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https://www.readbyqxmd.com/read/28091757/-renal-protection-in-intensive-care-myths-and-facts
#1
S John
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication in patients on the intensive care unit with a significant impact on patient mortality, morbidity and costs of care; therefore, renal protective therapy is most important in these severely ill patients. AIM OF THE REVIEW: Many renal protective strategies have been postulated during the last decades, which are sometimes still in place as a kind of "myth" but which are not always proven by evidence-based "facts"...
January 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28089416/strategies-to-overcome-therapeutic-resistance-in-renal-cell-carcinoma
#2
REVIEW
Peter J Siska, Kathryn E Beckermann, W Kimryn Rathmell, Scott M Haake
BACKGROUND: Renal cell cancer (RCC) is a prevalent and lethal disease. At time of diagnosis, most patients present with localized disease. For these patients, the standard of care includes nephrectomy with close monitoring thereafter. While many patients will be cured, 5-year recurrence rates range from 30% to 60%. Furthermore, nearly one-third of patients present with metastatic disease at time of diagnosis. Metastatic disease is rarely curable and typically lethal. Cytotoxic chemotherapy and radiation alone are incapable of controlling the disease...
January 11, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28089084/predicting-the-need-for-intra-operative-large-volume-blood-transfusions-during-thoraco-abdominal-aortic-aneurysm-repair
#3
M Pieri, P Nardelli, M De Luca, G Landoni, S Frassoni, G Melissano, A Zangrillo, R Chiesa, F Monaco
OBJECTIVE: Thoraco-abdominal aortic aneurysm (TAAA) repair is a complex procedure performed in patients at high cardiovascular risk. High volume intra-operative bleeding is often recorded, and the amount of intra-operative blood product transfusion is associated with relevant morbidity and mortality. The aim of the study was to identify pre-operative predictors of intra-operative large volume blood transfusions (LVBT) to stratify patients pre-operatively. METHODS: This was a retrospective analysis of prospectively collected data of all patients who underwent open TAAA surgery at San Raffaele Scientific Institute from January 2009 to December 2015...
January 6, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28089074/does-teaching-of-robotic-partial-nephrectomy-affect-renal-function-and-perioperative-outcomes
#4
Yannick Cerantola, Guillaume Ploussard, Wassim Kassouf, Maurice Anidjar, Franck Bladou
PURPOSE: Partial nephrectomy (PN) represents the treatment of choice for localized renal tumor<7cm. Minimally invasive approaches are considered standard of care in many institutions. Maintaining acceptable warm ischemic time (WIT) while teaching robotic PN (RPN) remains challenging. The goal of the present study was to assess the effect of teaching RPN on WIT and renal function in patients undergoing RPN. METHODS: Patients undergoing RPN for cT1-T2 renal tumors were included...
January 6, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28088910/sodium-glucose-cotransporter-2-inhibitors-sglt2i-their-role-in-cardiometabolic-risk-management
#5
Niki Katsiki, Dimitri P Mikhailidis, Michael J Theodorakis
BACKGROUND: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a novel category of oral antidiabetic drugs that inhibit renal glucose reabsorption and increase renal glucose excretion, thus lowering plasma glucose levels. This unique mechanism of SGLT2i action is insulin independent, thus improving glycemic control without promoting hypoglycemia in the absence of exogenously administered insulin. METHODS: The present narrative review addresses the putative associations between SGLT2i and several cardiovascular (CV) and microvascular risk factors, as well as their effects on cardiac and renal function...
