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Kidney, emergency, intensive care

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https://www.readbyqxmd.com/read/29739453/spontaneous-renal-hemorrhage-secondary-to-choriocarcinoma-in-a-man-with-congenital-hypospadias-and-cryptorchidism-a-case-report-and-literature-review
#1
Yi Li, Gang Chen, Han Chen, Shuang Wen, Chao-Yu Xiong, Zi-Yi Yang, Yun-Xiao Zhu, Nathan Jeffreys
BACKGROUND: Choriocarcinoma is a rare malignant germ-cell tumour, most commonly found in adult women. It infrequently presents as spontaneous renal haemorrhage (SRH). Genital malformation and SRH secondary to choriocarcinoma has previously been only reported in females. We present what we believe to be the first case of a male patient with genital malformation (hypospadias and cryptorchidism) and SRH at presentation of choriocarcinoma. CASE PRESENTATION: A 25-year-old man presented to the department with intense pain in the right flank region and lower back...
May 8, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29724988/total-gastric-necrosis-due-to-mucormycosis-a-rare-case-of-gastric-perforation
#2
Salah Termos, Feras Othman, Mohammad Alali, Bader M S Al Bader, Talal Alkhadher, Wael Fathi Hassanaiah, Ali Taqi, Abhijit Sapkal
BACKGROUND Spontaneous gastric perforation is usually a complication of peptic ulcer disease, or a postoperative complication resulting from gastric torsion. Mucormycosis (or zygomycosis) is an uncommon opportunistic fungal infection that is usually seen in immunocompromised patients and is associated with significant morbidity and mortality. This report is of a rare case of spontaneous gastric perforation due to mucormycosis infection. CASE REPORT A 52-year-old woman, with a past medical history of heroin abuse, diabetes mellitus, hypertension, and chronic kidney disease treated by dialysis, presented to the emergency department with cellulitis of the arms...
May 4, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29723569/promis-%C3%A2-pain-is-independent-of-stone-burden-and-predicts-surgical-intervention-in-patients-with-ureteral-stones
#3
Jennifer L Portis, Suzanne M Neises, Andrew J Portis
PURPOSE: Patients with obstructing ureteral stones typically experience sudden onset, severe pain. We examine the National Institutes of Health's Patient Reported Outcome Measurement Information System (PROMIS®) pain instruments in patients with acute ureteral stones. METHODS: PROMIS® pain measures were obtained from a complete cohort of patients presenting to a subspecialty kidney stone clinic after discharge from emergency department (ED). Patients were followed longitudinally through course of care...
April 30, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29705974/extreme-hypercalcemia-in-a-kidney-transplant-recipient
#4
Erol Demir, Cagla Karaoglan, Gulcin Yegen, Betul Sair, Halil Yazici, Aydin Turkmen, Mehmet Sukru Sever
Post-transplant hypercalcemia is a major problem in renal transplant recipients, which may negatively affect both graft and patient survival. In this paper, we present a 66-year-old male kidney transplant recipient, who was admitted to our clinic with symptoms of fever, nausea, vomiting and lethargy. Laboratory data showed good renal function; however, a serum calcium level of 22.1 mg/dL. The patient was treated by isotonic saline together with furosemide and methylprednisolone. Because of treatment resistance, subcutaneous calcitonin and ibandronate were added to the treatment protocol as well...
April 28, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29678895/healthcare-utilization-after-acute-kidney-injury-in-the-pediatric-intensive-care-unit
#5
Erin Hessey, Geneviève Morissette, Jacques Lacroix, Sylvie Perreault, Susan Samuel, Marc Dorais, Véronique Phan, Philippe Jouvet, Jean-Philippe Lafrance, Jacques LeLorier, Ana Palijan, Michael Pizzi, Louise Roy, Michael Zappitelli
BACKGROUND AND OBJECTIVES: Little is known about the long-term burden of AKI in the pediatric intensive care unit. We aim to evaluate if pediatric AKI is associated with higher health service use post-hospital discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is a retrospective cohort study of children (≤18 years old) admitted to two tertiary centers in Montreal, Canada. Only the first admission per patient was included. AKI was defined in two ways: serum creatinine alone or serum creatinine and/or urine output...
April 20, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#6
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29615192/acute-kidney-injury-predicts-mortality-in-emergency-general-surgery-patients
#7
Alexandra Briggs, Joaquim M Havens, Ali Salim, Kenneth B Christopher
BACKGROUND: Patients undergoing Emergency General Surgery (EGS) have increased risk of complications and death. The risk of AKI in patients undergoing EGS, along with associated outcomes, is unknown. METHODS: This two-institution observational study included adults admitted to intensive care units between 1997 and 2012. EGS was defined by 7 procedures occurring within 48 hours of ICU admission. The main outcome studied was AKI within 5 days, along with 90-day mortality...
