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

One possible route to cataract formation may be via the carbamoylation of lens proteins due to increased concentrations of cyanate in the body resulting from uraemia associated with renal failure and with severe diarrhoea. Carbamoylation of gamma-II-crystallin, which is found in the lens core, could alter the surface charge network of the molecules, resulting in aggregation, increased light-scattering and hence cataract. We have attempted to locate the site(s) of carbamoylation in gamma-II-crystallin. gamma-II-Crystallin was isolated by gel chromatography and ion-exchange chromatography. gamma-II-Crystallin was then carbamoylated by incubation with potassium [14C]cyanate, followed by citraconylation and digestion with trypsin to give peptides that were separated by high-resolution ion-exchange chromatography. The amino acid compositions of the radioactive peptides were compared with the expected peptide composition for gamma-II-crystallin. The radioactive peptide compositions, which agreed with the theoretical peptides, all matched with the N-terminal region of gamma-II-crystallin and had in common the presence of the N-terminal glycine residue. It appears that the alpha-amino group of the N-terminal glycine was the main site of carbamoylation. This site forms part of the charge network on the surface of gamma-II-crystallin.
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PMID:Site of carbamoylation of bovine gamma-II-crystallin by potassium [14C]cyanate. 259 Jan 75

In February and March 1989 a community-acquired outbreak of legionnaires' disease developed in Barcelona, involving at least 56 patients (48 males and 8 females) with a mean age of 60 years (range 22-87). 70% were smokers, 20% alcohol abusers, 50% had chronic bronchitis and 20% were immunologically depressed. The most common signs and symptoms were: fever (100%), features of lung condensation (77%), cough (51%), stupor (27%), diarrhea (18%), thoracic pain (18%, hyponatremia (53%), increased serum level of hepatic enzymes (44%) or CK (37%), and renal failure (21%). Radiological involvement was bilateral in 30% of cases. In most patients the diagnosis was made by seroconversion (70%). Late seroconversion (between 4 and 14 weeks) was seen in 20 patients, whose age was significantly higher than that of patients with early seroconversion (p less than 0.02). All cases were caused by Legionella pneumophila serogroup 1. Forty-six patients (81%) were admitted to the hospital and 10 (18%) required tracheal intubation. Although all received erythromycin, seven patients died. Hypoxemia, leukopenia, hyponatremia and renal failure were associated with a higher mortality rate. However, after multivariate analysis renal failure appeared as the only independent prognostic variable. Finally, it was concluded that in the community-acquired outbreaks of pneumonia Legionella pneumophila infection should be ruled out.
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PMID:[A community outbreak of Legionnaires' disease in Barcelona: clinical and microbiological study]. 262 51

