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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
#1
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
#2
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...
December 27, 2016: 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
#3
Voiculeț C, Zară O, Bogeanu C, Văcăroiu I, Aron G
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
https://www.readbyqxmd.com/read/27928449/severe-asymptomatic-coronary-obstruction-in-chronic-hemodialysed-patient-a-case-report
#4
Voiculeț C, Zara O, Văcăroiu I, Bogeanu C, Tiron T, Turcu F, Aron G, Ciocâlteu A
Introduction. Arterial stiffness and vascular calcifications are independent predictors of cardiovascular morbidity and mortality in the chronic kidney disease (CKD) stage 5D population. According to the guidelines, patients on renal replacement therapy represent a very high cardiovascular risk class. Case report. We report the case of a 67-year-old hypertensive male patient, known with CKD stage 5D on hemodialysis (three times per week), secondary bone mineral disease, admitted for progressive right leg pain...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27902848/topiramate-in-migraine-prevention-a-2016-perspective
#5
Stephen D Silberstein
BACKGROUND: In evidence-based guidelines published in 2000, topiramate was a third-tier migraine preventive with no scientific evidence of efficacy; recommendation for its use reflected consensus opinion and clinical experience. Its neurostabilizing activity, coupled with its favorable weight profile, made topiramate an attractive alternative to other migraine preventives that caused weight gain. When guidelines for migraine prevention in episodic migraine were published in 2012, topiramate was included as a first-line option based on double-blind, randomized controlled trials involving nearly 3000 patients...
January 2017: Headache
https://www.readbyqxmd.com/read/27871516/pediatric-patients-on-ketogenic-diet-undergoing-general-anesthesia-a-medical-record-review
#6
Elif Soysal, Heike Gries, Carter Wray
STUDY OBJECTIVE: To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). DESIGN: Retrospective medical record review. SETTING: Postoperative recovery area. PATIENTS: All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27757797/light-chains-removal-by-extracorporeal-techniques-in-acute-kidney-injury-due-to-multiple-myeloma-a-position-statement-of-the-onconephrology-work-group-of-the-italian-society-of-nephrology
#7
P Fabbrini, K Finkel, M Gallieni, G Capasso, M Cavo, A Santoro, S Pasquali
Acute kidney injury (AKI) is a frequent complication of multiple myeloma and is associated with increased short-term mortality. Additionally, even a single episode of AKI can eventually lead to end-stage renal disease (ESRD), significantly reducing quality of life and long-term survival. In the setting of multiple myeloma, severe AKI (requiring dialysis) is typically secondary to cast nephropathy (CN). Renal injury in CN is due to intratubular obstruction from precipitation of monoclonal serum free light chains (sFLC) as well as direct tubular toxicity of sFLC via stimulation of nuclear factor (NF)κB inflammatory pathways...
December 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27755068/clinical-practice-guidelines-for-sustained-neuromuscular-blockade-in-the-adult-critically-ill-patient
#8
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27687084/assessment-of-a-semi-quantitative-screening-method-for-diagnosis-of-ethylene-glycol-poisoning
#9
Arun Sankaralingam, Annette Thomas, David R James, Anthony S Wierzbicki
BACKGROUND: Ethylene glycol poisoning remains a rare but important presentation to acute toxicology units. Guidelines recommended that ethylene glycol should be available as an 'urgent' test within 4 h, but these are difficult to deliver in practice. This study assessed a semi-quantitative enzymatic spectrophotometric assay for ethylene glycol compatible with automated platforms. METHODS: The ethylene glycol method was assessed in 21 samples from patients with an increased anion gap and metabolic acidosis not due to ethylene glycol ingestion, and seven samples known to contain ethylene glycol...
September 28, 2016: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/27534835/metformin-associated-risk-of-acute-dialysis-in-patients-with-type-2-diabetes-a-nationwide-cohort-study
#10
Nicholas Carlson, Kristine Hommel, Jonas B Olesen, Thomas A Gerds, Anne-Merete Soja, Tina Vilsbøll, Anne-Lise Kamper, Christian Torp-Pedersen, Gunnar Gislason
Recent guidelines governing anti-diabetic medications increasingly advocate metformin as first-line therapy in all patients with type 2 diabetes. However, metformin could be associated with increased risk of acute kidney injury (AKI), acute dialysis and lactate acidosis in marginal patients. In a retrospective nationwide cohort study, a total of 168 443 drug-naïve patients with type 2 diabetes ≥50 years, initiating treatment with either metformin or sulphonyl in Denmark between 2000 and 2012 were included in this study (70...
December 2016: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/27416335/does-prenatal-diagnosis-of-hypoplastic-left-heart-syndrome-make-a-difference-a-systematic-review
#11
Varsha Thakur, Nadia Munk, Luc Mertens, Lynne E Nield
OBJECTIVE: Hypoplastic left heart syndrome is frequently diagnosed prenatally with variable benefit. We performed a systematic review to evaluate the impact of fetal diagnosis; the primary objective was to evaluate impact on mortality. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Seven databases were searched. Meta-analysis was performed using a random effects model to evaluate the effect of fetal diagnosis on mortality...
September 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27374392/-metformin-and-kidney
#12
Concetto Sessa, Julien Blanco, Antonio Granata, Pasquale Fatuzzo, Pietro Castellino, Luca Zanoli
Metformin is the first choice among drugs used for the treatment of type II diabetes mellitus mainly because of several advantages: proven hypoglycemic effect, good safety profile, virtually no risk of hypoglycemia, body weight reduction, lipid-lowering effect, efficacy in preventing micro- and macrovascular complications as well as adverse cardiac and cerebrovascular events and reduced cost. Previous reports had shown an increased risk of lactic acidosis in patients receiving metformin. However, the current Guidelines have greatly limited this risk to certain categories of patients, such as those with severe chronic renal failure, particularly when predisposing risk factors such as administration of iodinated contrast are present...