March 14, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29615168/reasons-for-removal-of-non-tunneled-double-lumen-catheters-in-incident-dialysis-patients
#8
Ruqaya Qureshi, Beena Salman, Salman Imtiaz, Murtaza F Drohlia, Aasim Ahmad
OBJECTIVE: To evaluate the reasons of removal of non-tunneled double lumen catheters (NTDLC) in incident hemodialysis (HD) patients in a tertiary renal care hospital. STUDY DESIGN: Observational retrospective study. PLACE AND DURATION OF STUDY: Department of Nephrology, The Kidney Centre Postgraduate Training Institute (TKC PGTI), Karachi, from June 2015 to May 2016. METHODOLOGY: All patients were selected who had naive NTDLC placement at TKC PGTI either in Emergency Room (ER) or Intensive Care Unit (ICU) during the study period...
April 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29549465/describing-pediatric-acute-kidney-injury-in-children-admitted-from-the-emergency-department
#9
Holly R Hanson, Lynn Babcock, Terri Byczkowski, Stuart L Goldstein
OBJECTIVE: To define those children who develop acute kidney injury (AKI) within 48 h of admission from the emergency department (ED) and ascertain patient-related factors in the ED associated with AKI. METHODS: Retrospective, cohort study of children, birth to 19 years, admitted to a tertiary pediatric hospital from the ED between January 2010 and December 2013 who had serum creatinine (SCr) drawn as part of clinical care. AKI was defined as a 50% increase in SCr above baseline, as measured within 48 h of hospital presentation...
March 17, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29545434/management-of-tumour-lysis-syndrome-during-first-line-palliative-chemotherapy-for-high-volume-colorectal-cancer
#10
Helena S Gouveia, Sílvia O Lopes, Ana Luísa Faria
Tumour lysis syndrome (TLS) is a rare oncological emergency in solid tumours. Because it is associated with bad short-term prognosis, early recognition and treatment are mandatory. This case refers to a middle-aged woman who presented with stage IV colon cancer, with massive hepatic involvement. After three cycles of first-line FOLFOX (folinic acid, 5-fluorouracil and oxaliplatin), she developed acute kidney injury and hyperkalaemia that did not respond to standard measures. High suspicion of TLS prompted further corroborating investigations and early intensive care unit admission...
March 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29500124/management-of-the-critically-ill-adult-with-congenital-heart-disease
#11
REVIEW
Wolf B Kratzert, Eva K Boyd, Johanna C Schwarzenberger
Survival of adults with congenital heart disease (CHD) has improved significantly over the last 2 decades, leading to an increase in hospital and intensive care unit (ICU) admissions of these patients. Whereas most of the ICU admissions in the past were related to perioperative management, the incidence of medical emergencies from long-term sequelae of palliative or corrective surgical treatment of these patients is rising. Intensivists now are confronted with patients who not only have complex anatomy after congenital cardiac surgery, but also complex pathophysiology due to decades of living with abnormal cardiac anatomy and diseases of advanced age...
November 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29485926/balanced-crystalloids-versus-saline-in-noncritically-ill-adults
#12
RANDOMIZED CONTROLLED TRIAL
Wesley H Self, Matthew W Semler, Jonathan P Wanderer, Li Wang, Daniel W Byrne, Sean P Collins, Corey M Slovis, Christopher J Lindsell, Jesse M Ehrenfeld, Edward D Siew, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Comparative clinical effects of balanced crystalloids and saline are uncertain, particularly in noncritically ill patients cared for outside an intensive care unit (ICU). METHODS: We conducted a single-center, pragmatic, multiple-crossover trial comparing balanced crystalloids (lactated Ringer's solution or Plasma-Lyte A) with saline among adults who were treated with intravenous crystalloids in the emergency department and were subsequently hospitalized outside an ICU...
March 1, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29480442/epidemiological-characteristics-of-and-risk-factors-for-patients-with-postoperative-acute-kidney-injury-a-multicenter-prospective-study-in-30-chinese-intensive-care-units
#13
Yu Zhang, Li Jiang, Baomin Wang, Xiuming Xi
BACKGROUND: Although there were studies to investigate the risk factors for acute kidney injury (AKI) after surgery, most of them focused on one specific type of surgeries. The risk factors for postoperative AKI in patients undergoing all surgeries in intensive care units (ICU) have not been reported. METHODS: Data from 1731 patients undergoing surgery in 30 ICUs of 28 tertiary hospitals in Beijing from March to August 2012 were prospectively collected. AKI was defined and staged by the KDIGO criteria...
February 26, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29478052/predicting-acute-kidney-injury-in-intensive-care-unit-patients-the-role-of-tissue-inhibitor-of-metalloproteinases-2-and-insulin-like-growth-factor-binding-protein-7-biomarkers
#14
Laura Di Leo, Federico Nalesso, Francesco Garzotto, Yun Xie, Bo Yang, Grazia Maria Virzì, Alberto Passannante, Raffaele Bonato, Mariarosa Carta, Davide Giavarina, Dario Gregori, Alessandra Brendolan, Fiorenza Ferrari, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) diagnosis is based on a rise in serum creatinine and/or fall in urine output. It has been shown that there are patients that fulfill AKI definition but do not have AKI, and there are also patients with evidence of renal injury who do not meet any criteria for AKI. Recently the innovative and emerging proteomic technology has enabled the identification of novel biomarkers that allow improved risk stratification. METHODS: Tissue inhibitor of metalloproteinases-2 (TIMP-2), insulin-like growth factor-binding protein 7 (IGFBP7) were measured to a cohort of 719 consecutive patients admitted to Intensive Care Unit (ICU)...
