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https://www.readbyqxmd.com/read/28811003/the-impact-of-thoracic-endovascular-aortic-repair-on-long-term-survival-in-type-b-aortic%C3%A2-dissection
#1
Xiaoying Lou, Edward P Chen, Yazan M Duwayri, Ravi K Veeraswamy, William D Jordan, Carl A Zehner, Bradley G Leshnower
BACKGROUND: Currently, optimal medical therapy is first-line therapy for uncomplicated acute type B aortic dissection (aTBAD) despite poor long-term outcomes. This study examines the impact of thoracic endovascular aortic repair (TEVAR) in the acute and chronic phases on short-term and long-term survival of patients presenting with aTBAD. METHODS: A review of the Emory aortic database from 2000 to 2016 identified 398 patients diagnosed with aTBAD. At index hospitalization, complicated patients underwent TEVAR (aTEVAR [thoracic endovascular aortic repair in the acute phase], n = 80) and uncomplicated patients received optimal medical therapy (n = 318)...
August 12, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28810996/rhabdomyolysis-after-crawling-military-training
#2
Danit Atias-Varon, Haggai Sherman, Ran Yanovich, Yuval Heled
INTRODUCTION: Rhabdomyolysis is a syndrome characterized by muscle necrosis followed by release of intracellular muscle contents into the circulation. Exertional rhabdomyolysis (ER) occurs in response to nonfamiliar and/or excessive, prolonged, or repetitive exercises, with eccentric characteristics. In military populations, due to the type of intense, all out physical loads, ER is a significant threat, particularly when training under heat stress. However, many other etiologies exist, and clinical presentations vary greatly...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810980/risk-factors-for-rhabdomyolysis-in-the-u-s-army
#3
Owen T Hill, Dennis E Scofield, Jenna Usedom, Lakmini Bulathsinhala, Craig McKinnon, Paul Kwon, Timothy Haley, Robert Carter
The standardized mortality rate of rhabdomyolysis (RM) in Active Duty U.S. Army Soldiers is considerably higher than in the civilian population. RM occurs when large amounts of intracellular contents from damaged skeletal muscle escape into circulation, leading to serious sequelae (e.g., acute renal failure, hyperkalemia, compartment syndrome). Extended physical exertion, especially in hot environments, and trauma can precipitate RM. The aim of this study was to identify RM risk factors among U.S. Active Duty Army (ADA) Soldiers...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810721/de-novo-low-dose-sirolimus-versus-mycophenolate-mofetil-in-combination-with-extended-release-tacrolimus-in-kidney-transplant-recipients-a-multicentre-open-label-randomized-controlled-non-inferiority-trial
#4
Kyu Ha Huh, Jae Geun Lee, Jongwon Ha, Chang-Kwon Oh, Man Ki Ju, Chan-Duck Kim, Hong Rae Cho, Cheol Woong Jung, Beom Jin Lim, Yu Seun Kim
Background: Most of the previous studies reported that tacrolimus (TAC) with sirolimus (SRL) was associated with worse post-transplant outcomes in kidney transplantation, compared with TAC with mycophenolate mofetil (MMF). These might be attributable to high-dose SRL. However, outcomes using low-dose SRL with TAC for kidney transplantation are uncertain. The aim of this study was to assess the efficacy and safety of low-dose SRL with extended-release tacrolimus (ER-TAC) versus MMF with ER-TAC...
August 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28810622/oral-n-acetylcysteine-for-prophylaxis-of-contrast-induced-nephropathy-in-patients-following-coronary-angioplasty-a-meta-analysis
#5
Jing-Xiu Li, En-Ze Jin, Long-Hao Yu, Yang Li, Nan-Nan Liu, Yu-Mei Dong, Xin Li, Xue-Qi Li
It is acknowledged that contrast-induced nephropathy (CIN) is a common cause of acute renal insufficiency after cardiac catheterization and affects mortality and morbidity. To date, it is unknown whether oral N-acetylcysteine (NAC) is able to prevent contrast-induced nephropathy (CIN) in patients undergoing coronary angioplasty. A meta-analysis of randomized controlled trials was performed to assess the effects of NAC in the prevention of CIN in patients following coronary angioplasty. A total of 19 studies published prior to January 2015 that investigated the efficacy of oral NAC for the prevention of CIN were collected from Medline, Cochrane and Embase databases and conference proceedings from cardiology and nephrology meetings...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28808989/can-we-reliably-predict-the-level-of-anticoagulation-after-enoxaparin-injection-in-elderly-patients-with-renal-failure
#6
Luca Pellizzari, Roberto Facchinetti, Luigi Corrà, Anna Sepe, Francesco Fantin, Giorgia Fontana, Mauro Zamboni, Vincenzo Di Francesco
OBJECTIVES: The aim of this study was to evaluate the activity of anti-activated factor X (anti-Xa) in patients with different degrees of chronic renal failure (CRF), treated with therapeutic doses of low molecular weight heparin. DESIGN: This prospective study evaluated the effect of age, renal function, BMI, gender, in determining the efficacy and safety of treatment with enoxaparin, evaluated by assessing the anti-Xa. The therapeutic anticoagulant range was set between 0...
