Direct current cardioversionPharmacological restoration of sinus rhythm       Non-pharmacological management   Cardiac surgeryAcute myocardial infarctionPregnancyVentricular pre-excitationHyperthyroidismPulmonary disease  相似文献   

2.
Ticlopidine-induced lupus with renal involvement.     
Takayasu Ohtake  Shuzo Kobayashi  Koji Okamoto  Machiko Oka  Kyoko Maesato  Takeo Yasu  Hidekazu Moriya 《Nephrology, dialysis, transplantation》2006,21(7):1992-1993
  Ticlopidine hydrochloride is a platelet aggregation inhibitorthat is used for the prevention of vascular thrombosis. So far,only six cases of ticlopidine-induced lupus have been documentedin the literature [1–3]. We report here a first case ofticlopidine-induced lupus with renal involvement.   A  相似文献   

3.
Familial juvenile hyperuricaemic nephropathy in a Caucasian family associated with inborn malformations.     
Peter Kotanko  Eva Gebetsroither  Falko Skrabal 《Nephrology, dialysis, transplantation》2002,17(7):1333-1335
  Familial juvenile hyperuricaemic nephropathy (FJHN; OMIM 162000)is considered a rare cause of end-stage renal disease (ESRD).FJHN is characterized by hyperuricaemia and gout after adolescenceand the slow development of renal insufficiency, leading toESRD in adulthood. The disorder is characterized by a renalunder-secretion of urate, which may be detected already duringearly childhood [1]. The histological lesions in affected subjectsare characterized by unspecific tubulo-interstitial nephropathy.FJHN is inherited in an autosomal dominant pattern with a highpenetrance. Recently, the gene(s) for FJHN was localized toa candidate interval at the short arm of chromosome 16 [2,3].   We report a Caucasian four-generation family with FJHN withoutconsanguinity between spouses and a clustering of  相似文献   

4.
Pharmacokinetics of tenofovir in haemodialysis.     
Hassane Izzedine  Vincent Launay-Vacher  Vincent Jullien  Guy Aymard  Claudine Duvivier  Gilbert Deray 《Nephrology, dialysis, transplantation》2003,18(9):1931-1933
  Tenofovir is an antiviral nucleotide with activity against humanimmunodeficiency virus type I (HIV-1). Tenofovir is extensivelyand rapidly excreted in the urine by the kidneys [1]. Thereare no available data on tenofovir pharmacokinetics in patientswith renal failure. We report here on the clinical effects andthe pharmacokinetics of tenofovir in one patient with end-stagerenal disease (ESRD) undergoing haemodialysis.   The patient was a 46-year-old Caucasian man co-infected withHIV-1 and hepatitis B virus (HBV) who was undergoing haemodialysistwice a week for end-stage renal failure (ESRD) secondary toautosomal polycystic kidney disease. At the time of the study,his creatinine clearance was 10 ml/min with a urinary outputof  相似文献   

5.
Thrombotic microangiopathy in a patient with Sezary syndrome treated with interferon-alpha.     
Marianna Politou  Panagiotis Tsaftarides  John Vassiliades  Marina P Siakantaris  Spyros Michail  Lydia Nakopoulou  Gerassimos A Pangalis  George Vaiopoulos 《Nephrology, dialysis, transplantation》2004,19(3):733-735
  Sezary syndrome is a cutaneous T-cell lymphoma (CTCL), characterizedby erythroderma and infiltration of the epidermis, the dermisand the bone marrow by monoclonal CD4+ T lymphocytes [1]. Renalcomplications of patients with CTCLs have rarely been reported[2–4]. In patients with other haematological malignancies,treated with interferon-   A 63-year old male, who had been diagnosed with Sezary syndrome  相似文献   

6.
Membranoproliferative glomerulonephritis associated with type 1 diabetes mellitus and Hashimoto's thyroiditis.     
Omer Dizdar  Serkan Kahraman  Gültekin Gen?toy  Dilek Ertoy  Mustafa Arici  Bülent Altun  Unal Yasavul  Cetin Turgan 《Nephrology, dialysis, transplantation》2004,19(4):988-989
  A wide spectrum of primary glomerular diseases may occur inpatients with type 1 diabetes mellitus (DM) due to autoimmunemechanisms [1,2]. We here report a patient with type 1 DM andHashimoto's thyroiditis who developed membranoproliferativeglomerulonephritis (MPGN).   A 35-year-old man with type 1 DM for 18 years and Hashimoto'sthyroiditis for 6 years was referred to  相似文献   

