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https://www.readbyqxmd.com/read/29159010/multiple-myeloma-presenting-as-acute-renal-failure-in-the-absence-of-other-characteristic-features
#1
Zachary N Gastelum, Diana M Biggs, Aaron Scott
This case report describes a 54-year-old, asymptomatic man who presented with hyperkalemia on routine lab testing who was later found to have acute renal failure, unresponsive to fluid resuscitation, with minimal improvement after hemodialysis. After a comprehensive evaluation ruled out common causes of acute renal failure, the patient underwent testing with a bone survey, urine protein electrophoresis (UPEP), serum protein electrophoresis (SPEP), and immunoelectrophoresis for suspected plasma cell dyscrasia and received plasmapheresis for hyperviscosity syndrome and nephrotoxicity, which resulted in improved renal function...
September 20, 2017: Curēus
https://www.readbyqxmd.com/read/29158058/regional-cerebral-oxygen-saturation-level-predicts-30-day-mortality-rate-after-left-ventricular-assist-device-surgery
#2
Soutik Ghosal, Jaimin Trivedi, James Chen, Michael P Rogers, Allen Cheng, Mark S Slaughter, Maiying Kong, Jiapeng Huang
OBJECTIVE: Left ventricular assist device (LVAD) surgery is complex, high risk, and expensive. The authors' hypothesis is baseline regional cerebral oxygen saturation (rSO2) might be a predictor of postoperative clinical outcomes. DESIGN: Retrospective review of 210 consecutive continuous flow LVAD patients between 2008 and 2014. The primary measure is 30-day mortality rate and secondary measures include modified major adverse cardiocerebral events (MACE), length of stay (LOS), and intensive care unit (ICU) stay...
August 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29154418/measuring-non-polyaminated-lipocalin-2-for-cardiometabolic-risk-assessment
#3
Kangmin Yang, Han-Bing Deng, Andy W C Man, Erfei Song, Jialiang Zhang, Cuiting Luo, Bernard M Y Cheung, Kwok-Yung Yuen, Pia Søndergaard Jensen, Akhmadjon Irmukhamedov, Atlanta G I M Elie, Paul M Vanhoutte, Aimin Xu, Jo G R De Mey, Yu Wang
AIMS: Lipocalin-2 is a pro-inflammatory molecule characterized by a highly diversified pattern of expression and structure-functional relationships. In vivo, this molecule exists as multiple variants due to post-translational modifications and/or protein-protein interactions. Lipocalin-2 is modified by polyamination, which enhances the clearance of this protein from the circulation and prevents its excessive accumulation in tissues. On the other hand, animal studies suggest that non-polyaminated lipocalin-2 (npLcn2) plays a causal role in the pathogenesis of obesity-associated medical complications...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29152583/inhibition-of-retrograde-transport-limits-polyomavirus-infection-in-vivo
#4
Saumya Maru, Ge Jin, Dhimant Desai, Shantu Amin, Shwetank, Matthew D Lauver, Aron E Lukacher
Polyomaviruses (PyVs) silently infect most humans, but they can cause life-threatening diseases in immunocompromised individuals. The JC polyomavirus (JCPyV) induces progressive multifocal leukoencephalopathy, a severe demyelinating disease in multiple sclerosis patients receiving immunomodulatory therapy, and BK polyomavirus (BKPyV)-associated nephropathy is a major cause of kidney allograft failure. No effective anti-PyV agents are available. Several compounds have been reported to possess anti-PyV activity in vitro, but none have shown efficacy in clinical trials...
