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https://www.readbyqxmd.com/read/28414662/weil-s-disease-from-a-local-new-orleans-bar
#1
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/28375886/unplanned-readmissions-following-outpatient-hand-and-elbow-surgery
#2
Mohamed Noureldin, Elizabeth B Habermann, Daniel S Ubl, Sanjeev Kakar
BACKGROUND: Unplanned readmission following surgery is a quality metric that helps surgeons assess initiatives targeted at improving patient care. We utilized the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to determine the rates, causes, and predictors of unplanned 30-day readmissions after outpatient elective hand and elbow surgery. METHODS: The ACS-NSQIP database was queried using hand-and-elbow-specific Current Procedural Terminology (CPT) codes to retrospectively identify patients who had undergone outpatient hand or elbow surgery in 2012 and 2013...
April 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28279408/declotting-the-thrombosed-access
#3
Keith B Quencer, Tamir Friedman
Because a patent access is the lifeline for a dialysis patient, access declotting is extremely important. Before embarking on a declot, it is important to evaluate the patient for potential contraindications such as pulmonary hypertension, right-to-left shunts and access infection in order to be able to avoid potential complications such as symptomatic pulmonary embolism, stroke, and sepsis. Multiple methods to perform a percutaneous declot exist. Four common methods are described here. We also discuss how to avoid causing an arterial embolism and how to treat it if it does occur...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28242402/hypoalbuminemia-predicts-perioperative-morbidity-and-mortality-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#4
Matthew R Peacock, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Nishant K Shah, Jeffrey J Siracuse
OBJECTIVES: Poor nutritional status has been associated with a higher risk of morbidity and mortality in general surgery patients, however outcomes in vascular surgery patients are unclear. Our goal was to determine the effect of poor nutritional status on perioperative morbidity and mortality after lower extremity bypass (LEB). METHODS: The 2005-2012 National Surgical Quality Improvement Program was analyzed to determine associated complications, mortality, length of stay (LOS), and readmissions for patients with hypoalbuminemia (serum albumin <3...
February 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28203095/burden-and-treatment-patterns-of-invasive-fungal-infections-in-hospitalized-patients-in-the-middle-east-real-world-data-from-saudi-arabia-and-lebanon
#5
Adel F Alothman, Abdulhakeem O Althaqafi, Madonna J Matar, Rima Moghnieh, Thamer H Alenazi, Fayssal M Farahat, Shelby Corman, Caitlyn T Solem, Nirvana Raghubir, Cynthia Macahilig, Claudie Charbonneau, Jennifer M Stephens
OBJECTIVES: The objective of this study was to document the burden and treatment patterns associated with invasive fungal infections (IFIs) due to Candida and Aspergillus species in Saudi Arabia and Lebanon. METHODS: A retrospective chart review study was conducted using data recorded from 2011 to 2012 from hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of IFI due to Candida or Aspergillus, which was culture proven or suspected based on clinical criteria...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28191535/association-of-serum-intact-fibroblast-growth-factor-23-with-left-ventricular-mass-and-different-echocardiographic-findings-in-patients-on-hemodialysis
#6
Amir Ahmad Nassiri, Monir Sadat Hakemi, Reza Safar-Pour, Ali Ahmadi, Maryam Tohidi, Babak Sharif Kashani, Fatemeh Esfehani, Soudabeh Alatab
OBJECTIVES: To determine the association of fibroblast growth factor 23 (FGF23) with left ventricular hypertrophy (LVH) through the assessment of left ventricular (LV) mass and left ventricular mass index (LVMI) in patients on hemodialysis, this study was done. METHODS: All patients on hemodialysis who are older than 18 years and in whom hemodialysis vintage was at least 6 months were enrolled. All patients were on hemodialysis thrice a week for 4 h using low-flux dialysis filters, polysulfone membranes, reverse osmosis purified water, and bicarbonate-base hemodialysis solution...
