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Biomedical subjects

D Adu

Publications and source records attributed to D Adu.

At least 127 records · Page 7Linked to original sources
PubMed1986

Non-steroidal anti-inflammatory drugs and renal failure.

In 3 years seventeen patients presented to one unit with renal failure associated with the use of non-steroidal anti-inflammatory drugs (NSAID). Seven patients presented with acute renal failure, in four due to acute tubular necrosis and in three to acute interstitial nephritis; all recovered when NSAID treatment was stopped. Four patients presented with symptomless renal impairment discovered during routine follow-up in a rheumatology clinic; again all improved on withdrawal of NSAID. The remaining six patients presented with chronic renal failure, a disorder not previously associated with NSAID treatment. The pattern of renal disease associated with NSAID may be more extensive than has previously been recognised. A history of NSAID use should be sought in all patients presenting with unexplained renal failure.

Acute Kidney Injury↗
PubMed1986

Change in plasma immunoreactive atrial natriuretic peptide during sequential ultrafiltration and haemodialysis.

Plasma immunoreactive human atrial natriuretic peptide (Ir-ANP) levels were measured in eight patients with chronic renal failure who were volume-expanded and during treatment by sequential ultrafiltration and haemodialysis. One patient was studied at two separate treatment sessions. Plasma Ir-ANP levels were raised in all patients (mean +/- SE 184 +/- 44 pmol/l, n = 9) compared with healthy controls (11 +/- 1.4 pmol/l), but showed considerable inter-patient variability. Plasma Ir-ANP levels fell with fluid removal during ultrafiltration (123 +/- 30 pmol/l, n = 9, P less than 0.02) and again as fluid was removed during haemodialysis (76 +/- 20 pmol/l, n = 9, P less than 0.02). Seven patients studied 48 h later, before their next dialysis treatment, had regained weight and showed a coincident rise in circulating plasma Ir-ANP (130 +/- 33 pmol/l, n = 7). Our data would support the hypothesis that the secretion of ANP is determined by volume or by a stimulus related to volume. However, it does not exclude the possibility that a factor other than extracellular fluid volume expansion contributes to the raised plasma Ir-ANP levels in chronic renal failure.

Adult↗
PubMed1986

Diagnosing Pneumocystis carinii pneumonia by cytological examination of bronchoalveolar lavage fluid: report of 15 cases.

Sixty episodes of pneumonia occurring in 53 immunosuppressed patients were investigated by bronchoalveolar lavage. Pneumocystis carinii was diagnosed on 15 (25%) occasions. In all cases the Papanicolaou stained lavage fluid presented a distinctive appearance and contained abundant, often biphasic, staining, "honeycomb" debris, and few alveolar macrophages. The Grocott methenamine silver technique confirmed the presence of characteristic cystic organisms in the debris in all 15 instances. Cysts containing internal sporozoites were identified in Gram stained material only with difficulty. Neither May-Grünwald-Giemsa stain nor fluorescence microscopy under ultraviolet light were effective for routine investigation.

Adolescent↗
PubMed1985

Vancomycin and tobramycin in the treatment of CAPD peritonitis.

Seventy-five episodes of continuous ambulatory peritoneal dialysis (CAPD) peritonitis were studied during a 1 year period at the Queen Elizabeth Hospital, Birmingham. When two simple culture methods were used in parallel, the causative organisms were identified in 97% of cases. Nearly two thirds of episodes of peritonitis were caused by coagulase-negative staphylococci (C-NS), many of which were multiply antibiotic-resistant. On the basis of detailed antibiotic sensitivities, intraperitoneal vancomycin and tobramycin were chosen for the initial treatment of CAPD peritonitis. With this regime, a cure was achieved in 32 of 38 episodes, compared with 15 of 27 episodes when cefuroxime was used. All but 1 of 24 episodes caused by C-NS were cured by vancomycin.

Adolescent↗
PubMed1985

Does cyclosporine inhibit renal prostaglandin synthesis?

Urinary PGE2 excretion was measured in female renal allograft recipients being treated either with prednisolone and cyclosporine (Cys) or with prednisolone and azathioprine. The mean urinary PGE2 excretion in patients on Cys of 940 pmol/4 hr was lower than in patients on prednisolone and azathioprine (2033 pmol/4 hr) although the difference did not achieve statistical significance. These data are consistent with the hypothesis that Cys inhibits renal prostaglandin synthesis.

Cyclosporins↗
PubMed1985

Conversion from cyclosporine to prednisolone and azathioprine. Safe or unsafe?

Out of 58 consecutive cadaveric renal allograft recipients whose initial immunosuppression was cyclosporine (Cys) and prednisolone, 18 were converted to prednisolone and azathioprine. Of these all four patients converted because of rejection lost their grafts. Renal function improved in seven patients converted because of nephrotoxicity and in six out of seven patients converted for miscellaneous reasons. Out of five patients converted electively at three months, one died of infection and three developed acute rejection episodes.

Azathioprine↗
PubMed1984

Disinfection of hands and tubing of CAPD patients.

During a 3 month study the effectiveness of two methods of handwashing was assessed in a group of 31 patients undergoing continuous ambulatory peritoneal dialysis. A defined, double rinse with alcohol, prior to bag exchange, was found to be more convenient and significantly more effective than povidone-iodine alone or povidone-iodine followed by alcohol. Spraying the tubing around the bag connector with 70 per cent ethanol reduced the numbers of adherent skin organisms so reducing the likelihood of bacteria being drawn into the dialysate. Although there was no difference in the overall incidence of peritonitis in the two groups of patients studied, there was an unexpected drop in the incidence of peritonitis caused by coagulase-negative skin staphylococci. This was attributed to an overall awareness of the importance of handwashing and aseptic procedures during bag exchange. Monitoring the bacteriology of the catheter exit site may give some prior indication as to the likelihood of subsequent peritonitis especially with Staphylococcus aureus and Gram-negative bacilli.

Catheters, Indwelling↗
PubMed1984

Complement activating cryoglobulins in the nephritis of systemic lupus erythematosus.

Complement activation in vitro by cryoglobulins isolated from the sera of 28 patients with systemic lupus erythematosus (SLE) was examined by incubating the cryoglobulin with normal human serum and performing crossed-immunoelectrophoresis of the mixture to detect C3 conversion. Eighteen of the 28 SLE cryoglobulins activated complement; eight by the classical pathway, four by the alternative pathway exclusively, and six by both pathways. In contrast only two out of 20 cryoglobulins isolated from the sera of normal subjects activated complement and both did so by the classical pathway. Twenty-three of the 28 SLE sera activated complement and complement activating cryoglobulins were isolated from 15 of these 23 sera. The parent sera of cryoglobulins activating complement had lower C4 and C3 concentrations than sera whose cryoglobulins did not split complement but these differences were not significant. The ability of SLE cryoglobulins to activate complement in vitro suggests that these immune complexes activate complement in vivo and thus may contribute to tissue damage in this disease. The activation of both classical and alternative complement pathways is in keeping with other evidence that both pathways are involved in SLE.

Adult↗
PubMed1984

Surgical treatment of hydrothorax complicating continuous ambulatory peritoneal dialysis.

Acute hydrothorax is a well recognized complication of continuous ambulatory peritoneal dialysis (CAPD) and is usually regarded as a contra-indication to the further use of this form of dialysis. We report the first case of treatment by surgical closure of a communication between the peritoneal and the right pleural cavity enabling CAPD to continue successfully. The development of an acute hydrothorax on CAPD is therefore not a reason to abandon this form of dialysis and can be treated by a simple thoracic surgical procedure.

Aged↗