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https://www.readbyqxmd.com/read/28444409/diagnostic-work-up-and-specific-causes-of-acute-kidney-injury
#1
REVIEW
Michael Darmon, Marlies Ostermann, Jorge Cerda, Meletios A Dimopoulos, Lui Forni, Eric Hoste, Matthieu Legrand, Nicolas Lerolle, Eric Rondeau, Antoine Schneider, Bertrand Souweine, Miet Schetz
Acute kidney injury (AKI) is common in critically ill patients and associated with grim short- and long-term outcome. Although in the vast majority of cases AKI is multifactorial, with sepsis, shock and nephrotoxicity accounting for most episodes, specific causes of AKI are not uncommon. Despite remaining uncertainties regarding their prevalence in the ICU, prompt recognition of specific aetiologies of AKI is likely to ensure timely management, limit worsening of renal dysfunction, and ultimately limit renal and systemic consequences of AKI...
April 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28442772/discriminative-and-distinct-phenotyping-by-constrained-tensor-factorization
#2
Yejin Kim, Robert El-Kareh, Jimeng Sun, Hwanjo Yu, Xiaoqian Jiang
Adoption of Electronic Health Record (EHR) systems has led to collection of massive healthcare data, which creates oppor- tunities and challenges to study them. Computational phenotyping offers a promising way to convert the sparse and complex data into meaningful concepts that are interpretable to healthcare givers to make use of them. We propose a novel su- pervised nonnegative tensor factorization methodology that derives discriminative and distinct phenotypes. We represented co-occurrence of diagnoses and prescriptions in EHRs as a third-order tensor, and decomposed it using the CP algorithm...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28441236/the-new-mirus-system-for-short-term-sedation-in-postsurgical-icu-patients
#3
Stefano Romagnoli, Cosimo Chelazzi, Gianluca Villa, Giovanni Zagli, Francesco Benvenuti, Paola Mancinelli, Giulio Arcangeli, Stefano Dugheri, Alessandro Bonari, Lorenzo Tofani, Andrea Belardinelli, A Raffaele De Gaudio
OBJECTIVES: To evaluate the feasibility and safety of the MIRUS system (Pall International, Sarl, Fribourg, Switzerland) for sedation with sevoflurane for postsurgical ICU patients and to evaluate atmospheric pollution during sedation. DESIGN: Prospective interventional study. SETTING: Surgical ICU. February 2016 to December 2016. PATIENTS: Postsurgical patients requiring ICU admission, mechanical ventilation, and sedation...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28439032/inactivation-of-transcriptional-regulators-during-within-household-evolution-of-escherichia-coli
#4
Dagmara I Kisiela, Matthew Radey, Sandip Paul, Stephen Porter, Kseniya Polukhina, Veronika Tchesnokova, Sofiya Shevchenko, Diana Chan, Maliha Aziz, Timothy J Johnson, Lance B Price, James R Johnson, Evgeni V Sokurenko
We analyzed the within-household evolution of two household-associated Escherichia coli strains from pandemic clonal group ST131-H30, using isolates recovered from five individuals within two families, each of which had a distinct strain. Family 1's strain was represented by a urine isolate from the index patient (older sister) with recurrent cystitis, and a blood isolate from her younger sister with fatal urosepsis. Family 2's strain was represented by a urine isolate from the index patient (father) with pyelonephritis and renal abscesses, blood and kidney drainage isolates from the daughter with emphysematous pyelonephritis, and urine and fecal isolates from the mother with cystitis...