2018: Blood Purification
https://www.readbyqxmd.com/read/29455034/preoperative-risk-factors-for-unexpected-postoperative-intensive-care-unit-admission-a-retrospective-case-analysis
#15
Joshua B Knight, Evan E Lebovitz, Theresa A Gelzinis, Ibtesam A Hilmi
INTRODUCTION: The purpose of this retrospective case-control study was to investigate preoperative risk factors for unexpected postoperative intensive care unit (ICU) admissions in patients undergoing non-emergent surgical procedures in a tertiary medical centre. METHODS: A medical record review of adult patients undergoing elective non-cardiac and non-transplant major surgical procedures during the period of January 2011 through December 2015 in the operating rooms of a large university hospital was carried out...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29354178/the-role-of-extracorporeal-membrane-oxygenation-in-patients-after-irreversible-cardiac-arrest-as-potential-organ-donors
#16
REVIEW
Tomasz Kłosiewicz, Mateusz Puślecki, Marcin Zieliński, Michał Mandecki, Marcin Ligowski, Sebastian Stefaniak, Marek Dąbrowski, Marek Karczewski, Łukasz Gąsiorowski, Maciej Sip, Agata Dąbrowska, Wojciech Telec, Bartłomiej Perek, Marek Jemielity
The number of people waiting for a kidney or liver transplant is growing systematically. Due to the latest advances in transplantation, persons after irreversible cardiac arrest and confirmation of death have become potential organ donors. It is estimated that they may increase the number of donations by more than 40%. However, without good organization and communication between pre-hospital care providers, emergency departments, intensive care units and transplantation units, it is almost impossible to save the organs of potential donors in good condition...
December 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29300236/contemporary-risk-factors-and-outcomes-of-transfusion-associated-circulatory-overload
#17
Nareg H Roubinian, Jeanne E Hendrickson, Darrell J Triulzi, Jerome L Gottschall, Michael Michalkiewicz, Dhuly Chowdhury, Daryl J Kor, Mark R Looney, Michael A Matthay, Steven H Kleinman, Donald Brambilla, Edward L Murphy
OBJECTIVES: Transfusion-associated circulatory overload is characterized by hydrostatic pulmonary edema following blood transfusion. Restrictive transfusion practice may affect the occurrence and severity of transfusion-associated circulatory overload in critically ill patients. We sought to examine contemporary risk factors and outcomes for transfusion-associated circulatory overload. DESIGN: Case-control study. SETTING: Four tertiary care hospitals...
April 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29279634/role-of-urinary-neutrophil-gelatinase-associated-lipocalin-as-a-biomarker-of-acute-kidney-injury-in-patients-with-circulatory-shock
#18
Radhey Shyam, Munna Lal Patel, Rekha Sachan, Satish Kumar, Durgesh Kumar Pushkar
Background: The early prediction of acute kidney injury (AKI) by the current clinical and laboratory methods remains inadequate. Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a promising noninvasive biomarker of kidney injury in shock. The aim of this study was to assess the ability of urinary NGAL (uNGAL) to predict AKI in adult Intensive Care Unit (ICU) patients. Materials and Methods: We prospectively studied 70 patients with circulatory shock admitted to the ICU over a period of 1 year...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29240277/how-perceived-feelings-of-wellness-influence-the-decision-making-of-people-with-predialysis-chronic-kidney-disease
#19
Sandra Campbell-Crofts, Glenn Stewart
AIMS AND OBJECTIVES: To identify the subjective meanings attached to decisions made by people living with chronic kidney disease as they consider their transition to renal replacement therapy. BACKGROUND: Within the challenging world of chronic illness, people draw upon their temporal life experiences to help them make the best or most balanced primary healthcare decisions. Understanding the risks and benefits associated with these decisions has been an area of intense interest in health research...
December 14, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29238581/a-spicy-status-synthetic-cannabinoid-spice-use-and-new-onset-refractory-status-epilepticus-a-case-report-and-review-of-the-literature
#20
Marc-Alain Babi, Christopher P Robinson, Carolina B Maciel
Synthetic cannabinoids refer to a wide variety of chemicals engineered to bind cannabinoid receptors (CB1 and CB2) and mimic the effects of delta-9-tetrahydrocanabinol. The potential for severe toxicity and limited in vivo data make synthetic cannabinoid intake an important public health and safety concern. Neurologic toxidromes associated with their use include mental status changes, panic attacks, memory distortions, acute psychosis (e.g. paranoia, delusional thoughts), disorganized behavior, and suicidal and homicidal thoughts...
2017: SAGE Open Medical Case Reports
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