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Sepsis in dialysis

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https://www.readbyqxmd.com/read/29774558/clinical-outcome-and-comparison-of-three-different-left-ventricular-assist-devices-in-a-high-risk-cohort
#1
Konstantin Zhigalov, Ahmed Mashhour, Marcin Szczechowicz, Sabreen Mkalaluh, Sergei Karagezian, Irakli Gogia, Maxim Isaev, Bakitbek K Kadyraliev, Jerry Easo, Juergen Ennker, Harald C Eichstaedt, Alexander Weymann
We present a comparison between three left ventricular assist devices (LVADs): HeartWare (HVAD) (HeartWare International Inc., Framingham, MA, USA), HeartMate II (HMII) and HeartMate III (HMIII) (Thoratec Corp., Pleasanton, CA, USA). To our knowledge, no study to date has aimed at placing these three devices in juxtaposition. Between June 2007 and June 2017, 108 consecutive patients received HMII, n = 77 (71.3%), HVAD, n = 14 (13%), or HM III, n = 17 (15.7%), for end-stage heart failure. Mean age was 63...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29751278/pregnancy-related-acute-kidney-injury-requiring-dialysis-as-an-indicator-of-severe-adverse-maternal-morbidity-at-a-tertiary-center-in-southwest-nigeria
#2
Ibraheem O Awowole, Oluseyi S Omitinde, Fatiu A Arogundade, Sekinah B Bola-Oyebamiji, Olumide A Adeniyi
OBJECTIVE: Despite being a Critical Intervention in the WHO Near-miss concept, the indications and clinical outcomes of patients with Pregnancy-Related Acute Kidney Injury (PRAKI) requiring dialysis at the Obafemi Awolowo University Teaching Hospitals Complex, Nigeria remain unknown. This retrospective review was conducted to facilitate counselling, prognostication and introduction of preventative measures by providing contemporary data on the aetiology and clinical outcomes of women with PRAKI...
May 2, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29750636/outcomes-of-very-elderly-treated-with-dialysis-for-acute-kidney-injury
#3
Ezra Gabbay, Yehudit Zangi, Alon Bnayah, Jawad Atrash, Itzchak Slotki, Linda Shavit
BACKGROUND: The factors that determine prognosis in elderly patients with dialysis-requiring acute kidney injury (AKI-D) is uncertain. The purpose of this study was to examine predictors of in-hospital mortality in these patients. MATERIALS AND METHODS: A retrospective, single-center study of hospitalized patients ≥ 70 years old with AKI-D. Clinical and demographic variables were compared between survivors and non-survivors, independent predictors of hospital mortality were identified by logistic regression...
May 11, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29744114/calcific-uremic-arteriolopathy
#4
Olanrewaju A Olaoye, Abhilash Koratala
Calcific uremic arteriolopathy (CUA) or Calciphylaxis is a rare disease typically seen in end stage renal disease patients on dialysis and is associated with high mortality rates, mainly because of sepsis. Medial calcification of the dermal arterioles is the characteristic histologic finding together with vascular thrombosis and ischemic necrosis. CUA involves legs, abdomen and gluteal region in majority of the patients. Herein, we present a case of CUA of the glans penis in a uremic patient. Unfortunately, the patient died of sepsis in a few weeks after initiating dialysis...
October 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29738027/hydralazine-associated-adverse-events-a-report-of-two-cases-of-hydralazine-induced-anca-vasculitis
#5
Roman Zuckerman, Mayurkumar Patel, Eric J Costanzo, Harry Dounis, Rany Al Haj, Seyedehsara Seyedali, Arif Asif
Hydralazine is a direct-acting vasodilator, which has been used in treatment for hypertension (HTN) since the 1950s. While it is well known to cause drug-induced lupus (DIL), recent reports are indicating the emergence of the drug-induced anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (DIV). Herein, we describe two patients (aged 57 and 87 years) who presented with severe acute kidney injury (AKI), proteinuria, and hematuria. Both were receiving hydralazine for the treatment of hypertension...
May 7, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29730235/national-trends-and-outcomes-in-dialysis-requiring-acute-kidney-injury-in-heart-failure-2002-2013
#6
Ashish Correa, Achint Patel, Kinsuk Chauhan, Harshil Shah, Aparna Saha, Mihir Dave, Priti Poojary, Abhishek Mishra, Narender Annapureddy, Shaman Dalal, Ioannis Konstantinidis, Renu Nimma, Shiv Kumar Agarwal, Lili Chan, Girish Nadkarni, Sean Pinney
BACKGROUND: Dialysis-requiring acute kidney injury (D-AKI) is a serious complication in hospitalized heart failure (HF) patients. However, data on national trends are lacking after 2002. METHODS: We used the Nationwide Inpatient Sample (2002-2013) to identify HF hospitalizations with and without D-AKI. We analyzed trends in incidence, in-hospital mortality, length of stay (LoS) and cost. We calculated adjusted odds ratios (aOR) for predictors of D-AKI and for outcomes including in-hospital mortality and adverse discharge (discharge to skilled nursing facilities, nursing homes, etc)...
