Biomedical subjects
Publications and source records attributed to C Leroux-Robert.
Over 75 years old peritoneal dialysis patients can be treated with at least as good results as those of hemodialysis. Peritoneal dialysis is the only method used to treat old patients at home with psychological profits. Regarding the lack of references on nutritional state of uremic old patients and on early death forecast factors geriatric peritoneal dialysis knowledges are not yet well established.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We report two cases of acute renal failure in patients with arteriosclerosis obliterans treated by intravenous infusion of naftidrofuryl oxalate. At renal biopsy the histological lesions were identical with those found in ARF due to hyperoxaluria of other causes, revealing tubular epithelial necrosis and massive intratubular precipitation of calcium oxalate monohydrate (C1) crystals. A second study was then conducted in four other patients with arteriosclerosis obliterans to evaluate serum and urinary levels of oxalate, and crystalluria during the intravenous administration of 800 mg of naftidrofuryl oxalate per day for 10 days. During the course of treatment, the serum and urinary oxalate levels were found to increase substantially, with the gradual onset of massive C1 crystalluria. These results indicate that naftidrofuryl oxalate was responsible for the acute renal failure in the first two patients. High intravenous doses of naftidrofuryl oxalate must be used cautiously, with close surveillance of renal function.
Explore the source record for details and available documents.
Melorheostosis is a benign, rare, congenital disorder of hyperostosis of one or more bones. Associated soft tissue abnormalities are often observed. A case of melorheostosis with minimal change nephrotic syndrome, mesenteric fibromatosis and capillary haemangiomas is reported. A congenital mesenchymal defect occurring early in embryonic life is suggested.
Chylous ascites is a rare clinical entity often secondary to a lymphoma. In peritoneal dialysis even mild chylous ascites can cause cloudiness of the peritoneal effluent and thus lead to early diagnosis. Twelve cases of chylous ascites (defined by the presence of chylomicrons) among 230 patients with chronic renal failure treated in two peritoneal dialysis centers (Limoges and Saint-Pierre de la Réunion) are reported. A malignancy was encountered in only two cases (a B-cell lymphoma and an ovarian cancer). In the other cases, a precise diagnosis was difficult to establish and was only presumed. Thus chylous effusion in seven cases seemed secondary to cirrhosis, chronic pancreatitis, systemic amyloïdosis or cardiac failure. In three cases the cause was unknown, although microtrauma due to the Tenckhoff catheter was highly suspected. Chylous ascites lasted more than two years in four cases. The long-term nutritional consequences did not justify a change in the method of dialysis.
Physical effort stimulates the reninangiotensin system (RAS). We studied the effect of an angiotensin-converting enzyme inhibitor (ACE inhibitor) in a double-blind placebo-controlled study, on eight volunteers undergoing physical stress on an ergometric bicycle. The effects of captopril (C) (50 mg, three times daily for 3 days) on arterial pressure (AP), O2 consumption (VO2), variations in auricular natriuretic factor (ANF), renin, angiotensin II (AII) plasma levels, as well as glomerular filtration rate (GFR) and microalbuminuria (MA) were evaluated. The different parameters were compared by analysis of variance (ANOVA). The pressure profile and VO2 were not modified by ACE inhibitor. Exercise stimulates release of renin; this action was greater with captopril administration (treatment effect: p < 10(-4), indicating blockade of the RAS. This inhibition was incomplete because AII levels increased markedly when captopril was given (no treatment effect: p < 0.37). Finally, ACE inhibitor resulted in decreased GFR (p = 115 +/- 5.8 ml/mn-1, C = 91.1 +/- 4, p < 0.05) with exercise without modification of MA. ACE inhibitor administration does not modify the physical performance of nonathletic subjects; AII is significantly increased with exercise despite captopril treatment; ACE inhibitor decreases GFR significantly but does not influence MA with prolonged physical effort.
A 25-year-old woman who was 20 weeks pregnant developed systemic lupus erythematosus with acquired ichthyosis and pyoderma gangrenosum. The course of these dermatoses suggests that an immunopathological mechanism was implicated in their pathogenesis.
A 64 year-old man was admitted for congestive heart failure induced by an acute renal failure due to obstruction. Retroperitoneal periaortic-aneurysmal fibrosis was the etiology of the obstruction. Type IV Ehlers-Danlos syndrome was diagnosed based upon clinical and histological cutaneous signs.
Bladder lithiasis is a frequent complication in paraplegics and tetraplegics. We report on a patient where treatment of a urinary infection with antibacterial sulfamides was the causative factor in the formation of bladder stones.
We report a case of hypokalemic flaccid quadriplegia with sudden respiratory arrest in a 38-year-old woman discovered to have distal renal tubular acidosis which lead to the diagnosis of primary Sjögren's syndrome. This case is compared to 8 similar cases previously described in the literature.
Explore the source record for details and available documents.
The presence and migration of stones in the urinary tract are the consequences of lithiasis, a pathological process whose evolutive potential determines the frequency of recurrence. The stones produce haematuria and above all obstruction which manifests itself by pain and may be complicated by infection. The most suggestive type of pain is renal colic, but other revealing manifestations may occur. Such signs require radiological exploration with plain X-ray of the abdomen, renal ultrasonography and intravenous urography. These three indispensable examinations complete each other, provide the diagnosis and in the vast majority of cases point to the appropriate treatment. The haemodynamic repercussions of urinary tract obstruction have been thoroughly documented and now form the basis of treatment of renal colic with non-steroidal anti-inflammatory drugs. Obstruction and infection are the causes of all complications of urinary stones. Their management has been facilitated by recent advances in urology and should prevent the disease from destroying the kidneys and eventually causing chronic renal insufficiency.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
According to literature kidney transplantation in patients above 65 years of age is justified. It is justified for selected patients with perfect cardiovascular status and several years of life expectancy. However it would be better not to enlarge these indications since there are not enough kidney transplants.