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critical nephrology

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https://www.readbyqxmd.com/read/27924467/indian-pediatric-postgraduate-s-perspective-on-future-career-intentions
#1
Latha M Sneha, Manipriya Ravindran, Rekha Kumar, Padmasani Venkatraman, Julius Scott, LakshmiNarayan Kannan
OBJECTIVE: To determine the factors that influence Pediatric residents to pursue a subspecialty career and establish their choice of future workplace. METHODS: The present questionnaire based study was conducted during a National level pediatric post graduate exam refresher course in Chennai, India and involved Pediatric residents from all parts of India. Datas was analysed with the statistical package for social sciences (SPSS, version 18.0). RESULTS: Seventy five respondents participated in the study...
December 7, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#2
D J Askenazi, Michael Heung, Michael J Connor, Rajit K Basu, Jorge Cerdá, Kent Doi, Jay L Koyner, Azra Bihorac, Ladan Golestaneh, Anitha Vijayan, Mark D Okusa, Sarah Faubel
As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915329/acute-kidney-injury-risk-assessment-and-the-nephrology-rapid-response-team
#3
Lilia Maria Rizo-Topete, Mitchell H Rosner, Claudio Ronco
Acute kidney Injury (AKI) is a serious medical condition affecting more than 10 million people around the world annually and resulting in poor outcomes. It has been suggested that late recognition of the syndrome may lead to delayed interventions with increased morbidity and mortality. Early diagnosis and timely therapeutic strategies may be the cornerstone of future improvement in outcomes. The purpose of this article is to provide a practical model to identify patients at high risk for AKI in different environments, with the goal to prevent AKI...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915328/critical-care-nephrology-a-multidisciplinary-approach
#4
Lilia Rizo-Topete, Claudio Ronco
Acute kidney injury (AKI) is a serious medical condition affecting millions of people. Patients in intensive care unit (ICU) who develop AKI have increased morbidity and mortality, prolonged length of stay in ICU and hospital and increased costs, especially when they require renal replacement therapy. In the latter case, morbidity and mortality increase further. In order to meet the needs of the critically ill patients, a multidisciplinary care team is required, combining the efforts of physicians and nurses from different disciplines as well as nephrologists and intensivists...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27900717/intravenous-fluids-balancing-solutions
#5
REVIEW
Ewout J Hoorn
The topic of intravenous (IV) fluids may be regarded as "reverse nephrology", because nephrologists usually treat to remove fluids rather than to infuse them. However, because nephrology is deeply rooted in fluid, electrolyte, and acid-base balance, IV fluids belong in the realm of our specialty. The field of IV fluid therapy is in motion due to the increasing use of balanced crystalloids, partly fueled by the advent of new solutions. This review aims to capture these recent developments by critically evaluating the current evidence base...
November 29, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27900491/treatable-renal-disease-in-children-with-silent-lupus-nephritis-detected-by-baseline-biopsy-association-with-serum-c3-levels
#6
Hiroyuki Wakiguchi, Syuji Takei, Tomohiro Kubota, Akinori Miyazono, Yoshifumi Kawano
Lupus nephritis is identified in up to 75% of patients with juvenile systemic lupus erythematosus and may present with abnormal urinary findings (overt lupus nephritis) or be apparent only upon renal biopsy (silent lupus nephritis). We investigated whether serum complement levels correlate with renal pathology in pediatric patients with silent lupus nephritis. We performed baseline renal biopsy in 45 children diagnosed with juvenile systemic lupus erythematosus who were admitted to Kagoshima University Hospital between January 2000 and June 2015...
November 30, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27852607/ion-transport-in-the-zebrafish-kidney-from-a-human-disease-angle-possibilities-considerations-and-future-perspectives
#7
Simone Kersten, Francisco J Arjona
Unique experimental advantages, such as its embryonic/larval transparency, high-throughput nature and ease of genetic modification, underpin the rapid emergence of the zebrafish (Danio rerio) as a preeminent model in biomedical research. Particularly in the field of nephrology, the zebrafish provides a promising model for studying the physiological implications of human solute transport processes along consecutive nephron segments. However, while the zebrafish might be considered a valuable model for numerous renal ion transport diseases and functional studies of many channels and transporters, not all human renal electrolyte transport mechanisms and human diseases can be modeled in the zebrafish...
November 16, 2016: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/27697956/team-based-learning-in-large-enrollment-classes
#8
Jonathan D Kibble, Christine Bellew, Abdo Asmar, Lisa Barkley
The goal of this review is to highlight the key elements needed to successfully deploy team-based learning (TBL) in any class, but especially in large enrolment classes, where smooth logistics are essential. The text is based on a lecture and workshop given at the American Physiological Society's Institute on Teaching and Learning in Madison, WI, in June 2016. After a short overview of the TBL method, its underpinning in learning theory, and a summary of current evidence for its effectiveness, we present two case studies from our own teaching practices in a new medical school...
