Retrograde menstruation: an unusual cause of fungal peritonitis in a patient on continuous ambulatory peritoneal dialysis.
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Biomedical subjects
Publications and source records attributed to S Ringoir.
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The haemodiafiltration is a valuable alternative to the conventional dialysis in the cases of both clinical and/or allergic intolerance in conventional dialysis. Moreover, it is suitable for the treatment of therapy-resistant hypertension as well as in all situations, where an insufficient elimination of solved substances is supposed. Up to now the higher expenses prevent the routine use of haemodiafiltration in all dialysis patients.
The risk of cardiovascular and fatal complications and the antihypertensive effect of a clonidine-beta-blocker combination was studied in 98 patients and was compared with the results for a group of patients treated with other antihypertensive regimens. The profile of complications was similar in the two groups for a total follow-up period of more than 2000 treatment-months. Clonidine in combination either with propranolol or atenolol had a distinct antihypertensive effect. However, clonidine plus atenolol resulted in a more immediate and pronounced fall in blood pressure. It is concluded that the combination of clonidine and a beta-blocker is an effective antihypertensive medication, and that patients treated with it are apparently at no greater risk of serious cardiovascular incidents than are those treated with other regimens.
One hundred twenty-seven selected stone formers were evaluated. With the simple ambulatory tests proposed by Pak for metabolic screening and a complete urologic evaluation an anomaly was found in more than 90 per cent of the cases. The patients were divided into three groups: (1) patients operated on for staghorn stones; (2) patients with episodes of spontaneous stone eliminations or young people with only one stone episode; and (3) patients operated on for stone disease. No significant differences were noted except for the occurrence of urinary tract infection and for struvite and calcium oxalate occurrence in the different groups. Urinary tract infection combined with a metabolic disorder appear to make the evolution from small kidney stone to staghorn stone a reality.
The present study compares data on blood pressure and clinical tolerance, obtained consecutively in the same patients during acetate and bicarbonate haemodialysis. Twenty-one patients were followed over an equal period of acetate and bicarbonate dialysis, averaging more than 30 months per patient. Absolute and relative blood pressure changes were noted. Contrary to what often has been claimed previously, it is concluded from the present long-term study that, bicarbonate haemodialysis has no specific beneficial effect on blood pressure in stabilised chronic patients. As far as vomiting and nausea are concerned, clinical tolerance is, however, significantly better than for acetate haemodialysis.
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Uremic ultrafiltrate was fractioned by chromatography on Sephadex G15; two fractions were highly inhibiting the total lactate dehydrogenase activity in rat kidney homogenate. The inhibiting fractions were eluates number 10 and 11 with an elution volume of respectively 17.4 ml and 19.3 ml and a Kav of 0.17 and 0.25. Both fractions presented a different pattern on analysis by analytical isotachophoresis.
This study presents an average follow up per patient of 33.5 +/- 3.7 and 70.1 +/- 5.9 months (hospital and home dialysis) showing an actuarial fistula survival rate of 86.2% and 85.5% respectively after 5 years. The data suggest a satisfactory survival rate of the fistula when a single needle technique is used in comparison to the survival observed with the two needles technique.
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Study of hemodialysis performance and recirculation ratios of subclavian catheter hemodialysis is reported. Data are compared to the results obtained when a conventional intrafistular single-lumen hemodialysis needle is used under similar conditions. Renal blood flow values were slightly but not significantly lower for subclavian hemodialysis. Small molecular extraction ratios were identical. Small molecular clearances were somewhat lower for the subclavian approach, especially at high dialyzer blood flow rates. However, the differences were not significant, and overall extraction ratios, calculated for the entire dialysis period with both access methods in 43 patients, were identical. Recirculation averaged 12.5% for the fistular approach and 20% for the subclavian approach. It is concluded that, as a whole, dialysis performance is somewhat lower with the subclavian vascular access method. This is mainly due to a higher recirculation rate, and in turn to the consequence of the length of the intravascular device. However, this minor differences do not necessitate changes in dialysis schedules.
The compartmental syndrome is not a rare complication of non-traumatic rhabdomyolysis. Early recognition and prompt surgical decompression of the affected area are essential. We feel that a lack of familiarity with the syndrome among nephrologists may contribute to delay in diagnosis and treatment and reduce the chances for functional neuromuscular recovery. Our experience with three cases following overdosage of alcohol (case 1), barbiturates (case 2) and a mixture of alcohol and sedatives (case 3) is reported. The pathogenesis, symptomatology and treatment of the compartmental syndrome in this setting are discussed.
Unipuncture hemofiltration using the double headed pump (Bellco BL 760) was performed in a patient who acted as her own control for 10 sessions with a 1.0 m2 AN69 membrane (group A), 10 sessions with a 1.4 m2 AN69 membrane (group B) and 10 sessions with a 1.0 m2 AN69 membrane Filtral (group C). A two needle standard hemofiltration technique (Hemoprocessor Sartorius) was used in this patient for 10 sessions with a 1.0 m2 AN69 membrane (group D). To obtain the same amount of ultrafiltration fluid the filtration time was respectively 266, 196, 214 and 260 minutes in groups A, B, C and D.
The complications related to the use of subclavian catheters for hemodialysis were prospectively studied in 257 consecutive acute and chronic renal failure patients. Using 394 catheters, 3006 single needle dialyses were performed. Indications for starting catheter dialysis were mainly the absence or disappearance of an adequate vascular access. Most hazardous complications were sepsis (9), malposition (6), hemothorax (3), bleeding (2), vena cava thrombosis (2) and pneumothorax (2). A number of mechanical problems occurred, where the obstructed catheter could easily be replaced by a modified Seldinger technique. No mortal complications occurred. Patient tolerance was excellent. It is concluded that single needle subclavian hemodialysis is a valuable alternative vascular access method in acute situations. It enables the continuation of hemodialysis on an ambulatory basis.