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Renal Supportive care

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https://www.readbyqxmd.com/read/28088774/association-between-e-alert-implementation-for-detection-of-acute-kidney-injury-and-outcomes-a-systematic-review
#1
Philippe Lachance, Pierre-Marc Villeneuve, Oleksa G Rewa, Francis P Wilson, Nicholas M Selby, Robin M Featherstone, Sean M Bagshaw
BACKGROUND: Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain. METHODS: We performed a systematic review. Electronic databases and grey literature were searched for original studies published between 1990 and 2016. Randomized, quasi-randomized, observational and before-and-after studies that included hospitalized patients, implemented e-alerts for AKI and described their impact on one of care processes, patient-centred outcomes or resource utilization measures were included...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28080911/evaluation-of-in-house-urine-dipstick-reference-laboratory-urinalysis-and-urine-protein-creatinine-ratio-from-a-colony-of-callimicos-callimico-goeldii
#2
Sarah A Cannizzo, Jennifer N Langan, Mark Warneke, Matthew Allender
This study evaluated results from an in-house (IH) laboratory dipstick, a reference laboratory (RL) urinalysis, and urine protein : creatinine (UPC) ratios from callimicos ( Callimico goeldii ). Urine was collected from 25 individuals comprising a single colony under professional care in North America and compared based on laboratory, sex, age class, and presence or absence of a normal urinalysis. Urine specific gravity and pH between laboratories were statistically different. Overall, 56% to 100% of animals had at least a trace amount of protein in their urine...
December 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28078833/clinical-profile-and-outcome-of-patients-with-severe-sepsis-treated-in-an-intensive-care-unit-in-india
#3
T T Paary, M S Kalaiselvan, M K Renuka, A S Arunkumar
Introduction: Sepsis is the leading cause of intensive care unit (ICU) admissions and is associated with high mortality. Objectives: To identify the incidence, risk factors and outcome of patients with severe sepsis and septic shock. Methods: A prospective observational study was done in a multidisciplinary ICU over a period of 18 months. We included all adult patients admitted to ICU with features of severe sepsis and septic shock as per SCCM/ACCP guidelines...
30, 2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28076709/phase-3-trial-of-177-lu-dotatate-for-midgut-neuroendocrine-tumors
#4
Jonathan Strosberg, Ghassan El-Haddad, Edward Wolin, Andrew Hendifar, James Yao, Beth Chasen, Erik Mittra, Pamela L Kunz, Matthew H Kulke, Heather Jacene, David Bushnell, Thomas M O'Dorisio, Richard P Baum, Harshad R Kulkarni, Martyn Caplin, Rachida Lebtahi, Timothy Hobday, Ebrahim Delpassand, Eric Van Cutsem, Al Benson, Rajaventhan Srirajaskanthan, Marianne Pavel, Jaime Mora, Jordan Berlin, Enrique Grande, Nicholas Reed, Ettore Seregni, Kjell Öberg, Maribel Lopera Sierra, Paola Santoro, Thomas Thevenet, Jack L Erion, Philippe Ruszniewski, Dik Kwekkeboom, Eric Krenning
Background Patients with advanced midgut neuroendocrine tumors who have had disease progression during first-line somatostatin analogue therapy have limited therapeutic options. This randomized, controlled trial evaluated the efficacy and safety of lutetium-177 ((177)Lu)-Dotatate in patients with advanced, progressive, somatostatin-receptor-positive midgut neuroendocrine tumors. Methods We randomly assigned 229 patients who had well-differentiated, metastatic midgut neuroendocrine tumors to receive either (177)Lu-Dotatate (116 patients) at a dose of 7...
