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Biomedical subjects

P Ackrill

Publications and source records attributed to P Ackrill.

At least 73 records · Page 4Linked to original sources
PubMed1983

Treatment of fracturing renal osteodystrophy by desferrioxamine.

Aluminium removal by desferrioxamine chelation has been demonstrated in three long-term haemodialysis patients with dialysis encephalopathy and fracturing renal osteodystrophy. Aluminium concentrations in serum and in both bone marrow and bone trabeculae, determined separately in transiliac biopsy specimens, fell significantly over the treatment period. Bone aluminium removal was confirmed by specific histochemical staining. In two patients osteomalacia disappeared, and in two patients osteitis fibrosa emerged but improved in one following vitamin D therapy. We conclude that desferrioxamine is capable of mobilising aluminium from bone and that the calcification defect in fracturing renal osteodystrophy may be overcome.

Adult↗
PubMed1982

Bobbing oscillopsia from gentamicin toxicity.

A series of 15 patients had been studied, all of whom suffered severe labyrinthine damage from gentamicin. All subjects were patients in a renal unit and had been in renal failure. The antibiotic was administered, either intramuscularly, intravenously or into the dialysate. In most of the patients there was a history of previous or simultaneous administration of another ototoxic agent, either another aminoglycoside, or a loop diuretic. None of the patients developed severe vertigo. They consistently complained, when they eventually were able to get out of bed, a vertical bouncing of their surroundings, when they walked, coinciding with each step. This sensation is made worse if the patient runs, or drives on a bumpy road, and stops as soon as the patient stands still. Caloric tests revealed non-functioning labyrinths on both sides. Gradual improvement in the symptom occurred over a period of months. No cochleotoxic effect was observed. The probable mechanism of this phenomenon is discussed.

Gentamicins↗
PubMed1981

Surgical management of idiopathic retroperitoneal fibrosis.

The management of 10 patients with idiopathic retroperitoneal fibrosis causing obstructive uropathy is presented. In all cases the obstruction was relieved by ureterolysis and corticosteroid therapy was not used during the initial treatment. In 9 patients the operation was well tolerated but one, who developed a pyonephrosis after pre-operative ureteric drainage, died of septiceamia 15 days post-operatively. In 2 patients further explorations and ureterolysis were necessary for recurrent fibrosis which may have been related to urinary leakage. A policy for the management of these cases is presented which recommends the use of silastic tubing splints after ureteric mobilisation and the use of an omental wrap.

Adult↗
PubMed1976

A comparison of the clearance of urographic contrast medium (sodium diatrizoate) by peritoneal and haemodialysis.

1. The clearance of isotopically labelled sodium diatrizoate by haemodialysis was measured in vitro, with simulated extracellular fluid, and in vivo in eleven patients, at varying rates of fluid or plasma flow. Clearance was also measured in five patients undergoing peritoneal dialysis. In all instances simultaneous measurements of urea clearance were made and the diatrizoate/urea clearance ratio was calculated. 2. In haemodialysis studies, diatrizoate and urea clearances showed a linear increase with increasing 'extracellular fluid' or plasma flow through the dialyser diatrizoate/urea clearance ratio fell. 3. The clearance of diatrizoate in vivo was slightly less than clearance in vitro at corresponding flow rates, but the diatrizoate/urea clearance ratio showed no significant difference. 4. Diatrizoate and urea clearances during peritoneal dialysis were very much lower than during haemodialysis but the diatrizoate/urea clearance ratios were within the same range. 5. The rapid removal of diatrizoate in patients with renal failure requires haemodialysis.

Diatrizoate↗
PubMed1976

Hemosiderosis in a patient on regular hemodialysis: treatment by desferrioxamine.

Hemosiderosis following regular administration of parenteral iron was observed in a patient receiving maintenance hemodialysis. Infusions of desferrioxamine in doses of 2,3 and 4 g each resulted in the removal of approximately 45 mg of iron during dialysis. Desferrioxamine 2 g was infused thrice weekly during dialysis for twelve months. Body iron stores, as judged by liver iron and serum ferritin concentrations, fell by about half. This agrees well with the result calculated from the amount of iron administered and the amount removed during dialysis.

Deferoxamine↗
PubMed1975

Successful pregnancy in patient on regular dialysis.

A pregnancy in a patient undergoing regular dialysis treatment was successfully managed. Premature labour occurred at 32 weeks. Fetal nutrition was satisfactory and the infant developed normally and showed no congenital abnormality during 12 months' observation.

Adult↗
PubMed1974

Iatrogenic osteomalacia and myopathy due to phosphate depletion.

In a patient receiving regular dialysis prolonged hypophosphataemia due to aluminium hydroxide therapy resulted in osteomalacia and severe proximal myopathy. Both osteomalacia and myopathy responded to correction of hypophosphataemia without vitamin D therapy.

Adult↗