ABSTRACT
BACKGROUND: Patients with spinal cord injury have a significant degree of morbidity and mortality caused by renal disease. Tubulointerstitial form of renal disease with minimal proteinuria predominate in this population. A retrospective study was performed to investigate the risk factors that may contribte to the development of proteinuria in patient with chronic spinal cord injury. METHODS: Between December 1999 and May 2000, 40 spinal cord injury patient in Korean Veterans Hospital were recurited retrospectively into the study. The information was gathered included medical record, laboratory data, and radiological study. RESULTS: Proteinuric subjects were older, had a longer duration of injury, had undergone a greater number of decubitus ulcer procedures and hydronephrosis. CONCLUSION: Proteinuria in the patients with spinal cord injury was related to the increase of the therapy for the decubitus ulceration, hydronephrosis, and the duration of the spinal cord injury, and it developed significantly more in paraplegia patients than in quadriplegia patients, which might be due to the more duration of the spinal cord injury in paraplegia patients. Therapeutic efforts directed toward preserving renal function should focus on avoidance of hydronephrosis, and decubitus ulceration.
Subject(s)
Humans , Amyloidosis , Hospitals, Veterans , Hydronephrosis , Medical Records , Mortality , Paraplegia , Pressure Ulcer , Proteinuria , Quadriplegia , Retrospective Studies , Risk Factors , Spinal Cord Injuries , Spinal CordABSTRACT
Pichia ohmeri is a very rare pathogen of human infection. To date, two cases of P. ohmeri infection were reported worldwide. We have experienced a case of catheter-related P. ohmeri fungemia. The patient had been admitted due to cerebrovascular accident in rehabilitation center since August 1998. He had been bedridden due to previous cerebrovascular accident and undergone several episodes of nosocomial infection. Multiple antimicrobial agents had been used with central venous catheter for parenteral nutrition. On February 1999, he had developed fever and dyspnea. Vancomycin and imipenem were administered empirically and central venous catheter was removed on the impression of central venous catheter related infection. Blood culture and catheter tip culture grew P. ohmeri. He developed septic shock and finally led to death before the administration of amphotericin B.
Subject(s)
Humans , Amphotericin B , Anti-Infective Agents , Catheters , Central Venous Catheters , Cross Infection , Dyspnea , Fever , Fungemia , Imipenem , Parenteral Nutrition , Pichia , Rehabilitation Centers , Shock, Septic , Stroke , VancomycinABSTRACT
Rhabdomyolysis is defined as skeletal muscle injury with release of muscle cell constituents into the plasma and may lead to acute renal failure secondary to myoglobinuria. The causes of rhabdomyolysis is diverse:alcohol abuse, primary muscle disease, disturbance of muscle metabolism, sustained seizure, infection, drugs, tox ins, trauma, severe exercise, CO intoxication etc. Rhabdomyolysis may cause acute derangement in electrolyte balance and death. It should be diagnosed earlier and managed properly. We experienced a 49 year-old woman developed acute renal failure and myoglobinuria after alcohol drinking. A kidney biopsy revealed acute interstitial nephritis. In the presence of otherwise unexplained acute renal failure in alcoholic patients, rhabdomyolysis should be considered in the differential diagnosis.