January 13, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28088774/association-between-e-alert-implementation-for-detection-of-acute-kidney-injury-and-outcomes-a-systematic-review
#6
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/28081313/clinical-and-histopathological-features-of-asymptomaticpersistent-microscopic-hematuria-in-children
#7
Serçin Güven, İbrahim Gökçe, Neslihan Çiçek Deniz, Ülger Altuntaş, Nurdan Yıldız, Harika Alpay
BACKGROUND/AIM: We analyzed the clinical and pathological features and prognosis of 106 children with persistent asymptomatic microscopic hematuria (PAMH) with or without mild proteinuria. MATERIALS AND METHODS: This was a retrospective study of 106 children who were referred to our clinics from 2000 to 2013 for evaluation of PAMH. RESULTS: Among the 106 patients, 69 (65%) were female and 37 (35%) were male. The patients were divided into two groups: 101 patients with isolated microscopic hematuria (IMH) and 5 patients with asymptomatic microscopic hematuria and mild proteinuria (AMHP)...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28081061/vital-signs-decrease-in-incidence-of-diabetes-related-end-stage-renal-disease-among-american-indians-alaska-natives-united-states-1996-2013
#8
Ann Bullock, Nilka Ríos Burrows, Andrew S Narva, Karen Sheff, Israel Hora, Akaki Lekiachvili, Hannah Cain, David Espey
BACKGROUND: American Indians and Alaska Natives (AI/AN) have the highest diabetes prevalence among any racial/ethnic group in the United States. Among AI/AN, diabetes accounts for 69% of new cases of end-stage renal disease (ESRD), defined as kidney failure treated with dialysis or transplantation. During 1982-1996, diabetes-related ESRD (ESRD-D) in AI/AN increased substantially and disproportionately compared with other racial/ethnic groups. METHODS: Data from the U...
January 13, 2017: MMWR. Morbidity and Mortality Weekly Report
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
#9
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/28078862/a-placebo-controlled-trial-of-a-proprietary-lipid-lowering-nutraceutical-supplement-in-the-management-of-dyslipidemia
#10
M Houston, R Rountree, J Lamb, S Phipps, S Meng, B Zhang
There is an ever growing emergence in the popularity of patient-driven care. As this health and wellness model grows, inquiries into diet, lifestyle, and supplemental approaches will continue to become a focal point for the healthcare consumer. Because of this, the aim of this study is to determine the tolerability, and overall effectiveness of a proprietary multi-ingredient lipid-lowering supplement in subjects with dyslipidemia. Forty participants were recruited for a single-center, double-blind randomized, placebocontrolled trial...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28078833/clinical-profile-and-outcome-of-patients-with-severe-sepsis-treated-in-an-intensive-care-unit-in-india
#11
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/28078828/biomarkers-upon-discontinuation-of-renal-replacement-therapy-predict-60-day-survival-and-renal-recovery-in-critically-ill-patients-with-acute-kidney-injury
#12
Tingting Yang, Si Sun, Yuliang Zhao, Qiang Liu, Mei Han, Liping Lin, Baihai Su, Songmin Huang, Lichuan Yang
Introduction There is no consensus on the specific indications for weaning critically ill patients with acute kidney injury (AKI) off renal replacement therapy (RRT). This study aimed to explore the prognostic value of several biomarkers measured upon discontinuation of RRT for their value in predicting 60-day survival and renal recovery in an effort to add knowledge to the decision-making process regarding RRT withdrawal. Methods We prospectively enrolled 102 patients with AKI who required RRT from the intensive care unit...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28077531/sodium-bicarbonate-does-not-prevent-postoperative-acute-kidney-injury-after-off-pump-coronary-revascularization-a-double-blinded-randomized-controlled-trial
#13
S Soh, J W Song, J K Shim, J H Kim, Y L Kwak
BACKGROUND: Acute kidney injury (AKI) is a common morbidity after off-pump coronary revascularization. We investigated whether perioperative administration of sodium bicarbonate, which might reduce renal injury by alleviating oxidative stress in renal tubules, prevents postoperative AKI in off-pump coronary revascularization patients having renal risk factors. METHODS: Patients (n=162) having at least one of the following AKI risk factors were enrolled: (i) age >70 yr; (ii) diabetes mellitus; (iii) chronic renal disease; (iv) congestive heart failure or left ventricular ejection fraction <35%; and (v) reoperation or emergency...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077410/health-policies-on-dialysis-modality-selection-a-nationwide-population-cohort-study
#14
Yi-Chun Lin, Yen-Chung Lin, Chih-Chin Kao, Hsi-Hsien Chen, Chih-Cheng Hsu, Mai-Szu Wu
OBJECTIVES: In Taiwan, peritoneal dialysis (PD) and haemodialysis are fully accessible to patients with end-stage renal disease. However, the usage of PD is considered low in Taiwan. Since 2005, 4 major policies have been implemented by Taiwan's Ministry of Health and Welfare, namely a multidisciplinary predialysis care programme and usage increasing the PD incidence as a key performance indicator (KPI) for hospital accreditation, both of which were implemented in 2006; reimbursement of the glucose-free dialysate, icodextrin that was implemented in 2007; and insurance reimbursement for renting automated PD machines that was implemented in 2008...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28077238/patterns-of-care-and-clinical-outcomes-in-patients-with-metastatic-renal-cell-carcinoma-results-from-a-tertiary-cancer-center-in-india
#15
Anant Ramaswamy, Amit Joshi, Vanita Noronha, Vijay M Patil, Rushabh Kothari, Arvind Sahu, Ram Abhinav Kannan, Nilesh Sable, Palak Popat, Santosh Menon, Kumar Prabhash
INTRODUCTION: The current treatment of metastatic renal cell carcinoma (mRCC) revolves around targeted agents, which have resulted in a median overall survival of 22 to 26 months in registration trials. However, the outcomes in a non-trial, real-world Indian population have not yet been evaluated. MATERIALS AND METHODS: The present study was a part of a prospective Clinical Trials Registry-India-registered study, the Kidney Cancer Registry, a prospectively maintained kidney cancer registry...
