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https://www.readbyqxmd.com/read/28321324/choosing-wisely-the-canadian-society-of-nephrology-s-list-of-5-items-physicians-and-patients-should-question
#1
Emilie Chan, Brenda Hemmelgarn, Scott Klarenbach, Braden Manns, Reem Mustafa, Gihad Nesrallah, Rory McQuillan
PURPOSE OF REVIEW: The purpose of this review is to contribute to the Choosing Wisely Canada campaign and develop a list of 5 items for nephrology health care professionals and patients to re-evaluate based on evidence that they are overused or misused. SOURCES OF INFORMATION: A working group was formed from the Canadian Society of Nephrology (CSN) Clinical Practice Guidelines Committee. This working group sequentially used a multistage Delphi method, a survey of CSN members, a modified Delphi process, and a comprehensive literature review to determine 10 candidate items representing potentially ineffective care in nephrology...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28320381/variation-in-readmission-and-mortality-following-hospitalisation-with-a-diagnosis-of-heart-failure-prospective-cohort-study-using-linked-data
#2
Rosemary J Korda, Wei Du, Cathy Day, Karen Page, Peter S Macdonald, Emily Banks
BACKGROUND: Hospitalisation for heart failure is common and post-discharge outcomes, including readmission and mortality, are often poor and are poorly understood. The purpose of this study was to examine patient- and hospital-level variation in the risk of 30-day unplanned readmission and mortality following discharge from hospital with a diagnosis of heart failure. METHODS: Prospective cohort study using data from the Sax Institute's 45 and Up Study, linking baseline survey (Jan 2006-April 2009) to hospital and mortality data (to Dec 2011)...
March 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28320343/targets-for-adapting-intravenous-iron-dose-in-hemodialysis-a-proof-of-concept-study
#3
N O Peters, N Jay, J Cridlig, G Rostoker, L Frimat
BACKGROUND: Intravenous iron is widely used to control anemia in dialysis patients and limits costs related to erythropoiesis-stimulating agents (ESA). Current guidelines do not clearly set upper limits for serum ferritin (SF) and transferrin saturation (TSAT). International surveys such as the Dialysis Outcomes and Practice Patterns Study (DOPPS) showed that this lack of upper limits potentially led nephrologists to prescribe iron infusions even for patients with a high SF. Recent publications have suggested a risk of short- and long-term adverse effects related to iron overload...
March 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28318656/clinical-characteristics-and-prognosis-of-patients-admitted-for-heart-failure-a-5-year-retrospective-study-of-african-patients
#4
Kwadwo Osei Bonsu, Isaac Kofi Owusu, Kwame Ohene Buabeng, Daniel D Reidpath, Amudha Kadirvelu
BACKGROUND: Mortality associated with heart failure (HF) remains high. There are limited clinical data on mortality among HF patients from African populations. We examined the clinical characteristics, long-term outcomes, and prognostic factors of African HF patients with preserved, mid-range or reduced left ventricular ejection fraction (LVEF). METHODS AND RESULTS: We conducted a retrospective longitudinal cohort study of individuals aged ≥18years discharged from first HF admission between January 1, 2009 and December 31, 2013 from the Cardiac Clinic, Directorate of Medicine of the Komfo Anokye Teaching Hospital, Ghana...
March 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28290865/-chronic-reno-cardial-continuum-in-glomerulonephritis
#5
I T Murkamilov, R R Kaliev, A Sh Sarybaev, J Sh Imanakunova, B F Imanov, A A Ibragimov, N T Davidova
OBJECTIVES: To elucidate main risk factors contributing to development of cardiovascular pathology at the predialysis stage of chronic glomerulonephritis. MATERIALS AND METHODS: We examined 173 patients (90 men, 83 women, age 15-70, mean age 36.8+/-12.9 years) at predialysis stage of chronic glomerulonephritis. Cardiovascular pathology (coronary heart disease, disturbances of cardiac rhythm, left ventricular hypertrophy, chronic heart failure) was found in 88 patients...
