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https://www.readbyqxmd.com/read/29732423/predicting-critical-care-unit-level-complications-after-long-segment-fusion-procedures-for-adult-spinal-deformity
#1
Rafael De la Garza-Ramos, Jonathan Nakhla, Yaroslav Gelfand, Murray Echt, Aleka N Scoco, Merritt D Kinon, Reza Yassari
Background: To identify predictive factors for critical care unit-level complications (CCU complication) after long-segment fusion procedures for adult spinal deformity (ASD). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database [2010-2014] was reviewed. Only adult patients who underwent fusion of 7 or more spinal levels for ASD were included. CCU complications included intraoperative arrest/infarction, ventilation >48 hours, pulmonary embolism, renal failure requiring dialysis, cardiac arrest, myocardial infarction, unplanned intubation, septic shock, stroke, coma, or new neurological deficit...
March 2018: Journal of Spine Surgery (Hong Kong)
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/29649586/nephrotoxicity-of-piperacillin-tazobactam-combined-with-vancomycin-should-it-be-a-concern
#3
Cafer Balcı, Ömrüm Uzun, Mustafa Arıcı, Sibel Aşçıoğlu Hayran, Deniz Yüce, Serhat Ünal
The combination of piperacillin-tazobactam (pip-tazo) and vancomycin provides a wide spectrum of activity against many pathogens acquired in the health-care setting. However, there have been reports of increased potential for nephrotoxicity with this combination. The aim of this study was to evaluate the nephrotoxic effect of pip-tazo plus vancomycin and compare it with that of pip-tazo and vancomycin alone, and meropenem plus vancomycin, another broad-spectrum combination. A total of 402 patients receiving either antimicrobial regimen for more than 48 hours were evaluated retrospectively in a two-year period...
April 9, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29582962/-atypical-hemolitic-uremic-syndrome-after-administration-of-docetaxel
#4
Alessandro Francesco Colombo, Rosalia Boito, Francesca Bova, Sebastiano Greco, Rosita Lucà, Arcangelo Sellaro, Giuseppe Rizzuto
The purpose of this study is to describe the clinical case of a patient suffering from a gland carcinoma with bilateral inguinal and pelvic lymph node metastases in treatment with weekly administrations of Docetaxel. After two therapy cycles, the patient developed an atypical uremic hemolytic Syndrome (SEUa), treated with infusions of frozen fresh plasma, hemodialysis, and antibiotics. Because of a severe septic secondary complication on an extensive lymph node abscess, the administration of Eculizumab was not possible...
March 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29567029/through-knee-amputation-is-a-feasible-alternative-to-above-knee-amputation
#5
Sungho Lim, Michael J Javorski, Pegge M Halandras, Bernadette Aulivola, Paul R Crisostomo
OBJECTIVE: Through-knee amputation (TKA) is a rare amputation performed in <2% of all major lower extremity amputations in the United States. Despite biomechanical benefits and improved rehabilitation compared with above-knee amputation (AKA), TKA has largely been abandoned by vascular surgeons because of concerns for poor wound healing. The purpose of this study was to evaluate surgical outcomes of TKA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program between 2005 and 2012 was queried using Current Procedural Terminology codes indicating AKA and TKA...
