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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical symptoms and laboratory measures of renal and liver function, coagulation, and inflammatory parameters were prospectively studied in 74 hospitalized patients (14-74 years of age) with serologic evidence of nephropathia epidemica. The most common clinical findings were acute onset of symptoms, fever (greater than or equal to 38 degrees C), thirst, headache, nausea, back pain, vomiting, myalgia, and abdominal pain. Twenty-seven patients (37%) had hemorrhagic manifestations, i.e., epistaxis, melena, hematemesis, petechial bleeding, macroscopic hematuria, or metrorrhagia. Disseminated intravascular coagulation developed in four patients. Fifty-one percent had thrombocytopenia. Proteinuria was recorded for all patients, while hematuria and glucosuria were noted for 85% and 58%, respectively. Serum creatinine levels were elevated in 71 (96%) of the patients. Levels of C-reactive protein or erythrocyte sedimentation rates were elevated in all cases, usually to levels found in serious bacterial diseases. Sixty-six (89%) of the patients were followed for up to 7 months, at which time all had recovered clinically. No patient died or required dialysis. We conclude that nephropathia epidemica in Sweden has a clinical picture similar to that of hemorrhagic fevers in other parts of the world, but with a milder course and a better prognosis.
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PMID:Clinical characteristics of nephropathia epidemica in Sweden: prospective study of 74 cases. 257 3

From January to December 1983, 12,207 specimens of urine were examined for ova of Schistosoma haematobium and 753 (6.17%) were positive. From this group, 44 adult patients were investigated for urinary tract abnormalities. Haematuria was the commonest presenting symptom (81.8%) followed by lower abdominal pain (77.3%) and dysuria (68.2%). Urinalysis revealed proteinuria in 55.5%, leucocyturia in 90.9% and microhaematuria in 88.6% of patients. Twenty-four hour protein excretion ranged from 230 mg to 2.2 g (mean 960 mg). Serum creatinine was raised in one patient (2.2 mg dl-1), Urological abnormalities included calcification of the bladder in 36.4%, ureteric strictures and dilatations in 65.9%, hydronephrosis in 9.1%, squamous cell carcinoma of the bladder in 4.5%, vesicle calculus in 2.3%, and multiple granulomatas in the bladder in 2.3% of the patients. The results of the study suggest that a sizeable population of this area is at risk of developing urological complications and consequently chronic renal insufficiency.
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PMID:Urinary schistosomiasis in Maiduguri, north east Nigeria. 311 28

Of a total of 780 patients with abdominal aortic aneurysms, 37 patients (4.7%) had inflammatory aneurysms. Presenting symptoms included back and abdominal pain (76%), leg edema, melena, uremia, claudication and pancreatitis. Mean erythrocyte sedimentation rate was 45 mm/hr. Weight loss and anorexia were common. Elevated urea and creatinine were seen on 11 patients, nine of whom had obstructive uropathy. Average aneurysm size was 9.3 cm. Thirty-six patients were treated surgically and one was observed. Involvement of the suprarenal (nine cases) or thoracic (three cases) aorta was common. Elective operations included resection and grafting in 21 patients and axillofemoral bypass in four patients. Patients with ureteral entrapment underwent simultaneous ureterolysis. Among the elective operations four deaths were noted (15%). Ten emergency operations were done for posterior rupture (four cases), aortoduodenal fistula (one case), inferior vena cava obstruction or fistula (two cases), hemorrhage into the aneurysmal wall (two cases), or presumed rupture (one case). There were seven deaths (70%) in this group. The operation of choice for inflammatory aneurysm is a bifurcation graft combined with ureterolysis.
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PMID:Inflammatory abdominal aortic aneurysms: a report of thirty-seven cases. 322 67

Hepatic dysfunction is one of the frequent manifestations of multisystemic involvement in preeclampsia. This study was conducted to establish the impact of liver dysfunction on maternal and neonatal outcome in women with pregnancy-induced hypertension (PIH). The prevalence of liver dysfunction as determined by an elevated serum glutamic oxalacetic transaminase (SGOT) concentration was 21% in a population of 355 patients with PIH. Liver dysfunction was associated with the presence of severe hypertension, proteinuria, a lower platelet count, and renal compromise (elevated blood urea nitrogen, creatinine, and uric acid serum concentrations). Abdominal pain was also associated with an SGOT elevation. Liver dysfunction was associated with intrauterine growth retardation and prematurity. Furthermore, the association with these neonatal complications was independent from the severity of the hypertension and the presence of proteinuria. Thus, we conclude that liver dysfunction is a frequent complication of PIH and that it is an independent risk factor for maternal and perinatal complications.
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PMID:Clinical significance of liver dysfunction in pregnancy-induced hypertension. 334 61

