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https://www.readbyqxmd.com/read/29890958/anemia-and-mortality-in-patients-with-nondialysis-dependent-chronic-kidney-disease
#1
Heide A Stirnadel-Farrant, Jiacong Luo, Lata Kler, Borut Cizman, Delyth Jones, Steven M Brunelli, Alexander R Cobitz
BACKGROUND: A combination of safety concerns and labeling changes impacted use of erythropoiesis-stimulating agents (ESAs) in renal anemia. Data regarding contemporary utilization in pre-dialysis chronic kidney disease (CKD) are lacking. METHODS: Electronic healthcare records and medical claims data of pre-dialysis CKD patients were aggregated from a large US managed care provider (2011-13). ESA use patterns, characteristics, and outcomes of ESA-treated/untreated patients were quantified...
June 11, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29869835/predicting-long-term-ischemic-events-using-routine-clinical-parameters-in-patients-with-coronary-artery-disease-the-opt-cad-risk-score
#2
Yaling Han, Jiyan Chen, Miaohan Qiu, Yi Li, Jing Li, Yingqing Feng, Jian Qiu, Liang Meng, Yihong Sun, Guizhou Tao, Zhaohui Wu, Chunyu Yang, Jincheng Guo, Kui Pu, Shaoliang Chen, Xiaozeng Wang
BACKGROUND: The prognosis of patients with coronary artery disease (CAD) at hospital discharge was constantly varying, and post-discharge risk of ischemic events remain a concern. However, risk prediction tools to identify risk of ischemia for these patients has not yet been reported. AIMS: We sought to develop a scoring system for predicting long-term ischemic events in CAD patients receiving antiplatelet therapy that would be beneficial in appropriate personalized decision-making for these patients...
June 5, 2018: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/29859542/hemoglobin-concentration-does-not-impact-3-month-outcome-following-acute-ischemic-stroke
#3
Kartavya Sharma, Daniel J Johnson, Brenda Johnson, Steven M Frank, Robert D Stevens
BACKGROUND: There is uncertainty regarding the effect of anemia and red blood cell transfusion on functional outcome following acute ischemic stroke. We studied the relationship of hemoglobin parameters and red cell transfusion with post stroke functional outcome after adjustment for neurological severity and medical comorbidities. METHODS: Retrospective cohort study of 536 patients discharged with a diagnosis of ischemic stroke from a tertiary care hospital between January 2012 and April 2015...
June 2, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29858280/blocking-properdin-prevents-complement-mediated-hemolytic-uremic-syndrome-and-systemic-thrombophilia
#4
Yoshiyasu Ueda, Takashi Miwa, Damodar Gullipalli, Sayaka Sato, Daisuke Ito, Hangsoo Kim, Matthew Palmer, Wen-Chao Song
Background Properdin (P) is a positive regulator of the alternative pathway of complement activation. Although P inhibition is expected and has been shown to ameliorate the alternative pathway of complement-mediated tissue injury in several disease models, it unexpectedly exacerbated renal injury in a murine model of C3 glomerulopathy. The role of P in atypical hemolytic uremic syndrome (aHUS) is uncertain. Methods We blocked P function by genetic deletion or mAb-mediated inhibition in mice carrying a factor H (FH) point mutation, W1206R (FHR/R ), that causes aHUS and systemic thrombophilia with high mortality...
June 1, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29843966/cd59-deficiency-presenting-as-polyneuropathy-and-moyamoya-syndrome-with-endothelial-abnormalities-of-small-brain-vessels
#5
Christian Klemann, Janbernd Kirschner, Sandra Ammann, Horst Urbach, Olaf Moske-Eick, Barbara Zieger, Myriam Ricarda Lorenz, Klaus Schwarz, Soroush Doostkam, Stephan Ehl, Rudolf Korinthenberg
CD59 is involved in lymphocyte signal transduction and regulates complement-mediated cell lysis by inhibiting the membrane attack complex. In the cases reported so far, congenital isolated CD59 deficiency was associated with recurrent episodes of hemolytic anemia, peripheral neuropathy, and strokes. Here, we report on a patient from a consanguineous Turkish family, who had a first episode of hemolytic anemia at one month of age and presented at 14 months with acute Guillain-Barré syndrome (GBS). The child suffered repeated infection-triggered relapses leading to the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP)...