March 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29560396/renal-failure-after-placement-of-an-articulating-antibiotic-impregnated-polymethylmethacrlyate-hip-spacer
#6
Robert P Runner, Amanda Mener, Thomas L Bradbury
A 58-year-old male presented with native joint septic arthritis of the hip and osteomyelitis. After treatment with an articulating antibiotic spacer, he developed acute renal failure requiring dialysis. He continued to have elevated serum tobramycin levels exclusively from the antibiotic spacer elution as no intravenous tobramycin was used. Subsequent explantation was required to correct his renal failure. Although renal failure after antibiotic impregnated cement placement is rare, the risk of this potential complication should be considered preoperatively and in the postoperative management of these patients...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29530855/elimination-of-doripenem-during-dialysis-and-pharmacokinetic-evaluation-of-posthemodialysis-dosing-for-patients-undergoing-intermittent-renal-replacement-therapy
#7
M G Vossen, L Ehmann, S Pferschy, A Maier-Salamon, M Haidinger, C Weiser, J M Wenisch, K Saria, C Kajahn, S Jilch, R Lemmerer, M Bécède, M Zeitlinger, C Kloft, W Jäger, F Thalhammer
Doripenem is a broad-spectrum parenteral carbapenem with enhanced activity against Pseudomonas aeruginosa and Enterobacteriaceae Current dosing regimens recommend the administration of 0.25 to 0.5 g once daily in patients undergoing intermittent renal replacement therapy. As patients are usually dialyzed thrice weekly, we aimed to investigate a 1-g posthemodialysis regimen, thus reducing treatment costs and enhancing patient compliance. A second objective of this trial was to describe the pharmacokinetics of intradialytic doripenem...
May 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29505885/emergence-of-multidrug-resistant-sequence-type-45-strains-among-borderline-oxacillin-resistant-meca-positive-staphylococcus-aureus-causing-bacteraemia-in-a-medical-centre-in-taiwan
#8
Yu-Tsung Huang, Chun-Hsing Liao, Shey-Ying Chen, Hsin-Sui Hsu, Lee-Jene Teng, Po-Ren Hsueh
Clinical data related to bacteraemia caused by mecA-positive borderline-oxacillin resistant (minimum inhibitory concentrations, 0.5-4 mg/L) Staphylococcus aureus (BORSA) isolates are limited. Patients (age >15 years) with bacteraemia due to BORSA who were admitted to the emergency department in a tertiary hospital between January 2001 and December 2015 were evaluated. Clinical characteristics of patients with bacteraemia caused by BORSA, methicillin-susceptible S. aureus and MRSA were compared. Minimum inhibitory concentrations of 12 antibiotics were determined using the agar dilution method...
March 2, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29474669/treatment-and-outcome-of-congenital-nephrotic-syndrome
#9
Sandra Bérody, Laurence Heidet, Olivier Gribouval, Jérome Harambat, Patrick Niaudet, Veronique Baudouin, Justine Bacchetta, Bernard Boudaillez, Maud Dehennault, Loïc de Parscau, Olivier Dunand, Hugues Flodrops, Marc Fila, Arnaud Garnier, Ferielle Louillet, Marie-Alice Macher, Adrien May, Elodie Merieau, Françoise Monceaux, Christine Pietrement, Caroline Rousset-Rouvière, Gwenaëlle Roussey, Sophie Taque, Julie Tenenbaum, Tim Ulinski, Rachel Vieux, Ariane Zaloszyc, Vincent Morinière, Rémi Salomon, Olivia Boyer
Background: Recommendations for management of Finnish-type congenital nephrotic syndrome (CNS) followed by many teams include daily albumin infusions, early bilateral nephrectomy, dialysis and transplantation. We aimed to assess the treatment and outcome of patients with CNS in France. Methods: We conducted a nationwide retrospective study on 55 consecutive children born between 2000 and 2014 treated for non-infectious CNS. Results: The estimated cumulative incidence of CNS was 0...
February 20, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29433878/the-effect-of-resident-involvement-on-bariatric-surgical-outcomes-an-acs-nsqip-analysis
#10
Ivy N Haskins, Jihad Kudsi, Kathleen Hayes, Richard L Amdur, Paul P Lin, Khashayar Vaziri
BACKGROUND: Surgical residency training programs in the United States are modeled on the principle of graduated responsibility. Residents are given greater responsibility and autonomy in the operating room and during perioperative care as they gain surgical skills and progress through their training. The impact of this method of surgical training on patient outcomes remains unknown. The purpose of this study is to compare early patient morbidity and mortality after bariatric surgery in cases with and without resident participation using the American College of Surgeons National Surgical Quality Improvement Program database...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29386307/a-retrospective-analysis-of-etiology-and-outcomes-of-refractory-capd-peritonitis-in-a-tertiary-care-center-from-north-india
#11
Venkatesh Thammishetti, Anupama Kaul, Dharmendra S Bhadauria, Karthikeyan Balasubramanian, Narayan Prasad, Amit Gupta, Raj K Sharma
BACKGROUND: Refractory peritonitis is defined as failure of clearance of peritoneal fluid despite 5 days of appropriate antibiotic therapy. Catheter removal decreases morbidity and mortality. Data on the outcomes of refractory peritonitis and of reinitiation of peritoneal dialysis (PD) in this group of patients are sparse. The present study analyzed etiology, outcomes, and prognostic factors of refractory peritonitis as well as survival of the reinitiation of the technique. METHODS: This was a single-center retrospective study that included 90 patients of refractory continuous ambulatory PD (CAPD) peritonitis at a tertiary care center in North India...
