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https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#1
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28515370/acute-kidney-injury-following-cardiopulmonary-bypass-in-children%C3%A3-risk-factors-and-outcomes
#2
Seon Hwa Lee, Soo-Jin Kim, Hyung Joong Kim, Jae Sung Son, Ran Lee, Tae Gyoon Yoon
BACKGROUND: Acute kidney injury (AKI) is the most common and most serious complication following heart surgery. We aimed to determine the prevalence of, and risk factors for, AKI following pediatric cardiac surgery.Methods and Results:We retrospectively analyzed 135 patients aged ≤18 years who underwent cardiac surgery for congenital heart defects; by RACHS-1 category, 58 patients (43%) had an operative risk score ≥3. AKI was defined and classified using the pediatric pRIFLE criteria (Pediatric Risk, Injury, Failure, Loss, and End-stage Kidney Disease); 19 patients (14...
May 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28509133/denosumab-for-treatment-of-immobilization-related-hypercalcemia-in-a-patient-with-end-stage-renal-disease
#3
Atsuko Uehara, Masahiko Yazawa, Atsumi Kawata, Rina Hachisuka, Yugo Shibagaki
The efficacy and safety of denosumab for the treatment of immobilization-related hypercalcemia in end-stage renal disease remain uncertain. We describe the case of a hemodialysis patient with immobilization-related hypercalcemia who was successfully treated with denosumab. A 79-year-old man admitted for hemodialysis after sustaining an acute kidney injury developed immobilization-related hypercalcemia due to the impairment resulting from an acute myocardial infarction, acute heart failure, and catheter-related bloodstream infection...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28506476/adherence-to-lipid-management-guidelines-is-associated-with-lower-mortality-and-major-adverse-limb-events-in-patients-undergoing-revascularization-for-chronic-limb-threatening-ischemia
#4
Thomas F X O'Donnell, Sarah E Deery, Jeremy D Darling, Katie E Shean, Murray A Mittleman, Gabrielle N Yee, Matthew R Dernbach, Marc L Schermerhorn
OBJECTIVE: The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501797/predictors-of-procedural-complications-in-adult-fontan-patients-undergoing-non-cardiac-procedures
#5
Alexander C Egbe, Arooj R Khan, Naser M Ammash, David W Barbara, William C Oliver, Sameh M Said, Emmanuel Akintoye, Carole A Warnes, Heidi M Connolly
OBJECTIVE: Limited data exist regarding the outcomes of non-cardiac procedures (NCPs) in adult patients after Fontan operations (Fontan patients). METHODS: To compare procedural outcomes after NCPs in Fontan patients with outcomes for two matched control groups: patients with repaired congenital heart disease and biventricular circulation (CHD-BiV) and patients with no heart disease (NHD). We defined cyanosis as oxygen saturation <90% and procedural hypoxia as saturation <80% or a decrease in saturation >10% from baseline...
May 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28495396/cardiovascular-risk-prediction-in-chronic-kidney-disease-patients
#6
Santiago Cedeño Mora, Marian Goicoechea, Esther Torres, Úrsula Verdalles, Ana Pérez de José, Eduardo Verde, Soledad García de Vinuesa, José Luño
INTRODUCTION: Scores underestimate the prediction of cardiovascular risk (CVR) as they are not validated in patients with chronic kidney disease (CKD). Two of the most commonly used scores are the Framingham Risk Score (FRS-CVD) and the ASCVD (AHA/ACC 2013). The aim of this study is to evaluate the predictive ability of experiencing a cardiovascular event (CVE) via these 2scores in the CKD population. MATERIAL AND METHODS: Prospective, observational study of 400 prevalent patients with CKD (stages 4 and 5 according the KDOQI; not on dialysis)...
May 8, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28495210/3-tesla-23-na-magnetic-resonance-imaging-during-acute-kidney-injury
#7
Matthias Hammon, Susan Grossmann, Peter Linz, Hannes Seuss, Rebecca Hammon, Daniela Rosenhauer, Rolf Janka, Alexander Cavallaro, Friedrich C Luft, Jens Titze, Michael Uder, Anke Dahlmann
RATIONALE AND OBJECTIVES: Sodium and proton magnetic resonance imaging ((23)Na/(1)H-MRI) have shown that muscle and skin can store Na(+) without water. In chronic renal failure and in heart failure, Na(+) mobilization occurs, but is variable depending on age, dialysis vintage, and other features. Na(+) storage depots have not been studied in patients with acute kidney injury (AKI). MATERIALS AND METHODS: We studied 7 patients with AKI (mean age: 51.7 years; range: 25-84) and 14 age-matched and gender-matched healthy controls...
