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https://www.readbyqxmd.com/read/28100157/characterization-of-planned-and-unplanned-30-day-readmissions-following-vascular-surgical-procedures
#1
Georges Tahhan, Alik Farber, Nishant K Shah, Brianna M Krafcik, Teviah E Sachs, Jeffrey A Kalish, Matthew R Peacock, Jeffrey J Siracuse
OBJECTIVE: Thirty-day readmission is increasingly used as a quality of care indicator. Patients undergoing vascular surgery have historically been at high risk for readmission. We analyzed hospital readmission details to identify patients at high risk for readmission in order to better understand these readmissions and improve resource utilization in this patient population. METHODS: A retrospective review and analysis of our medical center's admission and discharge data were conducted from October 2012 to March 2015...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28098112/autosomal-dominant-polycystic-kidney-disease-study-of-clinical-characteristics-in-an-indian-population
#2
Sanjay Vikrant, Anupam Parashar
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary form of kidney disease. Clinical data on this multisystem disorder are scarce from developing countries. We conducted a prospective observational study of the clinical profile of ADPKD patients at a single center over a period of six years. A total of 208 patients were studied. Majority were male (60.6%) and the mean age was 45.8 ± 14.5 years. About 61.5% had early stage (Stages 1-3) of chronic kidney disease (CKD) and 38.5% had advanced CKD (Stages 4 and 5)...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28098110/hepatitis-c-in-children-with-chronic-kidney-disease-a-single-center-egypt
#3
Doaa Mohammed Youssef, Hanaa Abdo, Ahmed Alakhras, Tamer Adham, Abdelnasser Hussien Mohamoud
Prevalence of hepatitis C varies largely according to geographical distribution, and Egypt so far has the highest prevalence worldwide. The aim of this study was to evaluate hepatitis C infection in chronic kidney disease (CKD) children in our center with regard to its incidence and other morbidities. This is a cross-sectional study involving 50 children with CKD, not on dialysis. All patients underwent a thorough history taking including disease duration and mean duration of admission, clinical examination including blood pressure measurements, and routine laboratory examination such as hemoglobin level, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea, and creatinine...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28098100/impact-of-residual-renal-function-on-clinical-outcome-and-quality-of-life-in-patients-on-peritoneal-dialysis
#4
Manns Manohar John, Amit Gupta, Raj K Sharma, Anupama Kaul
We studied the impact of residual renal function (RRF) on clinical outcome and quality of life in 61 patients on peritoneal dialysis (PD). They were assigned to two groups, at the time of initiation of PD, based on their estimated glomerular filtration rate (eGFR). The high RRF group had eGFR ≥5 mL/min/1.73 m[2] and the low RRF group hade GFR <5 mL/min/1.73 m[2]. All patients were followed up at regular intervals for clinical and biochemical variables. Baselines characteristics including age, sex, body mass index and cause of the kidney disease were similar in both groups...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28097101/novel-treatment-of-hepatitis-c-virus-infection-for-patients-with-renal-impairment
#5
REVIEW
Goki Suda, Koji Ogawa, Megumi Kimura, Masato Nakai, Takuya Sho, Kenichi Morikawa, Naoya Sakamoto
Prevalence of hepatitis C virus (HCV) infection is high in patients with end-stage renal dysfunction, including patients undergoing hemodialysis (HD). The HCV infection itself can cause glomerulonephritis and puts individuals at increased risk of developing end-stage renal disease; fortunately, successful HCV eradication sometimes restore HCV-related renal dysfunction. Moreover, the prognosis of dialysis patients infected with HCV is significantly worse and the renal allograft survival in HCV-infected patients is also worse than in dialysis patients without HCV infection...
December 28, 2016: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28096438/infection-prophylaxis-in-peritoneal-dialysis-patients-results-from-an-australia-new-zealand-survey
#6
Denise J Campbell, David W Mudge, Martin P Gallagher, Wai H Lim, Ranganathan Dwarakanathan, Walaa Saweirs, Jonathan C Craig
♦ Background: Clinical practice guidelines aim to reduce the rates of peritoneal dialysis (PD)-related infections, a common complication of PD in end-stage kidney disease patients. We describe the clinical practices used by Australian and New Zealand nephrologists to prevent PD-related infections in PD patients. ♦ Methods: A survey of PD practices in relation to the use of antibiotic and antifungal prophylaxis in PD patients was conducted of practicing nephrologists identified via the Australia and New Zealand Society of Nephrology (ANZSN) membership in 2013...
