ABSTRACT
A prospective analysis of 61 patients undergoing abdominal aneurysmectomy is presented. When compared with 87 historical controls we have shown that the incidence of hypotensive episodes (31 out of 62 patients in the original study compared with 13 out of 44 patients in the prospective analysis) is significantly reduced when fluid balance is monitored invasively using the pulmonary artery wedge pressure and keeping it at 10 mm H2O (p less than 0.03). Renal dysfunction, defined as a significant drop in urine output and a doubling of the serum creatinine, occurred in only 10% of patients compared with 33% in the controls (p less than 0.001). The decreased prevalence of renal failure accounts for the reduction in mortality noted (p less than 0.01). There were 27 deaths (31%) amongst the patients in the earlier study compared with 9 (15%) in the prospective analysis. The pathogenetic mechanisms responsible for the development of renal failure following surgical manipulation of the abdominal aorta are reviewed.
Subject(s)
Acute Kidney Injury/prevention & control , Aneurysm/surgery , Catheterization, Swan-Ganz , Fluid Therapy , Renal Artery/surgery , Abdomen , Acute Kidney Injury/etiology , Aged , Aged, 80 and over , Aneurysm/epidemiology , Female , Humans , Male , Middle Aged , Postoperative Complications/prevention & control , Prospective Studies , Pulmonary Wedge PressureSubject(s)
Liver/analysis , Nuclear Envelope/analysis , Animals , Nucleoproteins/analysis , Rats , Species Specificity , SwineSubject(s)
Kidney Transplantation , Tissue Donors , Humans , Patient Care Team , Psychology , Psychology, Social , Transplantation, HomologousABSTRACT
Biochemical studies of psychiatric patients have revealed many abnormalities but have failed to identify specific biochemical changes linked to the pathophysiology of the illnesses. Review of these data in the light of newer concepts of psychiatric diagnosis may help to clarify the relationship between biochemical abnormalities and disabilities. These concepts may also suggest useful directions for future research.
Subject(s)
Mental Disorders/diagnosis , Brain Diseases/complications , Humans , Mental Disorders/etiology , Mental Disorders/metabolism , Metabolism, Inborn Errors/complications , Metabolism, Inborn Errors/diagnosis , Phenethylamines/metabolism , Phenylalanine/metabolismABSTRACT
Eighteen chronic hemodialysis patients were interviewed by staff trained in sex therapy. Compared with the pre-uremic phase, sexual satisfaction was less in nine subjects, greater in four; frequency of intercourse had declined in ten subjects. Dysfunctions of sexual response were reported by five men and six women. Analysis of physical factors, medication and depression showed no clear association with sexual dysfunction, suggesting the importance of psychosocial factors. A trial of sex therapy in renal patients in proposed.
Subject(s)
Kidney Failure, Chronic/complications , Renal Dialysis , Sexual Dysfunction, Physiological/etiology , Adult , Aged , Antihypertensive Agents/adverse effects , Diabetes Complications , Erectile Dysfunction/etiology , Female , Humans , Libido , Male , Middle Aged , Orgasm , Sexual Behavior/drug effects , Sexual Dysfunction, Physiological/psychology , Sexual Dysfunction, Physiological/therapySubject(s)
Procaine/therapeutic use , Aged , Aging/drug effects , Anesthetics, Local/pharmacology , Anticholesteremic Agents/pharmacology , Dementia/drug therapy , Depression/drug therapy , Humans , Hydrogen-Ion Concentration , Monoamine Oxidase Inhibitors/pharmacology , Procaine/adverse effects , Procaine/metabolism , Procaine/pharmacologySubject(s)
Calcium/physiology , Cell Nucleus/physiology , Magnesium/physiology , Animals , Chickens , Chromatin/physiology , In Vitro Techniques , SwineABSTRACT
In a survey of 121 workers exposed to dusts containing derivatives of Bacillus subtilis, mainly proteolytic enzymes, skin tests showed evidence of sentiztation was higher among "atopic" subjects-16 out of tization was higher among "atopic" subjects-16 out of 25 (64%)-than among "non-atopic" subjects-32 out of 96 (33%). Reduced ventilatory capacity was found in 44% of sensitized workers compared with 14% of those not sensitized.