May 8, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28489799/comparison-of-clinical-outcomes-in-peripartum-cardiomyopathy-and-age-matched-dilated-cardiomyopathy-a-15-year-nationwide-population-based-study-in-asia
#8
Cheng-Hui Lu, Wen-Chen Lee, Michael Wu, Shao-Wei Chen, Jih-Kai Yeh, Chun-Wen Cheng, Katie Pei-Hsuan Wu, Ming-Shien Wen, Tien-Hsing Chen, Victor Chien-Chia Wu
Peripartum cardiomyopathy (PPCM), often classified as a form of dilated cardiomyopathy (DCM), is the myocardial dysfunction that occurs in late pregnancy and through the first few postpartum months.The aim of this study is to investigate the differences in the clinical outcomes of PPCM and DCM.Electronic medical records from 1997 to 2011 were retrieved from the Taiwan National Health Insurance Research Database. Patients with PPCM were compared with age- and clinical characteristics-matched patients with DCM...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28473637/chronic-fluid-overload-and-mortality-in-esrd
#9
Carmine Zoccali, Ulrich Moissl, Charles Chazot, Francesca Mallamaci, Giovanni Tripepi, Otto Arkossy, Peter Wabel, Stefano Stuard
Sustained fluid overload (FO) is considered a major cause of hypertension, heart failure, and mortality in patients with ESRD on maintenance hemodialysis. However, there has not been a cohort study investigating the relationship between chronic exposure to FO and mortality in this population. We studied the relationship of baseline and cumulative FO exposure over 1 year with mortality in 39,566 patients with incident ESRD in a large dialysis network in 26 countries using whole-body bioimpedance spectroscopy to assess fluid status...
May 4, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28466760/peripheral-arterial-disease-preoperatively-may-predict-graft-failure-and-mortality-in-kidney-transplant-recipients
#10
Salma I Patel, Harini A Chakkera, Paul W Wennberg, David A Liedl, Fadi Alrabadi, Stephen S Cha, Darren D Hooley, Hatem Amer, Hani M Wadei, Fadi E Shamoun
Patients with end-stage renal disease undergoing kidney transplant often have diffuse atherosclerosis and high cardiovascular morbidity and mortality rates. We analyzed the correlation of peripheral arterial disease (PAD), here quantified by an abnormal ankle-brachial index (ABI) measured within the 5 years prior to kidney transplant, with graft failure and mortality rates (primary end points) after adjusting for known cardiovascular risk factors (age, sex, smoking history, hypertension, diabetes, stroke, known coronary artery disease or heart failure, years of dialysis)...
March 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28465818/the-effect-of-hepatitis-c-virus-infection-on-cardiovascular-complications-in-end-stage-kidney-disease-patients-on-regular-hemodialysis
#11
Mohamed Salah Eldin Zaki
INTRODUCTION: Cardiovascular complications are the most important cause of mortality in patients with ESKD, such as coronary artery disease, left ventricular hypertrophy, heart failure and arrhythmia. Other well-known risk factors, such as diabetes mellitus, hypertension and dyslipidemia are prevalent in ESKD, yet they are not sufficient enough to explain the high prevalence of cardiovascular mortality, hence searching for other hidden risk factors to explain this high prevalence is of an utmost importance...
February 2017: Electronic Physician
https://www.readbyqxmd.com/read/28460874/risk-index-for-postoperative-acute-kidney-injury-after-valvular-surgery-using-cardiopulmonary-bypass
#12
Takashi Yamauchi, Shigeru Miyagawa, Yasushi Yoshikawa, Koichi Toda, Yoshiki Sawa
BACKGROUND: Acute kidney injury (AKI) after valvular surgical procedures with cardiopulmonary bypass carries potentially high mortality and morbidity rates. This study investigated the risk factors for AKI, and the study investigators developed a risk index to predict postoperative AKI. METHODS: A total of 1,484 consecutive non-dialysis-dependent patients who underwent valvular operations using cardiopulmonary bypass between 2008 and 2011 were retrospectively investigated...
