RESUMO
No disponible
Assuntos
Humanos , Doadores Vivos , Transplante de Rim/métodos , Insuficiência Renal Crônica/cirurgia , Complicações Pós-Operatórias/epidemiologia , Função Retardada do Enxerto/epidemiologia , Nefrectomia/éticaRESUMO
No disponible
No disponible
Assuntos
Humanos , Transplante de Rim/estatística & dados numéricos , Doadores de Tecidos/provisão & distribuição , Espanha/epidemiologia , Doadores Vivos/provisão & distribuição , Listas de Espera , Morte Encefálica , Transplante/tendênciasRESUMO
No disponible
Assuntos
Humanos , Transplante de Rim/estatística & dados numéricos , Transplante de Pâncreas/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , EspanhaAssuntos
Transplante de Rim , Doadores de Tecidos , Adolescente , Adulto , Fatores Etários , Idoso , Cadáver , Causas de Morte , Criança , Europa (Continente) , Feminino , Rejeição de Enxerto , Transplante de Coração/estatística & dados numéricos , Humanos , Transplante de Rim/estatística & dados numéricos , Transplante de Fígado/estatística & dados numéricos , Transplante de Pulmão/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Transplante de Pâncreas/estatística & dados numéricos , Diálise Renal , Espanha , Doadores de Tecidos/estatística & dados numéricosRESUMO
No disponible
Assuntos
Criança , Adulto , Idoso , Adolescente , Pessoa de Meia-Idade , Humanos , Transplante de Rim/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , Cadáver , Causas de Morte , Europa (Continente) , Rejeição de Enxerto , Transplante de Coração/estatística & dados numéricos , Transplante de Fígado/estatística & dados numéricos , Transplante de Pâncreas/estatística & dados numéricos , Diálise RenalRESUMO
No disponible
Assuntos
Humanos , Custos de Cuidados de Saúde , Análise Custo-Benefício , Política de Saúde , Espanha , Nefrologia , Saúde Pública , Hospitais Públicos , Insuficiência Renal Crônica , Economia HospitalarRESUMO
To examine the response of growth hormone (GH) to growth hormone releasing factor (GHRF) in patients on haemodialysis, we performed the acute GHRF test (50 micrograms administered intravenously as a bolus) in 10 uraemic male patients on haemodialysis and eight normal controls. Each patient was tested before and after a haemodialysis session (at 08.30 and 12.30). Controls were tested on the same time schedule. At 08.30, patients had significantly greater basal and peak GH values (2.5 +/- 0.6 and 27.8 +/- 5.5 micrograms/l) than controls (0.68 +/- and 11.5 +/- 4 micrograms/l). After the haemodialysis session, basal and peak values declined significantly (P less than 0.01) in the uraemic group (0.5 +/- 0.03 and 3.1 +/- 1.1 micrograms/l), whereas the controls did not show such a change in the 12.30 test. Basal and intratest glycaemic values were comparable both before and after haemodialysis. After dialysis test results did not change either with the use of glucose-free dialysate or with bicarbonate buffer. Uraemic patients display a greater GH response to GHRF injection than normal subjects, and this response decreases after haemodialysis. The degree of reduction has no relationship with either glycaemia or the dialysate buffer. We suggest that other GH secretion regulating factors are altered by the haemodialysis procedure.
Assuntos
Hormônio Liberador de Hormônio do Crescimento/farmacologia , Hormônio do Crescimento/metabolismo , Diálise Renal , Uremia/metabolismo , Adulto , Idoso , Hormônio Liberador de Hormônio do Crescimento/administração & dosagem , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We report a patient treated with periodic hemodialysis, who suffered the appearance of a mass in the forearm with compression of flexor muscles, median nerve and arteriovenous fistula. X-ray examination revealed a calcified and multiloculated mass which displace forearm vessels. We discuss the physiopathology, differential diagnosis and surgical treatment of the process.
Assuntos
Calcinose/diagnóstico por imagem , Antebraço/diagnóstico por imagem , Diálise Renal , Adulto , Neoplasias Ósseas/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Masculino , RadiografiaRESUMO
Herein we describe a patient with noninsulin dependent diabetes mellitus who developed acute anuric renal failure following eye surgery. This condition, ascribable to diabetic neurogenic bladder and probably to the use of anticholinergic agents, improved following placement of a urethral catheter. The physiopathological mechanisms and treatment are discussed.
