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https://www.readbyqxmd.com/read/28748892/clinical-profile-of-geriatric-acute-kidney-injury-in-a-tertiary-care-center-from-south-india
#1
Eshwarappa Mahesh, Praveen Nallamuthu, Mahesh Kumar, Parampalli Rakesh Madhyastha, Gurudev Konanna
The incidence of acute kidney injury (AKI) is high in the elderly, who comprise an ever-growing segment of the population. Elderly patients pose a different set of diagnostic and therapeutic challenge owing to their associated comorbidities. AKI in the elderly is associated with an increased risk of mortality, morbidity, prolonged length of stay, and progression to chronic kidney disease. Data regarding the clinical profile of AKI in the elderly from the South Indian population are limited. Hence, we present this analysis of the etiological and prognostic factors associated with AKI in elderly population from South India...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28689399/sphingomonas-paucimobilis-a-rare-infectious-agent-found-in-cerebrospinal-fluid
#2
Tuncer Göker, Rahile Zülal Aşık, Muhammet Bahadır Yılmaz, İlhami Çelik, Ayhan Tekiner
Sphingomonas paucimobilis (S. paucimobilis) is a gram negative bacillus. It has existed in soil, drinking water and plants. It has been isolated from distilled water tanks, respirators, and hemodialysis devices at the hospital setting. Patients with chronic disorders or immune suppression may be susceptible to infections with it. This microorganism has also been reported to infect healthy persons. Both nosocomial and community-acquired infections have been reported. So far, a variety of infections have been reported, including sepsis, septic pulmonary embolism, septic arthritis, peritonitis, and endophthalmitis...
July 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28682855/management-of-a-complex-peristomal-calciphylaxis-a-case-study
#3
Mary Famorca, Debra Beauchaine, Nancy Angulo
BACKGROUND: Calciphylaxis, also referred to as calcific uremic arteriolopathy, is a rare and serious syndrome of small blood vessels with a high mortality rate. Calciphylaxis lesions require intensive wound management with medical interventions for the patient to survive the sequelae of sepsis and present unique challenges when found in the peristomal skin. CASE: A 33-year-old man presented with multiple malodorous stage 4 pressure injuries of his sacrococcygeal and gluteal area...
July 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28672146/stroke-volume-guided-resuscitation-in-severe-sepsis-and-septic-shock-improves-outcomes
#4
Heath E Latham, Charles D Bengtson, Lewis Satterwhite, Mindy Stites, Dipti P Subramaniam, G John Chen, Steven Q Simpson
To determine whether stroke volume (SV) guided fluid resuscitation in patients with severe sepsis and septic shock alters Intensive Care Unit (ICU) fluid balance and secondary outcomes, this retrospective cohort study evaluated consecutive patients admitted to an ICU with the primary diagnosis of severe sepsis or septic shock. Cohorts were based on fluid resuscitation guided by changes in SV or by usual care (UC). The SV group comprised 100 patients, with 91 patients in the UC group. Net fluid balance for the ICU stay was lower in the SV group (1...
June 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28587576/risk-factors-for-wound-complications-and-30-day-mortality-after-major-lower-limb-amputations-in-patients-with-peripheral-arterial-disease
#5
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa
Purpose Risk factors for wound complications or 30-day mortality after major amputation in patients with peripheral arterial disease remain unclear. We investigated the outcomes of major amputation in patients with peripheral arterial disease. Methods Patients who underwent major amputation from 2008 to 2015 were retrospectively analyzed. The main outcome measures were risk factors for wound complications and 30-day mortality after major lower limb amputations. Major amputation was defined as above-knee amputation or below-knee amputation...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28584456/isolation-rate-and-clinical-significance-of-uropathogens-in-positive-urine-cultures-of-hemodialysis-patients
#6
Katerina G Oikonomou, Adib Alhaddad
BACKGROUND: Hemodialysis (HD) patients are known to be vulnerable to infections. However, there are limited data on the urine microbiology spectrum among patients with end-stage renal disease and on the development of antimicrobial resistance of uropathogens in these patients. MATERIALS AND METHODS: A single-center, retrospective study was conducted to assess the spectrum and antimicrobial resistance profile of microorganisms isolated in urine cultures of HD patients who were hospitalized between September 2008 and August 2015 with an admitting diagnosis of fever, sepsis, or urinary tract infection...
April 2017: Journal of Global Infectious Diseases
https://www.readbyqxmd.com/read/28574107/continuous-renal-replacement-therapy-forty-year-anniversary
#7
Claudio Ronco
In 1977 Peter Kramer performed the first CAVH (continuous arteriovenous hemofiltration) treatment in Gottingen, Germany. CAVH soon became a reliable alternative to hemo- or peritoneal dialysis in critically ill patients. The limitations of CAVH spurred new research and the discovery of new treatments such as CVVH and CVVHD (continuous veno-venous hemofiltration and continuous veno-venous hemodialysis). The alliance with industry led to development of new specialized equipment with improved accuracy and performance in delivering continuous renal replacement therapies (CRRTs)...