January 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29382394/pharmacokinetics-of-meropenem-in-septic-patients-on-sustained-low-efficiency-dialysis-a-population-pharmacokinetic-study
#12
Stephan Braune, Christina König, Jason A Roberts, Axel Nierhaus, Oliver Steinmetz, Michael Baehr, Stefan Kluge, Claudia Langebrake
BACKGROUND: The aim of the study was to describe the population pharmacokinetics (PK) of meropenem in critically ill patients receiving sustained low-efficiency dialysis (SLED). METHODS: Prospective population PK study on 19 septic patients treated with meropenem and receiving SLED for acute kidney injury. Serial blood samples for determination of meropenem concentrations were taken before, during and after SLED in up to three sessions per patient. Nonparametric population PK analysis with Monte Carlo simulations were used...
January 30, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29248269/uremic-pericarditis-in-patients-with-end-stage-renal-disease-prevalence-symptoms-and-outcome-in-2017
#13
Yassamine Bentata, F Hamdi, A Chemlal, I Haddiya, N Ismaili, N El Ouafi
The prevalence of uremic pericarditis (UP) used to range from 3% to 41%. More recently, it has decreased to about 5%-20% and to <5% in the last decades, as hemodialysis techniques have become widely used and dialysis quality improved. The objective of this work is to determine the initial clinical picture and the prognosis of patients presenting End Stage Renal Disease (ESRD) with UP. MATERIALS: This is a retrospective study (May 2015-September 2017). Inclusion criteria targeted patients who had uremic pericarditis defined as pericarditis occurring in a patient with ESRD before initiation of renal replacement therapy, or within eight weeks of its initiation...
March 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29211186/epidemiology-of-acute-kidney-injury-and-chronic-kidney-disease-in-the-intensive-care-unit
#14
Darwin Tejera, Fernanda Varela, Daniela Acosta, Stephanie Figueroa, Sebastián Benencio, Cristina Verdaguer, Mauricio Bertullo, Federico Verga, Mario Cancela
OBJECTIVE: To describe the epidemiology of acute kidney injury, its relationship to chronic kidney disease, and the factors associated with its incidence. METHODS: A cohort study and follow-up were conducted in an intensive care unit in Montevideo, Uruguay. We included patients admitted between November 2014 and October 2015 who were older than 15 years of age and who had at least two measurements of serum creatinine. We excluded patients who were hospitalized for less than 48 hours, patients who died at the time of hospitalization, and patients with chronic renal disease who were on hemodialysis or peritoneal dialysis...
October 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29124521/successful-peritoneal-dialysis-using-a-percutaneous-tube-for-peritoneal-drainage-in-an-extremely-low-birth-weight-infant-a-case-report
#15
Satoshi Yokoyama, Takayuki Nukada, Yuka Ikeda, Shigeto Hara, Akira Yoshida
BACKGROUND: Peritoneal dialysis (PD) for acute kidney injury (AKI) of newborns has been performed safely. AKI occurs in 8 to 24% of extremely low birth weight (ELBW) infants. Although PD has only been used occasionally in ELBW infants, prognosis is poor for ELBW infants with AKI. Several reports have described successful PD in these infants, but no guideline-based evidence concerning indications for renal replacement therapy in ELBW infants are currently available. Here, we report on our experience with PD in an ELBW infant with AKI resulting from septic shock...