January 17, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28067935/hepatitis-b-vaccination-in-haemodialysis-patients-an-underestimated-problem-factors-influencing-immune-responses-in-ten-years-of-observation-in-an-italian-haemodialysis-centre-and-literature-review
#7
E Cordova, I Miglia, F Festuccia, M G Sarlo, G Scornavacca, G Punzo, P Menè, C Fofi
OBJECTIVES: Despite universal infection control precautions, the risk of hepatitis B virus (HBV) infection in patients on chronic haemodialysis (HD) remains high. For this reason anti-HBV vaccination is recommended in these subjects. In hemodialyzed patients vaccinal response is often suboptimal and it's not clear what factors may influence it. STUDY DESIGN: The aim of our study is to assess the influence of some clinical and laboratory factors on seroconversion rate after anti HBV vaccination in a cohort of patients on maintenance HD...
January 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28064159/prognostic-significance-of-pre-end-stage-renal-disease-serum-alkaline-phosphatase-for-post-end-stage-renal-disease-mortality-in-late-stage-chronic-kidney-disease-patients-transitioning-to-dialysis
#8
Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Yoshitsugu Obi, Connie M Rhee, Elani Streja, Kunihiro Yamagata, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Higher serum alkaline phosphatase (ALP) levels have been associated with excess mortality in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) and end-stage renal disease (ESRD). However, little is known about the impact of late-stage NDD-CKD ALP levels on outcomes after dialysis initiation. METHODS: Among 17 732 US veterans who transitioned to dialysis between October 2007 and September 2011, we examined the association of serum ALP levels averaged over the last 6 months of the pre-ESRD transition period ('prelude period') with all-cause, cardiovascular and infection-related mortality following dialysis initiation, using Cox (for all-cause mortality) and competing risk (for cause-specific mortality) regressions adjusted for demographics, comorbidities, medications, estimated glomerular filtration rate and serum albumin levels over the 6-month prelude period, and vascular access type at dialysis initiation...
January 7, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28049587/response-to-active-hepatitis-b-vaccination-and-mortality-in-incident-dialysis-patients
#9
Emanuel Zitt, Hildegard Hafner-Giessauf, Birgitta Wimmer, Alexander Herr, Sabine Horn, Claudia Friedl, Hannelore Sprenger-Mähr, Reinhard Kramar, Alexander R Rosenkranz, Karl Lhotta
All patients with advanced chronic kidney disease or on renal replacement therapy should receive active hepatitis B vaccination. The aim of this retrospective cohort study was to investigate the association between the immune response to hepatitis B vaccination and all-cause, cardiovascular or infection-related mortality in incident dialysis patients starting dialysis between 2001 and 2008 (n=426) in two Austrian dialysis centers. Vaccination response was defined as follows: absent anti-HBs antibody titer or a titer <10IU/L was classified as non-response, seroconversion (SC) was defined as a titer ⩾10IU/L, and seroprotection (SP) as a titer ⩾100IU/L...
December 31, 2016: Vaccine
https://www.readbyqxmd.com/read/28040717/predictors-of-the-use-of-specific-critical-care-therapies-in-patients-with-metastatic-cancer
#10
Kah Poh Loh, Ankit Kansagra, Meng-Shiou Shieh, Penelope Pekow, Peter Lindenauer, Mihaela Stefan, Tara Lagu
OBJECTIVE: Understanding which factors are associated with the use of critical care therapies (CCTs) can help with clinical decision-making and goals of care discussion. The goal of this study was to describe the predictors of CCT use (eg, mechanical ventilation, tracheostomy, percutaneous endoscopic gastrostomy tube, total parenteral nutrition, acute use of dialysis) in hospitalized patients with metastatic cancer. METHODS: We used the 2010 California State Inpatient Databases sponsored by the Agency for Healthcare Research and Quality to identify all hospitalizations with a diagnosis of metastatic cancer (patients aged ≥18 years)...