October 19, 2016: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28076981/prenatal-drainage-of-fetal-urinoma-with-polyhydramnios-a-case-report-and-literature-review
#16
H J Zhang, H X Yang, Y Sun, L X Fan, X X Zhang
The appearance of fetal urinoma is rare in prenatal care, especially when associated with polyhydramnions. Many previous reports have concluded that the visualization of a prenatal urinoma is probably a sign of undelying renal dysplasia or poor function. Thus, the management of the reported cases, conservative treatment or uniroma drainage, has not been unified. In this paper, we present two cases of prenatally detected urinoma with prenatal drainage to improve the prognosis.
January 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28076709/phase-3-trial-of-177-lu-dotatate-for-midgut-neuroendocrine-tumors
#17
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/28075419/surveillance-of-clostridium-difficile-infections-results-from-a-six-year-retrospective-study-in-nine-hospitals-of-a-north-italian-local-health-authority
#18
Greta Roncarati, Laura Dallolio, Erica Leoni, Manuela Panico, Angela Zanni, Patrizia Farruggia
Clostridium difficile is an emerging cause of healthcare associated infections. In nine hospitals of an Italian Local Health Authority the episodes of C. difficile infection (CDI) were identified using the data registered by the centralized Laboratory Information System, from 2010 to 2015. CDI incidence (positive patients for A and/or B toxins per patients-days) was analysed per year, hospital, and ward. A number of cases approximately equivalent to the mean of identified cases per year were studied retrospectively to highlight the risk factors associated to CDI and their severity...
January 10, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28074458/endovascular-treatment-of-peripheral-and-visceral-arterial-injuries-in-patients-with-acute-trauma
#19
Aysun Erbahçeci Salık, Filiz Saçan İslim, Barbaros Erhan Çil
BACKGROUND: The present study is an evaluation of the efficacy of endovascular treatment in emergency setting for patients with acute peripheral and visceral arterial injury secondary to penetrating or blunt trauma. METHODS: Twelve patients (11 men) aged 35.8±11.3 years (range: 18-56 years) with penetrating or blunt trauma who underwent endovascular treatment in our department between March 2010 and June 2014 for peripheral and visceral arterial injury were retrospectively reviewed...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28073902/state-of-harmonization-of-24-serum-albumin-measurement-procedures-and-implications-for-medical-decisions
#20
Lorin M Bachmann, Min Yu, James C Boyd, David E Bruns, W Greg Miller
BACKGROUND: Measurements of serum and plasma albumin are widely used in medicine, including as indicators of quality of patient care in renal dialysis centers. METHODS: Pools were prepared from residual patient serum (n = 50) and heparin plasma (n = 48) from patients without renal disease, and serum from patients with kidney failure before hemodialysis (n = 53). Albumin was measured in all samples and in ERM-DA470k/IFCC reference material (RM) by 3 immunochemical, 9 bromcresol green (BCG), and 12 bromcresol purple (BCP) methods...
January 10, 2017: Clinical Chemistry
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