than Corynebacterium jeikeium and CDC group D2.

Site of action of torasemide in man.

The effect of torasemide, a new orally and parenterally active diuretic agent, on the renal mechanisms of dilution and concentration was studied in 6 healthy volunteers. The experimental conditions included water and osmotic diuresis. Torasemide caused maximal chloruresis and natriuresis during the 20-40 min after administration. The effect was more pronounced under osmotic diuresis and persisted throughout the 100 min of those experiments. A distinct effect both on free water clearance (CLH2O) during water diuresis and tubular reabsorption of solute free water (TcH2O) during osmotic diuresis strongly suggests that the major site of action of torasemide is the ascending limb of the loop of Henle. Comparison with furosemide under osmotic diuresis indicates longer abolition of TcH2O/GFR by torasemide in keeping with the fact that its half-life is 2- to 3-times longer than that of furosemide.

[Kidney transplantation in a case of amyloidosis]. / Transplantation rénale en cas d'amylose.

Renal transplantation was performed in five patients with various forms of amyloidosis (familial amyloidosis, Mediterranean fever and Crohn's disease). All grafts were functioning one year after the operation. Only one patient died of cardiac shock more than 10 years after transplantation; the other recipients are alive with a functioning graft from 12 to 67 (mean, 41) months after transplantation. No early severe infection was observed in any patient. Graft biopsy obtained in three patients disclosed amyloid deposits in only one: deposits initially (72 months post-transplantation) mild and perivascular, became more prominent in the vessels and extended into the mesangium 4 1/2 years later. Extrarenal amyloid involvement observed in four cases did not lead to serious clinical consequences during the follow-up period. Renal transplantation thus provides an effective treatment of terminal renal failure due to amyloidosis whatever its cause.

Late urinary tract infection after transplantation: prevalence, predisposition and morbidity.

We have evaluated the incidence, prevalence, predisposing factors and evolution of urinary tract infection (UTI) developing late after transplantation in 63 patients whose graft had lasted at least 3 months and whose follow-up averaged 7 years. Beyond 3 months after transplantation incidence of UTI decreases progressively, from 25 to 0%, 50% of the patients remaining free of infection throughout the period of observation. Neither the original kidney disease except perhaps diabetic nephropathy nor the presence of vesicoureteral reflux were predisposing factors. Incidence and prevalence in females were twice that in male. Late UTI did not affect graft or patient survival, or graft function at 5 years. Most UTI were asymptomatic and had a benign course. However, in 3 patients septicemia or graft dysfunction ensued demonstrating the need for continuous monitoring of urine cultures.

[Familial paroxysmal polyserositis: modern therapeutic possibilities (author's transl)]. / L'insuffisance rénale de la maladie périodique peut-elle bénéficier de méthodes thérapeutiques modernes?

Prognosis of familial paroxysmal polyserositis is primarily related to the presence of renal insufficiency due to the amyloidosis. Current treatment of terminal renal failure--haemodialysis and renal transplantation--has increased survival in these patients, but prognosis remains relatively poor because of the extrarenal, mainly cardiac deposits which have had time to develop. Preventive treatment is therefore all that can be hoped for, and initial results of the use of colchicine in this amyloid affection, by Israelian authors, appear encouraging.