May 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/27328890/arterial-blood-gases-during-and-their-dynamic-changes-after-cardiopulmonary-resuscitation-a-prospective-clinical-study
#13
Walter Spindelboeck, Geza Gemes, Christa Strasser, Kathrin Toescher, Barbara Kores, Philipp Metnitz, Josef Haas, Gerhard Prause
PURPOSE: An arterial blood gas analysis (ABG) yields important diagnostic information in the management of cardiac arrest. This study evaluated ABG samples obtained during out-of-hospital cardiopulmonary resuscitation (OHCPR) in the setting of a prospective multicenter trial. We aimed to clarify prospectively the ABG characteristics during OHCPR, potential prognostic parameters and the ABG dynamics after return of spontaneous circulation (ROSC). METHODS: ABG samples were collected and instantly processed either under ongoing OHCPR performed according to current advanced life support guidelines or immediately after ROSC and data ware entered into a case report form along with standard CPR parameters...
September 2016: Resuscitation
https://www.readbyqxmd.com/read/27181293/renal-replacement-therapy-in-the-critically-ill-does-timing-matter
#14
EDITORIAL
Ravindra L Mehta
No abstract text is available yet for this article.
July 14, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27179226/clinical-strategies-for-the-management-of-intestinal-obstruction-and-pseudo-obstruction-a-delphi-consensus-study-of-sicut-societ%C3%A3-italiana-di-chirurgia-d-urgenza-e-del-trauma
#15
Gianluca Costa, Paolo Ruscelli, Genoveffa Balducci, Francesco Buccoliero, Laura Lorenzon, Barbara Frezza, Piero Chirletti, Franco Stagnitti, Stefano Miniello, Francesco Stella
BACKGROUND: Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout. METHODS: The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds. Consensus was defined as an agreement of 75.0% or greater...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27095272/a-recommended-early-goal-directed-management-guideline-for-the-prevention-of-hypothermia-related-transfusion-morbidity-and-mortality-in-severely-injured-trauma-patients
#16
REVIEW
Ryan Perlman, Jeannie Callum, Claude Laflamme, Homer Tien, Barto Nascimento, Andrew Beckett, Asim Alam
Hypothermia is present in up to two-thirds of patients with severe injury, although it is often disregarded during the initial resuscitation. Studies have revealed that hypothermia is associated with mortality in a large percentage of trauma cases when the patient's temperature is below 32 °C. Risk factors include the severity of injury, wet clothing, low transport unit temperature, use of anesthesia, and prolonged surgery. Fortunately, associated coagulation disorders have been shown to completely resolve with aggressive warming...
April 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27023800/fetal-heart-rate-monitoring-category-3-during-the-2nd-stage-of-labor-is-an-independent-predictor-of-fetal-acidosis
#17
Tali Silberstein, Eyal Sheiner, Shimrit Yaniv Salem, Batel Hamou, Barak Aricha, Yael Baumfeld, Zehava Yohay, Debora Elharar, Inbal Idan, David Yohay
OBJECTIVE: To determine whether fetal heart rate (FHR) monitoring categories during the 1st and 2nd stage of labor can predict arterial cord pH <7.2. MATERIALS AND METHODS: A case control study was conducted including 653 consecutive term deliveries (37 weeks gestation and above) that were divided according to fetal pH ≤ 7.2 (n = 315) and fetal pH > 7.2 (n = 338). Deliveries occurred during the year 2013 in tertiary medical center, where arterial cord pH is routinely taken after birth...
February 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26985247/use-of-sodium-bicarbonate-in-cardiac-arrest-current-guidelines-and-literature-review
#18
REVIEW
Dimitrios Velissaris, Vassilios Karamouzos, Charalampos Pierrakos, Ioanna Koniari, Christina Apostolopoulou, Menelaos Karanikolas
The aim of the review was to summarize the literature over the last 25 years regarding bicarbonate administration in out-of-hospital cardiac arrest. A PubMed search was conducted using the terms "bicarbonates" and "cardiac arrest", limited to human studies and reviews published in English (or at least with a meaningful abstract in English) in the last 25 years. Clinical and experimental data raised questions regarding the safety and effectiveness of sodium bicarbonate (SB) administration during cardiac arrest...
April 2016: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/26960738/early-coagulopathy-and-metabolic-acidosis-predict-transfusion-of-packed-red-blood-cells-in-pediatric-trauma-patients
#19
Shane A Smith, Michael H Livingston, Neil H Merritt
BACKGROUND: Severely injured pediatric trauma patients often present to hospital with early coagulopathy and metabolic acidosis. These derangements are associated with poor outcomes, but it is unclear to what degree they predict transfusion of packed red blood cells (pRBC). METHODS: We retrospectively identified pediatric trauma patients from a level 1 trauma center from 2006 to 2013. Inclusion criteria were age less than 18years, Injury Severity Score greater than 12, and pRBC transfusion within 24h of admission...
May 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26946699/-news-in-diabetology-2015
#20
François R Jornayvaz
The year 2015 was punctuated by numerous events in diabetology. First, the ADA/EASD guidelines have been updated. The pharmacological panel for type 2 diabetes treatment saw the arrival of different new molecules. Two new basal insulins were also approved. Also, cardiovascular safety trials have been published regarding recent antidiabetic drugs. A new insulin pump than can be coupled with a glucosensor was released. Finally, a new unexpected complication of SGLT2 inhibitors treatment was reported, the euglycemic keto-acidosis...
January 13, 2016: Revue Médicale Suisse
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