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Renal Supportive care

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https://www.readbyqxmd.com/read/28730555/intermittent-versus-continuous-renal-replacement-therapy-in-acute-methanol-poisoning-comparison-of-clinical-effectiveness-in-mass-poisoning-outbreaks
#1
Sergey Zakharov, Jan Rulisek, Olga Nurieva, Katerina Kotikova, Tomas Navratil, Martin Komarc, Daniela Pelclova, Knut Erik Hovda
BACKGROUND: Intermittent hemodialysis (IHD) is the modality of choice in the extracorporeal treatment (ECTR) of acute methanol poisoning. However, the comparative clinical effectiveness of intermittent versus continuous modalities (CRRT) is unknown. During an outbreak of mass methanol poisoning, we therefore studied the effect of IHD versus CRRT on mortality and the prevalence of visual/central nervous system (CNS) sequelae in survivors. METHODS: The study was designed as prospective observational cohort study...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#2
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28727945/micronutrient-alterations-during-continuous-renal-replacement-therapy-in-critically-ill-adults-a-retrospective-study
#3
Amir Y Kamel, Nisha J Dave, Vivian M Zhao, Daniel P Griffith, Michael J Connor, Thomas R Ziegler
BACKGROUND: Continuous renal replacement therapy (CRRT) is commonly used to provide renal replacement therapy in the intensive care unit. Limited published data suggest that CRRT may lead to depletion of water-soluble vitamins and trace elements. The goal of this study was to identify the incidence of trace element and vitamin deficiencies in critically ill patients during CRRT. MATERIALS AND METHODS: This study is based on a retrospective chart review of patients who were referred to Emory University Hospital's nutrition support services and had at least 1 serum micronutrient level measured during CRRT (thiamin, pyridoxine, ascorbic acid, folate, zinc, and copper) between April 1, 2009, and June 1, 2012...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28723830/early-versus-delayed-coronary-artery-bypass-graft-surgery-for-patients-with-non-st-elevation-myocardial-infarction
#4
Le Dung Ha, Gbolahan Ogunbayo, Ayman Elbadawi, Odunayo Olorunfemi, Adrian Messerli
BACKGROUND: Although coronary artery bypass graft surgery (CABG) has been proven to have mortality and morbidity benefits in patients with non-ST elevation myocardial infarction and multivessel disease, the appropriate timing of this procedure remains unclear. Therefore, we proposed a propensity score-matched analysis comparing the clinical outcomes between patients who underwent CABG within the first 48 h of admission (early CABG) and patients who underwent CABG after 48 h of admission (delayed CABG)...
July 18, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28713799/the-use-of-ambulatory-blood-pressure-monitoring-as-standard-of-care-in-pediatrics
#5
REVIEW
Caitlin G Peterson, Yosuke Miyashita
Hypertension (HTN) is a significant global health problem, responsible for 7.5 million deaths each year worldwide. The prevalence of HTN is increasing in the pediatric population likely attributed to the increase in childhood obesity. Recent work has also shown that blood pressure (BP) tends to track from childhood to adulthood including BP-related target organ damage. In the last 25-30 years, pediatric use of ambulatory blood pressure monitoring (ABPM) has been expanding mainly in the setting of initial elevated BP measurement evaluation, HTN therapy efficacy follow-up, and renal disease...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28707167/supportive-care-for-patients-undergoing-immunotherapy
#6
Bernardo Leon Rapoport, Ronwyn van Eeden, Vincent Sibaud, Joel B Epstein, Jean Klastersky, Matti Aapro, Devan Moodley
Immune checkpoint inhibitors, a new class of cancer therapeutic agents, play an important role in the management of melanoma, NSCLC, and other malignancies. A workshop organized by three MASCC Study Groups: Oral Care, Skin Toxicities, and Neutropenia, Infection, and Myelosuppression during the MASCC Annual Meeting held in Adelaide, Australia on 23-25 June, 2016 focused on the new class of anti-cancer therapeutic agents. Topics in the workshop included the mechanism of action and clinical uses of immune anti-CTL4 and anti-PD1 antibodies, checkpoint inhibitor toxicities, including skin adverse events, gastrointestinal toxicities, oral complications, pulmonary toxicities, and endocrinological and immune-related infections...
