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Renal older

Dael Jarvie, Sherif Hanafy Mahmoud
PURPOSE: Levetiracetam (LEV) is a broad spectrum antiepileptic drug (AED) that has a more favorable side effect profile compared to older AEDs. Therapeutic drug monitoring (TDM) of LEV is generally unnecessary given its linear and predictable dose-serum concentration relationship, lack of drug-drug interactions, and broad therapeutic window. However, there is growing evidence showing that alteration of LEV pharmacokinetics (PK) may occur in special populations calling for the need for TDM...
2018: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
Takeshi Oichi, Yasushi Oshima, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To compare morbidity and mortality between nonagenarians and other older adult patients who underwent elective spine surgery. SUMMARY OF BACKGROUND DATA: There is a lack of information of the perioperative risks of nonagenarians undergoing spine surgery. METHODS: Data of patients aged ≥65 years who underwent elective spine surgery from July 2010 to March 2013 were extracted from the Diagnosis Procedure Combination database, a nationwide administrative inpatient database in Japan...
August 7, 2018: Spine
Haruko Iwase, Seigi Furukawa, Takeshi Hirasawa, Satoshi Asai, Tatsuru Ohara, Shinji Hosonuma, Shinichi Endo, Yuki Tazo, Hidetaka Sato, Toshio Takada, Masahide Arai, Masae Ikeda, Masako Shida, Norihito Yoshioka, Akiko Tozawa-Ono, Nao Suzuki, Mikio Mikami, Takashi Onda
OBJECTIVE: Chemotherapy is a standard adjuvant treatment after primary surgery for endometrial cancer in Japan. We aimed to characterize the clinical features of recurrent endometrial cancer (REC) patients in Japan. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 112 REC patients who were primarily treated at 1 of 3 university hospitals in Japan from 2005 to 2012. We analyzed overall survival since the first recurrence (R-OS) in accordance with several factors...
August 7, 2018: International Journal of Gynecological Cancer
Zhenbin Jiang, Meishun Cai, Bao Dong, Yu Yan, Bing Yang, Mi Wang, Yan Wang, Xin Li, Lichao Lian, Song Li, Li Zuo
Membranous nephropathy is typically classified as idiopathic and secondary, but nowadays the number of atypical membranous nephropathy (aMN) is increasing, many of which cannot determine its etiology in China. In this study, we compared the clinical and pathological characteristics of idiopathic membranous nephropathy (iMN) with aMN with unknown etiology from a single center in China.We retrospectively reviewed the clinical data of 577 patients with iMN and aMN at Peking University People's Hospital from January 2006 to December 2015 over a 10-year period, and analyzed their clinical and pathological characteristics...
August 2018: Medicine (Baltimore)
Dagmara McGuinness, Suhaib Mohammed, Laura Monaghan, Paul A Wilson, David B Kingsmore, Oliver Shapter, Karen S Stevenson, Shana M Coley, Luke Devey, Robert B Kirkpatrick, Paul G Shiels
Chronic kidney disease and associated comorbidities (diabetes, cardiovascular diseases) manifest with an accelerated ageing phenotype, leading ultimately to organ failure and renal replacement therapy. This process can be modulated by epigenetic and environmental factors which promote loss of physiological function and resilience to stress earlier, linking biological age with adverse outcomes post-transplantation including delayed graft function (DGF). The molecular features underpinning this have yet to be fully elucidated...
August 9, 2018: Aging Cell
Annika Rosengren, Jon Edqvist, Araz Rawshani, Naveed Sattar, Stefan Franzén, Martin Adiels, Ann-Marie Svensson, Marcus Lind, Soffia Gudbjörnsdottir
AIMS/HYPOTHESIS: Type 2 diabetes is an established risk factor for heart failure, but age-specific data are sparse. We aimed to determine excess risk of heart failure, based on age, glycaemic control and kidney function in comparison with age- and sex-matched control individuals from the general population. METHODS: Individuals with type 2 diabetes registered in the Swedish National Diabetes Registry 1998-2012 (n = 266,305) were compared with age-, sex- and county-matched control individuals without diabetes (n = 1,323,504), and followed over a median of 5...
August 9, 2018: Diabetologia
Mara A McAdams-DeMarco, Matthew Daubresse, Sunjae Bae, Alden L Gross, Michelle C Carlson, Dorry L Segev
BACKGROUND AND OBJECTIVES: Older patients with ESKD experience rapid declines in executive function after initiating hemodialysis; these impairments might lead to high rates of dementia and Alzheimer's disease in this population. We estimated incidence, risk factors, and sequelae of diagnosis with dementia and Alzheimer's disease among older patients with ESKD initiating hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We studied 356,668 older (age ≥66 years old) patients on hemodialysis (January 1, 2001 to December 31, 2013) from national registry data (US Renal Data System) linked to Medicare...