December 2016: Advances in Physiology Education
https://www.readbyqxmd.com/read/27643796/should-we-still-believe-in-randomized-controlled-trials-in-nephrology
#9
Monica Cortinovis, Norberto Perico, Giuseppe Remuzzi
The randomized controlled trial (RCT) is the cornerstone upon which clinical decision-making is based. Pivotal RCTs in the nephrology area efficiently demonstrated the renoprotective effects of treatment with renin-angiotensin system inhibitors in patients with diabetic and non-diabetic proteinuric nephropathies. However, there is concern about the increasing cost, complexity and duration of clinical studies. Moreover, recent large RCTs addressing key issues for patients with renal disease failed to achieve definitive conclusions mainly due to critical flaws in the investigational strategies, including the adoption of excessive/fixed doses of the study medications, inappropriate use of the placebo-controlled design, enrollment of low-risk individuals, poor reporting of adverse events or unreliable evaluation of renal function...
September 20, 2016: Nephron
https://www.readbyqxmd.com/read/27628103/significance-of-frailty-for-predicting-adverse-clinical-outcomes-in-different-patient-groups-with-specific-medical-conditions
#10
Martin Ritt, Karl-Günter Gaßmann, Cornel Christian Sieber
Frailty is a major health burden in an aging society. It constitutes a clinical state of reduced physiological reserves that is associated with a diminished ability to withstand internal and external stressors. Frail patients have an increased risk for adverse clinical outcomes, such as mortality, readmission to hospital, institutionalization and falls. Of further clinical interest, frailty might be at least in part reversible in some patients and subject to preventive strategies. In daily clinical practice older patients with a complex health status, who are mostly frail or at least at risk of developing frailty, are frequently cared for by geriatricians...
October 2016: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/27506948/acinetobacter-spp-are-associated-with-a-higher-mortality-in-intensive-care-patients-with-bacteremia-a-survival-analysis
#11
Aline C Q Leão, Paulo R Menezes, Maura S Oliveira, Anna S Levin
BACKGROUND: It has been challenging to determine the true clinical impact of Acinetobacter spp., due to the predilection of this pathogen to colonize and infect critically ill patients, who often have a poor prognosis. The aim of this study was to assess whether Acinetobacter spp. bacteremia is associated with lower survival compared with bacteremia caused by other pathogens in critically ill patients. METHODS: This study was performed at Hospital das Clínicas, University of São Paulo, Brazil...
2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27472686/hand-carried-ultrasound-use-in-clinical-nephrology-case-report
#12
Kathryn D Winters, Stephanie Toth-Manikowski, Carol Martire, Tariq Shafi
BACKGROUND: Correctly assessing and managing volume status are critical elements of daily care for patients managed by nephrologists. However, intravascular volume is difficult to assess by physical examination alone. METHODS: We present vignettes illustrating the potential for using hand-carried ultrasound (HCU) to improve volume assessment in common clinical scenarios faced by the renal consultant in the hospital setting. These include patients with acute kidney injury and patients treated with hemodialysis...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27469160/nephrology-training-curriculum-and-implications-for-optimal-kidney-care-in-the-developing-world
#13
Julius Okel, Ike G Okpechi, Bilal Qarni, Timothy Olanrewaju, Mark J Courtney, Valerie Luyckx, Sarala Naicker, Aminu K Bello
An effective workforce is essential for delivery of high-quality chronic disease care. Low-income nations are challenged by a dearth and/or maldistribution of an essential workforce required for all chronic disease care including chronic kidney disease (CKD). Nephrology education and training in developed countries have grown at pace with the technological advancement in the practice of medicine in order to meet the standards required of kidney health professionals towards high-quality, patient-centered medical care...
2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27420727/missense-mutation-of-pou-domain-class-3-transcription-factor-3-in-pou3f3l423p-mice-causes-reduced-nephron-number-and-impaired-development-of-the-thick-ascending-limb-of-the-loop-of-henle
#14
Alexandra Rieger, Elisabeth Kemter, Sudhir Kumar, Bastian Popper, Bernhard Aigner, Eckhard Wolf, Rüdiger Wanke, Andreas Blutke
During nephrogenesis, POU domain class 3 transcription factor 3 (POU3F3 aka BRN1) is critically involved in development of distinct nephron segments, including the thick ascending limb of the loop of Henle (TAL). Deficiency of POU3F3 in knock-out mice leads to underdevelopment of the TAL, lack of differentiation of TAL cells, and perinatal death due to renal failure. Pou3f3L423P mutant mice, which were established in the Munich ENU Mouse Mutagenesis Project, carry a recessive point mutation in the homeobox domain of POU3F3...