November 2017: MSphere
https://www.readbyqxmd.com/read/29145282/autosomal-dominant-polycystic-kidney-disease-combined-with-hypertrophic-cardiomyopathy-a-case-report
#5
Yingjing Shen, Chenggang Xu
INTRODUCTION: This report describes the novel sampling of autosomal dominant polycystic kidney disease (ADPKD) combined with hypertrophic cardiomyopathy (HCM). SYMPTOMS AND CLINICAL FINDINGS: A 48-year-old Chinese man presented with anasarca, hypourocrinia, gross hematuria, and weight gain by 10 kg subsequently developed acute kidney injury after struck by acute respiratory distress syndrome, really a threat to his heart. DIAGNOSES: Abdominal ultrasound revealed multiple small cysts in both kidneys, with the right kidney measuring 11...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29142980/effectiveness-of-multifaceted-care-approach-on-adverse-clinical-outcomes-in-nondiabetic-ckd-a-systematic-review-and-meta-analysis
#6
Aminu K Bello, Bilal Qarni, Arian Samimi, Julius Okel, Trish Chatterley, Ikechi G Okpechi, Ben Vandermeer, Branko Braam
Introduction: The risk of major adverse events associated with chronic kidney disease (CKD) could potentially be reduced with effective medical interventions. The impact of multifaceted interventions as compared with usual care in patients with nondiabetic CKD is unclear. We performed a systematic review to analyze the impact of multifaceted interventions on reducing the risk of major adverse events in this population. Methods: Systematic review and meta-analysis...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29142783/birth-order-and-maternal-age-for-reported-cases-of-severe-prenatal-cortical-hyperostosis-caffey-silverman-disease
#7
Rolf R Engel, Raul F Cifuentes
The spectrum of prenatal cortical hyperostosis includes a mild phenotype that typically presents after 35 weeks of gestation, and a severe form that presents earlier. The skeletal and systemic manifestations of the severe phenotype remain unexplained. A review of reported cases indicates that older mothers and firstborn infants are overrepresented. This combination suggests decreased fertility. Fourteen years after the birth of the present case, his mother presented with renal failure from multiple myeloma raising the possibility that a maternal antibody may play a role in the etiology of severe prenatal Caffey disease...
July 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29140472/uric-acid-predicts-adverse-outcomes-in-chronic-kidney-disease-a-novel-insight-from-trajectory-analyses
#8
Ching-Wei Tsai, Hsien-Tsai Chiu, Han-Chun Huang, I-Wen Ting, Hung-Chieh Yeh, Chin-Chi Kuo
Background: Very little is known about longitudinal trajectories of serum uric acid (SUA) over the course of chronic kidney disease (CKD). We aimed to determine whether longitudinal SUA trajectories are associated with the risk of end-stage renal disease (ESRD) and all-cause mortality among CKD patients. Methods: We conducted a prospective cohort study from a 13-year multidisciplinary pre-ESRD care registry. The final study population consisted of 5090 CKD patients aged 20-90 years between 2003 and 2015...
November 10, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29135158/-the-role-of-pharmacological-preconditioning-in-renal-ischemic-and-reperfusion-injury
#9
D A Kostina, T G Pokrovskaya, Yu V Olefir, A N Yavorskii, V V Elagin
Renal ischemic and reperfusion injury resulting in acute renal failure is a multidisciplinary problem at the junction of pathophysiology, transplantology, urology, nephrology, cardiac surgery and pharmacology. One of renal protection strategies is using the phenomenon of preconditioning. Preconditioning is one of the ways to adopt a tissue to repeated short-term effects of damaging factors to induce an enhanced tolerance to the long period of hypoxia and/or ischemia. There are multiple cellular and molecular mechanisms of the renal protective effects of preconditioning stimuli, but the key effectors and signaling molecules are ATP-dependent potassium channels, nitric oxide synthase, nitric oxide, and mitochondrial pore...
October 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/29129616/risk-of-periprosthetic-joint-infection-in-patients-with-multiple-arthroplasties
#10
W Parker Abblitt, Emily W Chan, Andrew A Shinar
BACKGROUND: Risk of subsequent periprosthetic joint infection (PJI) in a second prosthetic joint following initial PJI has been shown to be 19%-20%. We sought to identify (1) the risk of developing a second PJI for our patients with multiple prosthetic joints and (2) the effect of bacteremia on development of a subsequent PJI. METHODS: We retrospectively reviewed all patients treated surgically for PJI by a single surgeon from 2003 to 2014. Time between initial and subsequent infection, bacteremia, and risk factors for PJI were identified...
