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https://www.readbyqxmd.com/read/29159844/incidence-and-predictors-of-30-day-postoperative-readmission-in-children
#1
Daniel Vo, David Zurakowski, David Faraoni
BACKGROUND: Hospital readmissions are being used as a quality metric for hospital reimbursement without a clear understanding of the factors that contribute to readmission. OBJECTIVE: The objective of this study was to report the incidence of 30-day postsurgical readmission in children, identify the predictors for readmission, and create an algorithm to identify high-risk children. METHODS: Data from the 2012-2014 Pediatric database of the American College of Surgeons National Surgical Quality Improvement Program were analyzed using univariable and multivariable logistical regression analysis...
November 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29153441/complex-endovascular-repair-of-postdissection-arch-and-thoracoabdominal-aneurysms
#2
Rafaëlle Spear, Adrien Hertault, Katrien Van Calster, Nicla Settembre, Matthieu Delloye, Richard Azzaoui, Jonathan Sobocinski, Dominique Fabre, Mark Tyrrell, Stéphan Haulon
OBJECTIVE: We report our experience of the treatment of postdissection arch aneurysms and thoracoabdominal aortic aneurysms (TAAAs) by endovascular repair using fenestrated and branched endografts. METHODS: This study includes all patients presenting with chronic postdissection aneurysms >55 mm in diameter deemed unfit for open surgery and treated by complex endografting between October 2011 and April 2017. Where appropriate, staged management strategies including left subclavian artery revascularization, thoracic endografting, dissection flap fenestration, and tear enlargement were performed before the complex endovascular repair...
November 15, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29148856/novel-applications-for-serum-procalcitonin-testing-in-clinical-practice
#3
Justin J Choi, Matthew W McCarthy
Procalcitonin has emerged as a reliable marker of acute bacterial infection in hospitalized patients and the assay has recently been incorporated into several clinical algorithms to reduce antimicrobial overuse, but its use in patients with end-organ dysfunction is controversial. Areas covered: In this review, the authors examine what is known about procalcitonin testing in patients with organ dysfunction, including those with end-stage renal disease, congestive heart failure, chronic obstructive pulmonary disease, and cirrhosis, and explore how the assay is now being used in the management of non-infectious diseases...
November 17, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29145816/renal-failure-during-chemotherapy-renal-biopsy-for-assessing-subacute-nephrotoxicity-of-pemetrexed
#4
Maureen Assayag, Philippe Rouvier, Marion Gauthier, Ghania Costel, Philippe Cluzel, Lucile Mercadal, Gilbert Deray, Corinne Isnard Bagnis
BACKGROUND: Pemetrexed, a multitargeted antifolate cytotoxic agent, is currently used primarily in combination with cisplatin for metastatic non-small cell lung cancer and for malignant mesothelioma. Acute renal toxicity of pemetrexed has been recently described with polychemotherapy, in which the individual responsibility of each drug is difficult to establish. Only one recent report documents renal involvement in long-term exposed patients. CASE PRESENTATION: We report on a case of rapidly progressive nephropathy leading to the cessation of platinum salts and the secondary interruption of pemetrexed and bevacizumab...
November 16, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29145203/evaluation-of-mental-disorders-using-proton-magnetic-resonance-spectroscopy-in-dialysis-and-predialysis-patients
#5
Chun-Yun Zhang, Ying Chen, Shan Chen, Xiang-Chuang Kong, Yuan Liu, Chao-Qun You, Cheng Wan, Philip A Bondzie, Hua Su, Chun Zhang, Fang-Fang He
BACKGROUND/AIMS: Psychological complications are prevalent in patients with chronic kidney disease (CKD). This study aimed to investigate mental disorders in stage 4-5 CKD patients, to detect metabolite concentrations in the brain by proton magnetic resonance spectroscopy (1H-MRS) and to compare the effects of different dialysis therapies on mental disorders in end-stage renal disease (ESRD). METHODS: The sample population was made up of predialysis (13), hemodialysis (HD) (13), and peritoneal dialysis (PD) patients (12)...