January 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28009779/carbapenem-resistant-enterobacteriaceae-acquired-before-liver-transplantation-impact-on-recipient-outcomes
#11
M P Freire, I C V S Oshiro, L C Pierrotti, P R Bonazzi, L M de Oliveira, A T W Song, C H Camargo, I M van der Heijden, F Rossi, S F Costa, L A C D'Albuquerque, E Abdala
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) is an emergent microorganism of infections after liver transplant (LT). The aim of this study was to analyze the risk factors for CRE acquisition and infection after LT. METHODS: This was a prospective cohort study involving patients who underwent LT in the 2010-2014 period. Surveillance cultures for CRE were collected immediately before LT and weekly thereafter until hospital discharge. RESULTS: We analyzed 386 patients undergoing a total of 407 LTs...
December 22, 2016: Transplantation
https://www.readbyqxmd.com/read/27988089/predictors-of-mortality-among-u-s-veterans-with-streptococcus-pneumoniae-infections
#12
Jacob B Morton, Haley J Morrill, Kerry L LaPlante, Aisling R Caffrey
INTRODUCTION: Serious Streptococcus pneumoniae infections, encompassing pneumonia, bacteremia, and meningitis, are a major cause of mortality. However, literature regarding mortality is often limited to invasive pneumococcal disease, excluding pneumonia. This study sought to identify predictors of mortality among adults with serious pneumococcal disease, including pneumonia and invasive pneumococcal disease. METHODS: This was a nested case-control study of unvaccinated older Veterans with positive S...
December 14, 2016: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/27977558/intensive-care-admissions-for-children-with-enterovirus-and-human-parechovirus-infections-in-the-united-kingdom-and-the-republic-of-ireland-2010-14
#13
Serena Braccio, Melpo Kapetanstrataki, Mike Sharland, Shamez Ladhani
Enteroviruses and human parechoviruses (EV/HPeV) usually cause mild, self-limiting illnesses in children but can occasionally cause severe disease. During 2010-14, 104 children in the UK and the Republic of Ireland were admitted to a pediatric intensive care unit with severe EV/HPeV infection; 40% had neurologic symptoms, 20% respiratory failure, 16% cardiac complications and 11% septic shock. Annual number of cases and incidence increased in the five-year period, from 0.6/1,000 PICU admissions (12 cases) in 2010 to 1...
December 12, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27977557/safety-of-high-dose-acyclovir-in-infants-with-suspected-and-confirmed-neonatal-herpes-simplex-virus-infections
#14
Jessica E Ericson, Martyn Gostelow, Julie Autmizguine, Christoph P Hornik, Reese H Clark, Daniel K Benjamin, P Brian Smith
BACKGROUND: Acyclovir is used to treat herpes simplex virus (HSV) disease in infants. Treatment with high dose acyclovir, 60 mg/kg/day, is recommended; however, the safety of this dosage has not been assessed in the past 15 years, and this dosage is not currently approved for infants by the US Food and Drug Administration. METHODS: We included infants with neonatal HSV disease treated with ≥14 days of intravenous acyclovir starting in the first 120 days of life admitted to 1 of 42 neonatal intensive care units managed by the Pediatrix Medical Group from 2002-2012...
December 12, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27976490/therapy-with-ombitasvir-paritaprevir-ritonavir-plus-dasabuvir-is-effective-and-safe-for-the-treatment-of-genotype-1-and-4-hepatitis-c-virus-infection-hcv-in-patients-with-severe-renal-impairment-a-multicenter-experience
#15
Raquel Muñoz-Gómez, Diego Rincón, Adriana Ahumada, Eduardo Hernández, María José Devesa, Sonia Izquierdo, Maria Ortiz, Alicia Hernández-Albujar, Conrado Fernández-Rodríguez, Marta Calvo, Rosario González, Mar Lozano, Gregorio Castellano, Inmaculada Fernández-Vázquez
Limited data are available on direct-acting antivirals for treating hepatitis C virus (HCV) infection in patients with severe renal impairment. The aim of this study was to evaluate the effectiveness and safety of ombitasvir/paritaprevir/ ritonavir (OBV/PTV/r) ± dasabuvir (DSV) ± ribavirin (RBV) in patients with stage 4 or 5 chronic kidney disease (CKD) and HCV genotype 1 or 4 infection in real clinical practice, and to investigate pharmacological interactions. This retrospective study included patients treated with OBV/PTV/r+DSV±RBV or OBV/PTV/r+RBV with CKD stage 4 (eGFR: 15-29 mL/min/1...
