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Biomedical subjects

A Spital

Publications and source records attributed to A Spital.

At least 73 records · Page 4Linked to original sources
PubMed1987

Case 30-1986.

Explore the source record for details and available documents.

Adolescent↗
PubMed1987

The donor's decision in renal transplantation: a cost-benefit analysis.

We previously suggested that a fully informed competent potential donor be allowed to donate his/her kidney as long as society will not suffer from the proposed transplant, even if there is added risk for the donor. To help make this sometimes difficult determination, we have constructed a benefit equation that calculates the benefit to society (either positive or negative) of any proposed living-related transplant. We believe that as long as the benefit calculated is positive, the prospective donor should generally be allowed to donate his kidney, since society will not be injured. It is emphasized that the benefit equation should be viewed as a guide to be used in difficult situations where the donor may be at added risk of renal death, and is not meant to supplant the entire complex decision-making process regarding living-related kidney donation.

Adult↗
PubMed1987

Acute idiopathic tubulointerstitial nephritis: report of two cases and review of the literature.

Two patients who presented with severe renal failure and evidence of generalized proximal tubular dysfunction were found to have severe diffuse acute tubulointerstitial nephritis on renal biopsy. No etiology could be found in either case. Both patients had dramatic improvement in renal function following steroid therapy. In the first reported case of its kind, one patient relapsed when steroids were withdrawn, but improved again with reinstitution of steroid therapy. These cases, as well as others in the literature, show that steroids are effective and may be necessary to improve renal function in some patients with acute idiopathic tubulointerstitial nephritis. Evidence of proximal tubular dysfunction is a clue to the presence of this disorder.

Acute Disease↗
PubMed1987

Kidney donation: reflections.

Living related kidney donors are still the donors of choice for renal transplantation at most US transplant centers. Nevertheless, many centers are strongly paternalistic and do not allow the potential donor at added risk to determine his own medical suitability. There are several reasons for this paternalism, yet all are flawed. Therefore, we suggest that it is generally ethically justified to allow the informed competent donor at small or unknown added risk to determine his own medical suitability. We offer guidelines to help determine how much added risk a potential donor should be allowed to accept.

Attitude↗
PubMed1986

Paradoxical potassium depletion: a renal mechanism for extrarenal potassium adaptation.

Following nephrectomy and acute potassium loading, animals previously maintained on a high potassium diet have a smaller increment in plasma potassium than do animals on a control diet. The mechanism of this "extrarenal potassium adaptation" is not known. To explore the role of potassium depletion in this process, we studied rats adapted to either a high potassium (HK) or control (C) diet. When dietary potassium was withdrawn, urinary potassium losses in HK rats greatly exceeded those in C rats for at least two days, leading to greater potassium depletion in HK than C animals. A smaller increment in plasma potassium in HK compared to C rats was seen only after prolonged fasting preceded nephrectomy and acute potassium loading. Correction of potassium depletion incurred during fasting abolished extrarenal potassium adaptation. We conclude: after withdrawal of dietary potassium, urinary potassium losses are much greater in HK than in C rats; if the duration of dietary potassium deprivation is sufficient, these urinary potassium losses will cause potassium-adapted animals to paradoxically become more potassium depleted than controls; and this paradoxical potassium depletion may be responsible for extrarenal potassium adaptation.

Adaptation, Physiological↗
PubMed1986

The living kidney donor. Alive and well.

The results of cadaveric renal transplantation have markedly improved in recent years. Concurrently, a few long-term follow-up studies of living kidney donors found an increased incidence of proteinuria and hypertension. As a result, some have argued that living donors should no longer be the preferred source of kidneys. To see if transplant centers are moving away from the use of living donors, we sent a questionnaire to all US transplant centers. The results of our survey show that rather than becoming extinct, living donors are still the preferred source of kidneys at most US transplant centers. In fact, new ways are being sought to increase the supply of living kidney donors.

Cadaver↗
PubMed1986

The compelling case for seat belts on school buses.

The ability of seat belts to reduce injuries and fatalities in vehicular accidents has been established beyond question. Nevertheless, most school buses are not equipped with seat belts. The available evidence shows that seat belts would provide added safety for our children in school buses, just as they do in the family car. Moreover, the use of seat belts on school buses would foster a lifelong habit of seat belt use. By exerting their considerable influence in the community, physicians can contribute a great deal to the nationwide campaign to require the use of seat belts on school buses. If this campaign is successful, not only will our children ride their school buses in greater safety, but a whole generation of young Americans will learn a habit that is known to reduce drastically the number of tragic highway injuries and deaths.

Accidents, Traffic↗
PubMed1985

Potassium supplementation via the dialysate in continuous ambulatory peritoneal dialysis.

A small percentage of patients treated with continuous ambulatory peritoneal dialysis (CAPD) may become hypokalemic. Since both the intravenous and oral routes for potassium repletion have disadvantages, we studied the feasibility, effectiveness, and safety of acute potassium loading via the dialysate in patients on CAPD. Five patients were studied during an exchange containing 20 mEq/L of potassium. This was well tolerated and led to a gradual increase in the plasma potassium concentration (.44 +/- .11 mEq/L) as about three-fourths of the intraperitoneal load was absorbed, most of it by two hours. The greatest increase in the plasma potassium concentration was .63 mEq/L. A separate patient developed intense abdominal pain during an exchange containing 40 mEq/L of potassium. We conclude that the dialysate is a safe and effective route for acute potassium repletion during CAPD when the dialysate potassium concentration does not exceed 20 mEq/L.

Abdomen↗