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EN
Background: Together with increasing life expectancy of patients with cystic fibrosis (CF), there is a growing need to deal with unforeseen problems and complications. Among others renal dysfunction has become of great concern. Aim: Evaluation of renal function in CF children. Material and methods: We performed cross-sectional study on a group of 11 teenage inpatients with CF. Physical examination, past medical history analysis, renal function measurements and analysis were conducted in all of them. Renal assessment included: serum cystatin C and creatinine levels, measured and estimated creatinine clearance, estimated cystatin C clearance, urine indicators of crystallization risk and renal ultrasonography. Results: One patient had elevated serum cystatin C level and diminished McIsaac equation. Renal ultrasound revealed non-congenital anomaly in 1 case – it was nephrolithiasis. All the individuals had elevated at least 1 urine indicator of crystallization risk. Conclusion: There is a great need of good, standardized test of renal function in cystic fibrosis patients. The focus of research should turn towards finding a tool similar to faecal elastase, which is cheap, easy to perform, sensitive and specific, and can be used to confirm the diagnosis.
PL
Wstęp: Wraz z wzrastającą długością życia chorych na mukowiscydozę (CF), zaistniała potrzeba radzenia sobie z nowymi jej powikłaniami. Między innymi zaburzenie czynności nerek stało się nowym wyzwaniem. Cel: Ocena czynności nerek u dzieci z mukowiscydozą. Materiał i metody: Przeprowadzono badanie przekrojowe na grupie jedenastu nastoletnich pacjentów z CF hospitalizowanych w IMiDz. U wszystkich przeprowadzono dokładny wywiad dotyczący przebiegu choroby, wywiad rodzinny, badanie fizykalne oraz pomiary czynności nerek. Ocena nerek polegała na oznaczeniu: cystatyny C i kreatyniny w surowicy, klirensu kreatyniny oraz klirensu cystatyny C, wskaźników ryzyka krystalizacji moczu i USG nerek. Wyniki: Jeden pacjent miał podwyższone stężenie cystatyny C w surowicy oraz obniżony klirens cystatyny McIsaaca. W 1 przypadku USG nerek wykazało nieprawidłowość − była to kamica nerkowa. U wszystkich badanych pacjentów co najmniej jeden wskaźnik ryzyka krystalizacji moczu był podwyższony. Wniosek: Istnieje wielka potrzeba dobrego, wystandaryzowanego badania czynności nerek u pacjentów z mukowiscydozą. Przedmiotem badań powinno być znalezienie narzędzia podobnego do oznaczenia stężenia elastazy w kale – testu, który jest łatwy do wykonania, czuły i specyficzny oraz może być stosowany w celu potwierdzenia diagnozy.
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EN
Renal function impairment during interventional procedures became a real clinical problem. Contrast related nephropathy is the most common cause of renal failure, however, the procedure-related technical troubles may cause unexpected renal dysfunction.Technical failure of EVAR resulting in acute renal dysfunction is presented. The postprocedural occlusion of the right renal artery was treated in chimney technique. Early reintervention allowed the kidney preservation and renal function restoration. It is impossible to avoid all the complications following treatment of aortic aneurysm, but they can be anticipated and comprehensively treated in collaboration with other specialists.
EN
The subject of this study was to determine urine specific gravity (USg) and urinary creatinine (UCrn) in dogs with different diseases but with normal renal function. Sick dogs with different diseases were divided into nine groups. Dogs suffering from polyuria/polydipsia, vomits, diarrhoea and females in oestrus or pregnant were excluded from the studies. The healthy dogs served as a control group. Over a three-year period, a total of 267 dogs were examined clinically as well as using imaging and laboratory diagnostics methods. In sick dogs, USg and UCrn were found to be essentially decreased (except animals with neurological and uterine diseases, and neurological diseases, respectively), as compared with normal dogs. In clinically healthy animals of the control group, UCrn and USg did not significantly differ between the females and males. As for the control group, no correlation between UCrn/USg and the body weight/age was found, either.
EN
Schönlein-Henoch purpura is the commonest acute vasculitis in childhood. IgA deposits are seen in patient’s small blood vessels. They are the reason of local inflammation, circulatory disturbance and focal necrosis (vasculitis leukocytoclastica). Pathogenesis of the disease is not known. Plasma IgA (especially IgA1) level is increased and there are immune complexes and antibodies against IgA in the blood of affected patients. Complexes affects renal mesangium leading to various forms of glomerulonephritis. Renal symptoms have a wide range of severity, from asymptomatic microscopic haematuria to nephrotic syndrome and renal failure. Most renal involvement occurs early, 85% within first month. Nevertheless they can develop later, usually to 6 months from the beginning of the disease. They worsens generally good prognosis. Renal biopsy is indicated when there is the risk of long-term renal damage and more aggressive therapy is required. In estimation of the type of glomerulonephritis the ISKDC (International Study of Kidney Disease in Children) classification is commonly used. We describe here various strategies of the therapy of renal forms of the disease. Pulsed cyclophosphamide with methylprednisolone is well accepted therapy. Early intervention can prevent patients progressing to end stage renal failure.