September 2016: Kardiologiia
https://www.readbyqxmd.com/read/28277912/fetal-hemoglobin-bart-s-hydrops-fetalis-pathophysiology-prenatal-diagnosis-and-possibility-of-intrauterine-treatment
#6
Phudit Jatavan, Nipon Chattipakorn, Theera Tongsong
This review aimed to comprehensively summarize current available reports regarding the ultrasound markers and biomarkers in predicting fetal Hb Bart's disease and evaluate the potential role of cardiac function assessment in a clinical practice. This review involves various methods in prenatal predicting fetal Hb Bart's disease or alpha-thalassemia major and attempts to provide valuable insights regarding the underlying mechanisms responsible for heart failure in Hb Bart's fetuses. Moreover, this information may be used to predict the cardiac function before the development of hydrops fetalis...
March 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28242402/hypoalbuminemia-predicts-perioperative-morbidity-and-mortality-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#7
Matthew R Peacock, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Nishant K Shah, Jeffrey J Siracuse
OBJECTIVES: Poor nutritional status has been associated with a higher risk of morbidity and mortality in general surgery patients, however outcomes in vascular surgery patients are unclear. Our goal was to determine the effect of poor nutritional status on perioperative morbidity and mortality after lower extremity bypass (LEB). METHODS: The 2005-2012 National Surgical Quality Improvement Program was analyzed to determine associated complications, mortality, length of stay (LOS), and readmissions for patients with hypoalbuminemia (serum albumin <3...
February 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28241279/thiazolidinediones-and-advanced-liver-fibrosis-in-nonalcoholic-steatohepatitis-a-meta-analysis
#8
Giovanni Musso, Maurizio Cassader, Elena Paschetta, Roberto Gambino
Importance: Nonalcoholic steatohepatitis (NASH) is projected to be the leading cause of liver transplantation by 2020. Advanced fibrosis (stage F3-F4) on liver biopsy independently predicts all-cause and liver-related mortality in NASH. There are no known efficacious treatments for advanced fibrosis related to NASH. Thiazolidinedione therapy has been extensively evaluated in NASH, and new randomized clinical trials (RCTs) of its efficacy have been completed. Objective: To synthesize the evidence about the association of thiazolidinedione therapy with advanced liver fibrosis in NASH...
February 27, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28240317/non-invasive-mri-biomarkers-for-the-early-assessment-of-iron-overload-in-a-humanized-mouse-model-of-%C3%AE-thalassemia
#9
Laurence H Jackson, Evangelia Vlachodimitropoulou, Panicos Shangaris, Thomas A Roberts, Thomas M Ryan, Adrienne E Campbell-Washburn, Anna L David, John B Porter, Mark F Lythgoe, Daniel J Stuckey
β-thalassemia (βT) is a genetic blood disorder causing profound and life threatening anemia. Current clinical management of βT is a lifelong dependence on regular blood transfusions, a consequence of which is systemic iron overload leading to acute heart failure. Recent developments in gene and chelation therapy give hope of better prognosis for patients, but successful translation to clinical practice is hindered by the lack of thorough preclinical testing using representative animal models and clinically relevant quantitative biomarkers...
February 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28210642/high-output-heart-failure-contributing-to-recurrent-epistaxis-kiesselbach-area-syndrome-in-a-patient-with-hereditary-hemorrhagic-telangiectasia
#10
Venugopal Brijmohan Bhattad, Jennifer N Bowman, Hemang B Panchal, Timir K Paul
Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare genetic blood disorder that leads to abnormal bleeding due to absent capillaries and multiple abnormal blood vessels known as arteriovenous malformations. A feature of HHT is high-output heart failure due to multiple arteriovenous malformations. High-output heart failure can lead to recurrent epistaxis Kiesselbach area syndrome (REKAS), further exacerbating heart failure through increased blood loss and resultant anemia...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28193165/cardiorenal-anemia-syndrome-and-survival-among-heart-failure-patients-in-tanzania-a-prospective-cohort-study
#11
Pedro Pallangyo, Francis Fredrick, Smita Bhalia, Paulina Nicholaus, Peter Kisenge, Benjamin Mtinangi, Mohamed Janabi, Stephen Humphrey
BACKGROUND: Cardiorenal anemia syndrome (CRAS) is an evolving global epidemic associated with increased morbimortality and cost of care. The management of patients with CRAS remains a challenging undertaking worldwide and the lack of evidence-based clinical guidelines adds to the challenge. We aimed to explore the prevalence and survival rates of heart failure patients with CRAS in Tanzania. METHODS: We screened 789 patients and consecutively recruited 463 who met the inclusion criteria...