September 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28100157/characterization-of-planned-and-unplanned-30-day-readmissions-following-vascular-surgical-procedures
#7
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/28100152/rare-iatrogenic-cardiovascular-embolization-following-dialysis
#8
Arun Sharma, Sharmila Duraisamy, Priya Jagia, Gurpreet S Gulati
Intracardiac or intrapulmonary dislodgement of dialysis catheter or guidewire coating is extremely rare. When present, it can be potentially lethal as it may get complicated by arrhythmias, myocardial or pulmonary artery rupture, valvular perforation, pulmonary thromboembolism, infarction, and infective endocarditis. Percutaneous removal should be attempted as an initial measure and is usually effective in most of the cases. We report 2 such cases, where in first patient it was the hemodialysis catheter which broke, with a large part migrating into the heart, while in second patient, it was the hydrophilic coating of the guidewire that migrated into the pulmonary arteries...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27942955/management-dilemmas-in-pediatric-nephrology-time-limited-trials-of-dialysis-therapy
#9
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/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#10
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin-Gonzalez, Jonathan Sobocinski, Stéphan Haulon
BACKGROUND: The aim of this study is to describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. METHODS: In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement...
February 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27587067/pre-dialysis-renal-clinic-visits-and-patients-outcomes-on-peritoneal-dialysis
#11
Wen Tang, Xiu-Hong Hu, Lei Zhu, Zhe-Li Niu, Chu-Yan Su, Qing-Feng Han, Tao Wang
PURPOSE: To investigate the effect of pre-dialysis renal care on peritoneal dialysis (PD) patients' outcomes in China. METHODS: In this retrospective cohort study, patients who started PD during January 1, 2006, to December 31, 2014, were included. Patients' medical charts were reviewed to extract the information. To explore the effect of pre-dialysis renal care on patients' outcomes, patient were divided into two groups according to whether or not they had frequent renal clinic visits: Group A (with frequent visits) and Group B (without frequent visits)...
November 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27240960/simplified-frailty-index-as-a-predictor-of-adverse-outcomes-in-total-hip-and-knee-arthroplasty
#12
John I Shin, Aakash Keswani, Andrew J Lovy, Calin S Moucha
BACKGROUND: The modified frailty index (mFI) has been shown to predict adverse outcomes in multiple nonorthopedic surgical specialties. This study aimed to assess whether mFI is a predictor of adverse events in patients undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: Patients who underwent THA and TKA from 2005-2012 were identified in the National Surgical Quality Improvement Program database. mFI was calculated for each patient using 15 variables found in National Surgical Quality Improvement Program...
November 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27151579/stent-graft-repair-of-iatrogenic-femoral-arteriovenous-fistula-with-acute-bleeding-after-hemodialysis-catheter-insertion
#13
Chih-Hsien Lee
An arteriovenous fistula (AVF) is an abnormal connection between an artery and a vein. Double-lumen catheters are widely used for gaining temporary access in patients requiring acute hemodialysis (HD). Several complications are associated with the insertion of these catheters, including bleeding, infection, arterial injuries, and deep venous thrombosis. An iatrogenic AVF is a rare and severe complication following catheterization for temporary HD. Here, we report the case of a patient who developed an iatrogenic AVF following catheterization for acute HD resulting in acute bleeding...
October 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27108694/defibrotide-for-treatment-of-severe-veno-occlusive-disease-in-pediatrics-and-adults-an-exploratory-analysis-using-data-from-the-center-for-international-blood-and-marrow-transplant-research
#14
Christopher Strouse, Paul Richardson, Grant Prentice, Sandra Korman, Robin Hume, Bijan Nejadnik, Mary M Horowitz, Wael Saber
Veno-occlusive disease (VOD) is an early and serious complication of hematopoietic cell transplantation (HCT) that is associated with inferior survival, particularly when it is complicated by multiorgan failure (severe VOD). We evaluated the efficacy of defibrotide in the treatment of severe VOD using observational data from the Center for International Blood and Marrow Transplant Research (CIBMTR). Eight thousand three hundred forty-one patients treated by HCT between 2008 and 2011 were identified from the CIBMTR clinical database; 3...
July 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27006497/improving-outcomes-in-patients-receiving-dialysis-the-peer-kidney-care-initiative
#15
James B Wetmore, David T Gilbertson, Jiannong Liu, Allan J Collins
The past decade has witnessed a marked reduction in mortality rates among patients receiving maintenance dialysis. However, the reasons for this welcome development are uncertain, and greater understanding is needed to translate advances in care into additional survival gains. To fill important knowledge gaps and to enable dialysis provider organizations to learn from one another, with the aim of advancing patient care, the Peer Kidney Care Initiative (Peer) was created in 2014 by the chief medical officers of 14 United States dialysis provider organizations and the Chronic Disease Research Group...
