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Cardiac tamponade due to acute rheumatic carditis: Case report
Esra ?evketo?lu,Bahar Saliho?lu,Canan Hasbal,Sami Hatipo?lu
Medical Journal of Bakirk?y , 2006,
Abstract: Rheumatic fever is a serious complication of group A streptococcal infections in childhood. The patients rarely present different clinical presentation. We present a patient with cardiac tamponade due to Acute Rheumatic Fever (ARF). Case: A 12 years old male patient complained about chest and back pain, shortness of breath, palpitation. After the examination, echocardiogram was performed and pericardial tamponade, moderate aort insufficiency was diagnosed and periocardiosyntesis was performed at the same time. The uid was examined. Antibiotherapy and anti-in ammatory treatment was initiated. On the third day of treatment, control echocardiogram was performed and no pericardial effusion was detected. Besides in addition to moderate aort insufficiency, moderate- severe mitral insufficiency was observed. The diagnosis of ARF established by Jones criteria when the patient fulfilled one major and two minor criteria.
Cardiac tamponade due to acute rheumatic carditis: Case report
Esra ?evketo?lu,Bahar Saliho?lu,Canan Hasbal,Sami Hatipo?lu
Medical Journal of Bakirk?y , 2005,
Abstract: Rheumatic fever is a serious complication of group A streptococcal infections in childhood. The patients rarely present different clinical presentation. We present a patient with cardiac tamponade due to Acute Rheumatic Fever (ARF). Case: A 12 years old male patient complained about chest and back pain, shortness of breath, palpitation. After the examination, echocardiogram was performed and pericardial tamponade, moderate aort insufficiency was diagnosed and periocardiosyntesis was performed at the same time. The uid was examined. Antibiotherapy and anti-in ammatory treatment was initiated. On the third day of treatment, control echocardiogram was performed and no pericardial effusion was detected. Besides in addition to moderate aort insufficiency, moderate- severe mitral insufficiency was observed. The diagnosis of ARF established by Jones criteria when the patient fulfilled one major and two minor criteria.
"Acute renal failure: A prospective four months study at Shariati Hospital "
"Najafi I,Ganji MR,Kayedi M,Haghighatkhah HR
Acta Medica Iranica , 2001,
Abstract: To delineate the incidence , epidemiology, etiology, and prognosis of acute renal failure (ARF) and to compaed the findings with international data, we prospectively studied 2360 patients, admitted at shariati hospital during a four months period ending on Jan, 6, 1996. One hundred and twenty-four (5.1%) patients meeting ARF crieteria were encountered. The most common cause of ARF was prerenal azotemia, nephrotoxins were the second common cause, and primary renal disease were the third.In-hospital mortality was 5.5% and 31% of this mortality was related to ARF. Poor prognostic factors were oliguria, maximum serum ceratinine (Cr) level, rise of Cr during admission, multiorgan failure,and sepsis.
PREGNANCY RELATED ACUTE RENAL FAILURE
QURBAN ALI SHAIKH
The Professional Medical Journal , 2008,
Abstract: Introduction: Acute renal failure (ARF) during pregnancy is rareevent and continues to be common in developing countries. Period: 1998-2005. Setting: Nephro-urology unit atChandka Medical College, Larkana. Study Design: Retrospective study. Patients & Methods: 294 cases of AcuteRenal Failure were treated. Among these cases, 72 (24.5%) were pregnancy related in origin. All of these patients wereknown to be previously healthy. Results: Pregnancy related Acute Renal Failure was associated with, post partumhemorrhage was in 20(27.7%), intra uterine death in 20(27.7%) antipartum hemorrhage was 18(25%), preeclampsiaeclampsiain 8(11.11%) and septic abortion and puerperal sepsis in6(8.3%). Among these patients 65(90.3%) requireddialysis therapy because of moderate to severe azotemia. 35(48.61%) patients recovered normal function. 30(46.15%)developed irreversible renal function. Conclusion: Early reorganization of this disorder, improvement of health infrastructure, antenatal health care and intensive supportive therapy, can reduce maternal and fetal mortality and morbidity.