July 13, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28706103/vitamin-d-levels-in-critically-ill-patients-with-acute-kidney-injury-a-protocol-for-a-prospective-cohort-study-vid-aki
#7
Lynda Katherine Cameron, Katie Lei, Samantha Smith, Nanci Leigh Doyle, James F Doyle, Kate Flynn, Nicola Purchase, John Smith, Kathryn Chan, Farida Kamara, Nardos Ghebremedhin Kidane, Lui G Forni, Dominic Harrington, Geeta Hampson, Marlies Ostermann
INTRODUCTION: Acute kidney injury (AKI) affects more than 50% of critically ill patients. The formation of calcitriol, the active vitamin D metabolite, from the main inactive circulating form, 25-hydroxyvitamin D (25(OH)D), occurs primarily in the proximal renal tubules. This results in a theoretical basis for reduction in levels of calcitriol over the course of an AKI. Vitamin D deficiency is highly prevalent in critically ill adults, and has been associated with increased rates of sepsis, longer hospital stays and increased mortality...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28701592/risk-factors-of-postcardiotomy-ventricular-dysfunction-in-moderate-to-high-risk-patients-undergoing-open-heart-surgery
#8
Christoph Ellenberger, Tornike Sologashvili, Mustafa Cikirikcioglu, Gabriel Verdon, John Diaper, Tiziano Cassina, Marc Licker
INTRODUCTION: Ventricular dysfunction requiring inotropic support frequently occurs after cardiac surgery, and the associated low cardiac output syndrome largely contributes to postoperative death. We aimed to study the incidence and potential risk factors of postcardiotomy ventricular dysfunction (PCVD) in moderate-to-high risk patients scheduled for open-heart surgery. METHODS: Over a 5-year period, we prospectively enrolled 295 consecutive patients undergoing valve replacement for severe aortic stenosis or coronary artery bypass surgery who presented with Bernstein-Parsonnet scores >7...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28698823/a-nationwide-survey-of-healthcare-personnel-s-attitude-knowledge-and-interest-toward-renal-supportive-care-in-taiwan
#9
Hung-Bin Tsai, Chia-Ter Chao, Jenq-Wen Huang, Ray-E Chang, Kuan-Yu Hung
BACKGROUND: Renal supportive care (RSC) is an important option for elderly individuals reaching end-stage renal disease; however, the frequency of RSC practice is very low among Asian countries. We evaluated the attitude, the knowledge, and the preference for specific topics concerning RSC among participants who worked in different medical professions in Taiwan. METHODS: A cross-sectional questionnaire-based survey was employed. Healthcare personnel (N = 598) who were involved in caring for end-stage renal disease patients at more than 40 facilities in Taiwan participated in this study...
2017: PeerJ
https://www.readbyqxmd.com/read/28697170/critically-ill-children-with-hemophagocytic-lymphohistiocytosis-a-case-series-of-14-patients
#10
Esther Huimin Leow, Shui Yen Soh, Ah Moy Tan, Yee Hui Mok, Mei Yoke Chan, Jan Hau Lee
Children with hemophagocytic lymphohistiocytosis (HLH) are at an increased risk of critical illness. In this study, we described the clinical characteristics of critically ill children with HLH and identify factors associated with poor clinical outcomes. Children who were diagnosed with HLH with emergent admission to Children's Intensive Care Unit (CICU) between January 1, 2000 and October 31, 2015 were included. The primary outcome was CICU mortality. Over the 15-year period, there were 14 critically ill patients with HLH with 23 CICU admissions...
July 10, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28690174/clinical-outcomes-of-donation-after-circulatory-death-liver-transplantation-in-primary-sclerosing-cholangitis
#11
Palak J Trivedi, Irene Scalera, Emma Slaney, Richard W Laing, Bridget Gunson, Gideon M Hirschfield, Andrea Schlegel, James Ferguson, Paolo Muiesan
BACKGROUND AND AIM: Primary sclerosing cholangitis (PSC) is a progressive fibro-inflammatory cholangiopathy for which liver transplantation is the only life-extending intervention. These patients may benefit from accepting liver donation after circulatory death (DCD), however their subsequent outcome is unknown. METHODS: Clinical outcomes were prospectively evaluated in PSC patients undergoing transplantation from 2006 to 2016 stratified by donor type (DCD, n=35 vs...
July 6, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#12
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28683810/effect-of-dextran-70-on-outcome-in-severe-sepsis-a-propensity-score-matching-study
#13
Peter Bentzer, Marcus Broman, Thomas Kander
BACKGROUND: Albumin may be beneficial in patients with septic shock but availability is limited and cost is high. The objective of the present study was to investigate if the use of dextran-70 in addition to albumin and crystalloids influences organ failure or mortality in patients with severe sepsis or septic shock. METHODS: Patients with severe sepsis or septic shock (n = 778) admitted to a university hospital intensive care unit (ICU) between 2007 and 2015 that received dextran-70 during resuscitation were propensity score matched to controls at a 1 to 1 ratio...
July 6, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28679364/understanding-barriers-to-medication-dietary-and-lifestyle-treatments-prescribed-in-polycystic-kidney-disease
#14
Wen-Ching Tran, David Huynh, Tea Chan, Catherine A Chesla, Meyeon Park
BACKGROUND: Autosomal dominant polycystic kidney disease (PKD) is the most common genetic renal disease and the fourth leading cause of end-stage renal disease in the United States. Although there is no cure for PKD, several treatments are considered to be beneficial, including blood pressure control, exercise, low-salt diet, and high volume water intake. However, levels of understanding of the importance of these treatments and adherence to these recommendations vary among patients. This study explores illness perception models of patients with PKD to reveal barriers in adherence to prescribed therapies; satisfaction with medical care; and sources of medical information...