February 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28188967/prevalence-of-anemia-and-iron-deficiency-in-older-portuguese-adults-an-empire-substudy
#12
António Robalo Nunes, Cândida Fonseca, Filipa Marques, Aurora Belo, Dialina Brilhante, José Cortez
AIM: The present study aimed to characterize the prevalence of anemia and iron deficiency in older Portuguese adults, and to compare it with the prevalence in younger individuals. METHODS: A population-based, cross-sectional study (EMPIRE study) enrolling a representative sample of 6267 adults aged <65 years and 1617 adults aged ≥65 years was carried out. Hemoglobin, ferritin, creatinine and C-reactive protein levels were measured by Point-of-Care tests. RESULTS: Anemia was more prevalent (P < 0...
February 11, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28178159/adma-predicts-major-adverse-renal-events-in-patients-with-mild-renal-impairment-and-or-diabetes-mellitus-undergoing-coronary-angiography
#13
Fabian Heunisch, Lyubov Chaykovska, Gina von Einem, Markus Alter, Thomas Dschietzig, Axel Kretschmer, Karl-Heinz Kellner, Berthold Hocher
Asymmetric dimethylarginine (ADMA) is a competitive inhibitor of the nitric oxide (NO)-synthase and a biomarker of endothelial dysfunction (ED). ED plays an important role in the pathogenesis of contrast-induced nephropathy (CIN). The aim of our study was to evaluate serum ADMA concentration as a biomarker of an acute renal damage during the follow-up of 90 days after contrast medium (CM) application.Blood samples were obtained from 330 consecutive patients with diabetes mellitus or mild renal impairment immediately before, 24 and 48 hours after the CM application for coronary angiography...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28150074/a-phase-ii-study-of-carboplatin-plus-weekly-paclitaxel-with-bevacizumab-for-elderly-patients-with-non-squamous-non-small-cell-lung-cancer-nej016
#14
Satoru Miura, Makoto Maemondo, Akira Iwashima, Toshiyuki Harada, Shunichi Sugawara, Kunihiko Kobayashi, Akira Inoue, Taku Nakagawa, Yuichi Takiguchi, Hiroshi Watanabe, Takashi Ishida, Masaki Terada, Hiroshi Kagamu, Akihiko Gemma, Hirohisa Yoshizawa
Background The efficacy and safety of bevacizumab in elderly patients with non-small cell lung cancer remain controversial. This study focused on both selecting fit elderly patients and overcoming interpatient variability with respect to pharmacodynamics. Methods Elderly (age: ≥70 years) patients with advanced non-squamous non-small cell lung cancer were enrolled. Patients with uncontrolled congestive heart failure and uncontrolled diabetes were excluded. The treatment regimen comprised carboplatin at an area under the curve of 5 mg/ml/min on day 1, paclitaxel at 90 mg/m(2) on days 1 and 8, and bevacizumab at 15 mg/kg on day 1 every 21 days for up to 4 cycles, followed by maintenance bevacizumab...
April 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/28131609/geriatric-syncope-and-cardiovascular-risk-in-the-emergency-department
#15
Nissa J Ali, Shamai A Grossman
BACKGROUND: Syncope is a transient loss of consciousness that is caused by a brief loss in generalized cerebral blood flow. OBJECTIVE: This article reviews the background, epidemiology, etiologies, evaluation, and disposition considerations of geriatric patients with syncope, with a focus on cardiovascular risk. DISCUSSION: Although syncope is one of the most common symptoms in elderly patients presenting to the emergency department, syncope causes in geriatric patients can present differently than in younger populations, and the underlying etiology is often challenging to discern...