December 15, 2016: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/27974893/recoverable-record-high-lactic-acidosis-in-a-patient-with-glycogen-storage-disease-type-1-a-mixed-type-a-and-type-b-lactate-disorder
#16
Yonatan Oster, Isaiah D Wexler, Samuel N Heyman, Elchanan Fried
A 17-year-old patient with GSD type 1a (von Gierke disease) was hospitalized with an extremely elevated serum lactate following an intercurrent infection and interruption of his frequent intake of carbohydrates. The patient developed shock, oliguric renal failure, and cardiorespiratory failure requiring mechanical ventilation and inotropes. At the peak of metabolic decompensation and clinical instability, serum lactate reached a level of 47.6 mmol/L which was accompanied by a severe anion gap metabolic acidosis with a pH of 6...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27964855/a-case-of-brachiocephalic-fistula-steal-and-the-emergency-physician-s-approach-to-hemodialysis-arteriovenous-fistula-complications
#17
Erica Simon, Brit Long, Kyle Johnston, Shane Summers
BACKGROUND: Chronic kidney disease is common in the United States, with many patients maintained on hemodialysis (HD). The process of HD requires vascular access through an arteriovenous (AV) fistula, AV graft, or central venous catheter. Today, as a result of the National Kidney Foundation's "Fistula First" initiative, nearly 55% of HD patients utilize an AV fistula. As there is significant morbidity and mortality associated with fistula placement and recurrent fistula cannulation, emergency physicians must be equipped to recognize and treat fistula complications...
December 10, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27955633/the-clinical-and-economic-burden-of-pneumonia-in-patients-enrolled-in-medicare-receiving-dialysis-a-retrospective-observational-cohort-study
#18
Scott Sibbel, Reiko Sato, Abigail Hunt, Wendy Turenne, Steven M Brunelli
BACKGROUND: End-stage renal disease (ESRD) patients receiving dialysis are at particular risk for infection. We assessed the clinical and economic burden of pneumonia in a population of Medicare-enrolled ESRD patients with respect to incidence and case fatality rates, rates of all-cause and cardiovascular hospitalization, and costs. METHODS: Patients received dialysis between 01 January 2009 and 31 December 2011 and were enrolled in Medicare Parts A and B. Pneumonia episodes were identified from institutional and supplier claims...
December 12, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27942955/management-dilemmas-in-pediatric-nephrology-time-limited-trials-of-dialysis-therapy
#19
Aaron Wightman
BACKGROUND: Time-limited trials of dialysis have been proposed as a third option in addition to initiation of treatment and comfort-care only in the setting of high uncertainty or discordance between the treating team and child/family or among the treating team. CASE-DIAGNOSIS/TREATMENT: The index case was noted antenatally to have severe kidney disease and pulmonary hypoplasia. In light of the guarded, but uncertain prognosis and a lack of consensus among the treating team, as well as between the treating team and the family, a time-limited trial of dialysis was initiated...
December 9, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27942170/end-stage-renal-disease-in-tunisian-infants-etiology-and-outcome
#20
M Jellouli, A Boussetta, K Abidi, Y Hammi, C Zarrouk, T Gargah
End stage renal disease (ESRD) in infants has particular features in terms of etiologies and therapeutic modalities. The aim of our study is to describe the etiologies and the ESRD outcomes among Tunisian infants. This retrospective study was conducted over 15 years (from January 1998 to December 31, 2013) in the Pediatric Department at Charles Nicolle Hospital. In total, 157 pediatric patients had ESRD. The mean incidence was 4.25 million children. The study involved 24 infants; the sex ratio was equal to 2...
November 2016: Indian Journal of Nephrology
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