April 24, 2017: Journal of Bacteriology
https://www.readbyqxmd.com/read/28437377/microrna-21-is-required-for-local-and-remote-ischemic-preconditioning-in-multiple-organ-protection-against-sepsis
#5
Ping Jia, Xiaoli Wu, Yan Dai, Jie Teng, Yi Fang, Jiachang Hu, Jianzhou Zou, Mingyu Liang, Xiaoqiang Ding
OBJECTIVE: Sepsis, triggered by microbial infection, is a common and life-threatening systemic illness, often leads to impaired function of vital organs. Ischemic preconditioning induced by transient brief episodes of ischemia is a powerful innate mechanism of organ protection. We have reported that a 15-minute renal ischemic preconditioning substantially attenuated subsequent renal ischemia-reperfusion injury. Here, we investigate whether a brief ischemia and reperfusion in kidney can provide protection at local and remote sites against sepsis-induced organ injury, and whether this protection is microRNA-21 dependent...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437373/resuscitation-with-balanced-fluids-is-associated-with-improved-survival-in-pediatric-severe-sepsis
#6
Elizabeth T Emrath, James D Fortenberry, Curtis Travers, Courtney E McCracken, Kiran B Hebbar
OBJECTIVE: To evaluate outcomes in patients receiving balanced fluids for resuscitation in pediatric severe sepsis. DESIGN: Observational cohort review of prospectively collected data from a large administrative database. SETTING: PICUs from 43 children's hospitals. PATIENTS: PICU patients diagnosed with severe sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We reviewed data from the Pediatric Health Information System database from 2004 to 2012...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28432312/growth-differentiation-factor-15-deficiency-augments-inflammatory-response-and-exacerbates-septic-heart-and-renal-injury-induced-by-lipopolysaccharide
#7
Palida Abulizi, Neruja Loganathan, Duo Zhao, Tina Mele, Yixin Zhang, Terry Zwiep, Kexiang Liu, Xiufen Zheng
Septic acute kidney injury (AKI) and myocardial dysfunction are leading causes of mortality with no accepted method of therapy. In this study we demonstrate the role of growth differentiating factor 15 (GDF15) in septic AKI and myocardial dysfunction using a murine lipopolysaccharide (LPS)-induced sepsis model and an in vitro cell culture system. Data show that GDF15 deficiency augments inflammatory response and exacerbates renal and cardiac injury induced by LPS, while over-expression of GDF15 protects the kidney and heart from LPS-induced organ dysfunction...
April 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28430696/sequential-analysis-of-a-panel-of-biomarkers-and-pathologic-findings-in-a-resuscitated-rat-model-of-sepsis-and-recovery
#8
Nishkantha Arulkumaran, Marije L Sixma, Elisa Jentho, Elias Ceravola, Paul S Bass, John A Kellum, Robert J Unwin, Fred W K Tam, Mervyn Singer
OBJECTIVES: To characterize the temporal pattern of a panel of blood and urinary biomarkers in an animal model of fecal peritonitis and recovery. DESIGN: Prospective observational animal study. SETTING: University research laboratory. SUBJECTS: Male Wistar rats. INTERVENTIONS: A fluid-resuscitated, long-term (3 d) rat model of sepsis (fecal peritonitis) and recovery was used to understand the temporal association of sepsis biomarkers in relation to systemic hemodynamics, inflammation, and renal function...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28430592/resveratrol-protects-against-early-polymicrobial-sepsis-induced-acute-kidney-injury-through-inhibiting-endoplasmic-reticulum-stress-activated-nf-%C3%AE%C2%BAb-pathway
#9
Nian Wang, Li Mao, Liu Yang, Jiang Zou, Ke Liu, Meidong Liu, Huali Zhang, Xianzhong Xiao, Kangkai Wang
Resveratrol, a polyphenol compound derived from various edible plants, protects against sepsis-induced acute kidney injury (AKI) via its anti-inflammatory activity, but the underlying mechanisms remain largely unknown. In this study, a rat model of sepsis was established by cecal ligation and puncture (CLP), 30 mg/kg resveratrol was intraperitoneally administrated immediately after the CLP operation. HK-2 cells treated by 1 μg/ml lipopolysaccharide, 0.2 μM tunicamycin, 2.5 mM irestatin 9389 and 20 μM resveratrol were used for in vitro study...
April 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28427574/acute-noncardiovascular-illness-in-the-cardiac-intensive-care-unit
#10
Eric M Holland, Travis J Moss
BACKGROUND: Fifty years after the inception of the cardiac intensive care unit (CICU), noncardiovascular illnesses have become more prevalent and may contribute to morbidity and mortality. OBJECTIVES: The authors performed multivariate statistical analyses to determine the association of acute noncardiovascular illnesses with outcomes, including length of stay (LOS), mortality, and hospital readmission. METHODS: We studied 1,042 admissions between October 12, 2013 and November 28, 2014 to the CICU at the University of Virginia Health System, a tertiary-care academic medical center...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28427496/mortality-risk-factors-in-intensive-care-unit-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-a-retrospective-cohort-study%C3%A2
#11
Michael Schmitz, Frank P Tillmann, Ausra Paluckaite, Erich A Laufer, Brian Rayner, Lars C Rump, Peter J Heering
BACKGROUND: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. METHODS: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved...