During a two-year period, 30 patients with spontaneous bacterial peritonitis were documented. All patients had ascites and 70% were alcoholic cirrhosis. Fever and abdominal pain were the most frequent presenting manifestations (96.66% and 76.66% respectively). Triads of fever, abdominal pain and rebound tenderness were found in 40%. A third had hepatic encephalopathy and decreased bowel sound. Ascitic fluid was transudate. Positive ascitic fluid culture and blood culture were obtained in 40% and 59% respectively, and three quarters were due to gram negative enteric bacilli. There was no significant statistic correlation among the result of ascitic fluid gram's stain and ascitic fluid culture, and of ascitic fluid culture and blood culture. The clinical and laboratory findings of patients with positive and negative ascitic fluid culture were similar. Significant increased mortality was found in patients who had hepatic encephalopathy, hypotension, increased bilirubin level and serum creatinine. The over all mortality was 33.33%. We recommend abdominal paracentesis in every cirrhotic patients with ascites who were admitted into hospital.
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PMID:Spontaneous bacterial peritonitis in cirrhotics: clinical and ascitic fluid findings. 353 Jan 6

Primary lymphoma of the kidney is extremely rare; most lymphomatous renal masses represent extension from adjacent sites of disease or involvement by generalized disease (4,9,12). Three men and one woman, 45 to 71 years of age, presented with solitary renal masses clinically thought to be renal cell carcinoma. Each experienced abdominal pain, one with hematuria and one with "B" symptoms. Physical examination revealed no peripheral lymphadenopathy or hepatosplenomegaly. Lactic dehydrogenase (LDH) was elevated in three cases, and blood urea nitrogen (BUN) and creatinine were slightly increased in two. Two cases were diagnosed correctly from needle biopsy, with ultrastructural confirmation in one case and marker studies, DNA flow cytometry, and cytogenetics in the other. Because of a presumptive diagnosis of renal cell carcinoma, two patients underwent nephrectomy. Three cases were large-cell lymphoma, and one, small noncleaved cell lymphoma.
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PMID:Malignant lymphoma presenting as a renal mass: four cases. 355 31

Six horses had been admitted to the hospital because of illness other than renal failure; diarrhoea, myositis, abdominal pain and/or suspected bacterial sepsis. Hypotension and disseminated intravascular coagulopathy were frequent findings in the horses. Abnormally high serum creatinine concentration and urine specific gravity of less than 1.022 were found in the horses with acute renal failure. Hyponatraemia and hypochloraemia were the most common abnormal electrolyte findings. Pronounced hyperkalaemia was not found. Variable degrees of tubular necrosis were seen in three of the four horses that had kidney sections submitted for microscopic examination. Renal cortical necrosis occurred in one horse. Intravenous fluid and electrolyte replacement was the most important therapy in those cases that were non-oliguric. Furosemide, mannitol and dopamine were used in horses with oliguria. The prognosis was generally good if the predisposing cause could be corrected and the acute renal failure was not oliguric.
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PMID:Acute renal failure in six horses resulting from haemodynamic causes. 360 51

In a retrospective study of patients 18 years of age and younger over a 28-year period, 48 children had pancreatitis. Epigastric pain, nausea, and emesis were present in 90%. Hyperamylasemia was present in 34 children; elevated amylase/creatinine clearance ratio was helpful in diagnosing ten others. In four children, pancreatitis was diagnosed at laparotomy. Etiology of the pancreatitis was idiopathic in 16, drug-induced in 12, all of whom had received corticosteroids. Nine developed pancreatitis after blunt trauma; seven had obstruction of the pancreaticobiliary drainage system. Two children developed pancreatitis in association with sepsis, and two had recurrent hereditary pancreatitis. Thirty of the 48 patients were managed nonoperatively while operations were required in 18. Seven had drainage of pancreatic pseudocysts, four had a pancreatectomy, and four underwent laparotomy with debridement and drainage of necrotic pancreas. Bilioenteric bypass procedures were performed to prevent recurrent pancreatitis in three patients; while duodenojenjunostomy sphincteroplasty and cholecystectomy were performed in one child each. Cure was achieved in 38 of 48 children treated for pancreatitis and its complications; each subsequently grew and developed normally. Hemorrhagic pancreatitis occurred in seven children, six of whom died. Seven deaths occurred, all in the medically treated group. Fifteen of the 18 children treated operatively did well in long-term follow-up. Although rare, pancreatitis is a serious cause of abdominal pain in childhood; almost half of the children will benefit from operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical management of pancreatitis in childhood. 361 58

Pancreatic ultrasonography and the determination of serum amylase and amylase creatinine clearance ration were performed on 17 normal children and on 35 children with abdominal pain. In all 17 normal subjects the echodensity of the pancreas was equal to or greater than that of the liver. Nineteen patients with abdominal pain had reduced echodensity of the pancreas when compared to that in normal children, and two of the 19 had pseudocysts. Serum amylase values and/or amylase creatinine clearance ratio correlated poorly with ultrasonic and clinical evidence of pancreatitis.
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PMID:The ultrasonic and biochemical diagnosis of pancreatitis in children. 615 12

A 29-year-old woman admitted for alcohol detoxification five years after a 90% distal pancreatectomy for chronic pancreatitis had abdominal pain similar to that associated with preoperative pancreatitis. Although her clinical course was consistent with recurrent pancreatitis, the serum amylase level remained normal, but the amylase creatinine clearance ratio became elevated and then returned to normal, paralleling her clinical course. The ACCR may be a useful laboratory method in diagnosing chronic recurrent pancreatitis in patients with decreased functional pancreatic tissue.
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PMID:Elevated amylase creatinine clearance ratio and normal serum amylase levels in chronic relapsing pancreatitis after partial pancreatectomy. 616 Jun 21


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