Browsing by Author "Sinclair, P"

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    Hypertensive encephalopathy with CT confirmation in four children with acute renal disease
    (2005) Andronikou, S; Patel, M; Sinclair, P; McCulloch, M
    Hypertensive encephalopathy (HE) is a clinical syndrome that occurs infrequently in children and is often underdiagnosed. We review four patients with HE and describe their clinical presentation and radiological findings on computed tomography (CT). Our cases demonstrate typical features on CT and correlate clinically with the syndrome of HE. Prompt recognition of the syndrome aids in earlier diagnosis and treatment, and hence proves beneficial to the patient.
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    Overview of a paediatric renal transplant programme
    (2006) McCulloch, M; Gajjar, P; Spearman, W; Burger, H; Sinclair, P; Savage, L; Morrison, C; Davies, C; Ruysch van Dugteren, GPA; Maytham, D; Wiggelinkhuizen, J; Pascoe, M D; McCurdie, F J; Pontin, A; Muller, E; Numanoglu, A; Millar, A J W; Rode, H; Khan, D
    INTRODUCTION: Renal transplantation is the therapy of choice for children with end-stage renal failure. There are many challenges associated with a paediatric programme in a developing country where organs are limited. METHODS: A retrospective review was undertaken of 149 paediatric renal transplants performed between 1968 and 2006 with specific emphasis on transplants performed in the last 10 years. Survival of patients and grafts was analysed and specific problems related to drugs and infections were reviewed. RESULTS: On review of the total programme, 60% of the transplants have been performed in the last 10 years, with satisfactory overall patient and graft survival for the first 8 years post transplant. At this point, transfer to adult units with non-compliance becomes a significant problem. Rejection is less of a problem than previously but infection is now a bigger issue--specifically tuberculosis (TB), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections with related complications. A wide variety of drugs are available for tailoring immunosuppression to minimise side-effects. CONCLUSION: It is possible to have a successful paediatric transplant programme in a developing country. However, to improve long-term outcomes certain issues need to be addressed, including reduction of nephrotoxic drugs and cardiovascular risk factors and providing successful adolescent to adult unit transition.