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Biomedical subjects

G Eknoyan

Publications and source records attributed to G Eknoyan.

At least 19 recordsLinked to original sources
PubMed1995

A history of the parathyroid glands.

Diseases of the parathyroid glands have always existed, affecting occasional individuals in every period and culture of the past. The significant changes in body build associated with their dysfunction must have attracted in the popular mind bewildering connotations that can be gleaned from their mythology. Although their associated clinical features were described in the medical literature, the presence of the parathyroid glands and their function went long unrecognized. In the relatively slow evolution of endocrinology, compared with that of other medical disciplines, the parathyroid glands and their diseases were one of the last to be defined. It was only in the latter part of the nineteenth century that the glands were identified in humans by Ivar Sandström (1852-1889). Their subsequent experimental extirpation by Eugene Gley (1857-1930), as well as others, led to the differentiation of the neuromuscular symptoms that theretofore had been attributed to removal of the thyroid glands. That these symptoms were the result of the hypocalcemia that ensues parathyroidectomy was suggested in 1908 by W. G. MacCallum (1874-1944) and Carl Voegtlin (1879-1960). The possibility that parathyroid pathology may be associated with skeletal abnormalities was made in 1914 by Jacob Erdheim (18874-1937), and in the following year documented by Z. Schlagenhaufer from the observation that in patients with osteitis fibrosa cystica, only one parathyroid gland is enlarged. This was to set the stage for parathyroidectomy beginning in 1925, for the alleviation of bone disease of hyperparathyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Current status of chronic analgesic and nonsteroidal anti-inflammatory drug nephropathy.

The long-term use of analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) results in distinct renal abnormalities. The principal lesions induced by both groups is a tubulointerstitial nephropathy which, in the case of analgesics, results in renal papillary necrosis and progressive chronic renal failure. The tubulointerstitial nephropathy associated with NSAIDs presents with massive proteinuria and is generally reversible on discontinuation of the inciting NSAID. The scope and magnitude of the renal syndromes associated with these agents and the risk of renal failure associated with their use remains to be clearly defined. This review focuses on the current understanding of the processes involved and the initial defects in renal function that occur, with the goal of early detection and potential prevention.

Analgesics↗
PubMed1994

Arabic medicine and nephrology.

During the Dark Ages following the fall of the Roman Empire, the Arabic world was instrumental in fostering the development of the sciences, including medicine. The quest for original manuscripts and their translation into Arabic reached its climax in the House of Wisdom in Baghdad, and the dissemination of the compiled texts was facilitated by the introduction of paper from the East. Foremost among the Arabic physicians were Rhazes, Avicenna, Haly Abbas and Albucasis, who lived during the period 950-1050 AD. Their writings not only followed Hippocrates and Galen, but also greatly extended the analytical approach of these earlier writers. The urine was studied and the function and diseases of the kidneys described. Despite the fact that experimentation on the human body was prohibited by religion, some anatomic dissection and observation seems to have been undertaken, and the pulmonary circulation was described by Ibn Nafis. Anatomic illustrations began to appear in Arabic texts, though they did not have the detail and artistic merit of those of Vesalius.

Arabia↗
PubMed1993

Renal malacoplakia reappraised.

Renal malacoplakia is an unusual form of chronic tubulointerstitial nephritis with a predilection for patients with recurrent urinary tract infections and an immunocompromised state. Its characteristic feature is the parenchymal infiltration by macrophages with ample cytoplasm containing abundant periodic acid-Schiff-positive granules, known as von Hansemann cells, and the presence of diagnostic extracytoplasmic or intracytoplasmic calcospherites, known as Michaelis-Gutmann bodies. Renal malacoplakia is more common in women (female to male ratio 3:1), in whom the lesions develop in a younger age group (third to fifth decade) than in men (over 50 years). Enlarged kidneys in the presence of persistent urinary infection should lead to the consideration of this entity. The diagnosis can only be established by pathologic examination of renal tissue. Renal biopsy early in the course of the disease is essential since in an increasing number of cases medical therapy has resulted in resolution of the disease process and preservation of renal function.

Female↗
PubMed1992

Acute renal failure in the Armenian earthquake.

A destructive earthquake devastated northwestern Armenia on December 7, 1988. The size of the affected area (radius of 50 miles), the time of the day when it occurred (11:41 a.m.), deficiencies in the design and construction of buildings, and inadequate initial rescue and relief capabilities resulted in one of the most lethal and traumatic natural disasters of the century. A large but unknown number (estimated at 225 to 385) of the extricated victims who had sustained crush injury developed myoglobinuric acute renal failure requiring dialytic support. The limited number (8-10 dialysis machines) of antiquated dialysis facilities available locally were overwhelmed. International dialysis relief efforts resulted in meeting the immediate acute needs and provided the motivation and elements of the more efficient system for the future delivery of maintenance dialysis.

Acute Kidney Injury↗
PubMed1991

The role of phosphate in the potentiation or amelioration of acute renal failure.

Alterations in the balance of several cations have been shown to affect the severity of acute renal failure. It has been suggested in both clinical and experimental studies that changes in phosphate balance can markedly potentiate as well as ameliorate the renal dysfunction seen in both acute and chronic nephropathies. To determine the role phosphate plays in the course of gentamicin-induced acute renal failure, we examined rats maintained on control, phosphate-supplemented, and phosphate-depleted diets. In both control and phosphate-supplemented groups of rats, the degree and severity of gentamicin-induced acute renal failure was similar. By contrast, renal function was better preserved in the phosphate-depleted group. Furthermore, morphologic evaluation revealed a significantly lower number of necrotic proximal tubule cells in phosphate-depleted rats when compared to the control or phosphate-replete rats. Renal cortical gentamicin concentrations were not different between the phosphate-depleted and phosphate-supplemented groups. We conclude that phosphate depletion is protective against nephrotoxicity. This effect appears to be independent of alterations in serum calcium, urinary calcium excretion and renal cortical gentamicin concentration.

Acute Kidney Injury↗
PubMed1989

Salutary effects of modest fluid replacement in the treatment of adults with diabetic ketoacidosis. Use in patients without extreme volume deficit.

The optimal rate of fluid administration to correct the volume deficit associated with diabetic ketoacidosis remains undefined. Thus, this study evaluates prospectively in adult patients without extreme volume deficit two regimens of therapy that differed exclusively in the rate of fluid infusion. In protocol 1 (12 patients), normal saline was infused at 1000 mL/h (approximately 14 mL/kg per hour) in the initial 4 hours and 500 mL/h (approximately 7 mL/kg per hour) during the subsequent 4 hours. In protocol 2 (11 patients), normal saline was infused at half the rates of protocol 1. For plasma bicarbonate level, the increment from admission levels at 2, 4, 8, 16, and 24 hours after admission was greater with protocol 2 at all times, attaining a statistically significant difference at 4 hours (3.7 vs 0.7 mmol/L) and at 24 hours (13.2 vs 8.4 mmol/L). These data support cautious restraint in the volume of fluid replacement used in the therapy of diabetic ketoacidosis, since prompt recovery, lack of any harmful effects, and a significant reduction in the overall cost of medical therapy are achieved with lower rates of saline infusion.

Adult↗