May 3, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29724988/total-gastric-necrosis-due-to-mucormycosis-a-rare-case-of-gastric-perforation
#7
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/29705559/open-thoracic-and-thoraco-abdominal-aortic-repair-after-prior-endovascular-therapy
#8
Paula R Keschenau, Shirley Ketting, Barend Mees, Mohammad E Barbati, Jochen Grommes, Alexander Gombert, Geert Willem H Schurink, Drosos Kotelis, Michael J Jacobs
OBJECTIVE: The aim was to present current results of open thoracic and thoraco-abdominal aortic repair as secondary procedure after prior endovascular therapy. METHODS: This was a retrospective cross border single centre study. From 2006 to July 2017 45 open thoracic aortic (TAA) or thoraco-abdominal aortic aneurysm (TAAA) operations were performed on 44 patients (median age 58 [15-80] years) as secondary surgery after previous endovascular therapy comprising TEVAR (n = 38; 86%), EVAR (n = 3; 7%), fenestrated EVAR (n = 1; 2%) and TEVAR plus EVAR (n = 1; 2%)...
April 25, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29701354/isolated-tricuspid-valve-surgery-repair-versus-replacement
#9
Manuela Silva, Rui Cerejo, Pedro Coelho, José Fragata
INTRODUCTION: Isolated tricuspid valve surgery (ITVS) is an uncommon procedure with few studies published. We report our series of ITVS and compare surgical outcomes and mortality in patients undergoing valve repair (TVR) versus replacement (TVRep). METHODS: Retrospective study including all patients who underwent ITVS (n = 34) between July 2008 and June 2017, divided in two groups according to type of procedure: TVR 20 patients and TVRep 14 patients. We reviewed preoperative characteristics and analysed operative data, outcomes and mortality in both groups...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29686909/spontaneous-bacterial-peritonitis-due-to-lactobacillus-paracasei-in-cirrhosis
#10
Emily Harding-Theobald, Bharat Maraj
Lactobacillus species colonize the human gastrointestinal tract and are rarely pathogenic. We present a case involving a cirrhotic patient who presented with sepsis and was found to have peritoneal cultures demonstrating Lactobacillus as the sole pathogen concerning for spontaneous bacterial peritonitis. Treatment was achieved with high-dose penicillin and clindamycin but the patient developed hepatorenal syndrome and died from acute renal failure. Intra-abdominal Lactobacillus infections are typically seen in patients undergoing peritoneal dialysis or who have recently had bowel perforation...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29685512/causes-and-outcomes-of-finger-ischemia-in-hospitalized-patients-in-the-intensive-care-unit
#11
Gregory J Landry, Courtney J Mostul, Daniel S Ahn, Bryant J McLafferty, Timothy K Liem, Erica L Mitchell, Enjae Jung, Cherrie Z Abraham, Amir F Azarbal, Robert B McLafferty, Gregory L Moneta
OBJECTIVE: Vascular surgeons may be consulted to evaluate hospitalized patients with finger ischemia. We sought to characterize causes and outcomes of finger ischemia in intensive care unit (ICU) patients. METHODS: All ICU patients who underwent evaluation for finger ischemia from 2008 to 2015 were reviewed. All were evaluated with finger photoplethysmography. The patients' demographics, comorbidities, ICU care (ventilator status, arterial lines, use of vasoactive medications), finger amputations, and survival were also recorded...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29644069/clinical-course-after-parathyroidectomy-in-adults-with-end-stage-renal-disease-on-maintenance-dialysis
#12
Christopher Thiam Seong Lim, Thevandra Kalaiselvam, Normayah Kitan, Bak Leong Goh
Background: Parathyroidectomy (PTX) is done in cases of secondary hyperparathyroidism from chronic kidney disease to improve renal osteodystrophy. Despite this widespread practice, clinical outcomes regarding the benefits of this procedure are still lacking. Most studies in the literature have opted to report the laboratory outcome instead. Our study aimed to evaluate the postoperative clinical course for patients who had undergone total PTX without autoimplantation. Methods and results: All patients who underwent PTX between January 2010 and February 2014 in a tertiary referral center were included in this study and followed up for 12 months...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29609531/metformin-associated-lactic-acidosis-a-case-series-of-28-patients-treated-with-sustained-low-efficiency-dialysis-sled-and-long-term-follow-up
#13
Andrea Angioi, Gianfranca Cabiddu, Maura Conti, Gianfranco Pili, Alice Atzeni, Valeria Matta, Riccardo Cao, Matteo Floris, Marco Songini, Maria Franca Mulas, Mitchell Rosner, Antonello Pani
BACKGROUND: Metformin associated lactic acidosis (MALA) is a well-known serious side effect of biguanides. However, the best treatment strategy remains a matter of debate. In the last 14 years, we observed a significant increase in hospitalizations for MALA to our Center. We report the outcomes of our clinical and therapeutic approach. METHODS: This is a single-center case series. Twenty-eight patients affected with MALA and acute kidney failure admitted between January 2000 and September 2014 were included...