生长素反应因子作用机制研究进展
史梦雅,李阳,张巍,刘悦萍
生物技术通报 , 2012,
Abstract: 概述ARF的结构和功能特点,其与Aux/IAA阻遏子之间的作用方式,以及它在生长素信号转导过程中的调控机制;对ARF基因在不同植物中的分布构成,表达特点,突变体的表型,以及转录后调控的研究现状进行了归纳分析。
Continous venovenous hemodialysis (CVVHD): Report of 3 cases
Seirafian Sh,Bastani B
Tehran University Medical Journal , 1998,
Abstract: Some of ICU patients with Acute Renal Failure (ARF) require dialysis. Conventional or intermittent hemodialysis (HD) may cause hypotension and insufficient loss of fluids and toxins from blood. Peritoneal dialysis also my cause peritonitis and has lower efficiency than HD. We did continuous Venovenous Hemodialysis (CVVHD) for three ICU patients with ARF in Saint-Zahra Medical Center for the first time in our country. Method and Material: With a polysulfone membrane, blood pump, peritoneal dialysis solution, heparin, and a fix nurse, HD was done for 12-24 hours. Results: 1) Urea clearance was 18-50 ml/h. 2) Ultrafiltration was 160-1000 ml/h. 3) With dialysis, hemorrhage, coagulation disorder, and oxygenation recovered. 4) All of patients developed hyperglycemia and hypothermia. 5) All of patients died (two with septicemia and one with hypotension). Conclusion: In the absence of hemodialysis or peritoneal dialysis, CVVHD with present preliminary equipments is suitable and can excrete more toxins and fluids.
Continuous Renal Replacement Therapy
Dr. Manish Chaturvedi
Indian Anaesthetists' Forum , 2004,
Abstract: It is a mode of renal replacement therapy for hemodynamically unstable ;fluid overloaded; catabolic septic patients and finds its application in management of acute renal failure especially in the critical care /intensive care unit setting. The popularity of ?slow continuous therapies? for the treatment of critically ill patients with renal failure is increasing. The techniques most commonly used are slow continuous hemodialysis and hemodiafiltration. Slow continuous hemofiltration and slow continuous ultrafiltration also are commonly used.
ACUTE RENAL FAILURE
Khalid Amin
The Professional Medical Journal , 2001,
Abstract: OBJECTIVES: 1) To find out the etiology and prevalence of acute renal failure in our society2) To minimize the number of patients of ARF by adopting preventive measures 3) To providehealth facilities at door-step according to the nature of disease. PERIOD: Jan 1997 to end ofJune 1998. SETTING: Allied Hospital/PMC, Faisalabad, Aziz Fatima Trust Hospital andNational Hospital, Faisalabad. PATIENTS & METHODS: A total of 100 patients were studied. The datawas collected on a special proforma containing informations regarding name, age, sex, occupation, historyof oliguria, anuria, color of urine, body swelling, drug intake, vomiting, diarrhea, blood loss, stone etc.RESULTS: 62 were males and 38 females. The mean age was 54 years. Out of 100 patients pre-renalcauses were present in 48 patients i.e. 48%. Intrinsic renal azotemia was present in 45 patients i.e. 45% andpost renal azotemia was present in 7 patients i.e. 7%. CONCLUSIONS: ARF occurs in our society due tomis-managed obstetrical / gynacological or surgical problems, hot-humid environment, infections, drugabuse (Kushta intake), poisoning or partially treated medical causes. SUGGESTIONS: Government shouldprovide health facilities at door step, in case of gynaecological and surgical patients. Dai or quack handlingshould be avoided
ACUTE RENAL FAILURE
QURBAN ALI SHAIKH
The Professional Medical Journal , 2008,