November 21, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29144626/super-selective-robot-assisted-partial-nephrectomy-using-near-infrared-flurorescence-versus-early-unclamping-of-the-renal-artery-results-of-a-prospective-matched-pair-analysis
#6
Cecilia Lanchon, Valentin Arnoux, Gaëlle Fiard, Jean-Luc Descotes, Jean-Jacques Rambeaud, Jean-Benjamin Lefrancq, Delphine Poncet, Nicolas Terrier, Camille Overs, Quentin Franquet, Jean-Alexandre Long
INTRODUCTION: Super-selective clamping of tumor-specific segmental arteries was developed to eliminate ischemia of the remnant kidney while limiting hemorrhage during partial nephrectomy. The objective is to evaluate the benefice of super-selective clamping on renal functional outcome, compared to early-unclamping of the renal artery. MATERIALS AND METHODS: From March 2015 to July 2016, data from 30 patients undergoing super-selective robot-assisted PN (RAPN) for a solitary tumor by a single surgeon were prospectively collected...
November 19, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29142891/assessment-of-severity-of-malnutrition-in-peritoneal-dialysis-patients-via-malnutrition-inflammatory-score
#7
Afsoon Emami Naeeni, Nazila Poostiyan, Zahra Teimouri, Mojgan Mortazavi, Mojgan Soghrati, Elnaz Poostiyan, Zamzam Paknahad
Background: Regarding to the complications of malnutrition in dialysis patients, using an easy and reliable method for evaluating of malnutrition is important in patients with the end-stage renal disease. Based on the effect of inflammatory factors in malnutrition, A new scale has been designed which is called malnutrition-inflammatory scale (MIS). We designed current study to assess the severity of malnutrition in peritoneal dialysis patients in Isfahan via MIS. Materials and Methods: In this cross-sectional MIS was used for evaluation of malnutrition...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29137321/the-role-of-indoxyl-sulfate-in-renal-anemia-in-patients-with-chronic-kidney-disease
#8
Chih-Jen Wu, Cheng-Yi Chen, Thung-S Lai, Pei-Chen Wu, Chih-Kuang Chuang, Fang-Ju Sun, Hsuan-Liang Liu, Han-Hsiang Chen, Hung-I Yeh, Chih-Sheng Lin, Cheng-Jui Lin
Renal anemia is a common complication in patients with advanced chronic kidney disease. In vitro studies have shown that indoxyl sulfate decreases erythropoietin production. Whether this effect is seen in vivo remains unclear. Our goal was to explore the role of indoxyl sulfate in renal anemia. We found serum indoxyl sulfate levels are significantly and negatively associated with erythropoietin levels in human. A multiple stepwise linear regression analyses after adjustment for other independent parameters revealed that free indoxyl sulfate, and total indoxyl sulfate were significantly associated with erythropoietin levels...
October 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29136724/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-renal-impairment-of-multiple-myeloma
#9
(no author information available yet)
Renal impairment (RI) is a common complication of multiple myeloma (MM), which is presented as chronic kidney disease (CKD) or acute kidney injury (AKI). The typical pathological feature is cast nephropathy. Presently international system staging (ISS) is used in evaluating MM. Although the classic Durie-Salmon staging system could be still used in clinical practice, it may miss out some patients with renal impairment. For evaluations of RI in MM patients with CKD, it's recommended to assess the estimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration (EPI) or modification of diet in renal disease(MDRD) and to stage the renal injuries according to 2013 Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29132945/uric-acid-and-the-risks-of-kidney-failure-and-death-in-individuals-with-ckd
#10
Anand Srivastava, Arnaud D Kaze, Ciaran J McMullan, Tamara Isakova, Sushrut S Waikar
BACKGROUND: Serum uric acid concentrations increase in chronic kidney disease (CKD) and may lead to tubular injury, endothelial dysfunction, oxidative stress, and intrarenal inflammation. Whether uric acid concentrations are associated with kidney failure and death in CKD is unknown. STUDY DESIGN: Prospective observational cohort study. SETTINGS & PARTICIPANTS: 3,885 individuals with CKD stages 2 to 4 enrolled in the Chronic Renal Insufficiency Cohort (CRIC) between June 2003 and September 2008 and followed up through March 2013...