August 9, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Yasar Kandur, Ahmet Salan, Fatih Tuten
Introduction: To assess the association of frequently detected abnormalities (hydronephrosis and/or atrophy) on renal ultrasound with dimercaptosuccinic acid (DMSA) scan and the impact of vesicoureteral reflux (VUR) on these abnormalities to find new perspectives in pediatric age group. Materials and Methods: We retrospectively reviewed the DMSA, ultrasonography (US), micturating cystourethrography (MCUG) findings, and medical records of pediatric patients with hydronephrosis and/or atrophy who were at follow-up between January 2013 and December 2016 in our center which is located in the southeast region of Turkey...
July 2018: Urology Annals
Wen-Cheng Chao, Wei-Lun Chang, Chieh-Liang Wu, Ming-Cheng Chan
BACKGROUND: A ventilator-associated events (VAEs) algorithm was developed to detect events in mechanically ventilated subjects using objective parameters, and we aimed to use objective data of fluid balance to identify pulmonary edema-associated VAEs. METHODS: This single-center retrospective cohort study was conducted in a medical ICU and enrolled all mechanically ventilated patients between July 2016 and June 2017. Electronic medical records were reviewed to obtain data regarding ventilator-associated conditions (VACs), infection-related ventilator-associated complications (IVACs), possible ventilator-associated pneumonia (VAP), and traditionally defined VAP...
August 7, 2018: Respiratory Care
Chong Wang, Lei Jin, Fan Qiao, Qing Xue, Xin Guan Zhang, Lin Han
BACKGROUND: o evaluate the performance of Society of Thoracic Surgeons (STS) 2008 cardiac surgery risk scores for postoperative complications in Chinese patients undergoing single valve surgery at multicenter institutions.  Methods: From January 2009 through December 2012, 4493 consecutive patients older than 16 years who underwent single valve surgery at 4 cardiac surgical centers were collected and scored according to the STS 2008 risk scores. The final research population included the following isolated heart valve surgery types: aortic valve replacement, mitral valve replacement, and mitral valve repair...
June 19, 2018: Heart Surgery Forum
Georg Dultz, Tobias Müller, Jörg Petersen, Stefan Mauss, Tim Zimmermann, Marion Muche, Karl-Georg Simon, Thomas Berg, Stefan Zeuzem, Dietrich Hüppe, Klaus Böker, Heiner Wedemeyer, Tania M Welzel
BACKGROUND: With the aging of the hepatitis C virus (HCV)-infected patient cohort and the availability of highly effective and tolerable treatment regimens, an increasing number of elderly patients are now eligible for HCV therapy. This study investigated clinical and epidemiologic characteristics of elderly HCV-infected patients as well as the effectiveness and safety of available therapies. METHODS: Patients were enrolled into the German Hepatitis C Registry (DHC-R), a prospective, multicenter, real-world cohort study...
August 7, 2018: Drugs & Aging
Ngan N Lam, Krista L Lentine, Brenda Hemmelgarn, Scott Klarenbach, Robert R Quinn, Anita Lloyd, Sita Gourishankar, Amit X Garg
Background: Previous guidelines recommend that living kidney donors receive lifelong annual follow-up care to assess renal health. Objective: To determine whether these best practice recommendations are currently being followed. Design: Retrospective cohort study using linked health care databases. Setting: Alberta, Canada (2002-2014). Patients: Living kidney donors. Measurements: We determined the proportion of donors who had annual outpatient physician visits and laboratory measurements for serum creatinine and albuminuria...
2018: Canadian Journal of Kidney Health and Disease
Kana Fujikura, Bradley Peltzer, Nidhish Tiwari, Hye Gi Shim, Ally B Dinhofer, Sanyog G Shitole, Jorge R Kizer, Mario J Garcia
BACKGROUND: Patients with chronic kidney disease are at increased risk of cardiovascular disease (CVD). Even after kidney transplant, the rate of CVD events and death remain elevated. Early detection of patients at risk would be helpful for guiding aggressive preventive therapy. The purpose of this study was to evaluate global longitudinal strain (GLS) as a predictor of CVD events and death after kidney transplant. METHOD: Among patients with successful kidney transplant between 3/2009 and 12/2012 at our institution, 111 individuals had an echocardiogram within 6 months of the transplant...