2016: PloS One
https://www.readbyqxmd.com/read/27347425/needs-assessment-towards-a-more-responsive-canadian-society-of-nephrology-annual-general-meeting-csn-agm-program
#15
Barry A Cohen, Mark J Courtney, Louise M Moist, James Barton
BACKGROUND: A critical feature of any continuing medical education (CME) program is the inclusion of a needs assessment for its target audience. This assessment must identify both perceived and unperceived needs, so as to best capture the entire spectrum of learning opportunities for the group. OBJECTIVE: We describe the process developed by the Canadian Society of Nephrology (CSN) to enhance the educational effectiveness of its Annual General Meeting program. DESIGN: The design of this study is the analysis of a survey questionnaire and of the Canadian Organ Replacement Registry (CORR) database...
2016: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/27307245/epidemiology-of-acute-kidney-injury-in-children-worldwide-including-developing-countries
#16
Norbert Lameire, Wim Van Biesen, Raymond Vanholder
In this review we summarize the world-wide epidemiology of acute kidney injury (AKI) in children with special emphasis on low-income countries, notably those of the sub-Saharan continent. We discuss definitions and classification systems used in pediatric AKI literature. At present, despite some shortcomings, traditional Pediatric Risk Injury Failure Loss and End Stage Kidney Disease (pRIFLE) and Kidney Disease Improving Global Outcomes (KDIGO) systems are the most clinically useful. Alternative definitions, such as monitoring serum cystatin or novel urinary biomarkers, including cell cycle inhibitors, require more long-term studies in heterogenous pediatric AKI populations before they can be recommended in routine clinical practice...
June 15, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27274817/omics-databases-on-kidney-disease-where-they-can-be-found-and-how-to-benefit-from-them
#17
REVIEW
Theofilos Papadopoulos, Magdalena Krochmal, Katryna Cisek, Marco Fernandes, Holger Husi, Robert Stevens, Jean-Loup Bascands, Joost P Schanstra, Julie Klein
In the recent decades, the evolution of omics technologies has led to advances in all biological fields, creating a demand for effective storage, management and exchange of rapidly generated data and research discoveries. To address this need, the development of databases of experimental outputs has become a common part of scientific practice in order to serve as knowledge sources and data-sharing platforms, providing information about genes, transcripts, proteins or metabolites. In this review, we present omics databases available currently, with a special focus on their application in kidney research and possibly in clinical practice...
June 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27252402/sex-and-gender-differences-in-chronic-kidney-disease-progression-to-end-stage-renal-disease-and-haemodialysis
#18
REVIEW
Gabriela Cobo, Manfred Hecking, Friedrich K Port, Isabella Exner, Bengt Lindholm, Peter Stenvinkel, Juan Jesús Carrero
Sex and gender differences are of fundamental importance in most diseases, including chronic kidney disease (CKD). Men and women with CKD differ with regard to the underlying pathophysiology of the disease and its complications, present different symptoms and signs, respond differently to therapy and tolerate/cope with the disease differently. Yet an approach using gender in the prevention and treatment of CKD, implementation of clinical practice guidelines and in research has been largely neglected. The present review highlights some sex- and gender-specific evidence in the field of CKD, starting with a critical appraisal of the lack of inclusion of women in randomized clinical trials in nephrology, and thereafter revisits sex/gender differences in kidney pathophysiology, kidney disease progression, outcomes and management of haemodialysis care...
July 1, 2016: Clinical Science (1979-)
https://www.readbyqxmd.com/read/27245160/development-of-a-health-literacy-questionnaire-for-taiwanese-hemodialysis-patients
#19
Chung-Liang Shih, Tuan-Hsun Chang, Dana A Jensen, Chiung-Hsuan Chiu
BACKGROUND: Dialysis has long been a critical issue in the field of nephrology, though the burden this lifesaving technology places on society can be immense. Effectively increasing the health literacy of hemodialysis patients can be beneficial for their health outcomes and self-care abilities. Thus, the aims of this study are to: (1) develop a health literacy assessment tool in Chinese for patients receiving hemodialysis treatment; (2) assess the health literacy level of the Taiwanese hemodialysis population using the tool developed...
2016: BMC Nephrology
https://www.readbyqxmd.com/read/27217394/con-meta-analysis-some-key-limitations-and-potential-solutions
#20
Tonya M Esterhuizen, Lehana Thabane
Meta-analysis, a statistical combination of results of several trials to produce a summary effect, has been subject to criticism in the past, mainly for the reasons of poor quality of included studies, heterogeneity between studies meta-analyzed and failing to address publication bias. These limitations can cause the results to be misleading, which is important if policy and practice decisions are based on systematic reviews and meta-analyses. We elaborate on these limitations and illustrate them with examples from the nephrology literature...
June 2016: Nephrology, Dialysis, Transplantation
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