Loin pain haematuria syndrome 1967-2020: a review.

The purpose of this retrospective review is to question the validity of the condition 'loin pain haematuria syndrome' (LPHS). We highlight the possibility that most patients regarded as having LPHS have a psychiatric/psychological basis for their symptoms, particularly loin pain. Because of this, and because it recurs despite treatment, the review also questions the use of treatments that are invasive, expensive, and carry considerable morbidity.

Pulse Pressure Relationships with Demographics and Kidney Function in Ashanti, Ghana.

Introduction: Hypertension, particularly pulse pressure [PP] is a major risk factor for end-stage renal disease. However, the effect of individual components of hypertension namely PP, systolic [SBP] and diastolic blood pressure [DBP] on kidney function, in the general African population is unknown.

Methods: Data were collected on 944 participants [aged 40-75 y], living in villages in the area around the city of Kumasi, Ghana, on demographics, medications, height, weight, BP and 24-hour creatinine clearance (CrCl).

Nutcracker phenomenon presenting as loin pain haematuria syndrome.

A 19-year-old female presented with bilateral severe loin pain associated with recurrent macroscopic haematuria. A provisional diagnosis of loin pain haematuria syndrome was made; the severity and frequency of pain led to referral to the pain management service. Alternative diagnoses were considered.

Tuberculosis and tubulointerstitial nephritis: an intriguing puzzle.

Classical renal tuberculosis is a well-known cause of urinary tract scarring and calcification, and sometimes renal dysfunction. In the past two decades there have been reports, particularly from the United Kingdom among immigrants from the Indian subcontinent, of a more insidiously progressive form of renal disease. Ultrasound shows small smooth kidneys, and histology reveals tubulointerstitial nephritis including granulomas but not acid-fast bacilli.

Assessment of GFR by four methods in adults in Ashanti, Ghana: the need for an eGFR equation for lean African populations.

Background: Equations for estimating glomerular filtration rate (GFR) have not been validated in Sub-Saharan African populations, and data on GFR are few.

Methods: GFR by creatinine clearance (Ccr) using 24-hour urine collections and estimated GFR (eGFR) using the four-variable Modification of Diet in Renal Disease (MDRD-4)[creatinine calibrated to isotope dilution mass spectrometry (IDMS) standard], Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockcroft-Gault equations were obtained in Ghanaians aged 40-75. The population comprised 1013 inhabitants in 12 villages; 944 provided a serum creatinine and two 24-hour urines.

Shortage of healthcare workers in developing countries--Africa.

The already inadequate health systems of Africa, especially sub-Saharan Africa, have been badly damaged by the migration of their health professionals. There are 57 countries with a critical shortage of healthcare workers, a deficit of 2.4 million doctors and nurses.

Haemodialysis and peritoneal dialysis patients admitted to intensive care units.

Hutchison and colleagues report a 10-year experience of dialysis patients admitted to intensive care units (ICUs) in the UK excluding Scotland. Their study is the largest published so far and raises issues of interest to both ICU physicians and nephrologists. Overall, the dialysis patients, although sicker on admission and having pre-existing co-morbidities, do as well as other ICU patients.

Gastrointestinal symptoms in patients with end-stage renal disease undergoing treatment by hemodialysis or peritoneal dialysis.

Objectives: The aim of this study was to determine the prevalence of gastrointestinal symptoms in patients with end-stage renal disease undergoing hemodialysis (HD) or peritoneal dialysis (PD) treatment.

Methods: Patients undergoing HD or chronic ambulatory PD in the Department of Renal Medicine of our hospital were asked to complete a locally validated Rome II questionnaire. The same questionnaire was also administered to age- and gender-matched medical outpatients without renal failure, and community subjects.

Re-training refugee and other overseas doctors: re-qualification through the United Examining Board examination.

The Professional and Linguistic Assessments Board test is well suited to overseas doctors who have migrated for reasons of career development but less so for groups such as refugees who have not had time to prepare for migration and may not speak English. We describe a 12-month structured clinical course leading to re-qualification, for 70 refugee and other overseas doctors. Between 1996 and 2003, 69 of the 70 overseas doctors on the course (27 of whom were refugees) re-qualified through the examination of the United Examining Board.

A community programme to reduce salt intake and blood pressure in Ghana [ISRCTN88789643].

Background: In Africa hypertension is common and stroke is increasing. Detection, treatment and control of high blood pressure (BP) is limited. BP can be lowered by reducing salt intake.

Reducing selection bias in a cluster randomized trial in West African villages.

Selection bias in cluster randomized trials may threaten the validity of the results. This bias may occur either at the level of the cluster or of the individual. We describe measures for maintaining comparability of intervention groups in a cluster randomized trial of a health education package to reduce dietary salt.

Blood pressure and body mass index in lean rural and semi-urban subjects in West Africa.

Background: Blood pressure (BP) is positively related to body mass index (BMI) in persons of both Caucasian and African origin, but the precise nature of the relationship is unclear.

Objective: To study the relationship between BP and BMI in a lean African population.

Design: A community-based cross-sectional study.

Rural and semi-urban differences in salt intake, and its dietary sources, in Ashanti, West Africa.

Objectives: To provide a socioeconomic profile of rural and semi-urban settings in Ashanti, West Africa and to investigate the relationship between urbanization and sources of salt in the diet.

Setting: 12 villages (6 rural, 6 semi-urban) participating in a cluster randomized controlled trial of a health promotion in the Ashanti region of Ghana.

Participants: 1013 adult men (N = 385) and women (N = 628), aged 40-75.

Prevalence, detection, management, and control of hypertension in Ashanti, West Africa.

Hypertension and stroke are important threats to the health of adults in sub-Saharan Africa. Nevertheless, detection of hypertension is haphazard and stroke prevention targets are currently unattainable. Prevalence, detection, management, and control of hypertension were assessed in 1013 men (n=385) and women (n=628), both aged 55 [SD 11] years, living in 12 villages in Ashanti, Ghana.

Calcium urolithiasis, blood pressure and salt intake.

Objectives: To determine whether stone-formers have higher BP than controls drawn from the general population and matched for age, sex and ethnic origin and to compare the relationship between sodium and calcium excretion in the two groups.

Patients And Methods: Thirty-six patients [mean (+/-standard deviation, SD) = 49.0 +/- 11.