7.
Coping with the CKD epidemic: the promise of multidisciplinary team-based care.     
D C Mendelssohn 《Nephrology, dialysis, transplantation》2005,20(1):10-12
  It is well known that late referral to a nephrologist is associatedwith many adverse outcomes [1–4], and indeed has beenthe subject of a recent review in this journal [5]. Some ofthe more important negative outcomes include more rapid onsetof end-stage renal disease (ESRD), progression of co-morbidconditions such as anaemia and cardiovascular disease, suboptimalvascular access at initiation of dialysis, increased use ofcentre-based haemodialysis (HD), increased hospital utilization,increased cost and worse survival. The literature has many examplesof suboptimal chronic kidney disease (CKD) care provided byprimary care physicians prior to referral, and also shows clearlythat care provided by nephrologists is better [6,7]. There isa consensus within the renal community that early referral isdesirable [5,8–10].M   There is much less consensus  相似文献   

8.
Anaesthesia for lower limb revascularization     
Tovey  Gail; Thompson  Jonathan P 《CEACCP》2005,5(3):89-92
The first 150 words of the full text of this article appear below. Key points Surgery for lower limb revascularization is associatedwith a high risk of cardiac morbidity and mortality. Preoperativecardiac risk assessment is important and risk-reducing measuresshould be started appropriately. Perioperative ß-blockadedecreases perioperative cardiac complications in the highestrisk patients. The quality of anaesthetic practice rather thanspecific technique per se has the most important influence onpatient outcome. Acute limb ischaemia is an emergency thatprecludes prolonged preoperative cardiac evaluation.  
  Critical limb ischaemia (CLI) is defined as chronic ischaemicrest pain, ulcers or gangrene attributable to objectively provenarterial occlusive disease. Peripheral vascular disease (PVD)is a marker for severe multi-system atherosclerosis and patientswith critical limb ischaemia presenting for lower limb revascularizationpresent a significant challenge to the anaesthetist. They areusually elderly with a high prevalence of hypertension, diabetesmellitus, cerebrovascular and renal vascular disease, and smoking-relatedrespiratory disease. Only 8% of patients with PVD . . . [Full Text of this Article]Treatment strategies       MonitoringGeneral anaesthesiaRegional anaesthesia      相似文献   

9.
Anaesthesia and cognitive disturbance in the elderly     
Fines  Daniel P; Severn  Andrew M 《CEACCP》2006,6(1):37-40
The first 150 words of the full text of this article appear below. Key points Perioperative delirium and longer term cognitivedisturbance are common and disabling consequences of anaesthesiaand surgery in the elderly. Evidence is emerging that the riskof postoperative delirium can be predicted by preoperative screeningof otherwise asymptomatic patients. The risk of prolonged postoperativecognitive dysfunction (POCD) is
    Anaesthetic assessment   Possible causes of POCDEmboliPerioperative physiological disturbancesPre-existing cognitive impairmentOther factors   PremedicationConduct of anaesthesia    相似文献   

10.
Multifocal transitional cell carcinoma associated with renal cell carcinoma in a patient on long-term haemodialysis.     
Kousuke Takehara  Masaharu Nishikido  Shigehiko Koga  Yasuyoshi Miyata  Takashi Harada  Naoe Tamaru  Hiroshi Kanetake 《Nephrology, dialysis, transplantation》2002,17(9):1692-1694
  Patients with end-stage renal disease who require chronic dialysisare at high risk of developing malignancy. There are many reportedcases of the development of renal or urothelial cancer in suchpatients [1–8]. We report the first case, to our knowledge,of multifocal, invasive transitional cell carcinoma (TCC) andunilateral renal cell carcinoma (RCC) with acquired cystic disease,occurring simultaneously in a patient on haemodialysis treatedby complete urinary tract exenteration. Our patient was managedsuccessfully with an aggressive treatment.   A 69-year-old man was referred to our institution  相似文献   

