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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-eight goats with an artificial heart (AH) were studied pathologically. Being continued from the previous report, the liver, gastrointestinal tract, and kidneys were taken up in this paper and finally, general discussion was done to get our ideas in shape concerning the pathophysiological status of the goat. Central necrosis of the liver was always observed in the goats which survived for over 140 hours. This finding seemed to be caused mainly by circulatory insufficiency of the portal vein at the latter half of the survival time. Microscopic findings of degeneration, necrosis, and edema were commonly observed at the walls of gastrointestinal tracts, when goats showed poor apetite, mucous feces and constipation. But these problems have been improved by application of a new control method to regulate the output of AH system within a goat's physiological range since October 1974. The lesions seen in the kidneys are classified into 5 groups. The most important findings of them are lower nephron nephrosis and cortical necrosis, both of which indicate the occurrence of long standing vasoconstriction of proximal renal arteries. By means of microangiographic method and others, thrombi were detected frequently in the kidneys. The vascular walls, where thrombi were attached to, were often damaged. Therefore, these thrombi were thought to be formed in the local vessels in situ through renal circulatory insufficiency. The renal pathological lesions have been also improved and severe renal failure from which the previous goats could not escape, has been lessened since the application of a new AH control method. As a whole, the main pathophysiological status of the animals replaced by the AH are thought conclusively to be peripheral circulatory insufficiency. This would be caused by abnormal hemodynamics, so that, the essential clinical etiology is thought to be AH function itself.
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PMID:Pathological studies of the animals replaced totally with the artificial heart. Part II Concerning liver, gastrointestinal tract, kidney, and general discussion. 94 12

Two cases of spontaneous perforation of the colon in hemodialysed patients have thus far been published. Our observation of 5 new cases seems to indicate that this complication is more frequent in hemodialysed patients than in patients without renal failure (27 cases in the literature). An abnormal tissue fragility and very hard fecal masses appear to be responsible for this dangerous complication. The association of aluminium hydroxyde and substances with antiperistaltic effect should be avoided, and constipation must be alleviated.
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PMID:[Spontaneous perforation of the colon in patients in hemodialysis]. 101 98

Many studies have confirmed that the treatment of mild and moderate hypertension reduces mortality and morbidity from cardiovascular accidents and cardiac and renal failure; more recent studies suggest that there is some beneficial effect on ischemic heart disease. The harmful metabolic effects of some hypotensive agents on serum potassium, magnesium, uric acid, glucose, renin and lipids might reduce the beneficial effect of controlling raised blood pressure. Also, the adverse effects associated with most antihypertensive drugs have decreased quality of life and, possibly, compliance in many patients. In assessing the value of newer antihypertensive agents, other effects of the drugs must be taken into account. The calcium-channel antagonist verapamil produces a dose-dependent reduction in blood pressure with little postural effect. There is little change in heart rate and the major antihypertensive effect results from a decrease in peripheral vascular resistance, with no accompanying increase in cardiac output. In 75 patients followed for more than 1 year, tolerance to verapamil did not appear to develop, nor were there any significant changes in serum electrolytes or creatinine clearance. Fasting serum lipid levels were measured in 15 patients before and after 3 months of treatment with verapamil (80 to 160 mg, 3 times a day); there was no change in cholesterol, triglycerides or high-density lipoproteins. Verapamil is, therefore, an effective hypotensive agent with a rapid onset of action. Tolerance does not develop with prolonged use, nor does it appear to affect electrolytes or serum lipids adversely. Constipation appears to be its only limiting adverse effect.
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PMID:Long-term results with verapamil in essential hypertension and its influence on serum lipids. 351 14