12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28073820/predicting-6-month-mortality-risk-of-patients-commencing-dialysis-treatment-for-end-stage-kidney-disease
#5
Sara E Ivory, Kevan R Polkinghorne, Yeasmin Khandakar, Jessica Kasza, Sophia Zoungas, Retha Steenkamp, Paul Roderick, Rory Wolfe
BACKGROUND: There is evidence that end-stage kidney disease patients who are older or with more comorbidity may have a poor trade-off between benefits of dialysis and potential harms. We aimed to develop a tool for predicting patient mortality in the early stages of receiving dialysis. METHODS: In 23 658 patients aged 15+ years commencing dialysis between 2000 and 2009 in Australia and New Zealand a point score tool was developed to predict 6-month mortality based on a logistic regression analysis of factors available at dialysis initiation...
January 10, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28065700/integrating-supportive-care-principles-into-dialysis-decision-making-a-primer-for-palliative-medicine-providers
#6
Alvin H Moss
Despite advances in pre-dialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy and substantial physical, emotional, and spiritual suffering. Patients with acute kidney injury and end-stage renal disease, especially if they are older, often undergo prolonged hospitalizations, greater use of intensive medical treatment, and limited survival. Unfortunately, most nephrologists are not trained to conduct shared decision-making conversations to elicit patients' values, preferences, and goals for treatment and address their patients' multifactorial suffering...
January 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28063123/minimally-invasive-surgery-should-be-the-standard-of-care-for-paraesophageal-hernia-repair
#7
Francisco Schlottmann, Paula D Strassle, Timothy M Farrell, Marco G Patti
BACKGROUND: It is unclear if minimally invasive surgery (MIS) has been universally embraced for paraesophageal hernia (PEH) repair. The aims of this study were: (a) to assess the national utilization of MIS for PEH repair and (b) to compare the perioperative outcomes between MIS and open procedures METHODS: A retrospective population-based analysis was performed using the National Inpatient Sample for the period 2000-2013. Adult patients (≥18 years old) who underwent PEH repair were included...
January 6, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28062619/beyond-natriuretic-peptides-for-diagnosis-and-management-of-heart-failure
#8
REVIEW
Nasrien E Ibrahim, James L Januzzi
BACKGROUND: Heart failure (HF) is a complex syndrome with an enormous societal burden in terms of cost and morbidity and mortality. Natriuretic peptide (NP) testing is now widely used to support diagnosis, prognostication, and management of patients with HF, but NPs come with limitations, including vulnerability to the presence of obesity, atrial fibrillation, and renal dysfunction, for example. Beyond the NPs, novel biomarkers may supplement traditional clinical and laboratory testing to improve understanding of the complex disease process of HF, and possibly to personalize care for those affected through better individual phenotyping...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28060690/-peritoneal-dialysis-in-the-first-two-years-of-life-experience-of-a-nephrology-and-renal-transplantation-pediatric-unit
#9
Sofia Deuchande, Tânia Mano, Cristina Novais, Rute Machado, Rosário Stone, Margarida Almeida
INTRODUCTION: Peritoneal dialysis is the dialytic method of choice in chronic end-stage renal disease in children. This study main purpose was to characterize the long-term survival of a pediatric population who began peritoneal dialysis within the first two years of life. MATERIAL AND METHODS: A descriptive and retrospective study was performed in a portuguese nephrology and renal transplantation pediatric unit, between January 1991 and August 2014. End-stage renal disease etiology, mortality, comorbidities and complications of peritoneal dialysis and end-stage renal disease, growth and psychomotor development were evaluated...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28060152/an-elevated-low-cardiac-output-syndrome-score-is-associated-with-morbidity-in-infants-after-congenital-heart-surgery
#10
Kalia P Ulate, Ofer Yanay, Howard Jeffries, Harris Baden, Jane L Di Gennaro, Jerry Zimmerman
OBJECTIVES: To evaluate an empirically derived Low Cardiac Output Syndrome Score as a clinical assessment tool for the presence and severity of Low Cardiac Output Syndrome and to examine its association with clinical outcomes in infants who underwent surgical repair or palliation of congenital heart defects. DESIGN: Prospective observational cohort study. SETTING: Cardiac ICU at Seattle Children's Hospital. PATIENTS: Infants undergoing surgical repair or palliation of congenital heart defects...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28049485/the-dangers-of-accepting-a-single-diagnosis-case-report-of-concurrent-plasmodium-knowlesi-malaria-and-dengue-infection
#11
Soon Eu Chong, Rhendra Hardy Mohamad Zaini, Siti Suraiya, Kok Tong Lee, Jo Anne Lim
BACKGROUND: Dengue and malaria are two common, mosquito-borne infections, which may lead to mortality if not managed properly. Concurrent infections of dengue and malaria are rare due to the different habitats of its vectors and activities of different carrier mosquitoes. The first case reported was in 2005. Since then, several concurrent infections have been reported between the dengue virus (DENV) and the malaria protozoans, Plasmodium falciparum and Plasmodium vivax. Symptoms of each infection may be masked by a simultaneous second infection, resulting in late treatment and severe complications...
