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Biomedical subjects

R J Rigby

Publications and source records attributed to R J Rigby.

At least 37 records · Page 2Linked to original sources
PubMed1986

Algal peritonitis complicating continuous ambulatory peritoneal dialysis.

A 41-year-old woman on continuous ambulatory peritoneal dialysis (CAPD) presented with algal peritonitis. Prototheca wickerhamii was isolated from multiple dialysate effluent cultures. Despite treatment with amphotericin B, catheter removal was required. An attempt to reinsert a Tenckhoff catheter 3 months later was unsuccessful because of dense intraperitoneal adhesions. Prototheca sp are a rare cause of human disease, this being the first reported case of algal peritonitis complicating CAPD.

Adult↗
PubMed1986

Abdominal hernias complicating continuous ambulatory peritoneal dialysis.

Twenty-five percent of all CAPD patients reviewed in this study developed abdominal hernias. Eleven hernias (32.4%) occurred at the catheter insertion site, 17.6% were inguinal, 26.5% were epigastric and umbilical and 23.5% occurred at the site of previous abdominal incisions. The risk of developing a hernia was significantly greater in patients over 40 years of age, women of parity greater than 3, patients who had had undergone more than 3 laparotomies and those with a previous hernia repair. Three hernias became incarcerated, one with intestinal strangulation. Early surgical repair is advisable to avoid these complications.

Abdomen↗
PubMed1984

A prospective randomized trial of low-dose versus high-dose steroids in cadaveric renal transplantation.

Low-dose steroid regimens, in combination with azathioprine, have become increasingly common for immunosuppression of renal transplant recipients. The change from conventional high-dose steroid regimens was prompted by the results of several prospective trials that showed similar graft survivals with high-dose and low-dose steroids, but a lower incidence of steroid-induced complications in low-dose-steroid--treated patients. However, the number of patients entered into the trials was small, and consequently there remained a possibility that a clinically relevant difference in graft survival could have remained undetected. A multi-center prospective trial was performed to compare graft survival with high-dose (91 patients) and low-dose (98 patients) oral steroids in combination with azathioprine. There was significantly worse graft survival in the low-dose group. The difference was largely due to a poor graft survival in patients receiving low-dose steroids and azathioprine less than 1.75 mg/kg/day. Graft survivals were similar in the high-dose and low-dose steroid patients who received azathioprine doses of greater than 1.75 mg/kg/day. The results indicate that the combination of low doses of both steroids and azathioprine provides inadequate immunosuppression in renal transplantation, although higher doses of azathioprine allow the use of low-dose steroids without significantly more graft losses than with high-dose steroids.

Adult↗
PubMed1982

Experience with continuous ambulatory peritoneal dialysis.

Thirty-one patients were trained for continuous ambulatory peritoneal dialysis (CAPD) over a 34-month period. Their mean age (42 +/- 14 years) did not differ from that of the total dialysis population. The training was conducted primarily on an outpatient basis by one registered nurse. The duration of treatment ranged from two to 34 months (median, 8.0 months). The technique failed in seven patients, in four because of peritonitis and in three because of catheter complications. Nine patients received renal transplants and one died while on CAPD. Dialysis was very effective with good biochemical control and excellent control of hypertension. Haemoglobin concentrations rose in 28 of the 31 patients (mean at 12 months, 2.0 g/L in 12 patients). Rehabilitation was comparable to that of home haemodialysis patients and superior to that of patients on hospital haemodialysis. The incidence of peritonitis decreased over the study period because of better patient selection, improved technology, and increased experience.

Adult↗
PubMed1982

Severe tubulo-interstitial disease in a renal allograft due to cytomegalovirus infection.

A 34 year old female developed impaired function of her renal allograft 21 months post-transplant. This was associated with lethargy, pyrexia, tenosynovitis, pancytopenia and a colonic ulcer. Severe tubulo-interstitial changes with intranuclear inclusion bodies and intracytoplasmic herpes type viral particles were seen on renal biopsy. There was no evidence of rejection. Cytomegalovirus was cultured from the urine and there was a rise in CMV antibody titer. These findings suggested the renal impairment was due to a direct cytopathic effect of the CMV. Despite treatment with transfer factor and adenine arabinoside, there was progressive loss of graft function.

Adult↗
PubMed1980

Failure to demonstrate renal uptake of labelled platelets in chronic glomerulonephritis.

1. Renal localization of autologous 111In-labelled platelets was studied in patients with chronic glomerulonephritis. External imaging was performed with a gamma-camera fitted with a medium energy collimator and the images were collected by a computer. 2. Images of 111In-labelled platelet distribution showed that there was a marked contribution to the radioactivity within each renal silhouette from adjacent spleen or liver. It was not possible to demonstrate renal accumulation of 111In-labelled platelets. 3. The application of 111In-labelled platelets to the study of intrarenal platelet consumption in chronic glomerulonephritis is limited by the sensitivity of current techniques and the scatter from adjacent splenic and hepatic radioactivity.

Adult↗
PubMed1978

The treatment of paracetamol overdose with charcoal haemoperfusion and cysteamine.

A 53-year-old female was admitted to hospital one hour after taking an overdose of 60 g of paracetamol and 960 mg of codeine. Two hours after ingestion of the drug, the plasma concentration of paracetamol was 3040 mumol/l. In view of the enormous, and potentially fatal, plasma concentration of the drug, charcoal haemoperfusion was undertaken as well as cysteamine therapy. Charcoal haemoperfusion and cysteamine therapy led to the rapid removal of the paracetamol from the body and consequently prevented the development of severe hepatic necrosis. It is suggested that charcoal haemoperfusion as well as cysteamine has a role in the management of severe overdosage with paracetamol. This is the first report on the use of charcoal haemoperfusion for acute poisoning in Australia.

Acetaminophen↗
PubMed1978

Immunological studies in chronic atrophic gastritis and chronic (superficial) gastritis.

Detection of autoantibodies, HLA typing and immunofluorescence studies on gastric biopsies were carried out in subjects with histologically proven chronic atrophic gastritis (CAG) and chronic superficial gastritis (CG). All were seronegative for parietal cell antibody and did not have pernicious anemia. Except for positive antismooth muscle and antimitochrondrial antibodies in one patient with CAG, autoantibodies (antinuclear, smooth muscle, mitochrondrial, parietal cell) were absent in patients with CAG and CG. Immunofluorescence studies showed that Ig-G and IgA were presented in the lamina propria of all cases with CAG or CG and of subjects with normal gastric histology. Ig-M was seen less often, in about half the cases. Complement C3 was an uncommon finding, being positive in only one case with CAG and one case with CG and in none of the cases with normal gastric histology. Fibrinogen was more commonly seen in patients with CG (5/5 cases) than in those with CAG (3/11 cases). Fibrinogen was found in one case with normal gastric histology. The most consistent fluorescence was obtained with antiparietal cell antiserum. All subjects with CAG showed negative or weak staining only. In contrast, subjects with CG and normal gastric histology had strong specific fluorescence. An increased frequency of HLA-A1 plus HLA-B8 was found in subjects with CAG (20.7% in controls; 40% in CAG).

Adult↗
PubMed1978

HLA in systemic lupus erythematosus: influence on severity.

Forty-four patients with systemic lupus erythematosus (SLE) were classified as mild or more severe on the basis of renal biopsy changes and the degree of proteinuria. The HLA phenotype A2 plus B7 was associated with the mild cases, while A1 plus B8 was associated with more severe disease. These findings suggest that immunogenetic factors are important in determining the severity of SLE and that combinations of HLA-A and -B locus antigens may be significant in HLA disease associations.

Adolescent↗