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https://www.readbyqxmd.com/read/29334583/effects-of-carnosine-beta-alanyl-l-histidine-in-an-experimental-rat-model-of-acute-kidney-injury-due-to-septic-shock
#1
Sabiha Sahin, Dilek Burukoglu Donmez
BACKGROUND Acute kidney injury (AKI) secondary to sepsis is a major cause of morbidity and mortality in the human intensive care unit (ICU). Kidney function and the histological findings of AKI were investigated in an experimental rat model with sepsis induced by cecal ligation and puncture (CLP) and compared with and without treatment with carnosine (beta-alanyl-L-histidine). MATERIAL AND METHODS Twenty-four Sprague-Dawley rats were randomly divided into three groups consisting eight rats in each: Group 1 - control; Group 2 - septic shock; and Group 3 - septic shock treated with carnosine...
January 15, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29333883/simultaneous-intestinal-and-kidney-transplantation-in-adults
#2
Irum Amin, Charlotte Rutter, Adam Barlow, Neil K Russell, J Andrew Bradley, Andrew Jackson, Andrew J Butler
AIM OF THE STUDY: Intestinal transplantation (IT) is a life-saving procedure for carefully selected patients with intestinal failure. We evaluated patients who had undergone simultaneous intestinal and kidney transplantation (SIKT) to determine whether UK guidelines for inclusion of a renal allograft (dialysis dependent or estimated glomerular filtration rate ((eGFR)) < 45 ml/min/1.73 m2) are justified. METHODS: A single centre analysis was undertaken of adults undergoing IT at the Cambridge Transplant Centre between December 2007 and January 2016...
January 15, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29333675/sharing-innovations-to-enhance-renal-fellow-education-in-dialysis
#3
Laura J Maursetter, Lisa K Prince, Christina M Yuan, James F Simon
Dialysis care is an integral part of the practice of nephrology. Despite this, education of fellows in providing dialysis often remains rudimentary, relying on a combination of didactics and learning through experience. This runs the risk of training nephrologists who can provide dialysis care without truly being experts on the subject. In this article, a collection of novel or innovative teaching methods is presented that are meant to provide training programs with additional tools with which to improve the training of their fellows in dialysis...
January 14, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29333659/acute-renal-replacement-therapy-during-hospitalization-is-training-adequate
#4
Paul M Palevsky
Acute renal replacement therapy is one of the most common interventions provided by nephrologists, however, data on the quality of training provided to nephrology fellows is limited. Extensive curricula for acute renal replacement therapy and the management of poisonings and intoxications have been published, but personal experience suggests that there are significant opportunities to improve training. Particular areas to be considered include the use of novel technologies for assessment of volume status, greater emphasis on the dosing of medications during acute renal replacement therapy, greater training in assessing and tailoring treatment to the goals of care of the individual patient, incorporation of continuous quality improvement tools into the management of acute renal replacement therapy programs and development of robust simulation training to augment training...
January 14, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29331969/temporal-trends-in-antithrombotic-treatment-of-real-world-uk-patients-with-newly-diagnosed-atrial-fibrillation-findings-from-the-garfield-af-registry
#5
Patricia N Apenteng, Haiyan Gao, Fd Richard Hobbs, David A Fitzmaurice
OBJECTIVE: To investigate evolving patterns in antithrombotic treatment in UK patients with newly diagnosed non-valvular atrial fibrillation (AF). DESIGN: Prospective, multicentre, international registry. SETTING: 186 primary care practices in the UK. PARTICIPANTS: 3482 participants prospectively enrolled in four sequential cohorts (cohort 2 (C2) n=830, diagnosed September 2011 to April 2013; cohort 3 (C3) n=902, diagnosed April 2013 to June 2014; cohort 4 (C4) n=850, diagnosed July 2014 to June 2015; cohort 5 (C5) n=900, diagnosed June 2015 to July 2016)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331277/unplanned-reoperation-after-hepatectomy-an-analysis-of-risk-factors-and-outcomes
#6
Heather G Lyu, Gaurav Sharma, Ethan Y Brovman, Julius Ejiofor, Richard D Urman, Jason S Gold, Edward E Whang
BACKGROUND/PURPOSE: Reoperation is being increasingly utilized as a metric for surgical care quality. The aim of this study was to identify the incidence of and risk factors for unplanned reoperation following index hepatectomy. METHODS: Pre, intra- and post-operative information of patients who underwent partial hepatectomy in 435 hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program from 2011 to 2013 were analyzed...
January 11, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29330016/clinical-impact-of-delayed-catheter-removal-for-patients-with-central-venous-catheter-related-gram-negative-bacteremia
#7
Yu-Mi Lee, Chisook Moon, Young Jin Kim, Hee-Joo Lee, Mi Suk Lee, Ki-Ho Park
BACKGROUND: Gram-negative bacteria are increasingly the cause of catheter-related bloodstream infections (CRBSI), which show a rapidly rising prevalence of multidrug-resistant strains. We evaluated the impact of delayed central venous catheter (CVC) removal on clinical outcomes in patients with gram-negative CRBSI. METHODS: Between January 2007 and December 2016, patients with gram-negative bacteremia and CVC placement, from two tertiary care hospitals, were retrospectively included...