November 9, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/29107479/clinical-factors-and-outcomes-of-dialysis-dependent-end-stage-renal-disease-patients-with-emergency-department-septic-shock
#16
Kevin M Lowe, Alan C Heffner, Colleen H Karvetski
BACKGROUND: Infection is the second leading cause of death in end-stage renal disease (ESRD) patients. Prior investigations of acute septic shock in this specific population are limited. OBJECTIVE: We aimed to evaluate the clinical presentation and factors associated with outcome among ESRD patients with acute septic shock. METHODS: We reviewed patients prospectively enrolled in an emergency department (ED) septic shock treatment pathway registry between January 2014 and May 2016...
January 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29064179/a-case-of-hypothermia-on-crrt
#17
Gurwant Kaur, Prameela Banoth, Preethi Yerram, Madhukar Misra
A 64-year-old Asian man, with past medical history of hypertension, hypothyroidism, and hyperlipidemia, presented with 3 days history of fever associated with cough and worsening shortness of breath. Subsequent clinical course was complicated by acute lung injury leading to acute respiratory distress syndrome requiring positive pressure ventilation, septic shock requiring inotropic support, and acute kidney injury requiring continuous renal replacement therapy (CRRT). On day 3 of CRRT, the patient developed significant hypothermia (temporal temperature 27...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29044341/the-use-of-antimicrobials-in-septic-patients-with-acute-kidney-injury
#18
Fernanda Moreira de Freitas, Welder Zamoner, Durval Sampaio de Souza Garms, Mariele Gobo de Oliveira, André Luis Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and it may be associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administrate antimicrobials in dosis to achieve adequate serum levels, preventing overdosis and drug toxicity or underdosing and risk for resistance to antibiotics and higher mortality. To date, there aren't validated guidelines on antibiotic dosis adjustment in septic patients with AKI and the recommendations are extrapolated from studies conducted in non-critical patients with chronic kidney disease in end stage receiving chronic renal replacement therapy...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28953653/risk-analysis-of-dialysis-dependent-patients-who-underwent-coronary-artery-bypass-grafting-effects-of-dialysis-modes-on-outcomes
#19
Han-Yan Li, Chih-Hsiang Chang, Cheng-Chia Lee, Victor Chien-Chia Wu, Dong-Yi Chen, Pao-Hsien Chu, Kuo-Sheng Liu, Feng-Chun Tsai, Pyng-Jing Lin, Shao-Wei Chen
Cardiovascular disease is the major morbidity and leading cause of mortality for dialysis-dependent patients. This study aimed to stratify the risk factors and effects of dialysis modes in relation to coronary artery bypass grafting (CABG) surgery among dialysis-dependent patients.This retrospective study enrolled dialysis-dependent patients who underwent CABG from October 2005 to January 2015. All data of demographics, medical history, surgical details, postoperative complications, and in-hospital mortality were analyzed, and patients were categorized as those with or without in-hospital mortality and those with preoperative hemodialysis (HD) or peritoneal dialysis (PD)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28919596/outcome-of-pregnancy-related-acute-kidney-injury-observed-in-a-tertiary-care-hospital
#20
S U Ahammed, A A Chowdhury, A S Roy, M A Muqueet, M A Rahman, M S Kabir, M G Rabbani, M Asadujjaman, M B Hossain, M Akhtaruzzaman, S K Das, E H Khan, M A Islam, M J Hasan, M A Rahman, R K Talukder, J Ara, G C Barman, P P Roy, M K Saha, D Mondal
This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term maternal outcome of pregnancy related Acute Kidney Injury and to identify aetiological factors and to observe clinical features of pregnancy related Acute Kidney Injury. Total 60 pregnant women with AKI were included in the study as sample and equal (60) number of pregnant women with normal renal function was taken as control...
July 2017: Mymensingh Medical Journal: MMJ
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