May 31, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28491228/-survival-among-chronic-hemodialysed-patient-in-cameroon
#8
MULTICENTER STUDY
Hermine Fouda, Gloria Ashuntantang, François Kaze, Marie-Patrice Halle
INTRODUCTION: Haemodialysis is the only renal replacement therapy available in Cameroon; 95% of patients has received subsidies by the State since 2002 and the number of dialysis centers is growing. However, since the opening of the first center in 1990, there are no data on survival in chronic dialysis patients. METHODS: We conducted a multicenter prospective cohort study of 15 months in order to assess mortality rates and factors that influence the survival of chronic hemodialysis patients in Cameroon...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28485834/profile-and-outcomes-of-women-with-pregnancy-related-acute-kidney-injury-requiring-dialysis-at-a-center-in-ethiopia
#9
Delayehu Bekele, Momina Ahmed, Ahmed Ibrahim, Seman Kedir, Grace Chan
OBJECTIVE: To describe the clinical profile and outcomes of women with pregnancy-related acute kidney injury (AKI) undergoing dialysis at Saint Paul's Hospital Millennium Medical College, Addis Ababa, where the first publicly funded large-scale dialysis service in Ethiopia was established. METHODS: In a hospital-based retrospective study, clinical records were reviewed for all women with pregnancy-related AKI attending the hemodialysis unit at the study center between August 2013 and July 2015...
May 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28469851/acute-suppurative-thyroiditis-in-infected-thyroid-cyst-in-an-adult-patient-under-hemodialysis
#10
Hiroyuki Igarashi, Hiroshi Yoshino, Mai Hijikata, Naoki Kumashiro, Yasuyo Ando, Hiroshi Uchino, Kumiko Tsuboi, Takahisa Hirose
Acute suppurative thyroiditis (AST) accompanied by an abscess is a rare clinical case. Hemodialysis patients are at risk for infections. Sepsis mortality was from 100 to 300 times higher for chronic dialysis patients than that for the general public. Thus, special care should be taken against infection in patients under hemodialysis.
May 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28464841/the-impact-of-continuous-renal-replacement-therapy-on-renal-outcomes-in-dialysis-requiring-acute-kidney-injury-may-be-related-to-the-baseline-kidney-function
#11
Marisa Aparecida de Souza Oliveira, Thais Oliveira Claizoni Dos Santos, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão
BACKGROUND: Many controversies exist regarding the management of dialysis-requiring acute kidney injury (D-AKI). No clear evidence has shown that the choice of dialysis modality can change the survival rate or kidney function recovery of critically ill patients with D-AKI. METHODS: We conducted a retrospective study investigating patients (≥16 years old) admitted to an intensive care unit with D-AKI from 1999 to 2012. We analyzed D-AKI incidence, and outcomes, as well as the most commonly used dialysis modality over time...
May 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28457410/immunomodulation-acute-renal-failure-and-complications-of-basiliximab-use-after-liver-transplantation-analysis-of-114-patients-and-literature-review
#12
E C de Ataide, S R Perales, J B Bortoto, M A O Peres, F C Filho, R S B Stucchi, E Udo, I F S F Boin
Basiliximab is considered to be effective in preventing cellular rejection (CR) in solid organ transplantation and is commonly used for renal transplants. The aim of this study was describe the population of patients undergoing orthotopic liver transplantation (LT) receiving basiliximab in the period 2012-2016 in the liver transplant service at the State University of Campinas, São Paulo, Brazil. We analyzed 114 patients who underwent LT and received basiliximab; 83 (72.8%) were male and 31 (27.2%) female, with an overall mean age of 54...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28449641/cell-free-hemoglobin-mediated-oxidative-stress-is-associated-with-acute-kidney-injury-and-renal-replacement-therapy-in-severe-falciparum-malaria-an-observational-study
#13
Katherine Plewes, Hugh W F Kingston, Aniruddha Ghose, Richard J Maude, M Trent Herdman, Stije J Leopold, Haruhiko Ishioka, Md Mahtab Uddin Hasan, Md Shafiul Haider, Shamsul Alam, Kim A Piera, Prakaykaew Charunwatthana, Kamolrat Silamut, Tsin W Yeo, Md Abul Faiz, Sue J Lee, Mavuto Mukaka, Gareth D H Turner, Nicholas M Anstey, L Jackson Roberts, Nicholas J White, Nicholas P J Day, Md Amir Hossain, Arjen M Dondorp
BACKGROUND: Intravascular hemolysis is an intrinsic feature of severe malaria pathophysiology but the pathogenic role of cell-free hemoglobin-mediated oxidative stress in severe malaria associated acute kidney injury (AKI) is unknown. METHODS: As part of a prospective observational study, enrolment plasma cell-free hemoglobin (CFH), lipid peroxidation markers (F2-isoprostanes (F2-IsoPs) and isofurans (IsoFs)), red cell deformability, and serum creatinine were quantified in Bangladeshi patients with severe falciparum malaria (n = 107), uncomplicated malaria (n = 80) and sepsis (n = 28)...