January 3, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28044472/how-clinical-practice-is-changing-the-rules-the-sunitinib-2-1-schedule-in-metastatic-renal-cell-carcinoma
#12
Sergio Bracarda, Sylvie Negrier, Jochen Casper, Camillo Porta, Manuela Schmidinger, James Larkin, Marine Gross Goupil, Bernard Escudier
Currently, sunitinib is a standard of care in first-line treatment for metastatic renal cell carcinoma (mRCC). However, with the standard 4/2 schedule (sunitinib 50 mg/day; 4 consecutive weeks on treatment; 2 weeks' rest), 50% of patients require dose reductions to mitigate toxicity, highlighting the need to investigate alternative dosing schedules that improve tolerability without compromising efficacy. Areas covered: We present a concise critical review of published studies comparing the efficacy and safety of the 4/2 and 2/1 schedule (2 weeks on treatment; 1 week rest) for sunitinib...
January 3, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28032889/operating-a-monitoring-unit-in-the-geriatric-department-effects-on-outcomes
#13
Abram Abramovitch, Reuven Friedmann, Shoshana Zevin, Gabriel Munter, Amos M Yinnon, David Raveh-Brawer
OBJECTIVES: To compare the effect of a five-bed geriatric monitoring unit (MU) on in-hospital mortality and length of stay with the effect of usual care in a geriatric hospital department and a medical MU. DESIGN: Prospective, case-control, noninterventional study. PARTICIPANTS: All individuals hospitalized for 24 hours or longer in the geriatric MU (n = 89, aged 53-101, mean age 82.2 ± 9.6) over a period of 5 months (January-May 2015); individuals admitted to the geriatric department (n = 178, aged 55-100, mean age 83...
December 28, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28029474/hypertension-after-injury-among-burned-combat-veterans-a-retrospective-cohort-study
#14
Ian J Stewart, Jonathan A Sosnov, Brian D Snow, Augen Batou, Jeffrey T Howard, Jud C Janak, Mary Bollinger, Kevin K Chung
BACKGROUND: The long-term health effects of burn are poorly understood. We sought to evaluate the relationship between burn and the subsequent development of hypertension. METHODS: Retrospective cohort study of patients admitted to our burn center from 2003 to 2010. Data collected included demographic variables, burn size, injury severity score, presence of inhalation injury, serum creatinine, need for renal replacement therapy, as well as days spent in the hospital, in the intensive care unit and on mechanical ventilation...
October 28, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28024315/patient-physician-and-health-system-factors-influencing-the-quality-of-antidepressant-and-sedative-prescribing-for-older-community-dwelling-adults
#15
Rian Marie Extavour, Matthew Perri
OBJECTIVE: To identify determinants of potentially inappropriate (PI) antidepressant and anxiolytic/sedative prescribing for older, community-dwelling adults. DATA SOURCES/STUDY SETTING: Office visits from the 2010 National Ambulatory Medical Care Survey. STUDY DESIGN: A cross-sectional study measuring associations between various patient and physician factors and prescribing of PI antidepressants, and PI sedatives among elderly, using Beers 2012/2015 criteria, a clinical decision model, and multivariate logistic regressions...