April 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28428932/a-prime-determinant-in-selecting-dialysis-modality-peritoneal-dialysis-patient-survival
#13
REVIEW
Hyunwook Kim, Dong-Ryeol Ryu
The number of patients with end-stage renal disease (ESRD) has rapidly increased, as has the cost of dialysis. Peritoneal dialysis (PD) is an established treatment for ESRD patients worldwide; it has a variety of advantages, including autonomy and flexibility, as well as economic benefits in many countries compared to hemodialysis (HD). However, the long-term survival rate of PD remains poor. Although direct comparison of survival rate between the dialysis modalities by randomized controlled trials is difficult due to the ethical issues, it has always been a crucial point when deciding which dialysis modality should be recommended to patients...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28414662/weil-s-disease-from-a-local-new-orleans-bar
#14
H P Kahn, L Bateman
INTRODUCTION: Leptospirosis is a zoonotic infection that typically presents with fever, myalgias, nausea, and vomiting after contact with contaminated waters or infected animals (typically rodents); and their excrements. Conditions favorable to the transmission of leptospirosis are common in LA and, without treatment, leptospirosis can lead to both liver and renal failure, meningitis, pulmonary hemorrhage and ultimately death. CASE: A 56 year old woman with no past medical history presented to the Emergency Department with weakness, myalgias, jaundice and decreased urine output for one week...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28407633/psychosocial-factors-and-30-day-hospital-readmission-among-individuals-receiving-maintenance-dialysis-a-prospective-study
#15
Jennifer E Flythe, Johnathan Hilbert, Abhijit V Kshirsagar, Constance A Gilet
BACKGROUND: Thirty-day hospital readmissions are common among maintenance dialysis patients. Prior studies have evaluated easily measurable readmission risk factors such as comorbid conditions, laboratory results, and hospital discharge day. We undertook this prospective study to investigate the associations between hospital-assessed depression, health literacy, social support, and self-rated health (separately) and 30-day hospital readmission among dialysis patients. METHODS: Participants were recruited from the University of North Carolina Hospitals, 2014-2016...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28405987/cardiorenal-syndrome-clinical-outcome-study
#16
H R Shah, N P Singh, N P Aggarwal, D Singhania, A Kumar
BACKGROUND: Over recent years, the field of medicine has been challenged by the twin epidemic of heart failure and renal insufficiency. The coexistence of the two problems in the same patient, referred to as cardiorenal syndrome (CRS), is defined as 'disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The mechanisms underlying this interaction are complex and multifactorial in nature. OBJECTIVE OF STUDY: Identify and classify patients admitted with cardiorenal syndrome into various subtypes and assess clinical outcome at discharge and at three months...
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28395286/heart-failure-with-preserved-and-reduced-ejection-fraction-in-hemodialysis-patients-prevalence-disease-prediction-and-prognosis
#17
Marlies Antlanger, Stefan Aschauer, Chantal Kopecky, Manfred Hecking, Johannes J Kovarik, Johannes Werzowa, Julia Mascherbauer, Bernd Genser, Marcus D Säemann, Diana Bonderman
BACKGROUND/AIMS: Heart failure (HF) is a main cause of mortality of hemodialysis (HD) patients. While HF with reduced ejection fraction (HFrEF) is known to only affect a minority of patients, little is known about the prevalence, associations with clinical characteristics and prognosis of HF with preserved ejection fraction (HFpEF). METHODS: We included 105 maintenance HD patients from the Medical University of Vienna into this prospective single-center cohort study and determined the prevalence of HFpEF (per the 2013 criteria of the European Society of Cardiology) and HFrEF (EF <45%), using standardized post-HD transthoracic echocardiography...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28394274/vegetarian-diet-in-chronic-kidney-disease-a-friend-or-foe
#18
REVIEW
Anna Gluba-Brzózka, Beata Franczyk, Jacek Rysz
Healthy diet is highly important, especially in patients with chronic kidney disease (CKD). Proper nutrition provides the energy to perform everyday activities, prevents infection, builds muscle, and helps to prevent kidney disease from getting worse. However, what does a proper diet mean for a CKD patient? Nutrition requirements differ depending on the level of kidney function and the presence of co-morbid conditions, including hypertension, diabetes, and cardiovascular disease. The diet of CKD patients should help to slow the rate of progression of kidney failure, reduce uremic toxicity, decrease proteinuria, maintain good nutritional status, and lower the risk of kidney disease-related secondary complications (cardiovascular disease, bone disease, and hypertension)...
April 10, 2017: Nutrients
https://www.readbyqxmd.com/read/28390771/contemporary-outcomes-of-surgical-revascularization-of-the-lower-extremity-in-patients-on-dialysis
#19
Ajit Rao, Melissa Baldwin, James Cornwall, Michael Marin, Peter Faries, Ageliki Vouyouka
OBJECTIVE: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28376276/hot-off-the-press-prospective-and-explicit-clinical-validation-of-the-ottawa-heart-failure-risk-scale-with-and-without-use-of-quantitative-nt-probnp
#20
Corey Heitz, Justin Morgenstern, William K Milne
This prospective cohort study included patients >50 years old with dyspnea of <7 days duration, due to acute heart failure. (19) Patients too ill to be discharged were excluded. Treating physicians assessed the OHFRS approximately 2-8 hours after ED presentation. The primary outcome measured was SAE within 14 days, with SAEs including death from any cause within 30 days, admission to a monitored unit, any positive pressure ventilation, myocardial infarction, major cardiac procedure, new dialysis, or subsequent hospital admission if the patient was initially discharged from the ED...
April 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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