January 9, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29329518/the-use-of-eculizumab-in-gemcitabine-induced-thrombotic-microangiopathy
#8
Vinod Krishnappa, Mohit Gupta, Haikoo Shah, Abhijit Das, Natthavat Tanphaichitr, Robert Novak, Rupesh Raina
BACKGROUND: Thrombotic microangiopathy (TMA) secondary to gemcitabine therapy (GiTMA) is a very rare pathology that carries a poor prognosis, with nearly half of the cases progressing to end stage renal disease. GiTMA is most commonly associated with adenocarcinomas, most notably pancreatic cancers. The mainstay of management is withdrawal of the offending drug and supportive care. Plasmapheresis has a limited role and hemodialysis may help in the management of fluid overload secondary to renal failure...
January 12, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29329151/gadolinium-retention-brain-t1-hyperintensity-and-endogenous-metals-a-comparative-study-of-macrocyclic-versus-linear-gadolinium-chelates-in-renally-sensitized-rats
#9
Marlène Rasschaert, Andréa Emerit, Nathalie Fretellier, Cécile Factor, Philippe Robert, Jean-Marc Idée, Claire Corot
OBJECTIVES: This preclinical study was designed to compare gadolinium (Gd) brain uptake after repeated injections of a macrocyclic Gd-based contrast agent (GBCA) (gadoterate meglumine) or 2 linear GBCAs (L-GBCAs) (gadobenate dimeglumine or gadodiamide) on a translational model of moderate renal impairment in rats. METHODS: The study was carried out in subtotally nephrectomized rats. Animals received 4 intravenous injections per week of GBCA (gadoterate meglumine, gadobenate dimeglumine, or gadodiamide) for 5 weeks, resulting in a cumulative dose of 12 mmol/kg, followed by a 1-month injection-free period...
January 12, 2018: Investigative Radiology
https://www.readbyqxmd.com/read/29327534/gastric-angioinvasive-mucormycosis-in-immunocompetent-adult-a-rare-occurrence
#10
Mukesh Nasa, Zubin Sharma, Lipika Lipi, Randhir Sud
Mucormycosis is a rare, opportunistic fungal infection that occurs almost exclusively in immunocompromised hosts such as patients with diabetes mellitus, leukemia, lymphoma, renal disease, septicemia, burns, malnutrition, and following long-term treatment with steroids and antibiotics. Based on the clinical presentation and involvement, mucormycosis is classified as six major forms, namely, rhinocerebral, pulmonary, cutaneous, gastrointestinal (GI), disseminated and miscellaneous, with rhinocerebral and pulmonary being the common forms...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29327197/-new-kidney-function-tests-renal-functional-reserve-and-furosemide-stress-test
#11
REVIEW
D Kindgen-Milles, T Slowinski, T Dimski
Acute kidney injury (AKI) occurs in 30-50% of all intensive care patients. Renal replacement therapy (RRT) has to be initiated in 10-15%. The early in-hospital mortality is about 50%. Up to 20% of all survivors develop chronic kidney disease after intensive care discharge and progress to end-stage kidney disease within the next 10 years. For timely initiation of prophylactic or therapeutic interventions, it is crucial to exactly determine the actual kidney function, i. e., glomerular filtration rate (GFR), and to gain insight into the further development of kidney function...
January 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29325251/-extrapleural-solitary-fibrous-tumor-with-uncommon-histology-a-clinicopathologic-analysis-of-7-cases
#12
M Zhao, Z R Yang, Y B Wang, Y Chen, G W Qi, Y J Yan, W J Xu, G Q Ru, X L He
Objective: To investigate the clinicopathologic characteristics, immunophenotypes, and differential diagnostic features of extra-pleural solitary fibrous tumor (SFT) with uncommon histology. Methods: Seven cases of extra-pleural SFT with uncommon histology were collected during January 2015 and December 2016 in Zhejiang Provincal People's Hospital; the clinical and radiologic features, histomorphology, immunophenotype and prognosis were analyzed. EnVision method was used for immunohistochemical staining of STAT6, CD34 and other differential diagnosis associated markers...
January 8, 2018: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
https://www.readbyqxmd.com/read/29324940/risk-for-acute-kidney-injury-in-primary-health-care
#13
Maria Célia Laranjeira Rigonatto, Marcia Cristina da Silva Magro
OBJECTIVE: To identify hypertensive and diabetic patients at risk for developing acute kidney injury in the primary health care setting. METHOD: Observational, longitudinal, prospective study. Sample of 56 diabetic and hypertensive individuals. A semi-structured questionnaire was adopted for data collection. For the description of results, were calculated dispersion measures and the Spearman test was used for statistical analysis. The result was considered significant when p <0...
