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https://www.readbyqxmd.com/read/28630631/urinalysis-and-clinical-correlations-in-patients-with-p-vivax-or-p-falciparum-malaria-from-colombia
#1
Alberto Tobón-Castaño, Sebastián Barrera Escobar, Cecilia Giraldo Castro
BACKGROUND: Urinalysis is a poorly reviewed diagnostic tool in malaria patients; its application can show the presence of severe malaria. METHODS: Urinalysis was performed in a total of 620 patients diagnosed with malaria by thick blood smear; complications were classified according to WHO major criteria for severity and minor criteria according to the Colombian malaria guideline. RESULTS: Severe or moderate clinical complications were diagnosed in 31...
2017: Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28616838/assessment-of-renal-hemodynamic-toxicity-of-fluid-challenge-with-0-9-nacl-compared-to-balanced-crystalloid-plasmalyte-%C3%A2-in-a-rat-model-with-severe-sepsis
#2
Pierre-Yves Olivier, François Beloncle, Valérie Seegers, Maher Tabka, Mathilde Renou de La Bourdonnaye, Alain Mercat, Paul Cales, Daniel Henrion, Peter Radermacher, Lise Piquilloud, Nicolas Lerolle, Pierre Asfar
BACKGROUND: According to international guidelines, volume expansion with crystalloids is the first-line treatment for hemodynamic management in patients with severe sepsis or septic shock. Compared to balanced crystalloids, 0.9% sodium chloride (0.9% NaCl) induces hyperchloremia and metabolic acidosis and may alter renal hemodynamics and function. We compared the effects of 0.9% NaCl to a less chloride-concentrated fluid, PlasmaLyte(®) (PL) in targeted fluid resuscitation in a randomized, double-blind controlled study in an experimental model of severe sepsis in rats...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28616207/changes-in-metformin-use-in-chronic-kidney-disease
#3
Talha H Imam
Metformin is one of the oldest and most widely prescribed antidiabetic medicines worldwide. It is the only such medicine that has shown a reduction of cardiovascular mortality in diabetes mellitus type 2. Since many diabetic patients have chronic kidney disease, its use is often curtailed by practitioners due to fear of lactic acidosis and the US Food and Drug Administration (FDA) warnings that, until recently, had been in place for decades. Current guidelines, though somewhat vague regarding dosages, clearly pave the way for spreading the use of metformin in patients with lower glomerular filtration rates...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28530382/diabetes-update-new-pharmacotherapy-for-type-2-diabetes
#4
Beth Choby
Multiple new drugs for managing type 2 diabetes have entered the market in the past 5 years. Guidelines from the American Diabetes Association recommend metformin for initial therapy, followed by a second drug if A1c goals are not met or initially for patients with A1c levels greater than 9%. Conversely, the American Association of Clinical Endocrinologists recommends initial management with two drugs if the A1c level is greater than 7.5%. The risk of lactic acidosis associated with metformin has been shown to be less than previously thought, with newer guidelines permitting use with an estimated glomerular filtration rate of 45 to 60 mL/min/1...
May 2017: FP Essentials
https://www.readbyqxmd.com/read/28515908/renal-manifestations-of-primary-mitochondrial-disorders
#5
Josef Finsterer, Fulvio Alexandre Scorza
The aim of the present review was to summarize and discuss previous findings concerning renal manifestations of primary mitochondrial disorders (MIDs). A literature review was performed using frequently used databases. The study identified that primary MIDs frequently present as mitochondrial multiorgan disorder syndrome (MIMODS) at onset or in the later course of the MID. Occasionally, the kidneys are affected in MIDs. Renal manifestations of MIDs include renal insufficiency, nephrolithiasis, nephrotic syndrome, renal cysts, renal tubular acidosis, Bartter-like syndrome, Fanconi syndrome, focal segmental glomerulosclerosis, tubulointerstitial nephritis, nephrocalcinosis, and benign or malign neoplasms...
May 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28497085/evaluation-of-water-and-electrolytes-disorders-in-severe-acute-diarrhea-patients-treated-by-who-protocol-in-eight-large-hospitals-in-tehran-a-nephrology-viewpoint
#6
Alireza Soleimani, Fatemeh Foroozanfard, Mohammad Reza Tamadon
Introduction: The most common cause of death from diarrhea is the shock caused by dehydration, electrolytes and acid-base disorders. Objectives: The aim of this study was to evaluate water and electrolytes disorders in diarrhea patients after treating severe acute diarrhea. Patients and Methods: In this study we used a historical cohort and studied patients who were hospitalized due to acute diarrhea and were similarly treated for dehydration and water and electrolyte disorders as recommended by the World Health Organization (WHO) guideline...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28474371/metformin-associated-lactic-acidosis-moving-towards-a-new-paradigm
#7
EDITORIAL
Thomas A Bicsak, Brandon Walsh, Mark Fineman
No abstract text is available yet for this article.