Ofloxacin, a new fluoroquinolone, was given to fifty patients (29 females and 21 males) aged 25 to 86 years with urinary tract infection or prostatitis. Urinary tract infections usually chronic and associated with urologic anomalies, included 17 cases of cystitis and 19 cases of pyelonephritis. 14 patients had prostatitis. Pathogens recovered from the urine were 26 E. coli, 2 Citrobacter, 4 Proteus mirabilis, 2 Klebsiella, 2 Enterobacter, 3 Serratia, 3 Staphylococcus aureus and 11 Pseudomonas. Minimal inhibitory concentrations of ofloxacin ranged from 0.03 to 0.12 microgram/ml (mean MIC: 0.6 microgram/ml) for 27 nalidixic acid-sensitive strains, and from 0.25 to 4 micrograms/ml (mean MIC: 1 microgram/ml) for 26 nalidixic acid-resistant strains. Ofloxacin was given as single drug therapy in all patients, in a daily dosage of 200 mg b.i.d. in 46 patients and 400 mg b.i.d. in 4 patients, for 7 to 97 days (average 40 days). Follow-up after discontinuation of treatment was 3 to 12 months. Therapeutic results were as follows: 17 cures for the 17 cystitis patients, 17 cures and 2 failures by relapse for the 19 cases of pyelonephritis, and 11 cures, 1 failure by persistence of bacteriuria and failure by relapse for the 14 cases of prostatitis. Digestive disorders, i.e. nausea, abdominal pain, constipation, occurred in 6 patients and required withdrawal of the drug in 1; candidiasis of the tongue was recorded in one patient and digestive complaints with neuropsychic disorders in another. Two patients had short-lived, moderate leukopenia with granulopenia and one had transient worsening of preexisting renal failure. Hepatic tolerance was good.
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PMID:[Ofloxacin (RU 43280): clinical evaluation in urinary and prostatic infections]. 353 29

In a 26-year-old patient admitted to the emergency ward with acute abdomen, all the symptoms--nausea, vomiting, indeterminate abdominal pain, constipation, renal failure, polyuria and polydipsia--could be explained by calcium intoxication syndrome. Investigation revealed generalized sarcoidosis. Under medical treatment with prednisone all the pathologic findings rapidly regressed. The pathogenesis of hypercalcemia in sarcoidosis, and particularly the disorder of vitamin D metabolism with raised levels of 1,25-dihydroxycholecalciferol, are discussed.
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PMID:[Acute hypercalcemia syndrome in sarcoidosis]. 384 Sep 13

Necrosis of the cecum occurs in various settings, including low-flow states. Cecal necrosis in two dialysis patients with documented, sustained hypotension is presented. Spontaneous left colon perforations, which have been previously reported in renal failure patients, were considered secondary to distention from constipation. The cecum may be more susceptible to ischemia than the remainder of the colon. Maximal distention develops at this point. With an associated low-flow state, in a possible watershed area, necrosis can occur. The diagnosis of cecal necrosis and perforation should be entertained in any dialysis patient with an acute abdomen. Early exploration may be necessary.
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PMID:Cecal necrosis in the dialysis-dependent patient. 406 55

Spontaneous perforation of the colon by a barium stereoraceous fecaloma occurred two weeks after an upper gastrointestinal x-ray without intervening constipation or symptoms of intestinal obstruction. This patient is chronically uremic as have been a high percentage of the few previously reported similar cases. Renal failure and the associated factors in the management of uremia such as antacids, barium examinations, inactivity, changes in diet and finally abnormalities of the colonic mucosa due to uremia may all predispose these patients to an increased risk for this unusual serious complication.
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PMID:Spontaneous perforation of the colon in a hemodialysis patient. 744 20

Older patients and their physicians are likely to choose surgery, when indicated, despite old age. To facilitate recovery, functional assessment provides data to plan immediate and long-term needs. Functional assessment includes physical, social, and environmental data. It also helps define "normal" functioning after surgery. Cognitive assessment is especially important and can be obtained during the initial interview of the patient. Cognitive assessment tools may be indicated if data are unclear. Postoperative complications occur in all body systems and include: MI, CHF dysrhythmias, pneumonia, atelectasis, hyponatremia, renal failure, confusion, deconditioning, skin tears, incontinence, and constipation. Referral may be needed before dismissal for significant changes in functional ability.
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PMID:Nursing management of the elderly surgical patient. 753 83

