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Biomedical subjects

E F Haywood

Publications and source records attributed to E F Haywood.

8 recordsLinked to original sources

A method for the treatment of ureteric complications following renal transplantation.

Over an 8-year period, 117 renal transplants (97 cadaveric and 20 living related) were performed at the Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. Ureteric complications following renal transplantation occurred following seven transplants (6%). The technique of using a multiply fenestrated vesicocutaneous stent/drain to manage this problem is described. This was uncomplicated in all cases with the exception of one case in which the stent/drain was removed early because of blockage and sepsis, but most importantly on no occasion was the graft lost. We therefore recommend this technique for the management of this complication, whether early or late. We observed a disproportionate number of ureteric complications in living related transplants, a feature not described previously.

Adult↗

The effect of pyridoxine on oxalate dynamics in three cases of primary hyperoxaluria (with glycollic aciduria).

We have measured glomerular filtration rate (GFR), extracellular fluid volume (ECF), oxalate distribution volume (OxDV), plasma oxalate concentration (POx.), plasma total clearance of oxalate (PCOx.), oxalate metabolic pool size [(OxDV) X (POx.)], renal clearance of oxalate (RCOx.), oxalate excretion, tissue clearance of oxalate (TCOx.) and tissue oxalate accumulation rate [(TOx.A) = (TCOx.) X (POx.)] in three patients with type I primary hyperoxaluria (hyperoxaluria with hyperglycollic aciduria) when they were taking pyridoxine and after discontinuation of the vitamin. Seven days after stopping pyridoxine the plasma oxalate concentration, oxalate metabolic pool size and the urinary excretion of oxalate had all increased between seven- and eight-fold in two of the patients. The third patient showed no changes on stopping pyridoxine. These results support the view that pyridoxine acts by reducing oxalate biosynthesis in some patients with type I primary hyperoxaluria. The possible biochemical basis for this effect is discussed.

Adult↗

Renal transplantation. 12-Year experience.

The results of cadaveric renal transplantation in one centre over 12 years are reviewed. One hundred and sixty-eight grafts have been performed in 147 recipients. At one year after transplantation, patient survival rate was 86%, and graft survival rate was 63%. Analysis of factors influencing graft survival show that the age of recipients, the lack of blood transfusions, and the use of poorly matched grafts (three to four HLA mismatches against 0 to two mismatches), all had adverse effect on survival. Death was a significant cause of graft loss in patients over the age of 45 years. Patients who had not received blood transfusions, and who received grafts which were mismatched for three to four HLA antigens, did especially badly, graft survival rate at six months being only 24% compared with that of 70% in patients who received blood transfusions.

Adolescent↗

Toxic shock syndrome -- some new features.

A thirty-year-old female presented with a high fever, conjunctivitis, confusion, vomiting, watery diarrhoea, diffuse erythroderma, shock and oliguric renal failure. Staphylococcus aureus phage 29/52 (Group 1) was isolated from a high vaginal swab. In addition to all the previously reported features which defined toxic shock syndrome, there were pustular skin vesicles, altered red cell morphology, and severe myocardial involvement. Treatment with fluid replacement, cloxacillin, haemodialysis, positive inotropic agents, and supportive measures resulted in a full recovery.

Adult↗

The diagnosis and treatment of lymphocoeles associated with renal transplantation. A report of 6 cases and a review of the literature.

Six patients have developed a lymphocoele after renal transplantation, an incidence of 4%. A lymphocoele should be suspected in a patient who develops a rising creatinine with a pelvic mass or pressure effects on the pelvic veins 1 or more months after operation. The diagnosis is confirmed by intravenous urography, venography and ultrasonography: the use of the latter as a diagnostic measure is recommended. Treatment is by marsupialisation into the peritoneum or external drainage with breakdown of all loculi. Aspiration is unsatisfactory.

Abdomen↗