November 10, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29132520/gastroesophageal-reflux-disease
#11
REVIEW
Rick Kellerman, Thomas Kintanar
Gastroesophageal reflux disease (GERD) is a gastrointestinal motility disorder that results from the reflux of stomach contents into the esophagus or oral cavity resulting in symptoms or complications. The typical symptoms of GERD are heartburn and regurgitation of gastric contents into the oropharynx. GERD affects quality of life and may cause erosive esophagitis, esophageal strictures, and Barrett esophagus, a precursor to esophageal adenocarcinoma. GERD is a clinical diagnosis and is most effectively treated with proton-pump inhibitors (PPIs)...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29131132/points-of-concern-in-post-acute-kidney-injury-management
#12
Jill Vanmassenhove, Raymond Vanholder, Norbert Lameire
The incidence of acute kidney injury (AKI) will in the future remain high, partly due to an increase in comorbidities and other AKI favoring factors such as the rise in high-risk diagnostic and therapeutic interventions. AKI has emerged as a major public health concern with high human and financial costs. It has recently been demonstrated that patients surviving an AKI episode show increased all-cause mortality, chronic kidney disease (CKD), ESRD, cardiovascular events, and reduced quality of life. Although it is important to acknowledge that, after an AKI episode, the risk of dying by far exceeds the risk of developing incident or progressive CKD and/or entering a maintenance renal replacement therapy (RRT) program, currently only a minority of patients are referred for renal follow-up, even after AKI-requiring RRT...
November 2, 2017: Nephron
https://www.readbyqxmd.com/read/29130954/effects-of-tolvaptan-addition-to-furosemide-in-normo-and-hyponatremia-patients-with-heart-failure-and-chronic-kidney-disease-stages-g3b-5-a-subanalysis-of-the-k-star-study
#13
Naoto Tominaga, Keisuke Kida, Takayuki Inomata, Naoki Sato, Tohru Izumi, Yoshihiro J Akashi, Yugo Shibagaki
BACKGROUND: Tolvaptan increases free water clearance (aquaresis) and thereby improves hyponatremia. Although hyponatremia on admission is common in patients with congestive heart failure (CHF), little is known regarding the response to tolvaptan in those who also have chronic kidney disease (CKD) with or without hyponatremia. The aim of this subanalysis was to investigate the differences in treatment response between normo- and hyponatremia patients with CHF and CKD stages G3b-5. METHODS: The Kanagawa Aquaresis Investigators Trial of Tolvaptan on HF Patients with Renal Impairment (K-STAR) was a multicenter, open-label, randomized, controlled prospective clinical trial that included 81 Japanese patients with CHF and residual signs of congestion despite oral furosemide treatment (≥40 mg/day)...
November 7, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29130670/-risk-factors-associated-with-the-outcomes-of-heart-valve-replacement
#14
Zhi Fang, Er-Yong Zhang
OBJECTIVE: To determine risk factors associated with the outcomes of heart valve replacement,especially in the patients with rheumatic heart disease (RHD). METHODS: Data were extracted from 2 696 patients who received valve replacement from August 2012 to January 2015. Spearman correlation analyses were performed to identify potential risk factors. Logistic regression models were established to determine risk factors associated with deaths and complications. RESULTS: Duration of cardiopulmonary bypass (CPB) [standard partial regression coefficient ( B')=0...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29130450/lower-risk-of-end-stage-renal-disease-in-diabetic-nurse
#15
Cheng-Chin Pan, Hsiu-Ling Huang, Ming-Chih Chen, Chuan-Yu Kung, Pei-Tseng Kung, Wen-Yu Chou, Wen-Chen Tsai
OBJECTIVES: As professional medical caregivers, nurses have extensive medical knowledge and information than general population. However, they may use their professional knowledge and networks to seek prompt health services. In this study, we aimed to determine susceptibility of nurses with diabetes to developing end-stage renal disease requiring dialysis compared to diabetes patients in the general population. METHODS: This retrospective longitudinal study extracted data of nurses with newly diagnosed diabetes and general patients with diabetes from the National Health Insurance Database between 1998 and 2006 and follow-up to December 2009, satisfied the participant inclusion criteria was 518,058...