May 4, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28473291/oxytocin-administration-during-spontaneous-labor-guidelines-for-clinical-practice-chapter-5-maternal-risk-and-adverse-effects-of-using-oxytocin-augmentation-during-spontaneous-labor
#8
A Rousseau, A Burguet
No abstract text is available yet for this article.
May 1, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28457369/safety-and-efficacy-of-citrate-anticoagulation-for-continuous-renal-replacement-therapy-for-acute-kidney-injury-after-liver-transplantation-a-single-center-experience
#9
N Pertica, L Cicciarella, A Carraro, U Montin, P Violi, A Lupo, G Zaza
BACKGROUND: Acute kidney injury (AKI) after liver transplantation (LT) is a frequent and serious complication. The incidence of AKI requiring continuous renal replacement therapy (CRRT) ranges from 10% to 30%. Kidney Disease: Improving Global Outcomes guidelines indicate the use of citrate as a locoregional anticoagulant drug for CRRT regardless of the patient's hemorrhagic risk. Despite this indication, however, the use of citrate is still under debate in patients with liver failure and/or LT owing to the potential risk of plasmatic citrate accumulation due to reduced liver clearance...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28441439/hemodynamics-and-gas-exchange-during-chest-compressions-in-neonatal-resuscitation
#10
Payam Vali, Praveen Chandrasekharan, Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Bobby Mathew, Sara Berkelhamer, Jayasree Nair, Myra Wyckoff, Satyan Lakshminrusimha
PURPOSE: Current knowledge about pulmonary/systemic hemodynamics and gas exchange during neonatal resuscitation in a model of transitioning fetal circulation with fetal shunts and fluid-filled alveoli is limited. Using a fetal lamb asphyxia model, we sought to determine whether hemodynamic or gas-exchange parameters predicted successful return of spontaneous circulation (ROSC). METHODS: The umbilical cord was occluded in 22 lambs to induce asphyxial cardiac arrest...
2017: PloS One
https://www.readbyqxmd.com/read/28432751/acute-kidney-injury-plasma-lactate-concentrations-and-lactic-acidosis-in-metformin-users-a-godarts-study
#11
Paul J Connelly, Mike Lonergan, Enrique Soto-Pedre, Louise Donnelly, Kaixin Zhou, Ewan R Pearson
AIMS: Metformin is renally excreted and has been associated with the development of lactic acidosis. Although current advice is to omit metformin during illnesses that may increase risk of acute kidney injury (AKI), the evidence supporting this is lacking. We investigated the relationship between AKI, lactate concentrations and the risk of lactic acidosis in those exposed to metformin. METHODS: We undertook a population-based case-control study of lactic acidosis in 1,746 participants with Type 2 diabetes and 846 individuals without diabetes with clinically measured lactates with and without AKI between 1994-2014...
April 21, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28403066/non-hemodynamic-effects-of-catecholamines
#12
Clair Hartmann, Peter Radermacher, Martin Wepler, Benedikt Nubaum
Circulatory shock is defined as an imbalance between tissue oxygen supply and demand, and mostly results from a loss of blood volume, cardiac pump failure and/or reduction of vasomotor tone. The clinical hallmarks of circulatory shock are arterial hypotension and lactate acidosis. Since the degree and duration of hypotension are major determinants of outcome, vasopressor administration represents a cornerstone therapy to treat these patients. Current guidelines recommend the use of catecholamines as the drug of first choice...
April 11, 2017: Shock
https://www.readbyqxmd.com/read/28375568/fludrocortisone-therapy-for-persistent-hyperkalaemia
#13
S J H Dobbin, J R Petrie, M E J Lean, G A McKay
Hyperkalaemia is often seen in individuals with renal impairment and may be exacerbated, particularly in diabetic nephropathy, by hyporeninaemic aldosterone deficiency (type 4 renal tubular acidosis) which may, in turn, be caused or complicated by chronic interstitial nephritis or drug therapy (Table 1). Fludrocortisone is a synthetic corticosteroid with mineralocorticoid activity that increases sodium resorption and promotes potassium excretion in the distal convoluted renal tubule. It therefore seems a logical option to reverse hyperkalaemia in type 4 renal tubular acidosis; however, we can find no published guideline recommending this use [1,2]...
April 4, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28246924/jsa-guideline-for-the-management-of-malignant-hyperthermia-crisis-2016
#14
(no author information available yet)
Malignant hyperthermia (MH) can be fatal if the crisis is not appropriately treated. It is an inherited disease usually triggered by the administration of volatile inhalational anesthetics and/or succinylcholine, a muscle relaxant. In a patient with suspected MH, the mechanism of calcium release from storage in the sarcoplasmic reticulum in the skeletal muscle is abnormally accelerated. Unexplained hypercarbia representing >55 mmHg of end-tidal carbon dioxide, tachycardia, and muscle rigidity (including masseter muscle rigidity) are early signs of the initiation of MH, because the metabolism is accelerated...