April 13, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29843828/assessment-of-executive-functions-in-preschool-children-with-sickle-cell-anemia
#6
Michelle Downes, Fenella J Kirkham, Paul T Telfer, Michelle de Haan
OBJECTIVES: Children with sickle cell anemia (SCA) are commonly reported to experience executive dysfunction. However, the development of executive function (EF) in preschool-age children without stroke in this patient population has not been investigated so it is unclear when and how these deficits emerge. METHODS: This case-control study examines the feasibility of assessing the early development of executive functioning in 22 preschool children years with SCA in the domains of processing speed, working memory, attention, inhibitory control, and cognitive flexibility, as well as everyday function, in comparison to matched control children...
May 30, 2018: Journal of the International Neuropsychological Society: JINS
https://www.readbyqxmd.com/read/29791933/infantile-basal-ganglia-stroke-after-mild-head-trauma-associated-with-mineralizing-angiopathy-of-lenticulostriate-arteries-an-under-recognized-entity
#7
Sandra P Toelle, Tamara Avetisyan, Nune Kuyumjyan, Biayna Sukhudyan, Eugen Boltshauser, Annette Hackenberg
Basal ganglia infarction in young children, mostly after mild head trauma, has been repeatedly reported. The pathogenesis and the risk factors are not fully understood. Lenticulostriate vasculopathy, usually referred to as basal ganglia calcification, is discussed as one of them. We describe five young (7-13 months old on presentation) male children who suffered from hemiparesis due to ischemic stroke of the basal ganglia, four of them after minor head trauma. All of them had calcification in the basal ganglia visible on computed tomography or cranial ultrasound but not on magnetic resonance imaging...
May 23, 2018: Neuropediatrics
https://www.readbyqxmd.com/read/29789918/recent-experience-and-follow-up-after-surgical-closure-of-secundum-atrial-septal-defect-in-120-children
#8
Geoffroy de Beco, Natasha Mambour, Christophe Vô, Laetitia Vanhoutte, Stéphane Moniotte, Alain Poncelet, Thierry Sluysmans
While percutaneous catheter closure proves an effective treatment for secundum atrial septal defect (ASD2), some child patients require surgical closure. We assessed the risks associated with isolated surgical ASD2 closure by reviewing the outcomes of 120 children operated on between 1999 and 2011 (mean age 4.6 ± 3.9 years, mean weight 17 ± 12 kg). Direct sutures were performed in 4% and patch closures in 96%. The mean cardiopulmonary bypass duration was 38 ± 14 min, aortic cross-clamp time 19 ± 9 min, intensive care unit length of stay 1...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29789335/prediction-of-thrombotic-and-bleeding-events-after-percutaneous-coronary-intervention-credo-kyoto-thrombotic-and-bleeding-risk-scores
#9
Masahiro Natsuaki, Takeshi Morimoto, Kyohei Yamaji, Hirotoshi Watanabe, Yusuke Yoshikawa, Hiroki Shiomi, Yoshihisa Nakagawa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Takashi Akasaka, Keiichi Igarashi Hanaoka, Ken Kozuma, Kengo Tanabe, Yoshihiro Morino, Toshiya Muramatsu, Takeshi Kimura
BACKGROUND: Prediction of thrombotic and bleeding risk is important to optimize antithrombotic therapy after percutaneous coronary intervention. METHODS AND RESULTS: We developed the prediction rules for thrombotic and bleeding events separately in Japanese patients. Derivation and validation cohorts consisted of 4778 patients from CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort 2 and 4669 patients from RESET (Randomized Evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial) and NEXT (Nobori Biolimus-Eluting Versus Xience/Promus Everolimus-Eluting Stent Trial)...
May 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29773497/indications-for-red-cell-transfusions-in-pediatric-patients
#10
REVIEW
Jill M Cholette, Suzie A Noronha, Jerard Seghatchian, Neil Blumberg
Red cell transfusions are amongst the most common therapeutic procedures in seriously ill children, particularly in the inpatient setting. This is despite the fact that there is no evidence base for most clinical settings, with the exception of patients with hemoglobinopathies, particularly thalassemia and sickle cell anemia. Obviously exsanguinating hemorrhage and life threatening anemia are urgent indications for which no other therapeutic approach is currently available. Most transfusions are, however, given prophylactically to prevent the complications of hypoxia or hemodynamic stability, based upon expert opinion and a faith in the oxygen carrying capacity and beneficial hemodynamic properties of transfused red cells...