December 2017: BioMedicine
https://www.readbyqxmd.com/read/29129486/a-nationwide-analysis-of-re-exploration-after-liver-transplant
#16
Zhobin Moghadamyeghaneh, Mahmoud Alameddine, Joshua S Jue, Giselle Guerra, Gennaro Selvaggi, Seigo Nishida, J Fan, Thiago Beduschi, Rodrigo Vianna
BACKGROUND: A retrospective review to investigate rate and outcomes of re-exploration following liver transplantation in the United States. METHODS: The NIS database was used to examine outcomes of patients who underwent re-exploration following liver transplantation from 2002 to 2012. Multivariate regression analysis was performed to compare outcomes of patients with and without reoperation. RESULTS: We sampled a total of 12,075 patients who underwent liver transplantation...
November 9, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29128115/chronic-use-of-proton-pump-inhibitors-adverse-events-and-potential-biological-mechanisms-a-translational-analysis
#17
Farid Kheloufi, Diane Frankel, Elise Kaspi, Marion Lepelley, Michel Mallaret, Quentin Boucherie, Patrice Roll, Joelle Micallef
Proton pump inhibitors (PPIs) are among the most frequently prescribed drugs. Even if PPI are usually considered as safe, there is a growing concern for a range of adverse effects of chronic PPI therapy often in the absence of appropriate indications. We propose, after a summary of renal, cardiovascular and neurological complications (dementia, chronic kidney disease, myocardial infarction and stroke), an integrative overview of the potential biological mechanisms involved. Eleven positive pharmacoepidemiological studies, mainly based on health insurance database linkage to hospital database, reported an increased risk of complications associated to PPI use and often a graded association suggesting also a possible dose-response relationship...
October 14, 2017: Thérapie
https://www.readbyqxmd.com/read/29123005/percutaneous-ablation-for-hepatocellular-carcinoma-and-peritoneal-dialysis
#18
Annabel Boyer, Marc-Antoine Jegonday, Antoine Lanot, Maxence Ficheux, Thierry Lobbedez, Clémence Bechade
Hepatocellular carcinoma (HCC) is the second leading cause of death by cancer worldwide. Resection and liver transplantation are the gold standards, but only a minority of people are eligible. Percutaneous ablation therapies, such as microwave ablation (MWA), have consequently been developed. There is a lack of guidelines regarding the treatment of HCCs in end-stage renal disease (ESRD) patients. Here, we report the case of a 67-year-old patient who was undergoing peritoneal dialysis (PD) for chronic congestive heart failure and who presented with an HCC while undergoing PD...
November 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/29115800/the-current-role-of-renal-biopsy-in-diabetic-patients
#19
Sheila Bermejo, Julio Pascual, María J Soler
Diabetes Mellitus (DM) is a worldwide health problem due to its high prevalence, incidence and impact on patient morbidity and mortality. Chronic kidney disease (CKD) is one of the most important complications of DM. The indication of renal biopsy in diabetic patients is a widely debated topic and the final decision is usually individualized. The results of renal biopsy in diabetic patients can be classified into three groups: diabetic nephropathy (DN), non-diabetic renal disease (NDRD) or DN plus NDRD (mixed forms)...
November 7, 2017: Minerva Medica
https://www.readbyqxmd.com/read/29110930/determinants-of-acute-kidney-injury-and-renal-function-decline-after-endovascular-abdominal-aortic-aneurysm-repair
#20
Randolph G Statius van Eps, Banne Nemeth, Ronne T A Mairuhu, Jan J Wever, Hugo T C Veger, Hans van Overhagen, Lukas C van Dijk, Bob Knippenberg
OBJECTIVE/BACKGROUND: Endovascular aneurysm repair (EVAR) may be associated with renal injury and more insight is needed into potential risk factors. The aim was to identify clinical, anatomical, and peri-procedural parameters as potential risk factors for the occurrence of acute kidney injury (AKI) and to evaluate chronic kidney disease (CKD) after EVAR. METHODS: A cohort of 212 consecutive patients who underwent elective EVAR for abdominal aortic aneurysm from January 2009 to October 2016 was included...
October 27, 2017: European Journal of Vascular and Endovascular Surgery
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