April 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#12
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#13
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28424124/acute-respiratory-distress-syndrome-incidence-but-not-mortality-has-decreased-nationwide-a-national-trauma-data-bank-study
#14
Michael Fahr, Glenn Jones, Hollis O'Neal, Juan Duchesne, Danielle Tatum
Acute respiratory distress syndrome (ARDS) incidence is reported to have decreased in recent years. However, no large-scale study to date has exclusively examined ARDS in the critically injured. We sought to examine the national incidence of ARDS and its associated outcomes exclusively in adult trauma patients. The National Trauma Data Bank (NTDB) was queried to evaluate the incidence of ARDS and associated outcomes over a 6-year study period (2007-2012). Included patients were ≥18 years old, with at least one ventilator day, and complications recorded...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28423197/diabetic-kidney-transplant-recipients-impaired-infection-control-and-increased-alloreactivity
#15
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) has been associated with inferior patient and allograft outcomes. However, previous studies didn't identify differences in infection control and alloreactivity. METHODS: We studied 449 kidney transplant recipients (KTRs) between 2005 and 2013. 50 (11.1%) KTRs were diagnosed with PTDM and 60 (13.4%) KTRs with pre-existing diabetes. Samples were collected pretransplantation, at +1, +2, +3 months posttransplantation...
April 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28420565/analysis-of-prognostic-factors-for-acute-kidney-injury-with-continuous-renal-replacement-therapy-in-severely-burned-patients
#16
Jaechul Yoon, Youngmin Kim, Haejun Yim, Yong Suk Cho, Dohern Kym, Jun Hur, Wook Chun, Hyeong Tae Yang
BACKGROUND: Acute kidney injury (AKI) is a critical complications in severely burned patients associated with high morbidity and mortality. The purpose of this study was to investigate the impact of severity of AKI at the time of continuous renal replacement therapy (CRRT) start on patient outcome and to identify the prognostic factors in severely burned patients with CRRT application. METHODS: From January 2007 to June 2010, 84 burn patients with more than 40% of total body surface area (TBSA) burned who treated with continuous renal replacement therapy for acute kidney injury were analyzed retrospectively...
April 15, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28420464/-effect-of-combination-therapy-with-propofol-and-hydrogen-rich-saline-on-organ-damage-and-cytokines-in-a-murine-model-of-sepsis
#17
Yunchuan Hong, Hongguang Chen, Yonghao Yu, Keliang Xie
OBJECTIVE: To investigate the effect of combining propofol with hydrogen on organ damage and inflammation of sepsis in cecal ligation and puncture (CLP) mice model. METHODS: One hundred and forty male C57BL/6 mice were randomly divided into groups (n = 28): sham group, CLP group, propofol group, H2 group, and propofol and H2 group. The sepsis was induced by CLP operation. Mice in sham group did the same operation with ligation and puncture. The mice of propofol group and propofol and H2 group were given 50 mg/kg propofol through tail vein at 1 hour and 6 hours after CLP and the mice of H2 group and propofol and H2 group were given 5 mL/kg H2-rich saline i...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28412927/widespread-subcutaneous-necrosis-in-spotted-fever-group-rickettsioses-from-the-coastal-belt-of-sri-lanka-a-case-report
#18
Nathasha Luke, Hasini Munasinghe, Lakshmi Balasooriya, Ranjan Premaratna
BACKGROUND: Spotted fever group rickettsioses (SFGR) transmitted mostly by ticks are increasingly discovered around the World and some of them are either re-emerging or emerging in Sri Lanka. Accidental human infections caused by these vector borne zoonotic diseases generally give rise to nonspecific acute febrile illnesses which can be complicated by multi organ involvement carrying high morbidity and mortality. Nonspecific clinical features and non-availability of early diagnostic facilities are known to result in delay in the diagnosis of rickettsial infections...
April 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28412129/acute-kidney-injury-after-burn
#19
REVIEW
Audra Clark, Javier A Neyra, Tarik Madni, Jonathan Imran, Herb Phelan, Brett Arnoldo, Steven E Wolf
Acute kidney injury (AKI) is a common and morbid complication after severe burn, with an incidence and mortality as high as 30% and 80%, respectively. AKI is a broad clinical condition with many etiologies, which makes definition and diagnosis challenging. The most recent Kidney Disease: Improving Global Outcomes (KDIGO) consensus guidelines defined stage and severity of AKI based on changes of serum creatinine and urine output (UOP) across time. Burn-related kidney injury is typically classified as early (0-3days after injury) or late (4-14days after injury)...
April 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28411099/robot-assisted-transplanted-ureteral-stricture-management
#20
H M Abdul-Muhsin, S B McAdams, R N Nuñez, N N Katariya, E P Castle
OBJECTIVE: To assess the feasibility of robot assisted transplanted ureteral reimplantation as a minimally invasive alternative to open surgery. MATERIAL AND METHODS: Between August 2015 and March 2016, five patients presented with transplanted ureteral strictures after failure of previous endoscopic management. All patients underwent robot assisted ureteral reimplantation. Patients' demographics, perioperative outcomes and complications are reported. RESULTS: All patients presented with deterioration of kidney function with or without recurrent urinary tract infection...
April 11, 2017: Urology
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