11.
Complications of blood transfusion     
Maxwell  Melanie J; Wilson  Matthew J A 《CEACCP》2006,6(6):225-229
The first 150 words of the full text of this article appear below. Key points
  • Complications of blood transfusion are rare but canbe life-threatening.
  • Since 2005, it has been a legal requirementthat all serious adverse reactions attributable to the safetyor quality of blood are reported.
  • Most reported complicationsare because of transfusion of mismatched blood products andare avoidable through clinical vigilance.
  • Massive blood transfusionsresult in abnormalities of coagulation status, serum biochemistry,acid–base balance and temperature homeostasis.
  • Transfusion-relatedacute lung injury is the most common cause of major morbidityand death after transfusion.
  The serious hazards of transfusion (SHOT) scheme has collecteddata on significant adverse events resulting from transfusionof blood components from volunteer organizations since 1996.However, after the implementation of the European Union Directiveon Blood Safety and Quality in 2005, it is now a requirementthat all ‘Blood Establishments and Hospital Blood Banksreport to the Secretary of State for Health all serious adversereactions . . . [Full Text of this Article]
  CoagulationBiochemistryHypocalcaemiaHyperkalaemiaAcid–base abnormalitiesHypothermia   Clinical features       Immediate reactionsDelayed reactions       BacterialViralPrion      相似文献   

12.
Acute renal failure in SARS patients: more than rhabdomyolysis.     
Vin-Cent Wu  Po-Ren Hsueh  Wei-Chou Lin  Jenq-Wen Huang  Hung-Bin Tsai  Yung-Ming Chen  Kwan-Dun Wu 《Nephrology, dialysis, transplantation》2004,19(12):3180-3182
  Severe acute respiratory syndrome (SARS)-associated coronavirus(SARS-CoV) has been identified as the causal agent of SARS.Although not common, acute renal failure (ARF) in SARS patientsusually has a catastrophic outcome, with a mortality rate of77% [1]. The causes of ARF in association with SARS are unknown.An increase in creatine kinase (CK) may play a role [2]. Wepresent two patients who met the definition of probable SARS.   A 78-year-old man  相似文献   

13.
Massive haemorrhage in pregnancy     
Banks  Amelia; Norris  Andrew 《CEACCP》2005,5(6):195-198
The first 150 words of the full text of this article appear below. Key points Massive haemorrhage remains a significant causeof maternal mortality and morbidity. Clear and timely communicationbetween surgical, anaesthetic and haematology services is vitalto ensure optimal maternal and fetal outcome. Signs of hypovolaemiaoccur relatively late because of physiological changes in pregnancy. Theextent of intravascular volume deficit is not reflected by visualestimates of vaginal bleeding. The decision to perform a hysterectomyshould be made when other methods of haemostasis have failedand not delayed until control of maternal haemostasis and cardiovascularstability has been lost.   Massive haemorrhage is a major cause of maternal mortality.Life-threatening haemorrhage may occur as frequently as 6.7per 1000 deliveries.1 This equates to 1400 cases yr –1in the UK or 33.5 yr –1 in an obstetric unit with 5000deliveries annually. Pregnancy-related conditions and complicationsaccount for 0.8% of intensive care admissions; 35% of thesearise from massive haemorrhage.1 2 Management of massive . . . [Full Text of this Article]
      Antepartum haemorrhagePostpartum haemorrhageCoagulopathies   GeneralSpecific treatmentsPhysicalPharmacologicalSurgicalRadiologicalBlood and blood productsAnaesthesia for obstetric haemorrhageAutologous transfusion        相似文献   

14.
Reversible posterior leukoencephalopathy in a patient with systemic sclerosis/systemic lupus erythematosus overlap syndrome.   总被引：3，自引：0，他引：3  
Patrick F K Yong  Sally M A Hamour  Aine Burns 《Nephrology, dialysis, transplantation》2003,18(12):2660-2662
  Reversible posterior leukoencephalopathy is a recently recognizedneurological syndrome, first characterized 7 years ago [1].In this article, we present such a case with images typicalof the syndrome. This is followed by discussion of the typicalpresentation, its associations, hypothetical aetiology and treatmentmodalities.   A 39-year-old woman with systemic sclerosis/systemic lupus erythematosusoverlap syndrome was admitted with fever. This followed a secondcourse of pulsed intravenous cyclophosphamide for relapse oflupus nephritis  相似文献   

