Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Central venous total parenteral nutrition (TPN) has proved to be a valuable and often life-saving measure in selected newborn infants with surgically repairable, major anomalies of the gastrointestinal tract and infants with chronic intractable diarrhea. However, in infants of low--and especially very low--birth weight, the TPN regimen that was so successful in older infants was frequently associated with severe risks of hyperglycemia. An alternative approach that has proved to be the most satisfactory relies on the fact that the energy expenditure of a premature infant, nursing in a thermally neutral environment, rarely exceeds 50 kcal/kg, a level that can be safely and effectively maintained. With respect to the development of parenteral amino acid solutions, three generations of such mixtures can now be identified. The first of these was represented by the protein hydrolysates. With the advent of technology for the production of pure L-amino acids, a second generation of crystalline mixtures was developed. Evaluation of these revealed that extrapolation from data on oral nutrition was often unsatisfactory for the adequate formulation of such mixtures. The direct study of the parenterally nourished patient led to the third generation of special purpose amino acid solutions such as those targeted for patients with renal failure, liver failure, or trauma or for the promotion of anabolism. It seems likely that development of other solutions will follow the trend of relying on accurate definition of a given metabolic disorder and the perfection of a specific solution to correct it.
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PMID:History of parenteral nutrition in pediatrics with emphasis on amino acids. 642 10

Among 106 patients treated with conventional-dose methotrexate (MTX) following prior therapy with cis-diamminedichloride platinum (CDDP), six died with clinical manifestations of MTX toxicity. Death occurred 6-13 days after the administration of 20-50 mg/m2 MTX. Toxicity included severe stomatitis and myelosuppression, which appeared in all six patients, skin rash in five, and diarrhea in four. Renal failure appeared in five cases and hepatic toxicity in four. All these patients had received MTX earlier without developing any serious toxicity. At the time of the last MTX administration, all had normal blood counts and also normal kidney and liver function tests. Prior therapy with CDDP may be responsible for this relatively high incidence of MTX-related deaths.
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PMID:Methotrexate-related deaths in patients previously treated with cis-diamminedichloride platinum. 654 32

The toxicity of the weed-killer paraquat is related to the formation of superoxyde radicals responsible of a progressive and usually lethal pulmonary fibrosis. Recognition of lipid peroxidation of membrane bilayers by free radicals as the causative factor pointed to oxygen as an important cofactor in the severity of paraquat poisoning. It has been shown that any FiO2 over 21% accelerates this process and increases the the mortality of rats and humans. FiO2 21% gave a significant reduction of mortality in rats (DOUZE 1976). We proposed this therapy (1978-1879) in 6 cases of paraquat poisoning. It was conducted with induction of a barbiturate coma, hypothermia, curarisation and hypo-oxygenation (FiO2 around 14% thanks to the adjunction of nitrogen to assisted ventilation). In 5/6 patients, these technics did not prevent the evolution towards death. This evolution was in fact predicted, according the following prognostic factors: suicide, more than a mouthful ingestion, oesophago-gastric burns detected by endoscopy, organic renal failure, high plasma paraquat level. Associated methods of elimination (Fuller's earth, provoked diarrhea, furosemide, hemoperfusion and hemodialysis) did not change the early established prognosis. The only survival was observed in an accidental poisoning with undetectable plasma paraquat and isolated oral burns: the herbicide had been probably spit out. This survival cannot be related to hypo-oxygenation. This failure is not definitive, according to us: this therapy should be undertaken only after minimal, accidental poisoning possibly evolving to pulmonary fibrosis. It appears unuseful in massive, suicidal poisonings, leading readily to a lethal circulatory failure.
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PMID:[Hypo-oxygenation in paraquat poisoning. Apropos of 6 cases]. 661 25

The entity of the variable pictures of an illness summed up by the description "toxic shock syndrome" has been focussed on by a great number of publications in Northern America since 1978, but has been described scarcely until yet in Germany. An etiological relationship with formerly described "toxic scarlet fever" and "Kawasaki syndrome" is to be discussed. This case in charge deals with a 25-year-old female patient, who developed acutely without any former disease during her menstruation an illness of severe clinical presentation. The findings were high fever, arterial hypotension, and reversible renal failure, watery diarrhea and vomitus , different cutaneous manifestations and signs of disseminated intravascular coagulation, and severe thrombocytopenia with bleeding mucosal ulcerations. Massive growth of Staphylococcus aureus was demonstrable as well as growth of Proteus mirabilis and E. coli in a culture of vaginal smear.
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PMID:[Toxic shock syndrome]. 667 73