A previous article (Part I) described the patient population and operative management of 666 patients who had surgery for nonruptured abdominal aortic aneurysms. This article details the perioperative complications and, by chi-square and logistic regression analysis, identifies the variables that are associated with each complication. In summarizing the results (below) the incidence of each complication is listed, along with the predictive risk factors in parentheses that have significance levels less than 0.05. Vascular morbidity data are as follows: intraoperative bleeding, 4.8%; postoperative bleeding requiring transfusion, 2.3% or repeat operation, 1.4% (large volume of blood transfusion and/or use of an autotransfusion device); intraoperative limb ischemia, 3.5%; graft thrombosis, 0.9% (femoropopliteal disease and/or distal anastomosis at the femoral level); distal thromboembolism, 3.3% (male sex, femoral popliteal disease, and/or intraoperative graft thrombosis); amputation, 1.2%; graft infection, 1 case. General morbidity data are as follows: cerebrovascular event, 0.6%; paraplegia, 1 case; cardiac event, 15.1% (age, previous episode of congestive heart failure, and/or electrocardiogram [ECG] evidence of a previous myocardial infarction); myocardial infarction, 5.2% (advancing age, angina, and/or prolonged aortic cross-clamp time); congestive heart failure, 8.9% (previous history of congestive heart failure, ECG evidence of ischemia, and/or chronic obstructive lung disease); arrhythmia requiring treatment, 10.5% (preoperative ventricular premature beats and/or respiratory failure requiring ventilation for more than 48 hours); new arrhythmia, 8.4% (angina and/or chronic obstructive lung disease); respiratory failure, 8.4% (chronic obstructive lung disease, large volume of blood transfused, and/or occurrence of postoperative bleeding, cerebrovascular accident, congestive heart failure, or myocardial infarction); renal damage with rise in creatinine or blood urea nitrogen, 5.4% and/or renal failure requiring dialysis, 0.6% (elevated preoperative creatinine, suprarenal aortic cross-clamping, and/or renal vein ligation); diarrhea without evidence of ischemia colitis, 7.1% and ischemic colitis, 0.6% (pelvic flow interrupted); prolonged ileus, 11.0% (aortoiliac occlusive disease, deterioration of renal function, prolonged ventilation, and/or preoperative history of angina); superficial wound infection, 1.5% and deep infection, 0.5% (femoral anastomosis and/or female sex); coagulopathy, 1.1% (large volume of blood transfused).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Multicenter prospective study of nonruptured abdominal aortic aneurysm. Part II. Variables predicting morbidity and mortality. 264 60

Hypokalemia and hyperkalemia are common problems that may be artifactual, iatrogenic, or due to altered body homeostatic mechanisms. ECG may help one to recognize hyperkalemia but not hypokalemia. Excessive K supplementation is a common iatrogenic cause of hyperkalemia whereas fluid therapy is a common cause of iatrogenic hypokalemia. The most common causes of spontaneous hyperkalemia are renal failure and hypoadrenocorticism whereas the most common causes of spontaneous hypokalemia are vomiting, diarrhea, and renal wasting. Symptomatic therapy is usually done until the underlying cause(s) is resolved.
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PMID:Disorders of potassium homeostasis. 264 65

Congenital chloride diarrhoea was diagnosed in 16 Kuwaiti children over a 7 year period (1980-1986) with an estimated incidence of 7.6 per 100,000 live births. The mean age at diagnosis was 3.2 months (range 1 week to 5 months). There were 9 boys and 7 girls with a mean age of 3 years 10 months (range 10 months to 7 years). All children had a shortened gestational period, abdominal distension and chronic diarrhoea. The serum electrolytes in all patients prior to treatment showed hyponatraemia, hypokalaemia, hypochloraemia and metabolic alkalosis. The diagnosis was confirmed by a stool chloride content that exceeded the sum of faecal sodium and potassium. Fifteen patients survived and showed catch-up growth with adequate replacement therapy and 1 died with renal failure.
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PMID:Congenital chloride diarrhoea in Kuwaiti children. 265 Nov 31

A 76-year-old woman with a chronic leg ulcer for the last thirty-seven years was hospitalized in our institution for chronic diarrhea and terminal kidney failure with proteinuria. The diagnosis of secondary amyloidosis due to persistent skin inflammation was confirmed by aspiration of subcutaneous abdominal fat and by kidney biopsy which showed AA type systemic amyloidosis. This appears to be a rare complication of chronic leg ulcers as there have been only eight publications covering eleven cases in the literature.
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PMID:[Leg ulcer complicated by secondary amyloidosis]. 267 48