April 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28109968/hemoglobin-and-change-in-hemoglobin-status-predict-mortality-cardiovascular-events-and-bleeding-in-stable-coronary-artery-disease
#16
Paul R Kalra, Nicola Greenlaw, Roberto Ferrari, Ian Ford, Jean-Claude Tardif, Michal Tendera, Christopher M Reid, Nicolas Danchin, Janina Stepinska, Ph Gabriel Steg, Kim M Fox
BACKGROUND: Anemia is a predictor of adverse outcomes in acute myocardial infarction. We studied the relationship of hemoglobin, or its change over time, and outcomes in patients with stable coronary artery disease. METHODS: The ProspeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease is a prospective, cohort study of outpatients with stable coronary artery disease (32,901 in 45 countries 2009-2010): 21,829 with baseline hemoglobin levels...
January 19, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28104107/erythropoietin-and-nonhematopoietic-effects
#17
REVIEW
Alireza Nekoui, Gilbert Blaise
Erythropoietin (EPO) is the main regulator of red blood cell production. Since the 1990s, EPO has been used for the treatment of anemia associated with end-stage renal failure and chemotherapy. The erythropoietin receptors were found on other organs such as the brain, spinal cord, heart and skin. In addition, it has been shown that many tissues produce and locally release EPO in response to hypoxic, biochemical and physical stress. In cellular, animal and clinical studies, EPO protects tissues from ischemia and reperfusion injury, has antiapoptotic effects and improves regeneration after injury...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28098068/the-differential-diagnosis-of-dyspnea
#18
Dominik Berliner, Nils Schneider, Tobias Welte, Johann Bauersachs
BACKGROUND: Dyspnea is a common symptom affecting as many as 25% of patients seen in the ambulatory setting. It can arise from many different underlying conditions and is sometimes a manifestation of a life-threatening disease. METHODS: This review is based on pertinent articles retrieved by a selective search in PubMed, and on pertinent guidelines. RESULTS: The term dyspnea refers to a wide variety of subjective perceptions, some of which can be influenced by the patient's emotional state...
December 9, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28073728/biermer-anemia-hematologic-characteristics-of-66-patients-in-a-clinical-hematology-unit-at-senegal
#19
F Seynabou, N Fatou Samba Diago, D Oulimata Diop, S Abibatou Fall, D Nafissatou
Hematological manifestations can lead to diagnosis of pernicious anemia, also known as Biermer disease and Biermer anemia. This disease has been little studied among black Africans. Our aim is to describe its diagnostic and therapeutic aspects and outcome in our practice. This descriptive study retrospectively examined the records of 66 patients with pernicious anemia seen at the Clinical Hematology Unit of Le Dantec Hospital in Senegal from January 1, 2000, to June 30, 2014. Symptoms were anemic syndrome (40 cases), hemolytic anemia (13), anemic heart failure (7), isolated pallor of the mucous membranes (5), and venous thrombosis (2)...
November 1, 2016: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/28052754/the-burden-of-major-adverse-cardiac-events-in-patients-with-coronary-artery-disease
#20
I-Ting Tsai, Chao-Ping Wang, Yung-Chuan Lu, Wei-Chin Hung, Cheng-Ching Wu, Li-Fen Lu, Fu-Mei Chung, Chia-Chang Hsu, Yau-Jiunn Lee, Teng-Hung Yu
BACKGROUND: Patients with a history of cardiovascular disease are at high risk of developing secondary major adverse cardiac events (MACE). This study aimed to identify independent predictors of MACE after hospital admission which could be used to identify of high-risk patients who may benefit from preventive strategies. METHODS: This study included 1,520 consecutive patients with coronary artery disease (CAD) (654 with acute coronary syndrome (ACS) and 866 with elective percutaneous coronary intervention (PCI) patients) who received PCI and/or stenting...
January 4, 2017: BMC Cardiovascular Disorders
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