PL
Choroba Schönleina-Henocha jest najczęstszą formą zapalenia drobnych naczyń u dzieci. W naczyniach chorych odkładają się kompleksy immunologiczne zawierające immunoglobulinę A (IgA), wywołują one miejscowy stan zapalny i prowadzą do zaburzeń przepływu krwi i powstawania miejscowych ognisk martwicy (vasculitis leukocytoclastica). Przyczyna choroby pozostaje nieznana. W patomechanizmie podkreśla się zwiększenie stężenia IgA (zwłaszcza IgA1) w surowicy oraz obecność krążących kompleksów IgA i przeciwciał przeciwko IgA. Kompleksy immunologiczne mogą odkładać się w mezangium nerek, prowadząc do powstania różnych form kłębuszkowego zapalenia. Objawy ze strony nerek mogą przybierać różną formę: od bezobjawowego mikroskopowego krwinkomoczu do w pełni wyrażonego zespołu nerczycowego i niewydolności nerek. Zmiany w nerkach zazwyczaj pojawiają się wcześnie, w 85% przypadków w pierwszym miesiącu trwania choroby. Mogą jednak wystąpić w ciągu 6 miesięcy od pojawienia się pierwszych objawów. Ich obecność zmienia pomyślne zazwyczaj rokowanie na gorsze. W przypadku gdy istnieje zagrożenie przewlekłego uszkodzenia nerek i rozważa się wprowadzenie agresywnego leczenia, pojawiają się wskazania do wykonania biopsji nerki. W ocenie rodzaju kłębuszkowego zapalenia nerek posługujemy się powszechnie klasyfikacją ISKDC (International Study of Kidney Disease in Children). W opracowaniu zostały opisane najczęściej stosowane metody leczenia nerkowej postaci choroby. dotychczas nie ustalono jednego obowiązującego sposobu postępowania. Najczęściej stosowane są połączenia kortykosteroidów oraz pulsów z cyklofosfamidu. Jak najszybsze wdrożenie leczenia może zapobiec wystąpieniu przewlekłej choroby nerek i jej postępowi do formy schyłkowej.
EN
The effects of artificial UVC radiation on some blood and urine parameters related to hepatic and renal functions in mice radiated with 30-watt UVC lamp (254 nm and 0.00014 J/cm²/s) were examined. Sixty female mice (Swiss Albino) were used as test animals. The animals were fed a mouse diet and water ad libitum and then exposed to artificial UVC for 8 h daily. Blood and urine samples were taken before radiation (control) and at the 7th, 15th, 30th, 45th, 60th and 75th d after radiation exposure. The samples were collected in different pools. Urea, creatinine, cholesterol, ALT, AST, ALP, and GGT levels were determined in serum, and protein electrophoresis was made (SDS-PAGE) in urine samples. Significant increase (P<0.001) in serum urea values were observed on the 15th and 30th d of the exposure. Urea levels returned to the initial values. Increase in creatinine levels after 7th d of exposure and decrease until the 60th d (significant on the 15th and 45th d) were found. Creatinine levels increased again on the 75th d (P<0.001). Serum cholesterol and AST values were significantly increased (P<0.01) during the whole period of the exposure, except the 45th d. Serum ALT levels were not significantly affected during 30th d exposure. They decreased on the 45th d (P<0.01) and then increased on the 75th d (P<0.01). Serum GGT and ALP levels were decreased during the whole period of the exposure (P<0.01), and GGT activity was at immeasurable levels on the 30th, 45th, and 60th d. Proteinuria, determined by microscopic observation of urine sediment, and the increase in serum urea and creatinine, observed on the 7th and 75th d of the exposure, were considered a renal disorder, and according to the electrophoretical pattern of urine proteins (SDS-PAGE) were defined as mostly glomerulo-tubular type and glomerular type. This indicates that artificial UVC radiation significantly affected the renal function (P<0.01), while the hepatic functions were affected significantly (P<0.01) just on the 75th d of the exposure. Concerning the data, which coincide one on the top of the other, there was the opinion that the kidneys and liver showed different sensitivity to artificial UVC radiation.
EN
The experiment was carried out on 4 pregnant goats at age 2–3 years. Changes in basic indices of renal function were analysed in the scope of hydro–electrolyte management in the consecutive five months of gestation. Blood and urea samples were collected fortnightly during the first three months of gestation, and weekly during the remaining two months. The analyses included urea volume and glomerular filtration rate, as well as blood plasma concentration, clearance, tubular reabsorption and excretion of sodium, potassium, chlorides and total osmotically active substances.
EN
The effect of the Panax ginseng powder extract on reproduction, growth, renal and liver functions and some blood biochemical indices of Japanese quails were investigated. Panax ginseng powder extract at 2 mg and 4 mg/bird daily increased egg number per hen, average egg weight and hatchability. It slightly improved the efficiency of feed utilization and increased the levels of serum total protein, alkaline phosphatase and aspartate amino transferase (AST). The extract decreased significantly the levels of albumin, total lipids, triacylglycerols, cholesterol and glucose, and had no effect on body weight and the levels of serum bilirubin, urea and creatinine. This suggests that long term studies should be done on many different biochemical and physiological parameters and laboratory animals.
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