A common complication of critically ill patients is cardiac tachyarrhythmia. The role played by magnesium is not well appreciated. Well-documented cases indicated that magnesium may be effective in controlling the rhythm when conventional methods fail. The following tachyarrhythmias respond favorably to magnesium: (1) intractable ventricular tachycardia and fibrillation, whether hypo- or normomagnesemic, (2) torsades de pointes, (3) digitalis-toxic ventricular tachyarrhythmia, (4) multifocal atrial tachycardia and (5) hypomagnesemic atrial tachyarrhythmia. It is recommended that 10-15 ml of 20% MgSO4 be infused over 1 min, followed by 500 ml of 2% MgSO4 over 5 h. A second 500 ml over 10 h may be necessary. Renal failure, disappearance of deep tendon reflex, rise in serum Mg above 5 mEq/l, drop in systolic blood pressure below 80 or drop in pulse below 60 contraindicate the continued use of magnesium. If serum potassium is at or falls below 4.0 mEq/l, 20-40 mEq/l KCl should be added. Magnesium deficiency can be confirmed by a low serum level or by a greater than 50% retention of administered magnesium. The causes of magnesium deficiency can be remembered under 10 DS: (1) Diarrhea and gastrointestinal losses, (2) Diuretics and renal losses, (3) Diabetes and endocrine causes, (4) Dietary lack, (5) Diverted to free fatty acids, (6) Drugs such as cisplatin, (7) Drinking alcohol to excess, (8) Delivery with toxemia, (9) Decompensated heart, lungs or liver and (10) Denuded skin, such as burns.
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PMID:Magnesium therapy of cardiac arrhythmias in critical-care medicine. 269 48

The institutionalized elderly are at risk for developing fluid volume depletion with progression to hypernatremia. This is particularly common in patients transferred to an acute care setting from a nursing home. A marked reduction in intracellular fluid and the increase in body fat associated with normal aging predispose the elderly to water loss with very little environmental prompting. Conditions contributing to the development of fluid volume deficit include febrile illness, utilization of enteral supplements, gastrointestinal bleeding, use of loop diuretics, renal failure, prolonged vomiting, diarrhea, diabetes, and disability induced fluid restriction. This can lead to apathy and confusion, which are often incorrectly attributed to dementia. The utilization of Roy's Adaptation Model to this problem focuses on the regulator subsystem and the physiologic mode.
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PMID:Managing hypernatremia in fluid deficient elderly. 274 41

A 24 year-old woman developed severe congestive heart failure due to combined aortic and mitral valve failures associated with infectious endocarditis. She was operated on double valve replacement. At the open heart surgery, 7 units of blood were transfused. Her postoperative course was complicated with LOS and renal failure. She recovered gradually with assistance of intraaortic balloon pumping and hemodialysis. High fever, diarrhea, skin rash and impaired liver function appeared on the 10th postoperative day. Neither leukocytopenia or pancytopenia was seen. In blood cultures, organism was negative and endotoxemia was also negated after operation. Erythroderma developed rapidly after desquamation of skin rash. The skin sample showed the typical features which were observed in a graft-versus-host (GVH) disease. The patient died of cerebral bleeding on the 32nd postoperative day. In the HLA typing, two unmatched antigens of class II were exhibited in her lymphocyte sample but all of class I were matched. Y-chromatin was not detected in her lymphocytes. Anti-nuclear antibody was positive. The fact is noteworthy that she and her parents were human T lymphotropic virus-I (HTLV-I) carriers. In the literature, HTLV-I is activated in the immunocompromised state and yields alien antigens of major histocompatibility complex (MHC) in T cells, then the reaction is very similar to it in autoimmune disease. That mechanism may be involved in the cause of GVH reaction in our case. These results suggested that the GVH reaction in our case.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Graft versus host disease in a human T cell leukemia virus-I carrier]. 276 33

Nearly every known antibiotic has been implicated as a cause of Clostridium difficile colitis. We report the first case resulting from monotherapy with intravenous vancomycin. The patient was on chronic hemodialysis and was treated with intravenous vancomycin for presumed cervical osteomyelitis. After 29 days of therapy he developed abdominal pain and diarrhea and his stool was found to contain both C. difficile and cytotoxin. The patient responded with symptomatic and microbiological recovery to withdrawal of the drug and treatment with oral metronidazole. The prolonged elevation of serum vancomycin levels in patients with renal failure may predispose them to the development of C. difficile colitis.
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PMID:Clostridium difficile colitis secondary to intravenous vancomycin. 291 Jun 75


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