[Acquired multicystic disease in the chronic dialysis patient].
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Biomedical subjects
Publications and source records attributed to D Schillinger.
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ACKD is frequent in chronic dialysis patients: its incidence is proportional to the length of time on dialysis. It occurs also in uremic patients before dialysis and persists, despite a tendency towards involution, in transplanted patients. ACKD is frequently associated with adenoma which can evolve into adenocarcinoma. Screening studies by sonography, eventually completed by CT, are essential to discover patients with ACKD, to follow them up and propose bilateral nephrectomy if ACKD evolves towards malignancy. ACKD should be considered as a pre-malignancy state.
In reference to one new case of post-partum cerebral thrombophlebitis, the authors stress the difficulty of the clinical diagnosis. Because of its great reliability, conventional arteriography occupies a place of choice among the medical imaging techniques. Heparin therapy at isocoagulating doses has permitted to improve the very poor prognosis of this disease.
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Caprine Trypanosoma (N.) congolense infections were treated with sinefungin, an antifungal antibiotic nucleoside. Single doses from 10 to 20 mg/kg bodyweight given intramuscularly were not curative for goats; single doses of 25 and 50 mg/kg were toxic, and caused death. Five and 7.5 mg/kg administered twice daily over a three-day period, resulted in a cure in 2 animals, while 2 others relapsed. All animals relapsed when given a single daily dose of 5 or 7.5 mg/kg for 4 consecutive days. When such doses were given twice a day, they caused death in 50% of the goats and the remainder were cured. Raised serum urea levels indicated the severe nephrotoxic side-effects of sinefungin even at subcurative levels. Histopathological examinations revealed an acute tubulonephrosis.
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Hypertensive emergencies usually present to the emergency department. Nifedipine was administered to 15 patients presenting to the emergency department with a diastolic blood pressure greater than 120 mm Hg with chest pain, shortness of breath, or focal neurological symptoms. Average blood pressure on entry was 215/134.9 mm Hg and decreased to 158/88 mm Hg over a two-hour period. No patient had any worsening of symptoms or suffered deleterious effects. All patients with pulmonary edema or chest pain noted prompt improvement in symptoms. One patient became hypotensive without clinical significance. Two patients failed to respond to nifedipine and were treated with nitroprusside. Nifedipine appears to be safe and effective in the management of hypertensive crises.
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