August 14, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28806218/hypoxemic-patients-with-bilateral-infiltrates-treated-with-high-flow-nasal-cannula-present-a-similar-pattern-of-biomarkers-of-inflammation-and-injury-to-acute-respiratory-distress-syndrome-patients
#7
Marina García-de-Acilu, Judith Marin-Corral, Antonia Vázquez, Laura Ruano, Mònica Magret, Ricard Ferrer, Joan R Masclans, Oriol Roca
OBJECTIVE: To examine whether patients with acute hypoxemia and bilateral opacities treated with high-flow nasal cannula and acute respiratory distress syndrome patients who were directly mechanically ventilated are similar in terms of lung epithelial, endothelial, and inflammatory biomarkers. DESIGN: Prospective, multicenter study. SETTING: ICUs at three university tertiary hospitals. PATIENTS: Intubated and nonintubated patients admitted to the ICU with acute hypoxemia (PaO2/FIO2 ≤ 300) and bilateral opacities...
August 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28806046/electrolytes-sodium-disorders
#8
Michael M Braun, Megan Mahowald
Sodium disorders (ie, hyponatremia, hypernatremia) are common electrolyte disturbances in clinical medicine and are associated with increased rates of morbidity and mortality. Etiologies of hyponatremia are classified into four categories. The first is pseudohyponatremia, in which the sodium level is low due to hyperproteinemia, hyperlipidemia, or hyperglycemia. The other three categories are based on overall patient fluid status and include hypovolemic (commonly due to fluid loss), hypervolemic (commonly due to fluid retention from heart failure, cirrhosis, or renal failure), and euvolemic (most often because of syndrome of inappropriate secretion of antidiuretic hormone)...
August 2017: FP Essentials
https://www.readbyqxmd.com/read/28804005/performance-assessment-of-the-saps-ii-and-sofa-scoring-systems-in-hanta-virus-hemorrhagic-fever-with-renal-syndrome
#9
Zhenjun Yu, Ni Zhou, Ali Li, Jie Chen, Huazhong Chen, Zebao He, Fei Yan, Haihong Zhao, Jiansheng Zhu
BACKGROUND: Hemorrhagic Fever with Renal Syndrome (HFRS), caused by the hantavirus, is a natural infectious disease characterized by fever, hemorrhage and renal damage. China is the most severely endemic area for HFRS in the world. In recent years, critical scoring systems based on quantitative classification have become an important clinical tool for predicting and evaluating the prognosis of critical illness, and provide guidelines for clinical practice. METHODS: The sample comprised 384 patients with HFRS treated in the Taizhou Hospital from January 2006 to February 2017...
August 10, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28802909/variable-prognostic-value-of-blood-pressure-response-to-exercise
#10
Yuko Kato, Shinya Suzuki, Tokuhisa Uejima, Hiroaki Semba, Takeshi Yamashita
AIM: The aim of this study was to evaluate the impact of patient background including exercise capacity on the relationship between the blood pressure (BP) response to exercise and prognosis in patients visiting a cardiovascular hospital. METHODS: A total of 2134 patients who were referred to our hospital underwent symptom-limited maximal cardiopulmonary exercise testing, and were followed through medical records and mail. The BP response to exercise was defined as the difference between peak and rest systolic BP...
August 9, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28799694/patient-with-a-total-artificial-heart-maintained-on-outpatient-dialysis-while-listed-for-combined-organ-transplant-a-single-center-experience
#11
Ramy M Hanna, Huma Hasnain, Mohammad Kamgar, Mina Hanna, Raffi Minasian, James Wilson
Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH). Dealing with patients who have an implanted TAH who develop renal failure has been a challenge with the majority of such patients having to await a combined cardiac and renal transplant prior to transition to outpatient care...