May 10, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29732592/transcranial-doppler-ultrasound-in-peninsular-arab-patients-with-sickle-cell-disease
#11
Adekunle Adekile, Meaad Hassan, Akram Asbeutah, Mohamed Al-Hinai, Omar Trad, Nayef Farhan
OBJECTIVES: Transcranial Doppler ultrasound is used to identify patients with sickle cell disease (SCD) at risk for stroke. We performed transcranial Doppler studies in patients from 4 countries in the Arabian Peninsula (Kuwait, Oman, Iraq, and United Arab Emirates) to document the prevalence of abnormal transcranial Doppler findings. METHODS: The patients were recruited from outpatient clinics and studied in a steady state. Transcranial Doppler examinations were performed with standard equipment by experienced operators...
May 6, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29706372/preoperative-anemia-versus-blood-transfusion-which-is-the-culprit-for-worse-outcomes-in-cardiac-surgery
#12
Damien J LaPar, Robert B Hawkins, Timothy L McMurry, James M Isbell, Jeffrey B Rich, Alan M Speir, Mohammed A Quader, Irving L Kron, John A Kern, Gorav Ailawadi
BACKGROUND: Reducing blood product utilization after cardiac surgery has become a focus of perioperative care as studies have suggested improved outcomes. The relative impact of preoperative anemia versus packed red blood cells (PRBC) transfusion on outcomes remains poorly understood, however. In this study, we investigated the relative association between preoperative hematocrit (Hct) level and PRBC transfusion on postoperative outcomes after coronary artery bypass grafting (CABG) surgery...
April 4, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29703819/new-insights-from-studies-of-clonal-hematopoiesis
#13
Christopher J Gibson, David P Steensma
Clonal hematopoiesis (CH) describes an asymptomatic expansion of blood cells descended from a single hematopoietic stem cell. Recent studies have shown that CH increases in frequency with aging, and is often driven by somatic mutations in genes that are recurrently mutated in hematologic malignancies. When CH is associated with a mutation in a leukemia-associated gene at a variant allele frequency of 0.02 or greater, it is termed "clonal hematopoiesis of indeterminate potential" (CHIP).  CHIP has a 0...
April 27, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29668544/splenectomy-to-optimize-hemoglobin-s-control-in-children-with-sickle-cell-anemia-on-chronic-transfusion-therapy-for-stroke-prevention
#14
L Vandy Black, Jolie S Ramesar, Catherine H Boston
Chronic transfusion therapy with the goal of maintaining a hemoglobin (Hb) S <30% is the primary recommended treatment for children with sickle cell anemia and a history of overt stroke or abnormal transcranial Doppler examination. We report chronic hypersplenism as a cause of poor HbS% control in 3 children on chronic transfusion therapy for stroke prevention. Splenectomy resulted in a 39.77% (95% confidence interval, 34.3-45.3, P<0.0001) mean reduction in HbS% with no perioperative or infectious complications suggesting the need for additional research into splenectomy as a therapeutic option for select high-risk children to optimize transfusion therapy for stroke prevention...
April 17, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29666400/the-corticosteroid-compounds-prednisolone-and-vamorolone-do-not-alter-the-nociception-phenotype-and-exacerbate-liver-injury-in-sickle-cell-mice
#15
Luis E F Almeida, Jesse M Damsker, Sarah Albani, Nina Afsar, Sayuri Kamimura, Drew Pratt, David E Kleiner, Martha Quezado, Heather Gordish-Dressman, Zenaide M N Quezado
Clinicians often hesitate prescribing corticosteroids to treat corticosteroid-responsive conditions in sickle cell disease (SCD) patients because their use can be associated with complications (increased hospital readmission, rebound pain, strokes, avascular necrosis, acute chest syndrome). Consequently, SCD patients may receive suboptimal treatment for corticosteroid-responsive conditions. We conducted a preclinical trial of dissociative (vamorolone) and conventional (prednisolone) corticosteroid compounds to evaluate their effects on nociception phenotype, inflammation, and organ dysfunction in SCD mice...
