Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Sep 2003
Case Reports Comparative StudyRecurrent calcinosis in consecutively transplanted kidney grafts.
Repeated renal transplant calcinosis is a rare event. We report a young woman in whom repeated calcinosis was observed in two consecutive renal transplants. Persistent secondary hyperparathyoidism and hyperphosphatemia due to impaired renal function were assumed as the pathogenic factors for calcinosis. Sub-total parathyroidectomy performed shortly after the third transplantation and good function of the renal graft have prevented calcinosis in the third graft for more than five years.
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Wien. Klin. Wochenschr. · Sep 2003
Review Comparative Study[Sympathetic overactivity and the kidney].
Hypertension is present in the majority of patients with chronic renal failure and constitutes a major risk factor for the very high cardiovascular morbidity and mortality in this patient population. Furthermore hypertension is known to be a substantial progression factor in renal disease. In the past, it had been presumed that hypertension in chronic renal failure is due to enhanced sodium retention, chronic hypervolemia and increased activity of the renin-angiotensin-aldosterone-system. ⋯ The treatment goal in renal patients is to delay or even prevent progression of renal failure and to reduce the cardiovascular risk. Recent studies have investigated the respective impact of sympatholytic drugs, e.g. inhibitors of the renin-angiotensin-aldosterone-system, beta-blockers or I1-Imidazolin-receptor-agonists in fulfilling these aims. The present report will review experimental and clinical studies on the role of sympathetic overactivity in hypertension and chronic renal failure and possible new therapeutic options.
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Wien. Klin. Wochenschr. · Sep 2003
Case ReportsPosttraumatic splenic artery aneurysm presenting as occult gastrointestinal bleeding.
A 53-year-old man presented with a 19-month history of gastrointestinal bleeding. Repeated endoscopic investigation of the upper and lower intestine showed no source of bleeding. When the patient collapsed due to massive gastrointestinal hemorrhage he was referred to our center. ⋯ Arteriography of the celiac trunk confirmed the SAA diagnosis; the SAA was subsequently occluded by coils. So far, four months after discharge, the patient is in excellent health and no further episode of gastrointestinal bleeding has occurred. SAA is a very rare cause of upper gastrointestinal bleeding, but it must be considered when no other common bleeding source can be detected.
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Wien. Klin. Wochenschr. · Sep 2003
Comparative StudyEfficacy and tolerability of non-invasive ventilation delivered via a newly developed helmet in immunosuppressed patients with acute respiratory failure.
To assess efficacy and tolerability of a newly developed helmet for the delivery of non-invasive ventilation in patients with acute respiratory failure. ⋯ NIV delivered via the helmet is effective and may serve as a better tolerated alternative to endotracheal intubation and to NIV via a standard face mask.