15.
Sirolimus-based immunosuppression for transplant-associated thrombotic microangiopathy.   总被引：2，自引：1，他引：1  
Cedric Edwards  Andrew House  Vahakn Shahinian  Greg Knoll 《Nephrology, dialysis, transplantation》2002,17(8):1524-1526
  Thrombotic microangiopathy (TMA) is a well-recognized complicationof solid organ transplantation. Both calcineurin inhibitorscyclosporine [1] and tacrolimus [2] have been associated withTMA. Treatment strategies for TMA have included plasmapheresis[1,2], calcineurin inhibitor dose reduction [1,2], calcineurininhibitor withdrawal [1,2], and conversion from one calcineurininhibitor to the other [3]. However, calcineurin inhibitor dosereduction or discontinuation increases the risk of acute allograftrejection and recurrent TMA has been described in patients thatwere converted from cyclosporine to tacrolimus [4,5]. We presenttwo cases of biopsy-proven transplant-associated TMA that weresuccessfully treated by discontinuation of tacrolimus followedby the use of sirolimus, mycophenolate mofetil (MMF) and prednisonefor the prevention of allograft rejection.   A 42-year-old white male with end-stage  相似文献   

16.
Diffuse alveolar haemorrhage in a systemic lupus erythematosus patient successfully treated with rituximab: a case report.     
Cordula M Nellessen  Uwe P?ge  Karl A Brensing  Tilman Sauerbruch  Hans-Ulrich Klehr  Christian Rabe 《Nephrology, dialysis, transplantation》2008,23(1):385-386
  Diffuse alveolar haemorrhage (DAH) often mimics, clinicallyand radiologically, severe pneumonia or ARDS [1]. The causesof DAH include a variety of non-infectious diseases, e.g. collagenvascular disease. In DAH associated with SLE, a regimen of corticosteroidscombined with cyclophosphamide and plasma exchange is generallyrecommended [2]. We describe here a ventilated SLE patient withDAH refractory to standard therapies. To our knowledge, thisrepresents the first successful application of rituximab inDAH.   A 29-year-old North African female presented to our institution  相似文献   

17.
Optimal peritoneal dialysis: choice of volume and solution.     
Cornelis H Schr?der 《Nephrology, dialysis, transplantation》2004,19(4):782-784
  Traditionally, peritoneal dialysis is performed using a volumeof 2 l of fluid, containing glucose as an osmotic agent andlactate as a buffer. Currently, both the volume to be appliedand the composition of the dialysis solution are subject todiscussion. An interesting contribution with respect to thevalue of pH-neutral dialysis solutions is reported in this issueof Nephrology Dialysis Transplantation [1].   Historically, 2 l of dialysis fluid are administered for thedwell during peritoneal dialysis in adult patients. This willvary from 1.5 l in the very small adult to 2.5  相似文献   

18.
Kidney biopsies taken before and after oral sodium phosphate bowel cleansing.     
Willy Aaseb?  Helge Scott  Rüdiger Ganss 《Nephrology, dialysis, transplantation》2007,22(3):920-922
  Acute renal failure due to phosphate nephropathy following bowelcleansing with an oral sodium phosphate solution is a rare,but well-known, complication [1]. Several authors have reporteddiffuse tubular injury and tubular deposition of calcium phosphatein biopsies taken from such patients [1–4]. In these patients,the term acute phosphate nephropathy more aptly describes thisentity than the previously used term acute nephrocalcinosis[1]. It has been a matter of debate whether these changes aredirectly induced by the phosphate load or whether they werebeing present before the procedure [3]. We, therefore, reporta patient with acute phosphate nephropathy who had kidney biopsiestaken before and after bowel cleansing with sodium phosphate.   In 2002, a 69-year-old woman was  相似文献   

