Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022672 (acute tubular necrosis)
 2,175 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of 1197 renal transplant recipients on the Oxford Transplant Programme, 25 (2%) needed arthroplasties for painful osteonecrosis of the hip. Nine of them had bilateral operations, giving a total of 34 primary total hip replacements (THR). The mean time from onset of symptoms to THR was 2.4 years and from transplantation to THR 5.1 years. The mean follow-up was 5.1 (1 to 14) years. THR relieved the pain in all the patients, but survival analysis indicated a lower survival rate than is usual for primary THR. There were eight major complications. One graft-related problem, early acute tubular necrosis, resolved rapidly after immediate treatment. One patient developed deep infection at 3.5 years after THR which settled with conservative treatment. Five hips developed aseptic loosening requiring revision arthroplasty at a mean of 8.8 years' follow-up. One patient had a non-fatal pulmonary embolism. THR is the treatment of choice for patients with painful osteonecrosis of the hip after renal transplant, but has higher rates of both early and late complications. Surgery should be performed in close association with a renal transplant unit.
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PMID:Total hip replacement in renal transplant patients. 770 52

A statistical analysis was made of 2,000 consecutive cases in which prostatic operations were done in the period 1947-1957 at the Southern Pacific General Hospital. The operations included transurethral resections as well as perineal, retropubic and suprapubic prostatectomy. The mortality rates were lowest for transurethral resection and highest for retropubic prostatectomy. Coronary artery disease and pulmonary embolism were the chief causes of death. It was generally felt that preliminary partial vasectomy previous to transurethral resection added very little to successful convalescence. Although distilled water was used routinely for irrigation during transurethral resection, there was no incidence of lower nephron nephrosis. The incidence of recurrence of prostatic obstruction was highest by far after transurethral resection.
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PMID:Prostatectomy: a survey of 2,000 cases. 1383 45

Percutaneous mechanical thrombectomy (PMT) has been gaining acceptance as a preferred approach for the treatment of acute deep venous thrombosis (DVT). In addition to treating acute DVT and decreasing the risk of pulmonary embolism, it has been reported that direct extraction of the thrombus decreases the risk of post-thrombotic syndrome (PTS), the economic impact of managing which is reported to account for 75% of the total cost of management of DVT patients. PMT combines localized thrombolysis with mechanical thrombectomy. Recently, there have been some reports of reversible acute kidney injury (AKI) occurring post-PMT. The pathophysiology of AKI in such cases is due to hemoglobinuria-associated acute tubular necrosis. Therefore, the overall prognosis of AKI post-PMT has been reported to be good. We report here a case of AKI post-PMT for an extensive DVT of the lower extremity whereby the patient continues to require HD even 5 months after the procedure. The patient had normal renal function prior to the procedure and evidence of hemoglobinuria at the time of diagnosis of AKI. Our case illustrates that patients with a large thrombus load may develop severe AKI post-PMT thus requiring hemodialysis for an extended period of time. Limiting the length of time that the mechanical thrombectomy is performed and quantifying the amount of effluent obtained would appear to be a prudent practice to reduce the risks of renal failure. However, no specific guidelines exist as for the limits of hemolysed exudates to be collected.
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PMID:Prolonged renal failure post-percutaneous mechanical thrombectomy. 2594 90