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Biomedical subjects

S Keane

Publications and source records attributed to S Keane.

9 recordsLinked to original sources
PubMed2005

The impact of skin disease following renal transplantation on quality of life.

BACKGROUND: The immunosuppressive therapy a patient requires to sustain a functioning renal allograft in the long term is associated with various skin complications. While quality of life (QoL) after renal transplantation has been studied, no publications document the effect of post-transplant dermatological complications on QoL. OBJECTIVES: The objective of the study was to document the prevalence of the skin diseases that commonly occur in association with post-transplant immunosuppression. A general dermatological quality of life questionnaire, the Dermatology Life Quality Index (DLQI), was used to assess the QoL effect of these cutaneous complications. The study was designed to examine further the impact of age, sex, duration since transplant and immunosuppressive regimen on the DLQI score of renal transplant recipients (RTR). METHODS: One hundred and seventy-three RTR completed the DLQI, were interviewed and examined for evidence of common post-transplant skin diseases. RESULTS: Sixteen per cent of RTR had DLQI scores >6, reflecting a significant impact on their QoL. Dry skin, itch, hypertrichosis, sebaceous gland hyperplasia, acne, genital warts and a history of >4 herpes simplex virus type 1 infections in the past year were all found to have a significant impact on the quality of life (P < 0.05). Multivariate analysis revealed that the greatest impact on QoL was in RTR who were younger, female and with multiple skin problems (P < 0.05). CONCLUSIONS: The dermatological complications of immunosuppressive therapy are common in RTR and can significantly impair QoL in certain individuals. Visible, infectious and cosmetic skin problems had most impact on QoL while a history of skin cancer had a lesser impact. Early dermatological referral and careful choice of immunosuppression may enhance the QoL, particularly in young and female RTR.

Adult↗
PubMed2002

Cerebral venous thrombosis during diabetic ketoacidosis.

Neurological deterioration during an episode of diabetic ketoacidosis is usually assumed to be caused by cerebral oedema. We present a case of cerebral venous sinus thrombosis presenting in a similar manner, also associated with severe iron deficiency anaemia. Computed tomography scanning provided the correct diagnosis and allowed institution of anticoagulation with improvement in neurological outcome. Neuroimaging should always be performed in suspected cerebral oedema associated with diabetic ketoacidosis in order to exclude other pathologies.

Anticoagulants↗
PubMed1991

Descending brainstem projections of the pedunculopontine tegmental nucleus in the rat.

Descending brainstem projections from the pedunculopontine tegmental nucleus (PPN) were studied in the rat by use of the anterograde tracer Phaseolus vulgaris-leucoagglutinin (PHA-L) and the retrograde tracer lectin-conjugated horseradish peroxidase (HRP-WGA). Results of these experiments demonstrated prominent bilateral projections to the pontomedullary reticular nuclei, but direct connections to the motor and sensory nuclei of the cranial nerves could not be ascertained. The PPN fibers terminated mainly in the pontine reticular nuclei oralis and caudalis and in ventromedial portions (pars alpha and pars ventralis) of the gigantocellular reticular nucleus. A smaller number of labeled fibers distributed to more dorsal regions of the gigantocellular nucleus, lateral para-gigantocellular, ventral reticular nucleus of the medulla and lateral reticular nucleus. Although a significant number of PHA-L labeled fibers was seen in two cases in the contralateral medial portion of the facial nucleus, and all cases exhibited a sparse predominantly ipsilateral projection to the lateral facial motor neurons, the retrograde tracing experiments have revealed that these facial afferents originated in the nuclei surrounding the PPN. The results are discussed in the context of PPN involvement in motor functions. It is suggested that the PPN may participate in a complex network involved in the orienting reflex.

Animals↗
PubMed1991

Potential role of PFOB enhanced sonography of the kidney. II. Detection of partial infarction.

Aside from its ability to assess flow velocity within vessels, color Doppler and gray-scale sonography cannot distinguish perfused from non-perfused tissues. In this study we evaluated whether Perfluorooctylbromide (PFOB), a sonographic contrast agent given i.v., could aid sonography with this recognition. Partial renal infarction was produced by a 1 mm bead embolized in the right, the left, or both renal arteries of 20 normal rabbits. The sonographer, unaware of rabbit assignment, attempted to diagnose the infarct 24 hours later. All 20 rabbits were studied with gray-scale and color Doppler sonography, 10 before and after PFOB and 10 only after PFOB. Angiography and post-mortem examination were done for confirmation. Of the 20 kidneys evaluated before PFOB, the sonographer was unable to diagnose the 10 partial infarctions. Color Doppler identified five of the ten infarcted kidneys, but accurately localized the infarction in only two. Of the 40 kidneys evaluated after PFOB infusion, 20 scanned before and 20 scanned only after PFOB, all 20 partial infarctions were accurately diagnosed with both gray-scale and color Doppler. PFOB enhanced the echogenicity of perfused renal tissue allowing the easy detection of the unenhanced infarct. Because of the increased signal from vessels after PFOB, color Doppler displayed the entire vascular tree, allowing the detection of the truncated embolized branch. The ability of PFOB to enhance Doppler signals and the echogenicity of perfused tissues improved the diagnostic accuracy of sonography when used to detect partial renal infarctions.

Animals↗
PubMed1986

Resident parents during paediatric admissions.

During a 9-month study period, 20% of parents (usually mothers) of children admitted to an acute medical paediatric ward opted to live in the hospital. We compared 34 resident parents with 23 from within the visiting group; the children were group-matched for age and sex. Our findings suggest that a number of resident parents perceive their children as temperamentally vulnerable and that they are in special need of reassurance and explanation. Thought needs to be given to how the hospital can respond optimally to them.

Attitude↗
PubMed1985

Renal enlargement as a primary presentation of acute lymphoblastic leukaemia.

It is not uncommon to see renal involvement in children with the established diagnosis of acute lymphoblastic leukaemia (ALL). Previous reports suggest renal enlargement in 24% of all diagnosed ALL patients (Hann et al, 1981). In severe cases there is marked bilateral and symmetrical enlargement of both kidneys. The calyces and the infundibula are markedly stretched and these appearances are similar to those seen in adult polycystic kidneys. However, in ALL stretching of the calyces and the infundibula is not associated with cysts. These appearances led to the presumptive diagnosis of ALL in two children.

Child, Preschool↗
PubMed1981

Severe lithium intoxication in a child.

A mentally retarded six-year-old child became severely intoxicated with lithium carbonate whilst on maintenance lithio-therapy for control of aggressive behaviour in an institutional setting. His lithium level of 5.15 mmol/l returned to normal after two weeks. Treatment consisted of an initial saline infusion but was otherwise supportive. Although lithium toxicity is rare in children this may be because it had been used infrequently and cautiously. We feel his young age and situation accounted for some of the severity of his intoxication, and wish to stress the potential toxicity of lithium when used under these circumstances.

Aggression↗