November 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29123570/cyclophosphamide-and-regional-citrate-anticoagulation-a-sour-combination
#11
Tim Hendra, Jonathan Simon, Alastair Lowe
We present a case of a woman in her 70 s, on cyclophosphamide for multiple myeloma, who was admitted to critical care with grade III acute kidney injury. Renal replacement therapy with regional citrate anticoagulation was commenced. Shortly thereafter her systemic-ionised calcium levels fell and remained stubbornly low until post-filter calcium return was doubled. Her total-to-ionised calcium ratio gradually increased and so, to avoid further accumulation of citrate, anticoagulation was changed to heparin...
November 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29116996/leptospirosis-in-icu-a-retrospective-study-of-134-consecutive-admissions
#12
Benjamin Delmas, Julien Jabot, Paul Chanareille, Cyril Ferdynus, Jérôme Allyn, Nicolas Allou, Loïc Raffray, Bernard-Alex Gaüzere, Olivier Martinet, David Vandroux
OBJECTIVES: Leptospirosis causes reversible multiple organ failure, and its mortality remains high. The aim of this study was to determine the mortality rate of leptospirosis in an ICU offering all types of organ support available nowadays and to compare it with mortality in bacterial sepsis. DESIGN: Retrospective, descriptive, and single-center cohort study. SETTINGS: The largest ICU of Reunion Island (Indian Ocean) in a teaching hospital...
November 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29113335/maternal-and-fetal-outcomes-of-pregnant-women-with-type-1-diabetes-a-national-population-study
#13
Shu-Fu Lin, Chang-Fu Kuo, Meng-Jiun Chiou, Shang-Hung Chang
Pregnancy in women with type 1 diabetes is associated with poor maternal and neonatal outcomes. However, the risk of these outcomes has never been evaluated in an Asian national population. In this work, we report the maternal and fetal outcomes of pregnant women with type 1 diabetes in Taiwan. A total of 2,350,339 pregnancy records created between 2001 and 2012 were obtained from the National Health Insurance database and analyzed. Here, 630 pregnancy records were identified in women having type 1 diabetes...
October 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/29108268/inherent-characteristics-of-metachronous-metastatic-renal-cell-carcinoma-in-the-era-of-targeted-agents
#14
Jang Hee Han, Seung Hwan Lee, Won Sik Ham, Woong Kyu Han, Koon Ho Rha, Young Deuk Choi, Sung Joon Hong, Young Eun Yoon
Background: To assess the prognostic and predictive factors of time to treatment failure (TTF) and overall survival (OS), respectively, in patients with metachronous metastatic renal cell carcinoma (mRCC) who were treated with targeted agents. Materials and Methods: We retrospectively reviewed metachronous mRCC patients, defined as individuals diagnosed with metastatic disease >3 months after initial nephrectomy, treated at an institute since 2005. Cox proportional hazard regression analysis was performed to discover the most determinant variables associated with TTF and OS...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29103584/selective-aortic-arch-and-root-replacement-in-repair-of-acute-type-a-aortic-dissection
#15
Fernando Fleischman, Ramsey S Elsayed, Robbin G Cohen, James M Tatum, S Ram Kumar, Kayvan Kazerouni, Wendy J Mack, Mark L Barr, Mark J Cunningham, Amy E Hackmann, Craig J Baker, Vaughn A Starnes, Michael E Bowdish
BACKGROUND: Controversy exists regarding the optimal extent of repair for type A aortic dissection. Our approach is to replace the ascending aorta, and only replace the aortic root or arch when intimal tears are present in those areas. We examined intermediate outcomes with this approach to acute type A aortic dissection repair. METHODS: Between March 2005 and October 2016, 195 patients underwent repair of acute type A aortic dissection. Repair was categorized by site of proximal and distal anastomosis and extent of repair...
November 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29098408/increased-serum-wisteria-floribunda-agglutinin-positive-mac-2-binding-protein-mac-2-binding-protein-glycosylation-isomer-in-chronic-heart-failure-a-pilot-study
#16
Atsushi Okada, Hideaki Kanzaki, Yasuhiro Hamatani, Seiji Takashio, Hiroyuki Takahama, Makoto Amaki, Takuya Hasegawa, Yasuo Sugano, Satoshi Yasuda, Toshihisa Anzai
BACKGROUND: Serum Wisteria floribunda agglutinin positive Mac-2 binding protein (WFA(+)-M2BP) or Mac-2 Binding Protein Glycosylation Isomer (M2BPGi) is a novel biomarker currently applied for evaluating hepatic fibrosis. The aim of this study was to evaluate the utility of serum WFA(+)-M2BP level as a biomarker in chronic heart failure (HF) patients with abnormal liver function. METHODS AND RESULTS: Fifty chronic HF patients who underwent measurement of serum WFA(+)-M2BP were evaluated...
