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Biomedical subjects

P K Chandran

Publications and source records attributed to P K Chandran.

16 recordsLinked to original sources
PubMed2001

Oncogenic Cushing's syndrome and nephrotic syndrome in the same patient.

The association of the nephrotic syndrome with malignancy is well established. This case report describes a patient who presented with renal cell carcinoma and went on to develop ectopic adrenocorticotropic hormone (ACTH) syndrome as well as the nephrotic syndrome. The patient's presentation was with hypokalemia refractory to conventional medical therapy. Oncogenic Cushing's syndrome and minimal change disease were diagnosed. We discuss the differentiation of Cushing's disease and Cushing's syndrome as well as oncogenic nephrotic syndrome and therapeutic options.

ACTH Syndrome, Ectopic↗
PubMed1993

Patient survival on PAN/AN69 membrane hemodialysis: a ten-year analysis.

Survival characteristics over a 10-yr period of 352 patients on hemodialysis (HD) with polyacrylonitrile membranes in a single center were retrospectively analyzed and compared with national data collected by the U.S. Renal Data System (USRDS). Only those patients who stayed on HD for longer than 3 months were included. Any outcome other than death was considered as lost to follow-up. The number of expected deaths in the entire patient population according to the USRDS data base was 203, whereas the observed actual rate was only 132, reaching high statistical significance. Several subgroups of patients, stratified on the basis of age and time on starting HD, diabetes mellitus as the cause of original renal disease, etc., also exhibited significantly better survival. HD with a biocompatible membrane, providing adequate removal of low- as well as "middle"-molecular-weight uremic toxins, may be one important explanation for improved survival.

Acrylic Resins↗
PubMed1993

Biochemical changes following parathyroidectomy.

Biochemical changes that had appeared after subtotal parathyroidectomy (PTx) in 26 patients with end-stage renal failure were observed. The volume of excised parathyroid glands was also measured. Serum calcium and inorganic phosphorus levels fell after PTx; only to rise in due course. Serum alkaline phosphatase levels rose after PTx, reaching a peak by the 14th post-operative day. These elevated levels returned to normal range at about three months after PTx. Strong correlation was noted among the degree of post-operative hypocalcemia, and increase in serum alkaline phosphatase, but not between absolute pre or post-operative alkaline phosphatase levels and changes in serum calcium or phosphorus concentrations. Nevertheless, significant correlation was seen between pre-PTx levels of alkaline phosphatase and its short-lived post-operative rise, indicating hastened osteoblastic activity.

Adult↗
PubMed1993

Patient survival on PAN/AN69 membrane hemodialysis: a ten year analysis.

Survival characteristics over a 10 year period of 340 patients on hemodialysis (HD), using PAN/AN69 membrane, were retrospectively analyzed and compared with national data collected by the U.S. Renal Data System (USRDS). Only those patients who stayed on HD longer than three months were included. Any outcome other than death was considered as lost to follow-up. The number of expected deaths in the entire patient population according to USRDS database was 190, whereas the observed actual rate was only 120, a highly statistically significant difference. Several subgroups of patients also exhibited significant improvement in survival. Adequate HD with a biocompatible membrane is offered as one important explanation for improved patient survival.

Adolescent↗
PubMed1991

Patient and technique survival for blind and sighted diabetics on continuous ambulatory peritoneal dialysis: a ten-year analysis.

A retrospective analysis of patient and technique survival over 10 years in a group of 66 diabetics (40 being blind) and 71 non-diabetics was undertaken. Patient survival profiles showed that the blind diabetics lived longer than the sighted, but for a shorter time than the nondiabetics. In technique success, the sighted diabetics out did the blind and the non-diabetics, long term. Short term, the blind performed better than sighted diabetics. The key to success and longer survival on CAPD depended on motivation on the part of the patient, patient's acceptance of given disability, family (social) support, and willingness on the part of renal care personnel to train the disabled diabetic to perform CAPD. With adequate education and support, blind diabetics did CAPD as well as sighted patients. There was no increased frequency of peritonitis in blind diabetics compared to sighted diabetics. Both blind diabetics and non-diabetics had fewer episodes than sighted diabetics. Intraperitoneal route of insulin administration achieved good glycemic control in diabetic population. Refractory congestive cardiac failure and/or fatal arrhythmias was the most common cardiac cause of death in diabetics on CAPD.

Attitude to Health↗
PubMed1990

Rhabdomyolysis and myoglobinuric renal failure following cardioversion and CPR for acute MI.

A 50-year-old man suffered an MI with VFIB at work, and efforts at resuscitation were initiated immediately. Ninety minutes of CPR and 14 cardioversions were given by trained personnel before VFIB converted to sinus rhythm. Reversible myoglobinuric renal failure ensued, requiring two weeks of hemodialysis. Scanning with technetium-99m pyrophosphate revealed extensive muscle injury in the regions of cardioversion and a large anterolateral MI. Prolonged resuscitative efforts involving repeated cardioversion may predispose to myoglobinuric renal failure.

Acute Kidney Injury↗
PubMed1989

Acute abdominal events and their impact on morbidity and mortality in a CAPD program.

A retrospective analysis was done to explore the impact of acute abdominal events other than peritonitis, on morbidity and mortality in a CAPD program over a span of 6 years. Subtlety of clinical manifestations and low yield from investigational attempts (except microbiologic) made decision-making as to whether or not to continue CAPD, hard. An increased prevalence of septicemic shock with its inevitable high risk of morbidity and mortality was striking. Timely termination of CAPD and change over to hemodialysis may help to prevent dissemination of infection in these patients. Among the vascular causes of death in CAPD patients, bowel infarction seemed to be the most common.

Abdomen, Acute↗
PubMed1985

Blood eosinophilia in patients undergoing maintenance peritoneal dialysis.

To determine the prevalence of blood eosinophilia in patients receiving maintenance peritoneal dialysis, routine peripheral WBC counts of 49 such patients were reviewed. In 29 patients, blood eosinophilia was noted. Elevations in blood eosinophil counts tended to be mild and episodic. They were often associated with concomitant elevation of peritoneal fluid eosinophil counts. Possible predisposing factors included recent peritoneal catheter insertion and antibiotic therapy for peritonitis.

Eosinophilia↗
PubMed1982

Wegener's granulomatosis: prolonged patient survival after pneumonectomy and renal transplantation.

Wegener's granulomatosis was diagnosed in a 42-year-old female 16 years ago. From the outset there was upper respiratory, pulmonary, and renal involvement. Over the years she received varying combinations of glucocorticoids and azathioprine. Renal function deteriorated, and she was treated by hemodialysis and living related donor transplantation 9 and 10 years, respectively, after the onset of the disease. 3 months prior to transplantation, the patient had a right pneumonectomy for bronchial stenosis, bronchiectasis and repeated sepsis. 5 years' posttransplantation, she is well and has no signs of activity of original disease.

Adult↗
PubMed1982

Successful treatment by defibrination with ancrod in a patient with hyperacute renal allograft failure and a deficiency of plasma prostacyclin stimulating factor.

Hyperacute and renal allograft failure, whether due to rejection or other mechanisms, such as perfusion injury, is usually associated with extensive intraglomerular fibrin deposition and allograft loss. Defibrination with ancrod was used to treat a patient with hyperacute renal allograft failure and extensive glomerular fibrin deposition and necrosis. The patient's plasma had normal fibrinolytic activity but a complete absence of the ability to generate prostacyclin-like activity from rat aortic endothelium "in vitro". Treatment was associated with complete recovery of renal function, disappearance of glomerular fibrin, and restoration toward normal of glomerular structure.

Adult↗