Abstract: Objective: To find out the various causes of acute renal failure (ARF) and its out come in our settingof tertiary Care Hospital in rural areas. Design: A retrospective Study. Setting: Nephro-urology department ChandkaMedical College teaching hospital Larkana. Period: From March 1998 to March 2005. Patients & Methods: Reviewof 294 patients of acute renal failure admitted in Nephro-urology department Chandka Medical College teachinghospital Larkana. Detailed history, physical examination and laboratory data of 294 consecutive patients of acute renalfailure were analyzed. Result: 294 patients were included in this study. Among them 149 (51.7%) were in the youngerage group (less than 40 years) with dominance of males (1.61 to 1.00 male to female ratio). Major cause of ARF waspre renal, seen in 172 (66.6%) patients, 70 (23.8%) of all cases of acute renal failure had gynecological and obstetricalback ground. Other causes C.V.A in 24 (9.3%), HHD in 14(4.5%). Glomerulonephritis in 22(8.5%),and obstructiveuropathy in 16(6.2%). 92 Patients (31.3%) improved on conservative treatment,166(56.5%) needed dialysis and36(12.2%) left against medical advice. Conclusion: This data reveals that pre renal element is the single mostimportant cause of acute renal failure, in which commonest cause was pregnancy related ARF followed by C.V.A,HHD,glomerulonephrits and obstructive urophathy. Early indentification, referral treatment of pre renal factors, good perinatal care and good therapeutic measures substantially bring down the incidence of acute renal failure. 12.2% patientsleft against medical advice due to heavy expenses on the treatment and needs NGOs and Government support fortreatment of poor patients.
Continuous veno-venous hemofiltration for ARF in critically Ill patients
Lobo Valentine,Joshi Aniket,Joseph Seema,Wandre Sudhir
Indian Journal of Critical Care Medicine , 2004,
Abstract: The mortality of critically ill patients who develop ARF in an ICU setting is extremely high (50-80%). Any mode of renal replacement therapy chosen should be able to achieve solute and water clearance while maintaining hemodynamic stability, have a positive effect on nutrition, and have low complication rates. AIM: To determine the efficacy and feasibility of Continuous Venovenous hemofiltration (CVVH) in critically ill patients with ARF. Inclusion criteria: Patients with ARF requiring 2 or more inotropes to maintain systolic blood pressure >100 mm of Hg. Failed or technically impossible hemodialysis or peritoneal dialysis. Time Period: July 2002 - June 2003. MATERIALS AND METHODS: Polysulfone hemofilter 0.7m2, [Aquamax (Edwards) or Multimat BL680 (Bellco).] Blood flow of 150-200 ml/minute (Travenol). Volumetrically controlled Ultrafiltration of > 2000 ml per hour (Watson Marlowe) and replacement fluid infusion [(Infusomat-P) post filter]. Anticoagulation: Heparin infusion or regional heparinisation. RESULTS: 22 patients included, 6 with recent abdominal surgery. 11 underwent hemodiafiltration and hemofiltration each. Severe sepsis was present in 21, and DIC in18. 5 patients were on immunosuppressive therapy. The time from ICU admission to the start of CVVH was 114 + 88.08 hours. The duration of CVVH was 35.93 + 20.91 hours, (range 11 to 84 hours). The mean hourly ultrafiltration of 93.72 + 65.57 ml and total ultrafiltration of 3955.55 + 4132 ml was tolerated by all patients without limiting hypotension. The APACHE II scores had significantly worsened between admission (22.5 + 6.71) to starting CVVH (36.05 + 4.08), [P<0.001]. The daily costs of CVVH were Rs. 5000 compared to Rs. 2150 for PD and Rs. 1500 for extended daily dialysis CONCLUSIONS: CVVH was effective in providing metabolic correction in ARF, in the setting of multi-organ failure. It is technically feasible even when conventional hemodialysis or peritoneal dialysis cannot be performed.
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