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Biomedical subjects

P Ackrill

Publications and source records attributed to P Ackrill.

At least 55 records · Page 3Linked to original sources
PubMed1988

Intraperitoneal teicoplanin in the treatment of peritonitis associated with continuous ambulatory peritoneal dialysis.

The efficacy of teicoplanin in the treatment of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) was evaluated in a randomised comparison with vancomycin. The dosage regimen used was 50 mg of vancomycin or teicoplanin per 2 1 bag of dialysate for 48 h followed by 25 mg per bag for a further five days. Twelve episodes of peritonitis were studied. There was no significant difference in the bacteriological or clinical cure rates of either antibiotic.

Anti-Bacterial Agents↗
PubMed1988

Anti-glomerular basement membrane antibody-mediated nephritis complicating transplantation in a patient with Alport's syndrome.

Loss of an allograft caused by anti-GBM antibody-mediated nephritis is a rare complication of renal transplantation in Alport's syndrome. We describe a patient in whom this occurred. He belongs to the subgroup of patients with hereditary nephritis and deafness with an abnormal Goodpasture antigen, and he developed a high level of circulating anti-GBM antibodies within 20 days of transplantation of a kidney with a presumably normal Goodpasture antigen. The antibody titer fell, only to rise again when he developed evidence of acute infection with CMV. Coincident with this second rise in antibody titer he developed an anti-GBM antibody-mediated crescentic nephritis with resultant loss of graft function and transplant nephrectomy. This case provides support for the hypothesis that the abnormality in the basement membrane in some patients with Alport's syndrome involves the Goodpasture antigen, and raises the possibility that viral infection may have triggered autoantibody production.

Adult↗
PubMed1988

Role of endothelial cell injury in the spectrum of azathioprine-induced liver disease after renal transplant: light microscopy and ultrastructural observations.

Three cases of azathioprine-induced complex of liver diseases are described, and their light microscopy and ultrastructural findings are detailed. It was found that the drug produces a spectrum of pathological changes that include veno-occlusive disease, peliosis hepatis, perisinusoidal (Disse space) fibrosis, and nodular regenerative hyperplasia. It is suggested that the explanation for this spectrum is the variable degree of damage to the endothelial cells lining the sinusoids and the terminal hepatic venules. This spectrum is seen almost exclusively in male patients with renal transplant.

Adult↗
PubMed1987

The shoulder pain syndrome and soft-tissue abnormalities in patients on long-term haemodialysis.

Fifteen patients on long-term haemodialysis were studied. Twelve patients were symptomatic and ten of these patients had shoulder pain. Eleven patients had associated carpal-tunnel syndrome. A statistically significant correlation was observed between the soft-tissue abnormalities of the hands, carpal-tunnel syndrome and the shoulder pain. Radiological changes were also common and were noted in 14 patients; cysts and erosions were the commonest. The shoulder joint was the most commonly involved joint. No obvious correlation existed with either raised parathormone or calcium levels. The possible role of beta 2-microglobulin and associated amyloidosis in the causation of this syndrome is discussed.

Adult↗
PubMed1986

Carpal tunnel syndrome caused by amyloid containing beta 2 microglobulin: a new amyloid and a complication of long term haemodialysis.

Three patients receiving long term haemodialysis treatment for chronic renal failure due to non-amyloid nephropathy developed the carpal tunnel syndrome requiring decompression surgery. The excised material contained amyloid, which by immunocytochemical techniques was shown to contain beta 2 microglobulin. This is, therefore, a new chemical form of amyloid whose deposition is likely to be the cause of osteoarticular and connective tissue disorders, which are being recognised with increasing frequency in patients receiving long term haemodialysis. Raised beta 2 microglobulin levels are known to occur in chronic renal failure, and the molecule is unable to cross conventional dialysis membranes. The importance of beta 2 microglobulin amyloidosis lies in the threat which it poses to the success of long term haemodialysis.

Adult↗
PubMed1985

Desferrioxamine in the treatment of aluminum overload.

Aluminum removal is essential in treating patients with aluminum accumulation. Currently the most effective method is chelation of aluminum with desferrioxamine (DFO). DFO administration has been shown to improve dialysis encephalopathy and dialysis bone disease. The optimum dose of DFO and the mode of administration have yet to be determined. Commonly between 40 and 80 mg/kg is given parenterally once weekly. The very high serum aluminum concentrations which develop do not appear to be toxic. The administration of small doses of DFO with each dialysis may also be advocated. Monitoring of serum aluminum levels and of iron status is advisable during DFO treatment. DFO may also play a role in evaluating tissue aluminum accumulation.

Aluminum↗
PubMed1984

Captopril-induced acute renal artery thrombosis and persistent anuria in a patient with documented pre-existing renal artery stenosis and renal failure.

We describe an elderly man, with pre-existing renal failure and atheromatous renal artery stenosis, who developed persistent anuria due to renal artery thrombosis after acute hypotension following captopril administration. Caution should be used when captopril is first administered to patients with impaired renal function in whom renal artery stenosis is known or suspected.

Aged↗
PubMed1983

Bromocriptine improves reduced libido and potency in men receiving maintenance hemodialysis.

Twenty-five men on maintenance hemodialysis commenced a placebo-controlled, double-blind, crossover trial of bromocriptine for erectile impotence. Eight patients on bromocriptine and one on placebo failed to complete the trial due to side-effects and 2 were withdrawn following renal transplantation. Libido or the frequency and/or quality of erections or both improved in 11 of the remaining 14 patients during bromocriptine treatment. A significant (P less than 0.01) improvement in patients' perception of sexual performance occurred on bromocriptine compared with placebo. The 3 patients in whom potency failed to improve had the lowest serum testosterone concentrations. Bromocriptine is usually effective in the management of impotence in males receiving maintenance hemodialysis provided pretreatment serum testosterone is above the lower end of the normal range, but side-effects are relatively common.

Adult↗