December 26, 2016: Health Services Research
https://www.readbyqxmd.com/read/28007064/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-public-reporting-initiative
#16
REVIEW
Jeffrey P Jacobs
Three basic principles provide the rationale for the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database (CHSD) public reporting initiative: (1) Variation in congenital and pediatric cardiac surgical outcomes exist. (2) Patients and their families have the right to know the outcomes of the treatments that they will receive. (3). It is our professional responsibility to share this information with them in a format they can understand. The STS CHSD public reporting initiative facilitates the voluntary transparent public reporting of congenital and pediatric cardiac surgical outcomes using the STS CHSD Mortality Risk Model...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27999961/long-term-outcomes-of-initial-therapy-for-idiopathic-membranous-nephropathy
#17
Masayo Sato, Takashi Takei, Takahito Moriyama, Mitsuyo Itabashi, Kosaku Nitta
BACKGROUND: The objective of this study is to determine whether initial steroid therapy is actually effective for the treatment of iMN, and we examined a 40% reduction in estimated glomerular filtration rate (eGFR) and remission rates. METHODS: This was a retrospective study between 1993 and 2013. First, we divided patients with iMN having a urinary protein level of ≥1 g/gCre into two groups: those who had received steroid therapy (Group S1; n = 52) within 6 months of diagnosis and those who had received supportive therapy (Group H1; n = 31)...
December 20, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27999694/a-case-of-pulmonary-renal-syndrome-leading-to-the-diagnosis-of-legionnaires-disease
#18
Erasmia Sabani, Pantelis A Sarafidis, Antonios Lazaridis, Theodora Kouloukourgiotou, Konstantinos Stylianou, Afroditi Pantzaki, Aikaterini Papagianni, Georgios Efstratiadis
We report a case of a 51-year-old Caucasian man referred at our department due to acute renal failure (ARF) complicating respiratory failure during hospitalization in a regional hospital. The patient was previously started on steroids due to the suspicion of rapidly progressive glomerulonephritis (RPGN) in the context of Goodpasture syndrome. However, clinical and laboratory findings did not support this diagnosis; instead a careful evaluation limited differential diagnosis of the renal insult to acute tubular necrosis or acute interstitial nephritis (AIN) following respiratory infection...
2016: Case Reports in Nephrology
https://www.readbyqxmd.com/read/27992110/kidney-exchange-to-overcome-financial-barriers-to-kidney-transplantation
#19
M A Rees, T B Dunn, C S Kuhr, C L Marsh, J Rogers, S E Rees, A Cicero, L J Reece, A E Roth, O Ekwenna, D E Fumo, K D Krawiec, J E Kopke, S Jain, M Tan, S R Paloyo
Organ shortage is the major limitation to kidney transplantation in the developed world. Conversely, millions of patients in the developing world with end-stage renal disease die because they cannot afford renal replacement therapy-even when willing living kidney donors exist. This juxtaposition between countries with funds but no available kidneys and those with available kidneys but no funds prompts us to propose an exchange program using each nation's unique assets. Our proposal leverages the cost savings achieved through earlier transplantation over dialysis to fund the cost of kidney exchange between developed-world patient-donor pairs with immunological barriers and developing-world patient-donor pairs with financial barriers...
November 7, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27990438/the-experience-of-older-people-in-the-shared-decision-making-process-in-advanced-kidney-care
#20
Nicola Thomas, Karen Jenkins, Breeda McManus, Brian Gracey
Introduction. This qualitative descriptive study was designed to understand the experiences of older people (>70 years) when making a decision about renal replacement therapy. This was a coproduced study, whereby patients and carers were involved in all aspects of the research process. Methods. A Patient and Carer Group undertook volunteer and research training. The group developed the interview questions and interviewed 29 people who had commenced dialysis or made a decision not to have dialysis. Interview data were transcribed and analysed, and common themes were identified...
2016: BioMed Research International
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