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Biomedical subjects

A J Wing

Publications and source records attributed to A J Wing.

At least 109 records · Page 6Linked to original sources

Nephrotic syndrome in the elderly.

Though the nephrotic syndrome is generally believed to be uncommon in the elderly, patients aged 60 years or more accounted for 25 out of 100 consecutive adult cases. Six (24%) of these had the minimal change lesion, compared with 16% of the younger adults. The incidence of membranous glomerulonephritis was similar in the two age groups, but proliferative glomerulonephritis was more common in the younger (29%) than in the older group (16%). Amyloidosis did not have a higher incidence in the higher age group. Five of the elderly patients with minimal change lesion were treated with prednisone-in four a complete remission from the nephrotic syndrome followed, while the fifth patient's course is unknown.These results suggest that, when the patient's other circumstances allow, the nephrotic syndrome in an elderly patient should be investigated and managed as in younger age groups.

Adolescent↗

Maintenance of sinus rhythm after DC reversion of atrial fibrilllation. A double-blind controlled trial of long-acting quinidine bisulphate.

Ninety-two patients were entered in a double-blind controlled trial of long-acting quinidine bisulphate for the maintenance of sinus rhythm following DC reversion of atrial fibrillation. By random selection two statistically comparable groups of patients were obtained, a control group being given a placebo and a treated group quinidine bisulphate 1.5 g. per day in two 12-hourly doses. Thirty-seven patients were followed up in the control group and twenty-eight patients in the treated group. The maintenance of sinus rhythm in the treated group was significantly longer than in the control group, especially during the first three months. The mean serum quinidine level in the treated group was 2.2+/-0.3 (SEM) mg. per litre. There was one death among the patients treated with quinidine, which may have been due to quinidine toxicity caused by a high serum quinidine level.

Adult↗

Optimum calcium concentration of dialysis fluid for maintenance haemodialysis.

To define the minimum and maximum levels for calcium concentration of dialysis fluid a combination of acute and long-term observations was carried outIn acute experiments the external calcium balance during dialysis was dependent on the gradient between plasma ultrafilterable calcium and dialysis fluid calcium concentration. Changes in plasma calcium during dialysis did not correlate with measured external balance.In long-term studies it was found that raising the dialysis fluid calcium concentration from 5.0 to 6.0 mg./ 100 ml. both arrested biochemical and radiological changes of hyperparathyroidism, and, by causing a progressive fall in plasma phosphates, made metastatic calcification less likely. Raising the concentration to 6.5 mg./lOO ml. in an attempt to compensate for negative alimentary calcium balance caused nausea and vomiting in some patients.A concentration of 6.0+/-0.2 mg./100 ml. is recommended.

Calcinosis↗

Transient and persistent hypercalcaemia in patients treated by maintenance haemodialysis.

In a group of 32 patients with terminal renal failure the initial hypocalcaemia was corrected after two months' adequate maintenance haemodialysis. In seven patients hypercalcaemia occurred with a peak incidence after about six months' treatment. In six of these patients hypercalcaemia was transient and the plasma calcium became normal with haemodialysis alone. In one patient the hypercalcaemia was persistent and the plasma calcium reverted to normal only after subtotal parathyroidectomy. This patient had no radiological bone disease, a normal alkaline phosphatase, and no metastatic calcification of the soft tissues.It is concluded that in some patients with terminal renal failure treated with maintenance haemodialysis autonomy of the parathyroids becomes evident in the absence of bone disease or a raised plasma alkaline phosphatase, and that subsequently with continued dialysis there is a spontaneous involution towards normal parathyroid function.

Adolescent↗