August 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28798192/coronary-angiography-in-worsening-heart-failure-determinants-findings-and-prognostic-implications
#12
João Pedro Ferreira, Patrick Rossignol, Biniyam Demissei, Abhinav Sharma, Nicolas Girerd, Stefan D Anker, John G Cleland, Kenneth Dickstein, Gerasimos Filippatos, Hans L Hillege, Chim C Lang, Marco Metra, Leong L Ng, Piotr Ponikowski, Nilesh J Samani, Dirk J van Veldhuisen, Aeilko H Zwinderman, Adriaan Voors, Faiez Zannad
OBJECTIVES: Coronary angiography is regularly performed in patients with worsening signs and/or symptoms of heart failure (HF). However, little is known on the determinants, findings and associated clinical outcomes of coronary angiography performed in patients with worsening HF. METHODS: The BIOSTAT-CHF (a systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure) programme enrolled 2516 patients with worsening symptoms and/or signs of HF, either hospitalised or in the outpatient setting...
August 10, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28795142/plasma-proenkephalin-and-poor-long-term-outcome-in-renal-transplant-recipients
#13
Lyanne M Kieneker, Oliver Hartmann, Joachim Struck, Andreas Bergmann, Ron T Gansevoort, Michel M Joosten, Else van den Berg, Rudolf A de Boer, Stephan J L Bakker
BACKGROUND: Proenkephalin (pro-ENK), a stable and reliable surrogate marker for unstable enkephalins, was found to be associated with acute kidney injury and chronic renal failure in previous studies. We aimed to investigate whether pro-ENK is linked to chronic kidney injury and poor long-term outcome in renal transplant recipients (RTR). METHODS: We included 664 stable RTR and 95 healthy kidney donors. Pro-ENK was measured in plasma with a double monoclonal sandwich immunoassay...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28793997/effect-of-intensive-versus-standard-blood-pressure-treatment-according-to-baseline-prediabetes-status-a-post-hoc-analysis-of-a-randomized-trial
#14
Adam P Bress, Jordan B King, Kathryn E Kreider, Srinivasan Beddhu, Debra L Simmons, Alfred K Cheung, Yingying Zhang, Michael Doumas, John Nord, Mary Ellen Sweeney, Addison A Taylor, Charles Herring, William J Kostis, James Powell, Anjay Rastogi, Christianne L Roumie, Alan Wiggers, Jonathan S Williams, Reem Yunis, Athena Zias, Greg W Evans, Tom Greene, Michael V Rocco, William C Cushman, David M Reboussin, Mark N Feinglos, Vasilios Papademetriou
OBJECTIVE: To determine whether the effects of intensive (<120 mmHg) compared with standard (<140 mmHg) systolic blood pressure (SBP) treatment are different among those with prediabetes versus those with fasting normoglycemia at baseline in the Systolic Blood Pressure Intervention Trial (SPRINT). RESEARCH DESIGN AND METHODS: This was a post hoc analysis of SPRINT. SPRINT participants were categorized by prediabetes status, defined as baseline fasting serum glucose ≥100 mg/dL versus those with normoglycemia (fasting serum glucose <100 mg/dL)...
August 9, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28793394/tranexamic-acid-induced-acute-renal-cortical-necrosis-in-post-endoscopic-papillectomy-bleeding
#15
Doo Hyun Ko, Tae Hyung Kim, Jong Wook Kim, Ja Joong Gu, Baek Hyun Yoon, Ji Hong Oh, Seung Goun Hong
Acute renal failure can be the result of acute renal cortical necrosis (RCN), which commonly occurs from complications occurring during pregnancy. RCN is rarely caused by medications, although tranexamic acid, which is used in patients with acute bleeding for its antifibrinolytic effects, reportedly causes acute RCN in rare cases. An 82-year-old woman experienced gastrointestinal bleeding after endoscopic papillectomy of an ampullary adenoma. The bleeding was controlled with tranexamic acid administration; however, 4 days later, her urine volume decreased and she developed pulmonary edema and dyspnea...