April 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#15
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
March 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28134407/-metformin-associated-lactic-acidosis-and-acute-kidney-injury
#16
Paolo Greco, Giuseppe Regolisti, Riccardo Antoniotti, Caterina Maccari, Elisabetta Parenti, Silvia Corrado, Enrico Fiaccadori
Metformin is recommended as the treatment of choice in patients with type 2 diabetes mellitus because of its efficacy, general tolerability and low cost. Recent guidelines have extended the use of metformin to patients with Chronic Kidney Disease (CKD) up to stage III. However, in the recent literature, cases of MALA (metformin-associated lactic acidosis) are increasingly reported. MALA is the most dangerous side effect of the drug, with an incidence rate of 2-9 cases per 100000 person-years of exposure. We report on two patients with accidental metformin overdose, severe lactic acidosis and acute kidney injury...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28106712/very-low-protein-diet-vlpd-reduces-metabolic-acidosis-in-subjects-with-chronic-kidney-disease-the-nutritional-light-signal-of-the-renal-acid-load
#17
Biagio Raffaele Di Iorio, Lucia Di Micco, Stefania Marzocco, Emanuele De Simone, Antonietta De Blasio, Maria Luisa Sirico, Luca Nardone, On Behalf Of Ubi Study Group
BACKGROUND: Metabolic acidosis is a common complication of chronic kidney disease; current guidelines recommend treatment with alkali if bicarbonate levels are lower than 22 mMol/L. In fact, recent studies have shown that an early administration of alkali reduces progression of CKD. The aim of the study is to evaluate the effect of fruit and vegetables to reduce the acid load in CKD. METHODS: We conducted a case-control study in 146 patients who received sodium bicarbonate...
January 17, 2017: Nutrients
https://www.readbyqxmd.com/read/28057873/attainment-of-guideline-targets-in-eurodopps-haemodialysis-patients-are-differences-related-to-a-country-s-healthcare-expenditure-and-nephrologist-workforce
#18
Sophie Liabeuf, Karlijn J Van Stralen, Fergus Caskey, Francesca Tentori, Ronald L Pisoni, Ayesha Sajjad, Kitty J Jager, Ziad A Massy
BACKGROUND: In the field of chronic kidney disease, global clinical practice guidelines have been developed and implemented with a view to improving patient care and outcomes. The attainment of international and European guideline targets for haemodialysis patients in European countries has not been audited recently. Hence, we sought to establish whether the attainment of the targets set out in guidelines and inappropriate care are similar across European countries and whether inter-country differences are related to disparities in national healthcare expenditures (as a percentage of gross domestic product) and/or the nephrologist workforce per capita...
January 5, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27998188/can-the-surgical-tourniquet-be-used-in-patients-with-sickle-cell-disease-or-trait-a-review-of-the-literature
#19
REVIEW
Marco Pignatti, Sara Zanella, Caterina Borgna-Pignatti
In patients with sickle cell disease, circulatory stasis, acidosis, and hypoxemia induce red cell deoxygenation and consequent sickling. Tourniquets are an important adjunct in limb surgery to obtain a bloodless field. Many local and systemic effects, due to the inflation and deflation of the tourniquet, can develop. These effects may have severe consequences if comorbidities are present. The use of a tourniquet in sickle cell patients is controversial because it may provoke vaso-occlusive complications. Areas covered:We reviewed the literature to detect reports of the use of tourniquet in sickle cell disease or sickle trait...
February 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/27928454/the-role-of-oral-sodium-bicarbonate-supplementation-in-maintaining-acid-base-balance-and-its-influence-on-the-cardiovascular-system-in-chronic-hemodialysis-patients-results-of-a-prospective-study
#20
RANDOMIZED CONTROLLED TRIAL
C Voiculeț, O Zară, C Bogeanu, I Văcăroiu, G Aron
Background: Major acid-base variations during dialysis and the imbalances in serum calcium levels intensified by them play a role in cardiovascular damage of hemodialysis patients. Early vascular walls modifications can be objectified by determining the pulse wave velocity (PWV) - a marker of vascular stiffness that is associated with increased risk of cardiovascular events. Material and methods: This was a prospective study conducted on 63 chronic hemodialysis patients with diuresis above 500 mL/ 24 hours and predialysis blood pressure below 160 mmHg (treatment controlled) randomized in two groups for 12 months - the study group receiving interdialitic oral sodium bicarbonate doses and control group, without oral sodium bicarbonate supplementation, but receiving higher bicarbonate prescriptions in dialysis...
October 2016: Journal of Medicine and Life
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