April 27, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28444069/predictors-and-pattern-of-weaning-and-long-term-outcome-of-patients-with-prolonged-mechanical-ventilation-at-an-acute-intensive-care-unit-in-north-india
#14
Syed Nabeel Muzaffar, Mohan Gurjar, Arvind K Baronia, Afzal Azim, Prabhakar Mishra, Banani Poddar, Ratender K Singh
Objective: This study aimed to examine the clinical characteristics, weaning pattern, and outcome of patients requiring prolonged mechanical ventilation in acute intensive care unit settings in a resource-limited country. Methods: This was a prospective single-center observational study in India, where all adult patients requiring prolonged ventilation were followed for weaning duration and pattern and for survival at both intensive care unit discharge and at 12 months...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28426914/the-recommended-dose-of-idarucizumab-may-not-always-be-sufficient-for-sustained-reversal-of-dabigatran
#15
A Simon, H Domanovits, C Ay, G Sengoelge, J H Levy, A O Spiel
Essentials Reversal of anticoagulant effects of dabigatran may occur despite application of idarucizumab. Monitoring of dabigatran level after antidote application is crucial to detect rebound. Repeated doses of idarucizumab may be necessary in cases of massive dabigatran accumulation. Combination of antidote application and renal replacement therapy may offer additional benefit. SUMMARY: Idarucizumab is a monoclonal antibody fragment designed for reversing the anticoagulant effects of dabigatran...
April 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28412129/acute-kidney-injury-after-burn
#16
REVIEW
Audra Clark, Javier A Neyra, Tarik Madni, Jonathan Imran, Herb Phelan, Brett Arnoldo, Steven E Wolf
Acute kidney injury (AKI) is a common and morbid complication after severe burn, with an incidence and mortality as high as 30% and 80%, respectively. AKI is a broad clinical condition with many etiologies, which makes definition and diagnosis challenging. The most recent Kidney Disease: Improving Global Outcomes (KDIGO) consensus guidelines defined stage and severity of AKI based on changes of serum creatinine and urine output (UOP) across time. Burn-related kidney injury is typically classified as early (0-3days after injury) or late (4-14days after injury)...
August 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28405987/cardiorenal-syndrome-clinical-outcome-study
#17
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/28366423/glp-1-levels-predict-mortality-in-patients-with-critical-illness-as-well-as-end-stage-renal-disease
#18
Corinna Lebherz, Georg Schlieper, Julia Möllmann, Florian Kahles, Marvin Schwarz, Jan Brünsing, Nada Dimkovic, Alexander Koch, Christian Trautwein, Jürgen Flöge, Nikolaus Marx, Frank Tacke, Michael Lehrke
BACKGROUND: Glucagon-like peptide 1 (GLP-1) is an incretin hormone, which stimulates glucose-dependent insulin secretion from the pancreas and holds immune-regulatory properties. A marked increase of GLP-1 has been found in critically ill patients. This study was performed to elucidate the underlying mechanism and evaluate its prognostic value. METHODS: GLP-1 plasma levels were determined in 3 different patient cohorts: 1) critically ill patients admitted to our intensive care unit (n = 215); 2) patients with chronic kidney disease on hemodialysis (n = 173); and 3) a control group (no kidney disease, no acute inflammation, n = 105)...
March 31, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28356667/hemophagocytic-lymphohistiocytosis-secondary-to-hemodialysis-catheter-related-blood-stream-infection
#19
U Anandh, S Johari, B Vaswani
A 57-year-old man on dialysis presented with fever due to Pseudomonas septicemia. Workup revealed very high triglycerides and serum ferritin levels. A bone marrow examination showed hemophagocytosis. A diagnosis of hemophagocytic lymphohistiocytosis (HLH) was made and steroids were started. He was put on automated peritoneal dialysis. Patients' condition continued to deteriorate and he succumbed to his illness. This case illustrates the development of HLH secondary to infections which are increasingly being recognized in the literature...
March 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28341509/dialysis-access-hemorrhage-access-rescue-from-a-surgical-emergency
#20
Tazo Inui, Valy Boulom, Dennis Bandyk, John S Lane, Erik Owens, Andrew Barleben
OBJECTIVE: Hemorrhage from a dialysis access can be a life-threatening condition. This study details our experience using access rescue strategies, including in situ graft replacement, primary repair, or conversion to an autogenous fistula; coupled with treatment of central vein occlusion to maintain access usage in patients presenting with conduit hemorrhage. METHODS: During a 3-yr period (2012-2014), 26 patients (14 women, 12 men) on chronic hemodialysis were treated for access conduit bleeding (n=18) or life-threatening hemorrhage (n=8); located in the upper extremity (n=23) or thigh (n=3)...
March 21, 2017: Annals of Vascular Surgery
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