July 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26948291/double-filtration-plasmapheresis-in-the-treatment-of-antineutrophil-cytoplasmic-autoantibody-associated-vasculitis-with-severe-renal-failure-a-preliminary-study-of-15-patients
#16
Yinghua Chen, Liu Yang, Kang Li, Zhengzhao Liu, Dehua Gong, Haitao Zhang, Zhihong Liu, Weixin Hu
Our aim was to investigate the clinical efficacy of double filtration plasmapheresis (DFPP) in the treatment of antineutrophil cytoplasmic autoantibody-(ANCA) associated vasculitis (AAV) with severe renal involvement. Fifteen AAV patients who had severe renal failure (median SCr 5.6(IQR 5.2-9.0) mg/dL) and needed initial renal replacement therapy (RRT) were treated with DFPP and immunosuppressive therapy. Two plasma volumes were processed during each DFPP session. The changes of serum ANCA and renal function were investigated...
April 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/26900309/recipient-criteria-predictive-of-graft-failure-in-kidney-transplantation
#17
Ernesto P Molmenti, Asha Alex, Lisa Rosen, Mohini Alexander, Jeffrey Nicastro, Jingyan Yang, Eric Siskind, Leesha Alex, Emil Sameyah, Madhu Bhaskaran, Nicole Ali, Amit Basu, Mala Sachdeva, Stergiani Agorastos, Prejith Rajendran, Prathik Krishnan, Poornima Ramadas, Leo Amodu, Joaquin Cagliani, Sameer Rehman, Adam Kressel, Christine B Sethna, Georgios C Sotiropoulos, Arnold Radtke, George Sgourakis, Richard Schwarz, Steven Fishbane, Alessandro Bellucci, Gene Coppa, Horacio Rilo, Christine L Molmenti
Several classifications systems have been developed to predict outcomes of kidney transplantation based on donor variables. This study aims to identify kidney transplant recipient variables that would predict graft outcome irrespective of donor characteristics. All U.S. kidney transplant recipients between October 25,1999 and January 1, 2007 were reviewed. Cox proportional hazards regression was used to model time until graft failure. Death-censored and nondeath-censored graft survival models were generated for recipients of live and deceased donor organs...
March 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/26872307/predictors-of-thirty-day-hospital-readmission-following-posterior-cervical-fusion-in-3401-patients
#18
Winward Choy, Sandi K Lam, Zachary A Smith, Nader S Dahdaleh
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To determine readmission rates and predictors of readmission following posterior cervical fusion (PCF). SUMMARY OF BACKGROUND DATA: PCFs are common spinal operations for a variety of spinal disorders including cervical myelopathy, unstable fractures, cervical deformity and tumors. Data elaborating on risk factors for 30 day readmission are limited. METHODS: Data were collected from the 2006 to 2013 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
January 14, 2016: Spine
https://www.readbyqxmd.com/read/26844465/impact-of-chronic-kidney-disease-on-short-term-cardiac-implantable-electronic-device-related-infection-a-nationwide-population-based-cohort-study
#19
Yu-Sheng Lin, Tien-Hsing Chen, Ming-Shyan Lin, Dong Yi Chen, Chun-Tai Mao, Jen-Te Hsu, Huang-Chung Chen, Mien-Cheng Chen
Chronic kidney disease (CKD) increased the incident cardiac implantable electronic device (CIED) infection, but risk factors of CIED infection in CKD patients remain unclear.Patients who received new CIED implantation between January 1, 1997 and December 31, 2011 were selected from the Taiwan National Health Insurance Database and were divided into 3 groups: patients with normal renal function, CKD patients without dialysis, and CKD patient with dialysis. Two outcomes, CIED infection during index hospitalization and within 1 year after discharge, were evaluated...
February 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26836919/the-critically-ill-kidney-transplant-recipient-a-narrative-review
#20
REVIEW
Emmanuel Canet, Lara Zafrani, Élie Azoulay
Kidney transplantation is the most common solid organ transplantation performed worldwide. Up to 6% of kidney transplant recipients experience a life-threatening complication that requires ICU admission, chiefly in the late posttransplantation period (≥ 6 months). Acute respiratory failure and septic shock are the main reasons for ICU admission. Cardiac pulmonary edema, bacterial pneumonia, acute graft pyelonephritis, and bloodstream infections account for the vast majority of diagnoses in the ICU. Pneumocystis jirovecii pneumonia is the most common opportunistic infection, and one-half of the patients so infected require mechanical ventilation...
June 2016: Chest
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