Total Sacral Agenesis (TSA) is a rare congenital anomaly of the lower vertebral column, frequently associated with bladder dysfunction. The diagnosis is often delayed until the evidence of neurological disorders addresses at neuro-radiological examination. In the last 9 years we observed 7 children, 3 males and 4 females, with TSA. The average age at diagnosis was 8 years (range: 1-15 years). Maternal diabetes was present only in one case. In 5 patients, urological ones have been the symptoms of presentation. In one case, TSA has been discovered because of the presence of a sacral mass (lipoma) and the subsequent development of club-foot. The neurological screening, performed in all patients with anorectal anomalies, led to the diagnosis of total sacral agenesis in a child with anteriorized anus. All patients have been evaluated by means of Magnetic Resonance Imaging, renal ultrasound, voiding cystography, renal nuclear scan and urodynamics. The functional evaluation of the lower urinary tract has shown a pattern of neurogenic bladder dysfunction in all children, while bilateral vesico-ureteral reflux has been detected in 2 cases. Intermittent clean catheterization (ICC) has been instituted at the diagnosis in all children. Surgery for continence and protection of upper urinary tract (bladder augmentation and bilateral ureteral reimplantation) has been performed in one patient. At a medium follow-up of 3 years (range: 1-5 years) 2 patients have been lost, normal renal function and urinary continence have been achieved in 4 and one child is continent but has renal failure. An early diagnosis and a correct neuro-urological evaluation and treatment are necessary to prevent urinary tract damage and achieve urinary continence in these patients. Symptoms, clinical findings and relationship with maternal diabetes are discussed. The diagnosis can be enough early if physicians pay attention to maternal diabetes, subtle neurological symptoms (voiding disturbance, constipation, club-foot) and careful physical examination of the back.
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PMID:[Total agenesis of the sacrum and neurogenic bladder dysfunction]. 931 45

End-stage renal disease (ESRD) is the stage of renal failure at which an individual requires dialysis therapy or a renal transplant to survive. The prevalence of ESRD is disproportionately higher among patients aged > 65 years, and the average age of new ESRD patients is continually rising in the US Medicare population. Medication management in this population is challenging because of the combination of multiple comorbid disease states, a plethora of medications and the added dimension of dialysis therapy, as well as pharmacokinetic and pharmacodynamic changes attributable to the aging process. Cardiovascular disorders such as hypertension, coronary artery disease, congestive heart failure and arrhythmias are common in elderly patients with ESRD, and account for most of the deaths in this population. Constipation is common in patients aged > 65 years, and its incidence is even higher among those receiving dialysis. Pain management is of particular concern because elderly dialysis patients are frequently prescribed inappropriate pain relief regimens. Many healthcare practitioners do not realise that patients with uraemia are at a higher risk of bleeding caused by nonsteroidal anti-inflammatory drugs than are patients with normal renal function. In addition, most practitioners do not appreciate that virtually all opioids (narcotics) and their active metabolites accumulate in patients with renal failure, leading to an increased risk of narcosis. Infectious complications are frequent in the ESRD population, with dialysis access infections and pneumonia being the 2 most common infections seen in hospitalized patients receiving dialysis treatment. The establishment of vaccination programmes for the prevention of hepatitis B, influenza and pneumococcal infections is important because of the increased risk of these disease in this population. Unfortunately, these high-risk patients display, in general, a decreased immunogenic response to vaccinations. This article addresses some of the practical issues that surround the medication management or prevention of these particular diseases in elderly patients undergoing haemodialysis. Specifically, we discuss the pharmacokinetic and pharmacodynamic changes that occur with specific medications in such patients. Drug dialysability is also discussed.
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PMID:Drug therapy in haemodialysis patients. Special considerations in the elderly. 963 93


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