July 22, 2018: International Journal of Cardiology
Pia Kontos, Alisa Grigorovich, Romeo Colobong, Karen-Lee Miller, Gihad E Nesrallah, Malcolm A Binns, Shabbir M H Alibhai, Trisha Parsons, Sarbjit Vanita Jassal, Alison Thomas, Gary Naglie
BACKGROUND: Exercise improves functional outcomes and quality of life of older patients with end-stage renal disease undergoing hemodialysis. Yet exercise is not promoted as part of routine care. Health care providers and family carers rarely provide encouragement for patients to exercise, and the majority of older patients remain largely inactive. There is thus the need for a shift in the culture of hemodialysis care towards the promotion of exercise for wellness, including expectations of exercise participation by older patients, and encouragement by health care providers and family carers...
August 6, 2018: BMC Nephrology
Piccoli Giorgina Barbara, Breuer Conrad, Cabiddu Gianfranca, Testa Angelo, Jadeau Christelle, Brunori Giuliano
Nephrology is a complex discipline, including care of kidney disease, dialysis, and transplantation. While in Europe, about 1:10 individuals is affected by chronic kidney disease (CKD), 1:1000 lives thanks to dialysis or transplantation, whose costs are as high as 2% of all the health care budget. Nephrology has important links with surgery, bioethics, cardiovascular and internal medicine, and is, not surprisingly, in a delicate balance between specialization and comprehensiveness, development and consolidation, cost constraints, and competition with internal medicine and other specialties...
August 3, 2018: Journal of Clinical Medicine
Flávio Teles, Renata Oliveira Santos, Helder Marx Almeida de Moura Lima, Rodrigo Peixoto Campos, Eline Calumby Teixeira, Ananda Camilla de Andrade Alves, André Falcão Pedrosa Costa, Jorge Artur Peçanha de Miranda Coelho
INTRODUCTION: Aging is a global phenomenon. Recent forecasts indicate that Brazil will be the sixth country in population of elderly individuals in 2020. The incidence of acute kidney injury (AKI) among the elderly varies, but studies have indicated that older individuals are more prone to developing AKI and have higher mortality rates than the general population with renal disease. The impact of dialysis in elderly patients with AKI - and critically ill individuals with multiple dysfunctions - has been discussed for years...
August 2, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Annette Ilg, Ari Moskowitz, Varun Konanki, Parth V Patel, Maureen Chase, Anne V Grossestreuer, Michael W Donnino
STUDY OBJECTIVE: Confusion, uremia, elevated respiratory rate, hypotension, and aged 65 years or older (CURB-65) is a clinical prediction rule intended to stratify patients with pneumonia by expected mortality. We assess the predictive performance of CURB-65 for the proximal endpoint of receipt of critical care intervention in emergency department (ED) patients admitted with community-acquired pneumonia. METHODS: We performed a retrospective analysis of electronic health records from a single tertiary center for ED patients admitted as inpatients with a primary diagnosis of pneumonia from 2010 to 2014...
August 2, 2018: Annals of Emergency Medicine
J Q Li, Y Lu, Y L Qiu, J S Wang
Objective: To summarize and review the clinical and genetic features of neonatal sclerosing cholangitis (NSC) caused by DCDC2 variations. Methods: Whole exome sequencing was performed to identify DCDC2 variants in two Chinese siblings with NSC who were diagnosed in Children's Hospital of Fudan University in May 2017. Clinical, laboratory and genetic data of the two cases were summarized. Key words of "DCDC2" "neonatal sclerosing cholangitis" were searched in Chinese databases and PubMed for articles published until April 2018, and all the relevant literature were reviewed...
August 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Hao Lin, Yukui Du, Cuntao Yu, Xiangyang Qian, Xiaogang Sun, Chuan Tian, Yanhai Meng, Huawei Pei, Chunmao Wang, Penghong Liu, Xiaobo Guo, Mingxing Ma, Qian Chang
OBJECTIVES: To evaluate the efficacy of the less invasive hybrid zone 0 (Z0) total aortic arch repair (HAR, ascending repair + complete debranching + thoracic endovascular aortic repair [TEVAR]) without deep hypothermic circulatory arrest in management of DeBakey type I aortic dissection (IAD). The adverse outcome was defined as a single composite endpoint comprising peri-operative mortality, permanent neurological deficit, and renal failure necessitating haemodialysis at discharge...
August 1, 2018: European Journal of Vascular and Endovascular Surgery
Aishwarya Ravindran, Fernando C Fervenza, Richard J H Smith, An S De Vriese, Sanjeev Sethi
OBJECTIVE: To describe the clinicopathological features, complement abnormalities, triggers, treatment, and outcomes of C3 glomerulopathy. PATIENTS AND METHODS: A total of 114 patients with C3 glomerulopathy seen at Mayo Clinic from January 1, 2007, through December 31, 2016, were evaluated in this study. RESULTS: The mean age at diagnosis for the entire cohort was 40.4±22.3 years, with a median serum creatinine level and proteinuria value of 1...
August 2018: Mayo Clinic Proceedings
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