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Biomedical subjects

T V Whelan

Publications and source records attributed to T V Whelan.

13 recordsLinked to original sources
PubMed1990

Nonocclusive mesenteric ischemia in renal patients: recognition and prevention of intestinal gangrene.

Nonocclusive mesenteric ischemia (NOMI) is a disorder with an extremely high mortality. Salvage of affected patients requires early recognition and aggressive intervention to prevent intestinal gangrene. Dialysis patients represent a group at particularly high risk for this condition. Clinicians should develop a high index of suspicion for NOMI in dialysis patients to lessen the risk of death. A high interventional posture must be maintained due to the notoriously unreliable signs and symptoms of this disorder.

Aged↗
PubMed1988

Nephrotic syndrome associated with Kimura's disease.

Kimura's disease consists of lesions that appear as single or multiple red-brown papules or as subcutaneous nodules with a predilection for the head and neck region. Although it principally affects the skin and soft tissues, there is a high prevalence of associated renal disease. We report a case of nephrotic syndrome associated with Kimura's disease. Our patient is distinctive in that his disease first manifested while residing in the Western hemisphere; the renal disease was characterized as mesangial proliferative glomerulonephritis with renal impairment, and his nephrotic syndrome remitted with standard doses of prednisone.

Adolescent↗
PubMed1988

Urinary Charcot-Leyden crystals in the hypereosinophilic syndrome with acute renal failure.

A 48-year-old man with idiopathic hypereosinophilic syndrome (IHS) developed blast crisis along with a fulminant autoimmune hemolytic anemia. Hemoglobinuria and anuric acute renal failure (ARF) ensued. Urinalysis revealed countless Charcot-Leyden crysals (CLC). This is the only known report of Charcot-Leyden crystalluria. The CLC protein (lysophospholipase) should normally undergo glomerular filtration and catabolism by the tubules during reabsorption. Its abundant presence in the urine of our patient may reflect impairment of tubular reabsorption, saturation of the tubular reabsorptive process by excessive CLC load through residual functioning glomeruli, or a combination thereof. The extreme degree of hypereosinophilia suggests a massive load of CLC protein and acute tubular necrosis implies impaired tubular function, so both mechanisms should have been operative. At the autopsy, no eosinophilic infiltrates were present in the kidneys, which points against a local spillage of CLC protein into the tubules.

Acute Kidney Injury↗
PubMed1988

Insertion of peritoneal dialysis catheters: the lateral approach.

Potential complications of peritoneal dialysis catheters include ventral herniation, dialysate leakage, and catheter dysfunction. Using local anesthesia and a paramedian, muscle-splitting approach, we have significantly reduced the morbidity of the procedure. Security of fascial closure and identification of the peritoneum, even in obese patients, has been facilitated through this technique.

Catheterization↗
PubMed1988

Minimal-change nephropathy associated with pancreatic carcinoma.

A 67-year-old man presented with nephrotic syndrome and polymyalgia rheumatica. A renal biopsy revealed minimal-change nephropathy. The proteinuria and rheumatologic findings responded to prednisone therapy. The patient presented three months later with biliary tract obstruction secondary to pancreatic adenocarcinoma metastatic to the liver. The glomerulopathy and polymyalgia rheumatica in this case seemed to be components of the paraneoplastic syndrome. The response of both entities to prednisone therapy supports the hypothesis that they are caused by derangements in cell-mediated immunity. The fact that the tumor progressed despite resolution of the nephrosis and polymyalgia rheumatica suggests that cell-mediated immunity in general is altered by the tumor and not that the carcinoma liberates a factor that directly damages the kidney.

Adenocarcinoma↗
PubMed1985

Renal biopsy: localization using computed tomography.

The percutaneous renal biopsy is a commonly used diagnostic procedure. Computed axial tomography (CAT) can assist in precise placement of the biopsy needle into the renal parenchyma in clinical situations in which standard imaging techniques (fluoroscopy and ultrasound) are not suitable.

Adult↗
PubMed1984

Acute renal failure associated with mannitol intoxication. Report of a case.

Mannitol intoxication has been reported as a potentially life-threatening complication when the agent is used unrestrictedly in patients with established renal failure. We report a case of mannitol intoxication in which acute oliguric renal failure occurred without a known predisposing factor other than the intravenous infusion of massive quantities of mannitol.

Acute Kidney Injury↗
PubMed1982

CSF pleocytosis.

Explore the source record for details and available documents.

Adult↗
PubMedDate not supplied

Diabinese-Dialume: a potential catastrophe.

An oral hypoglycemic drug (Diabinese-chlorpropamide) was given inadvertently to a nondiabetic with renal insufficiency instead of the prescribed phosphate binder (Dialume-aluminum hydroxide). It was determined from this situation that hemodialysis is of no benefit in removing the drug from serum; the hypoglycemic effect of chlorpropamide is profound in nondiabetics, and the duration of therapy with dextrose infusions can be quite prolonged. We provide recommendations regarding therapy, bedside glucose monitoring, and prevention.

Adult↗