January 2018: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29324936/the-impact-of-lung-perfusion-scintigraphy-in-the-emergency-management-of-patients-with-suspected-pulmonary-embolism
#14
Cristina Ferrari, Alessandra Cimino, Giacomo Bianco, Francesca Iuele, Alessandra Di Palo, Margherita Fanelli, Artor Niccoli-Asabella, Giuseppe Rubini
OBJECTIVE: Pulmonary Embolism (PE) is an emergency condition that requires immediate treatment. As the symptoms and the risk factors are nonspecific, PE differential diagnosis is often required. Even if angio-CT is considered the gold standard for PE diagnosis, the frequent allergic condition and/or chronic renal failure of patients make, in most cases, not possible the use of contrast enhancement in emergency with even more increasing use of Lung Perfusion Scintigraphy (LPS), as a simple and fast examination with no preparation/contraindication...
September 2017: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29324634/point-of-care-ultrasound-evaluation-of-severe-renal-trauma-in-an-adolescent
#15
Jeremy M Root, Alyssa Abo, Joanna Cohen
Traumatic renal injuries are more common in pediatrics because of the relatively larger size of the kidneys in the pediatric patient. Although computerized tomography remains the criterion standard for the initial evaluation of blunt renal trauma, there is evidence that renal ultrasound may serve a role in postinjury surveillance. Here, we present a case in which point-of-care ultrasound was used to image severe blunt renal trauma in a 17-year-old adolescent boy. In this case, point-of-care ultrasound identified severely distorted renal parenchyma after a grade 5 renal laceration was identified on computerized tomography scan...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29324582/quality-measures-in-acute-kidney-injury
#16
Amjad Mehboob, Robert Zimmerman, Stuart Abramson, Mark G Parker
PURPOSE OF REVIEW: Quality measure assessment and reporting is evolving in end-stage renal disease care and is inchoate in ambulatory nephrology clinic care. Acute kidney injury (AKI) quality measures have not received sufficient attention, yet deserve consideration in view of the substantial proportion of effort nephrology providers devote to AKI care. RECENT FINDINGS: Accumulating literature permits consideration of timing of nephrology consultation, follow-up after AKI hospitalization, early detection, medication dosing, hospital readmissions and length of stay, cost, and mortality as putative AKI quality measures...
January 10, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29321797/prediction-model-of-in-hospital-mortality-in-elderly-patients-with-acute-heart-failure-based-on-retrospective-study
#17
Qian Jia, Yu-Rong Wang, Ping He, Xue-Liang Huang, Wei Yan, Yang Mu, Kun-Lun He, Ya-Ping Tian
Objectives: The aim of this study was to develop a clinical risk model that is predictive of in-hospital mortality in elderly patients hospitalized with acute heart failure (AHF). Methods: 2486 patients who were 60 years and older from intensive care units of Cardiology Department in the hospital were analyzed. Independent risk factors for in-hospital mortality were obtained by binary logistic regression and then used to establish the risk prediction score system (RPSS)...
November 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29321041/effects-of-stress-ulcer-prophylaxis-in-adult-icu-patients-receiving-renal-replacement-therapy-sup-icu-renal-siren-study-protocol-for-a-pre-planned-observational-study
#18
Joerg C Schefold, Anders Perner, Theis Lange, Jørn Wetterslev, Matt P Wise, Mark Borthwick, Stepani Bendel, Frederik Keus, Anne Berit Guttormsen, Søren Marker, Mette Krag, Morten Hylander Møller
BACKGROUND: Proton pump inhibitors are often used in critically ill patients to prevent gastrointestinal bleeding despite limited evidence for benefit. Patients with acute kidney injury requiring renal replacement therapy (RRT) are at high risk of gastrointestinal bleeding as (pre-)uremia induces coagulopathy through effects on platelets and coagulation cascades. No high-quality randomized clinical trials have previously assessed the benefits and harms of prophylactic proton pump inhibitor use in this high-risk population of adult critically ill patients...
January 10, 2018: Trials
https://www.readbyqxmd.com/read/29320602/when-metformin-is-not-enough-pros-and-cons-of-sglt2-and-dpp-4-inhibitors-as-a-second-line-therapy
#19
REVIEW
Angelo Avogaro, Elías Delgado, Ildiko Lingvay
The newer oral therapies for type 2 diabetes (T2DM); dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium glucose cotransporter 2 (SGLT2) inhibitors have advantages over older agents. DPP-4 inhibitors are weight neutral, and have few adverse effects. SGLT2 inhibitors have additional benefits; weight loss, blood pressure reduction, cardiovascular risk reduction, and renoprotective effects. SGLT2 inhibitors, have increased risk of urogenital infections and possible risk of "euglycaemic" diabetic ketoacidosis...
January 10, 2018: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/29319774/renal-artery-pseudoaneurysm
#20
Luiz Inácio Roman, Cauana Fabrício Efel, Victória Teles França, Carolina Meert Merten, Claus Dieter Dummer
The renal artery pseudoaneurysm embody a rare vascular complication coming of percutaneous procedures, renal biopsy, nephrectomy, penetrating traumas and more rarely blunt traumas. The clinical can be vary according the patient, the haematuria is the symptom more commom. Is necessary a high level of clinical suspicion for your diagnosis, this can be elucidated by through complementary exams as the eco-color Doppler and the computed tomography scan (CT). This report is a case of a patient submitted a right percutaneous renal biopsy and that, after the procedure started with macroscopic haematuria, urinary tenesmus and hypogastric pain...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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