We report here our first experience with the use of a total artificial heart in a human being. The heart was developed at the University of Utah, and the patient was a 61-year-old man with chronic congestive heart failure due to primary cardiomyopathy, who also had chronic obstructive pulmonary disease. Except for dysfunction of the prosthetic mitral valve, which required replacement of the left-heart prosthesis on the 13th postoperative day, the artificial heart functioned well for the entire postoperative course of 112 days. The mean blood pressure was 84 +/- 8 mm Hg, and cardiac output was generally maintained at 6.7 +/- 0.8 liters per minute for the right heart and 7.5 +/- 0.8 for the left, resulting in postoperative diuresis and relief of congestive failure. The postoperative course was complicated by recurrent pulmonary insufficiency, several episodes of acute renal failure, episodes of fever of unidentified cause (necessitating multiple courses of antibiotics), hemorrhagic complications of anticoagulation, and one generalized seizure of uncertain cause. On the 92nd postoperative day, the patient had diarrhea and vomiting, leading to aspiration pneumonia and sepsis. Death occurred on the 112th day, preceded by progressive renal failure and refractory hypotension, despite maintenance of cardiac output. Autopsy revealed extensive pseudomembranous colitis, acute tubular necrosis, peritoneal and pleural effusion, centrilobular emphysema, and chronic bronchitis with fibrosis and bronchiectasis. The artificial heart system was intact and uninvolved by thrombosis or infectious processes. This experience should encourage further clinical trials with the artificial heart, but we emphasize that the procedure is still highly experimental. Further experience, development, and discussion will be required before more general application of the device can be recommended.
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PMID:Clinical use of the total artificial heart. 1476 80

A patient with chronic active hepatitis and membranous glomerulonephritis acquired an acute, fatal illness characterized by a toxic erythematous desquamative dermatitis with bulla formation, fever, diarrhea, and hepatic and renal failure. The cutaneous histopathologic appearance resembled that found in erythema multiforme, toxic epidermal necrolysis, and the acute graft vs host reaction. The cutaneous eruption may have been part of a widespread atuoimmune reaction, possibly triggered by drugs or infection.
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PMID:A severe bullous eruption occurring in a patient with chronic active hepatitis and glomerulonephritis. 677 68

Twenty-six patients with a malignancy who were receiving intermittent cytotoxic chemotherapy acquired putative bacterial infections while neutropenic. Fourteen patients with neutrophil counts less than 100 X 10(6)/L received cefuroxime plus amikacin. Twelve patients with neutrophil counts between 100 and 500 X 10(6)/L were given cefuroxime alone. The dosages were amikacin, 500 mg BID, and cefuroxime, 1.5 gm TID, although the dose of cefuroxime was halved in three patients because of low body weight and in one patient because of impaired renal function. Bacteriological proof of infection was obtained in 14 patients. In all but two, the bacteria were eradicated by therapy; those two had strains resistant to cefuroxime. Clinical cure was obtained in 15 patients (58%); marked improvement, in seven (27%). One of the patients not cured was probably not infected. In another, the organism was eradicated but the patient did not recover from preexisting shock and renal failure. There were minimal side effects. One patient had diarrhea, one complained of pain on injection, and two had slight increases in transaminase levels. Of particular note is the lack of renal toxicity, particularly in the five patients previously treated with cisplatin.
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PMID:Treatment of cytotoxic drug-related infections. 687 21

Two young women with toxic shock syndrome are reported and compared with three previous New Zealand cases. Both presented with fulminant diarrhoea, confusion, collapse and an erythematous desquamating rash. One, complicated by disseminated intravascular coagulation, rhabdomyolysis, myoglobinuria and renal failure, recovered following peritoneal dialysis. At the onset of their illnesses both were menstruating and using tampons. Light growths of Staphylococcus aureus were cultured from the vagina in one case and the faeces in the other. Successful treatment depended on a vigorous intensive care regime.
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PMID:Staphylococcal toxic shock: two fulminant cases with recovery. 695 24

Four men with renal failure developed Clostridium difficile-associated diarrhoea while being cared for in the same ward at about the same time. Cross infection appeared to play a role. All patients had received antibiotics; three were treated for chest infections and one for a urinary tract infection. The antibiotics implicated were cefoxitin alone in two patients, cefoperazone alone in one patient and cloxacillin, cefoperazone and amoxycillin in the last patient. Two patients had received immunosuppressive agents as well. Clostridium difficile cytotoxin was detected in stools from all patients using a cell culture assay. Pseudomembranous colitis was demonstrated in two patients at sigmoidoscopy and in one at post mortem. All patient were given oral vancomycin. Two died with the disease, one following relapse in the absence of antibiotics, and two patients were cured only to die later of unrelated diseases. Isolation of affected patients seems prudent as the disease may be infectious.
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PMID:Clostridium difficile-associated colitis: cross infection in predisposed patients with renal failure. 695 68

A 38-year-old woman had polyarthralgia, proteinuria, and intractable diarrhea. Biopsy of the synovium, and intractable diarrhea. Biopsy of the synovium, rectal mucosa, and kidney revealed abundant deposition of amyloid, and the diagnosis of primary amyloidosis was made. The joint symptoms and diarrhea subsequently subsided, but her renal function progressively deteriorated. Maintenance hemodialysis was started 3 1/2 years later and was successfully continued for five years without major complications except for osteonecrosis of the femoral heads. Her Brescia shunt, however, failed frequently until a polytetraflouroethylene shunt was installed. Although the prognosis of primary amyloidosis and renal failure is poor, our case illustrates that persistent remission of the extrarenal symptoms can take place and that these patients can be successfully maintained by hemodialysis.
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PMID:Long-term hemodialysis in a patient with primary amyloidosis, renal failure, and a vascular necrosis of the femoral heads. 711 84


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