August 9, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28793300/the-burden-of-malignancy-in-a-tertiary-hospital-intensive-cardiovascular-care-unit
#16
Israel Mazin, Shlomi Matetzky, Linor Shemer, Dana Fourey, Paul Fefer, Amit Segev, Arsalan Abu-Much, Roy Beigel, Elad Asher
OBJECTIVES: During the past decade, the most common causes of mortality and morbidity were cardiovascular diseases and malignancies. The aim of the current study was to describe the incidence, course of admission, and short-term (30-day) prognosis of patients with and without malignancy, admitted to a tertiary center intensive cardiovascular care unit (ICCU). METHODS: A prospective observational study of 2,259 patients admitted to the ICCU was conducted between January 2014 and December 2015...
August 10, 2017: Cardiology
https://www.readbyqxmd.com/read/28792635/favorable-results-in-abo-incompatible-renal-transplantation-without-b-cell-targeted-therapy-advantages-and-disadvantages-of-rituximab-pretreatment
#17
Manabu Okada, Yoshihiko Watarai, Kenta Iwasaki, Kenta Murotani, Kenta Futamura, Takayuki Yamamoto, Takahisa Hiramitsu, Makoto Tsujita, Norihiko Goto, Shunji Narumi, Asami Takeda, Kunio Morozumi, Kazuharu Uchida, Takaaki Kobayashi
The effectiveness of desensitization with rituximab in ABO-incompatible renal transplantation (ABO-I) has been widely reported. However, ABO-I outcomes are still worse than those of ABO-identical or ABO-compatible renal transplantation (ABO-Id/C). We retrospectively examined the outcomes in consecutive living donor ABO-Id/C (n = 412) and ABO-I (n = 205) cases to elucidate the causes of inferiority in ABO-I. ABO-I cases included recipients treated with rituximab (RIT, n = 131), splenectomy (SPX, n = 21), or neither because of low anti-A/B antibody titers (NoR/S, n = 53)...
August 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28792535/occurrence-and-severity-of-non-occlusive-mesenteric-ischemia-nomi-after-cardiovascular-surgery-correlate-with-preoperatively-assessed-fgf-23-levels
#18
Jonas Stroeder, Matthias Klingele, Hagen Bomberg, Stefan Wagenpfeil, Arno Buecker, Hans-Joachim Schaefers, Marcus Katoh, Peter Minko
PURPOSE: To evaluate the value of preoperatively assessed fibroblast growth factor 23 (FGF-23) levels and to correlate FGF-23 with angiographic findings in non-occlusive mesenteric (NOMI) ischemia using a standardized scoring system. MATERIALS AND METHODS: Between 2/2011 and 3/2012 a total of 865 patients (median age: 67 years) underwent cardiovascular surgery during this ethics committee approved, prospective study. 65 of these patients had clinical suspicion of NOMI and consequently underwent catheter angiography of the superior mesenteric artery...
2017: PloS One
https://www.readbyqxmd.com/read/28789663/inorganic-nitrate-as-a-treatment-for-acute-heart-failure-a-protocol-for-a-single-center-randomized-double-blind-placebo-controlled-pilot-and-feasibility-study
#19
Roman Falls, Michael Seman, Sabine Braat, Joshua Sortino, Jason D Allen, Christopher J Neil
BACKGROUND: Acute heart failure (AHF) is a frequent reason for hospitalization worldwide and effective treatment options are limited. It is known that AHF is a condition characterized by impaired vasorelaxation, together with reduced nitric oxide (NO) bioavailability, an endogenous vasodilatory compound. Supplementation of inorganic sodium nitrate (NaNO3) is an indirect dietary source of NO, through bioconversion. It is proposed that oral sodium nitrate will favorably affect levels of circulating NO precursors (nitrate and nitrite) in AHF patients, resulting in reduced systemic vascular resistance, without significant hypotension...
August 8, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28789642/uremic-encephalopathy-with-isolated-brainstem-involvement-revealed-by-magnetic-resonance-image-a-case-report
#20
Li-Jing Jia, Zhen-Zhen Qu, Xue-Qian Zhang, Yu-Juan Tian, Ying Wang
BACKGROUND: Uremic Encephalopathy (UE) is a neurological complication associated with acute or chronic renal failure. Imaging findings of UE may present involvement of the basal ganglia, cortical or subcortical regions, and white matter. We report a rare case of UE caused by neurogenic bladder with isolated brainstem involvement revealed by magnetic resonance imaging (MRI). Immediate therapy resulted in full recovery of neurological signs and changes on MRI. CASE PRESENTATION: A 14-year-old Han Chinese woman with a history of chronic renal failure caused by neurogenic bladder...
August 8, 2017: BMC Neurology
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