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Biomedical subjects

R Cade

Publications and source records attributed to R Cade.

At least 37 records · Page 2Linked to original sources
PubMed1980

Routine or indicated operative cholangiography?

An assessment was made both the reliability of routine operative cholangiography and of the incidence of unsuspected common duct stones identified by this technique. It is suggested that its disadvantages, in particular the incidence of unnecessary bile duct explorations consequent upon false-positive cholangiograms, make routine operative cholangiography undesirable. If any suspicion of common duct stone exists by virtue of clinical, biochemical or operative findings, an operative cholangiogram should be performed. Following adoption of this policy our findings suggest that the incidence of undetected stone will be negligible.

Cholangiography↗
PubMed1979

Advanced digoxin toxicity in renal failure: treatment with charcoal hemoperfusion.

Glycoside toxicity, a common and potentially fatal complication among patients taking digoxin, is treated basically by managing cardiac arrythmias until the patient can excrete enough drug to decrease the intoxication. Patients with renal failure, however, are particularly difficult to manage. We describe a case of advanced digoxin toxicity in an elderly man with severe renal failure, treated with a charcoal hemoperfusion device.

Aged↗
PubMed1979

Obstruction of the inferior vena cava complicating hemodialysis in polycystic kidney disease.

Two patients with polycystic kidney disease and renal failure developed profound hypotension within 30 minutes after starting hemodialysis. After ruling out all recognized causes of hypotension during early dialysis, we found that their vena cavas were obstructed by compression of the vessels against the spinal column by the greatly enlarged polycystic kidneys. Immediately after bilateral nephrectomy, the patients had dialysis, with removal of large amounts of fluid without causing hypotension. We speculate that compression of the vena cava by massively enlarged polycystic kidneys may significantly contribute to the renal insufficiency by greatly increasing renal venous pressure.

Humans↗
PubMed1978

Hemodialysis in chronic schizophrenic patients.

Ten schizophrenic patients were dialyzed once a week for 16 weeks. They showed marked abnormalities in thinking, affect, and behavior. When out of the hospital, they lived vegetative, nonproductive lives. Seven patients at the end of the 16-week period showed no or minimal symptoms involving thinking, affect, and behavior. One patient showed moderate improvement, and there were two treatment failures.

Adult↗
PubMed1978

New method for obtaining uncontaminated urine from women.

Midstream sampling and colony counts have greatly improved precision in diagnosing urinary tract infections. In women, however, contamination by vaginal flora and cells still poses a diagnostic problem. We have devised an instrument for helping collect uncontaminated urine from women and have tested it in three sets of observations. Approximately 96% of 200 women were able to use the device successfully after minimal instruction. Bacterial colony counts and quantitative estimation of vaginal epithelial cells were performed on urine collected by 18 female volunteers using conventional clean-catch technics and on urine collected by the same 18 women using the Clean Streamer. The average bacterial colony count in conventionally collected urine was 8,100/ml while in Clean Streamer collected urine it was 1,722/ml. The average number of vaginal epithelial cells in conventionally collected urine was 22.4/ml while in Clean Streamer collected urine it was 14.1/ml. The difference in both comparisons is statistically significant (P = .01). We believe that use of the Clean Streamer greatly facilitates the ability of a woman to collect a urine sample uncontaminated by vaginal secretions and flora.

Bacteriuria↗
PubMed1977

Chronic renal vein thrombosis.

Twenty-eight patients with demonstrated chronic renal vein thrombosis were studied. In seven, only small venous channels were involved; in 21, both small and large veins were thrombosed. A constellation of findings occurred with such frequency in these patients that we believe it virtually diagnostic of renal venous obstruction. These findings include the nephrotic syndrome, great variability in proteinuria and glomerular filtration rate, pulmonary embolization, sterile pyuria, hematuria, hyperchloremic acidosis, decreased renal tubular threshold for glucose and increased fibrin degradation products. These findings are an indication for definitive angiographic and biopsy procedures. Prolonged anticoagulant therapy was generally very effective.

Adolescent↗
PubMed1977

Reversible systemic abnormalities associated with renal cell carcinoma.

A sixty-eight-year-old male was found to have renal carcinoma after seven months of constitutional symptoms. Initial study of the patient showed a puzzling array of laboratory abnormalities. These led initially to a search for gastrointestinal malignancy and then later to consideration of multiple myeloma. This case serves as a reminder of the propensity of early renal carcinoma to produce striking constitutional symptoms and marked hematologic and serum protein abnormalities. These may occur in the absence of metastases and are frequently reversible as shown in this case with resection of the primary lesion.

Adenocarcinoma↗
PubMed1976

Low dose, long-term treatment of rheumatoid arthritis with azathioprine.

Sixteen patients with classical rheumatoid arthritis which had been present for longer than two years, representing anatomic stages II-IV, were treated with azathioprine in doses of 50 to 175 mg/day. They were followed up for up to six years. Using the criterion of ability to work, 93% of the patients improved markedly during the time observed. Complement levels were low before treatment and tended to stabilize within the normal range as the disease became less active. Erythrocyte sedimentation rate (ESR) fell during therapy but changes in ESR did not correlate well with the patients' clinical states. Titers of rheumatoid agglutinins showed little change after as long as six years of therapy. When all patients were stable a double-blind cross-over study, using a placebo tablet, was instituted. Fifteen of 16 patients had a marked exacerbation of disease activity after receiving placebo for three to eight weeks. When azathioprine was reinstituted, gradual improvement again occurred so that all patients were back to their asymptomatic or mildly symptomatic state within seven months.

Adult↗
PubMed1976

Papillary necrosis in kidney transplant patients.

Of 158 renal transplant recipients, 75 underwent excretory urography at some point during a six-year period, 24 hours to 7 years after transplantation. In 11 patients, renal papillary necrosis (RPN) was found. RPN was associated in 9 patients with one or more disease entities known to be the etiologic factor to RPN in nontransplanted kidneys. In 2 patients, previous rejection episodes were the probable case for RPN. Renal papillary necrosis, a rather late complication with renal allograft, was demonstrated in this population on an average of 28.1 months after transplantation.

Adult↗
PubMed1975

Immunoglobulin A glomerulonephritis: a clinicopathologic study.

Renal biopsies from 10 patients staining predominantly for immunoglobulin A are reviewed. Historically, nine of 10 patients were less than 32 years of age; they all presented with either microscopic or gross hematuria. The initial creatinine clearances demonstrated good function in all patients; only one patient experienced a progressive decline in the creatinine clearance. Similarly, proteinuria was mild. The light and electron microscopic findings presented a variable pattern, including a group with changes confined to the mesangium, another group also having glomerular basement membrane changes, and one patient with severe, progressive glomerular sclerosis. Immunogluorescence demonstrated large amounts of IgA predominantly within the mesangium but occasionally involving the peripheral capillary loops. Serum IgA levels were elevated in six of eight patients tested, and two of five patients had elevated nasal IgA concentrations. These data suggest that there is an immunologic entity, IgA glomerulonephritis, characterized by the above clincial findings in association with elevated serum and occasionally nasal IgA levels, but that the pathologic findings are highly variable. Neither the mechanism nor the particular pathogenetic significance of the raised IgA levels is presently known. The similarities of this entity to the reported findings in anaphylactoid purpura are mentioned.

Administration, Intranasal↗