April 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29664857/restrictive-versus-liberal-strategy-for-red-blood-cell-transfusion-a-systematic-review-and-meta-analysis-in-orthopaedic-patients
#16
Wan-Jie Gu, Xiao-Ping Gu, Xiang-Dong Wu, Hao Chen, Joey S W Kwong, Lu-Yang Zhou, Shuo Chen, Zheng-Liang Ma
BACKGROUND: Current guidelines recommend restrictive criteria for red blood-cell transfusion in most clinical settings. However, patients undergoing orthopaedic surgery may require distinct transfusion criteria since benefits and potential harm often vary considerably based on patient characteristics and surgical procedures. We aimed to assess the efficacy and safety of restrictive transfusion in patients undergoing orthopaedic surgery, especially in important subgroups. METHODS: Electronic databases were searched to identify randomized controlled trials investigating restrictive (mostly a hemoglobin level of 8...
April 18, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29653202/clinicopathological-features-and-outcomes-of-pythiosis
#17
Maria Nina Chitasombat, Noppadol Larbcharoensub, Ariya Chindamporn, Theerapong Krajaejun
OBJECTIVES: Vascular pythiosis is a life-threatening infection caused by the oomycete Pythium insidiosum. This article reports the clinical presentation, serodiagnosis, pathology, and outcomes seen at the authors' institution. METHODS: The cases of patients with proven vascular pythiosis at Ramathibodi Hospital, Mahidol University, Bangkok, Thailand from January 2006 to December 2016 were analyzed retrospectively. RESULTS: Thirteen patients were analyzed, eight of whom had underlying thalassemias...
June 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29628940/moderate-to-severe-anemia-is-associated-with-poor-functional-outcome-in-acute-stroke-patients-treated-with-mechanical-thrombectomy
#18
Cetin Kursad Akpinar, Erdem Gurkas, Emrah Aytac
Background: Anemia will negatively affect cerebral collaterals and penumbra. Eventually, it may cause worse clinical outcomes and even increase mortality rates in stroke patients. Anemia has recently been suggested to be an independent risk factor for ischemic stroke. Therefore, we aimed to investigate the effects of the presence of anemia on clinical outcomes in ischemic stroke patients undergoing mechanical thrombectomy. Methods: This was a retrospective study involving the prospectively and consecutively collected data of 90 adult patients between January 2015 and August 2016...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29614631/simple-chronic-transfusion-therapy-a-crucial-therapeutic-option-for-sickle-cell-disease-improves-but-does-not-normalize-blood-rheology-what-should-be-our-goals-for-transfusion-therapy
#19
Jon A Detterich
Sickle cell anemia is characterized by a mutation resulting in the formation of an abnormal beta-hemoglobin called hemoglobin S. Hemoglobin S polymerizes upon deoxygenation, causing impaired red blood cell deformability and increased blood viscosity at equivalent hematocrits. Thus, sickle cell disease is a hemorheologic disease that results in various pathologic processes involving multiple organ systems including the lungs, heart, kidneys and brain. Red blood cell mechanics and the perturbations on blood flow-endothelial interaction underlie much of the pathology found in sickle cell disease...
2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29606044/impact-of-preoperative-endovascular-embolization-on-immediate-meningioma-resection-outcomes
#20
Michael G Brandel, Robert C Rennert, Arvin R Wali, David R Santiago-Dieppa, Jeffrey A Steinberg, Christian Lopez Ramos, Peter Abraham, J Scott Pannell, Alexander A Khalessi
OBJECTIVE Preoperative embolization of meningiomas can facilitate their resection when they are difficult to remove. The optimal use and timing of such a procedure remains controversial given the risk of embolization-linked morbidity in select clinical settings. In this work, the authors used a large national database to study the impact of immediate preoperative embolization on the immediate outcomes of meningioma resection. METHODS Meningioma patients who had undergone elective resection were identified in the National (Nationwide) Inpatient Sample (NIS) for the period 2002-2014...
April 2018: Neurosurgical Focus
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