November 2, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29084247/the-effect-of-a-novel-extracorporeal-cytokine-hemoadsorption-device-on-il-6-elimination-in-septic-patients-a-randomized-controlled-trial
#17
Dirk Schädler, Christine Pausch, Daniel Heise, Andreas Meier-Hellmann, Jörg Brederlau, Norbert Weiler, Gernot Marx, Christian Putensen, Claudia Spies, Achim Jörres, Michael Quintel, Christoph Engel, John A Kellum, Martin K Kuhlmann
OBJECTIVE: We report on the effect of hemoadsorption therapy to reduce cytokines in septic patients with respiratory failure. METHODS: This was a randomized, controlled, open-label, multicenter trial. Mechanically ventilated patients with severe sepsis or septic shock and acute lung injury or acute respiratory distress syndrome were eligible for study inclusion. Patients were randomly assigned to either therapy with CytoSorb hemoperfusion for 6 hours per day for up to 7 consecutive days (treatment), or no hemoperfusion (control)...
2017: PloS One
https://www.readbyqxmd.com/read/29076289/orthotopic-liver-transplantation-for-sensenbrenner-syndrome
#18
Ruth Linda Ackah, Dor Yoeli, Michael Kueht, Nhu Thao Nguyen Galván, Ronald Timothy Cotton, Abbas Rana, Christine Ann O'Mahony, John Alan Goss
Sensenbrenner syndrome, or cranioectodermal dysplasia, is a rare heterogeneic autosomal recessive disorder, affecting ~1 of 1 000 000 live births. The syndrome usually manifests within the first year of life and can present with progressive liver and renal involvement. For all Sensenbrenner patients, renal and liver diseases are the main contributors of morbidity and mortality. In this report, we present the case of a 7-year-old boy with congenital liver disease progressing to liver failure secondary to Sensenbrenner syndrome...
October 26, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29074040/heart-failure-and-inflammation-related-biomarkers-as-predictors-of-new-onset-diabetes-in-the-general-population
#19
Navin Suthahar, Wouter C Meijers, Frank P Brouwers, Hiddo J L Heerspink, Ron T Gansevoort, Pim van der Harst, Stephan J L Bakker, Rudolf A de Boer
BACKGROUND: There is a strong reciprocal relationship between heart failure (HF) and diabetes mellitus (DM). Shared pathophysiological mechanisms might be a possible explanation. Therefore, we hypothesised that biomarkers linked to HF would also predict new-onset type 2 DM in the general population. METHODS AND RESULTS: We utilized the Prevention of Vascular and Renal End-stage Disease (PREVEND) cohort (mean age 48.9years, 51% female) to study the relationship between HF and DM in 7953 participants free of baseline HF and DM...
October 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29066121/patterns-of-intraosseous-recurrence-after-stereotactic-body-radiation-therapy-for-coxal-bone-metastasis
#20
Kei Ito, Takuya Shimizuguchi, Keiji Nihei, Tomohisa Furuya, Hiroaki Ogawa, Hiroshi Tanaka, Keisuke Sasai, Katsuyuki Karasawa
PURPOSE: To analyze the detailed pattern of intraosseous failure after stereotactic body radiation therapy (SBRT) for coxal bone metastasis. METHODS AND MATERIALS: Patients treated with SBRT to coxal bone metastasis were identified by retrospective chart review. The SBRT doses were 30 Gy or 35 Gy in 5 fractions. A margin of 5 to 10 mm was added to the gross tumor volume to create the clinical target volume. We evaluated the presence or absence of intraosseous recurrence using magnetic resonance imaging...
September 5, 2017: International Journal of Radiation Oncology, Biology, Physics
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