April 2, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29579873/long-term-survival-and-evolution-of-the-kidney-function-for-liver-transplant-patients-who-required-postoperative-dialysis
#14
F Rosique, J B Cabezuelo, D Ferreras, M R González-Sánchez, J Ros, J A Pons, P A Cascales-Campos, F Sánchez-Bueno, R Robles, P Ramírez, P Parrilla
Patients who underwent orthotopic liver transplantation (OLT) frequently develop chronic kidney disease, with those who present postoperative acute kidney failure and require renal replacement therapy (RRT) at higher risk. The objective of the study was to assess the kidney function and long-term survival of patients who underwent OLT and required RRT during or in the immediate postoperative period. Medical records of OLT and postoperative RRT patients with over 6-month survival were reviewed between January 1, 2005, and December 31, 2015...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29567029/through-knee-amputation-is-a-feasible-alternative-to-above-knee-amputation
#15
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/29543788/trends-in-hospitalizations-for-acute-kidney-injury-united-states-2000-2014
#16
Meda E Pavkov, Jessica L Harding, Nilka R Burrows
Acute kidney injury is a sudden decrease in kidney function with or without kidney damage, occurring over a few hours or days. Diabetes, hypertension, and advanced age are primary risk factors for acute kidney injury. It is increasingly recognized as an in-hospital complication of sepsis, heart conditions, and surgery (1,2). Its most severe stage requires treatment with dialysis. Acute kidney injury is also associated with higher likelihood of long-term care, incidence of chronic kidney disease and hospital mortality, and health care costs (1,2)...
March 16, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29514222/short-term-mechanical-circulatory-support-for-severe-primary-graft-dysfunction-following-orthotopic-heart-transplant
#17
Michal Hulman, Panagiotis Artemiou, Matej Ondrusek, Vladan Hudec, Ivo Gasparovic, Martin Bena, Ivan Glonek
OBJECTIVES: Primary graft dysfunction (PGD) is a devastating complication and the most common cause of early death following a heart transplant. The goal of this study was to report our experience of using mechanical circulatory support to manage severe PGD. METHODS: Following 208 heart transplants performed between January 2007 and May 2017, 14 (6.7%) patients presented with severe PGD. We provided haemodynamic support using the following approaches: a venoarterial extracorporeal membrane oxygenation device, left ventricular assist device, right ventricular assist device and biventricular assist device...
March 5, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29501063/tight-glycemic-control-in-critically-ill-pediatric-patients-a-systematic-review-and-meta-analysis
#18
Lvlin Chen, Tiangui Li, Fang Fang, Yu Zhang, Andrew Faramand
BACKGROUND: Hyperglycemia is prevalent in patients in the pediatric intensive care unit. The purpose of this study was to describe the benefits and risks of tight glucose control (TGC) in critically ill children. METHODS: A systemic review and meta-analysis of the literature was carried out on randomized controlled trials of TGC in critically ill children admitted to the pediatric intensive care unit. The databases searched were Medline, Embase, and CENTRAL databases until May 1, 2017...
March 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29456210/appraising-the-outcome-and-complications-of-peritoneal-dialysis-patients-in-self-care-peritoneal-dialysis-and-assisted-peritoneal-dialysis-a-5-year-review-of-a-single-saudi-center
#19
Jamal Saleh Al Wakeel, Mohammed A Al Ghonaim, Abdullah Aldohayan, Saira Usama, Saad Al Obaili, Ahmad R Tarakji, Mohammad Alkhowaiter
Our objective is to study the outcomes and complications of peritoneal dialysis (PD) including comparison of self-care PD with home-care assisted PD during a five-year period. A retrospective study of PD data at King Saud University-affiliated hospital in Riyadh from January 1, 2009, to December 31, 2013. One hundred and eleven patients were included (female 55%). The average age was 47.4 (1-83) years. Twenty-one (18.91%) patients were on continuous ambulatory PD and 90 (81.08%) on automated PD. The mean time on PD was 23...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29433878/the-effect-of-resident-involvement-on-bariatric-surgical-outcomes-an-acs-nsqip-analysis
#20
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
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