Pneumomediastinum as a complication of fast bowling in cricket.
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Biomedical subjects
Publications and source records attributed to D V Hamilton.
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The use of cyclosporin A (CyA) with a protocol designed to avoid the effects of nephrotoxicity resulted in a one-year survival of 86% in recipients of renal allografts from unmatched cadaveric donors. The drug also controlled rejection of liver and pancreatic allografts. It was possible to change patients initially treated with CyA to azathioprine and corticosteroids and vice versa, thus enlarging the potential value of CyA in organ allografting. Of 34 recipients of renal allografts, 29 were currently receiving only CyA as immunosuppressive treatment. Twelve patients never required any adjuvant steroid treatment. These results suggest that CyA is an effective immunosuppressant, and if used with care side effects need not be severe.
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The converting-enzyme inhibitor, captopril, was given to ten patients with refractory severe hypertension of renal origin: 6 patients had chronic renal failure, 3 patients had hypertension following renal transplantation, and one patient had hypertension and congestive cardiac failure. Control of blood pressure was achieved with doses from 78 to 400 mg/day. Severe hyperkalaemia occurred in one patients, ageusia (dose dependent) in another, and one patients withdrew from treatment because of nausea.
Renal function, as represented by serum creatinine and creatinine clearance, 18 to 24 months after renal transplantation was studied in 21 patients receiving Cyclosporin A and compared with that of 25 patients on corticosteroids and azathioprine. Although renal function at six months post transplantation was significantly poorer in those patients on Cyclosporin A compared with those on conventional therapy, it did not deteriorate with time. No significant alteration in renal function was observed in five hepatic transplant recipients on Cyclosporin A after three months. Lower serum bicarbonate was observed more frequently in those renal transplant recipients on Cyclosporin A than in those on conventional therapy, reflecting possible tubular damage.
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Three members of one family who presented in adult life with pseudohypoparathyroidism are reported. The importance of screening members of the family of patients with pseudohypoparathyroidism is stressed. Higher doses of 1α-hydroxycholecalciferol are required than in idiopathic or surgical hypoparathyroidism or in chronic renal failure.
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