Assuntos
Injúria Renal Aguda/etiologia , Anuria/etiologia , Neuropatias Diabéticas/complicações , Complicações Pós-Operatórias , Bexiga Urinaria Neurogênica/complicações , Retenção Urinária/etiologia , Injúria Renal Aguda/induzido quimicamente , Anuria/induzido quimicamente , Atropina/efeitos adversos , Extração de Catarata , Diabetes Mellitus Tipo 2/complicações , Neuropatias Diabéticas/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/induzido quimicamente , Bexiga Urinaria Neurogênica/fisiopatologia , Retenção Urinária/induzido quimicamenteRESUMO
Anticardiolipin antibodies are autoantibodies clinically associated with hypercoagulability. Systemic thrombosis and thrombosis of the vascular access for haemodialysis coexist with immunoregulation abnormalities in end-stage renal disease (ESRD). The aim of the present study was to analyse the incidence of thrombotic episodes and the presence of anticardiolipin antibodies and lupus anticoagulant in 73 patients with ESRD--51 on haemodialysis and 22 on conservative treatment. Four (18%) patients on conservative treatment had IgG-anticardiolipin, three of them also having lupus anticoagulant. Sixteen (31%) patients on haemodialysis showed IgG-anticardiolipin and 11 (22%) lupus anticoagulant; overall, 19 (37%) patients on haemodialysis had IgG-anticardiolipin and/or lupus anticoagulant. This greater incidence in haemodialysis was associated with a more frequent use of cuprophane membranes (68% versus 34%, P less than 0.05). Six patients with ESRD--one on conservative treatment--met criteria for the diagnosis of primary antiphospholipid syndrome, clinically characterised by thrombosis of the vascular access. IgG-anticardiolipin and/or lupus anticoagulant are frequently found in ESRD and their incidence increases with haemodialysis, probably due to some kind of membrane bioincompatibility. IgG-anticardiolipin and lupus anticoagulant can be associated with thrombotic episodes, being constituents of an ESRD-related antiphospholipid syndrome.
Assuntos
Autoanticorpos/análise , Cardiolipinas/imunologia , Falência Renal Crônica/imunologia , Inibidor de Coagulação do Lúpus/análise , Adulto , Idoso , Síndrome Antifosfolipídica/complicações , Feminino , Humanos , Imunoglobulina G/análise , Falência Renal Crônica/sangue , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Tempo de Tromboplastina Parcial , Diálise RenalRESUMO
Planned study of 110 patients suffering infections of the upper respiratory tract. Soon after a smear of the focus for bacterial examination was taken a treatment with diacetyl-midecamycin was scheduled during 7 days. Thereafter another control smear and checking of the clinical status was realized. The issue of the study was very good, excepting 3 cases in which the drug was discontinued owing to gastrointestinal intolerance.
Assuntos
Infecções Bacterianas/tratamento farmacológico , Leucomicinas/uso terapêutico , Infecções Respiratórias/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Protocolos Clínicos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We describe a 76-year-old woman with severe uterine prolapse with secondary bilateral ureterohydronefrosis and acute renal failure, which improved after the reposition of the uterus. Physiopathological mechanisms and treatment of obstructive uropathy related with uterine prolapse are discussed.
Assuntos
Injúria Renal Aguda/etiologia , Prolapso Uterino/complicações , Idoso , Constrição Patológica/complicações , Feminino , HumanosRESUMO
Treatment of anemia with human recombinant erythropoietin (EPO-R) and its effect on bone marrow was studied in 10 anemic patients on periodic hemodialysis (HD). Blood transfusion was not required once treatment started. Hemoglobin (Hb) levels normalized at six months in all patients (7.2 +/- 0.2 vs 12.4 +/- 3 g/dl, p less than 0.01). Serum ferritin levels decreased progressively as Hb increased (r = -0.5609), and six patients needed iron supplement since the third month. Bone marrow iron deposits decreased significantly (p less than 0.001), together with an increase of cellularity and improvement of erythrodysplasia. EPO-R was associated with worsening hypertension in previously hypertensive patients, although it could be controlled with more aggressive treatment. Thrombotic events either systemic or at the vascular access, were not observed. EPO-R corrects the anemia in uremic patients undergoing HD. Iron stores and blood pressure in hypertensive patients on treatment with EPO-R must be monitored regularly.
Assuntos
Anemia/tratamento farmacológico , Eritropoetina/uso terapêutico , Falência Renal Crônica/complicações , Diálise Renal , Adulto , Anemia/etiologia , Medula Óssea/efeitos dos fármacos , Medula Óssea/patologia , Humanos , Pessoa de Meia-Idade , Proteínas Recombinantes/uso terapêuticoRESUMO
The Growth Hormone Releasing Hormone (GH-RH) constitutes the most potent and specific stimulus for Growth Hormone secretion. Nevertheless, in some pathologic situations a Prolactin (PRL) response to GH-RH stimulus is also observed. In order to evaluate the possible effect of GH-RH over seric levels of PRL in uremic patients we carried out a study in a group of ten male patients on hemodialysis (HD), who were given an acute stimulus of GH-RH (an IV 50 mcg. bolus) immediately before and after the HD session, with blood extractions at times -15, 0, 15, 30, 45, 60, and 90 minutes for PRL determinations. The same procedure was carried out in 8 healthy controls. Basal PRL levels in the HD group (14 +/- 3.2 micrograms/L) were significantly greater (p less than 0.01) than control group (3.8 +/- 1.4 micrograms/L). There was no PRL response to GH-RH either in uremic patients before or after HD or in healthy controls. Our results show that there is a significant increase in PRL levels in uremic patients both before and after dialysis with a GH-RH response comparable to healthy subjects.