July 5, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28668445/comparison-of-four-measures-in-reducing-length-of-stay-in-burns-an-asian-centre-s-evolved-multimodal-burns-protocol
#15
Si Jack Chong, Yee Onn Kok, Abby Choke, Esther W X Tan, Kok Chai Tan, Bien-Keem Tan
INTRODUCTION: Multidisciplinary burns care is constantly evolving to improve outcomes given the numerous modalities available. We examine the use of Biobrane, micrografting, early renal replacement therapy and a strict target time of surgery within 24h of burns on improving outcomes of length of stay, duration of surgery, mean number of surgeries and number of positive tissue cultures in a tertiary burns centre. METHODS: A post-implementation prospective cohort of inpatient burns patients from 2014 to 2015 (n=137) was compared against a similar pre-implementation cohort from 2013 to 2014 (n=93) using REDCAP, an electronic database...
June 28, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28663062/community-pharmacist-training-and-communication-network-and-drug-related-problems-in-patients-with-ckd-a-multicenter-cluster-randomized-controlled-trial
#16
Lyne Lalonde, Patricia Quintana-Bárcena, Anne Lord, Robert Bell, Valérie Clément, Anne-Marie Daigneault, Marie-Ève Legris, Sara Letendre, Marie Mouchbahani, Ghaya Jouini, Joëlle Azar, Élisabeth Martin, Djamal Berbiche, Stephanie Beaulieu, Sébastien Beaunoyer, Émilie Bertin, Marianne Bouvrette, Noémie Charbonneau-Séguin, Jean-François Desrochers, Katherine Desforges, Ariane Dumoulin-Charette, Sébastien Dupuis, Maryame El Bouchikhi, Roxanne Forget, Marianne Guay, Jean-Phillippe Lemieux, Claudia Morin-Bélanger, Isabelle Noël, Stephanie Ricard, Patricia Sauvé, François Ste-Marie Paradis
BACKGROUND: Appropriate training for community pharmacists may improve the quality of medication use. Few studies have reported the impact of such programs on medication management for patients with chronic kidney disease (CKD). STUDY DESIGN: Multicenter, cluster-randomized, controlled trial. SETTING & PARTICIPANTS: Patients with CKD stage 3a, 3b, or 4 from 6 CKD clinics (Quebec, Canada) and their community pharmacies. INTERVENTION: Each cluster (a pharmacy and its patients) was randomly assigned to either ProFiL, a training-and-communication network program, or the control group...
June 26, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28658196/late-term-gestation-is-associated-with-improved-survival-in-neonates-with-congenital-heart-disease-following-postoperative-extracorporeal-life-support
#17
Jane M McKenzie, Thomas Scodellaro, Yves d'Udekem, Roberto Chiletti, Warwick Butt, Siva P Namachivayam
OBJECTIVE: Several population-based studies have shown that gestational age 39-40 weeks at birth is associated with superior outcomes in various pediatric settings. A high proportion of births for neonates with congenital heart disease occur before 39 weeks. We aimed to assess the influence of late-term gestation (39-40 wk) on survival in neonates requiring extracorporeal life support following surgery for congenital heart disease. DESIGN: Retrospective cohort study...
June 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28652122/predictors-of-hospital-admission-and-urologic-intervention-in-adult-emergency-department-patients-with-ct-confirmed-ureteral-stones
#18
Brock Daniels, Elizabeth Schoenfeld, Andrew Taylor, Karrin Weisenthal, Dinesh Singh, Christopher L Moore
PURPOSE: Over one million patients seek care in an Emergency Department (ED) for kidney stones annually, but a minority require admission or urologic procedure. We aim to describe predictors of hospital admission or urologic intervention. MATERIALS AND METHODS: This secondary analysis of prospective data includes ED patients with CT-confirmed obstructing ureteral stone. All patients also received a point-of-care limited renal ultrasound (PLUS). Need for urologic intervention at 90 days was assessed by follow-up interview...
June 23, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28648314/direct-cost-for-treating-chronic-kidney-disease-at-an-outpatient-setting-of-a-tertiary-hospital-evidence-from-a-cross-sectional-study
#19
Rajiv Ahlawat, Pramil Tiwari, Sanjay D'Cruz
BACKGROUND: Chronic kidney disease (CKD) has a high morbidity and mortality in developing countries. And this burden is also increasing rapidly in India. Unaffordability due to high cost of medication and hemodialysis remains one of the major barriers in the successful treatment of CKD. OBJECTIVES: To determine the direct cost involved in treating CKD at an outpatient department of a public tertiary care hospital. METHODS: This cross-sectional study was carried out at a public tertiary care hospital...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28642999/continually-improving-standards-of-care-the-uk-renal-registry-as-a-translational-public-health-tool
#20
REVIEW
Lucy A Plumb, Alexander J Hamilton, Carol D Inward, Yoav Ben-Shlomo, Fergus J Caskey
A disease registry uses observational study methods to collect defined data on patients with a particular condition for a predetermined purpose. By providing comprehensive standardised data on patients with kidney disease, renal registries aim to provide a 'real world' representation of practice patterns, treatment and patient outcomes that may not be captured accurately by other methods, including randomised controlled trials. Additionally, using registries to measure variations in outcomes and audit care against standards is crucial to understanding how to improve quality of care for patients in an efficacious and cost-effective manner...
June 22, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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