19.
Intracapillary proliferative glomerulonephritis due to heavy chain deposition disease.   总被引：1，自引：1，他引：0  
Anouk C Vedder  Jan J Weening  Raymond T Krediet 《Nephrology, dialysis, transplantation》2004,19(5):1302-1304
  Heavy chain deposition disease (HCDD) is a rare manifestationof plasma cell dyscrasia. Only 11 cases have been describedin the literature [1]. The clinical picture is variable, butin all patients renal biopsy showed a nodular sclerosing glomerulopathy[1–5]. We report a patient with rapidly progressive glomerulonephritisin whom the renal biopsy showed mainly intracapillary proliferativeglomerulonephritis due to HCDD.   The patient is a 55-year-old musician with an uneventful medicalhistory except ankylosing spondylitis diagnosed at the age of47. Six weeks before admission he noticed foamy urine, at 2weeks he developed generalized swelling, dyspnoea and a severeheadache. Upon admission  相似文献   

20.
Iatrogenic fistula between prosthetic haemodialysis access graft and autogenous vein: unusual cause of graft thrombosis.     
Seung Kee Min  Yeon Ho Park  Hyun Hee Lee  Joon Seung Lee  Woo Kyung Chung  Jong Ho Lee  Young Hwan Koh  Tae-Seok Seo 《Nephrology, dialysis, transplantation》2004,19(10):2647-2649
  Haemodialysis access graft is so important as to be called alifeline for the patient on maintenance haemodialysis. The vascularaccess problem is the leading cause of admission in patientswith end-stage renal disease. Many complications of the prostheticvascular access graft are reported, such as graft thrombosis,infection, aneurysm or pseudoaneurysm, and arterial steal syndrome[1]. We recently experienced two cases of graft thrombosis relatedto the iatrogenic fistula between haemodialysis access graftand autogenous vein at the needling site during haemodialysis.We report our cases with their clinical manifestation and thetreatment outcome and possible methods of prevention [2].   A 76-year-old female on long-term haemodialysis  相似文献   

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1.
Bajpai  Abhay; Rowland  Edward 《CEACCP》2006,6(6):219-224
The first 150 words of the full text of this article appear below. Key points
  • Atrial fibrillation (AF) is the commonest cardiacarrhythmia; its incidence increases with age.
  • Diabetes mellitus,hypertension and ventricular hypertrophy are commonly associatedwith non-valvular atrial fibrillation.
  • Primary aims of managementof AF are conversion to sinus rhythm, maintenance of sinus rhythmand prevention of thromboembolic complications.
  • In elderlypatients who are asymptomatic, adequate rate control of AF appearsto offer the same benefits as rhythm control.
  • Chronic AF carriesa high risk of ischaemic stroke from thromboembolism; all patientsat risk must receive adequate anticoagulation.
  • Anticoagulationshould be continued in patients with risk factors despite successfulconversion to sinus rhythm.
  Atrial fibrillation (AF) is the commonest cardiac arrhythmia.The incidence increases with age and affects 5% of UK populationabove the age of 65 yr and 10% above 75 yr.1 2 In the UnitedStates, AF accounts for more than 35% of all admissions forcardiac arrhythmias.3 Men are . . . [Full Text of this Article]
   Definition and electrocardiographic patterns    Classification    Pathophysiology and mechanisms    Causes and risk factors    Principles of management    Restoration of sinus rhythm    Maintenance of sinus rhythm    Rate control of atrial fibrillation    Prevention of thromboembolism    Management in special situations    Introduction    Case    Introduction    Case    Introduction    Case    Introduction    Case    Introduction    Case    Introduction    Multidisciplinary team-based CKD care    Critical limb ischaemia    Preoperative assessment    Preoperative management    Perioperative management    Postoperative management    Acute limb ischaemia    Delirium    Dementia    Postoperative cognitive dysfunction    Anaesthetic technique and postoperative cognitive impairment    Future developments    Introduction    Case    Massive transfusion    Transfusion-related acute lung injury    Pathogenesis    Incidence    Haemolytic transfusion reactions    Non-haemolytic febrile reactions    Allergic reactions    Transfusion-related infections    Transfusion-associated graft-vs-host disease    Immunomodulation    Introduction    Case 1    Definitions    Physiology    Causes of haemorrhage    Management of haemorrhage    Protocols and fire drills    Problems in early pregnancy    Web resources    Introduction    Case    Introduction    Case 1    Introduction    Case report    Introduction    Volume    Introduction    Case report    Introduction    Case    Introduction    Case 1
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