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acute renal failure management

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https://www.readbyqxmd.com/read/29792359/adverse-effect-analysis-of-high-intensity-focused-ultrasound-in-the-treatment-of-benign-uterine-diseases
#1
Yunchang Liu, Wendy Wenyi Zhang, Min He, Chunmei Gong, Bin Xie, Xiangxia Wen, Dandan Li, Lian Zhang
OBJECTIVE: To retrospectively analyze the adverse effects of high-intensity focused ultrasound (HIFU) in management of benign uterine diseases. MATERIALS AND METHODS: From 2011 to 2017, 27,053 patients with benign uterine diseases were treated with HIFU in 19 centers in China. Among them, 17,402 patients had uterine fibroids, 8434 had adenomyosis, 876 had caesarean scar pregnancies, and 341 had placenta accreta. RESULTS: The median age, height, weight, BMI of the patients was 42 years, 158 mm, 56 kg, 22...
May 24, 2018: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/29787959/high-voltage-electrical-injury-complicated-by-compartment-syndrome-and-acute-kidney-injury-with-successful-limb-salvage-a-case-report-and-review-of-the-literature
#2
Christopher Wei Guang Ho, Shi-Hui Yang, Chu Hui Wong, Si Jack Chong
INTRODUCTION: Although an uncommon form of admission to a burns centre, the deep, penetrating nature of noxious currents mean that electrical burns have the most catastrophic consequences of all burn injuries. Understanding the physics of electricity is crucial to explaining the mechanisms of tissue damage and organ failure in electrical injuries which necessitate special management above and beyond that of regular thermal burns. PRESENTATION OF CASE: We present a young man who suffered significant occupation-related electrical burns that was complicated by compartment syndrome, rhabdomyolysis and acute kidney injury...
May 16, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29777841/acute-ischemic-pancreatitis-secondary-to-aortic-dissection
#3
Rong Wang, Jun-Ming Zhu, Rui-Dong Qi, Yong-Min Liu, Jun Zheng, Nan Zhang, Li-Zhong Sun
OBJECTIVE: Acute ischemic pancreatitis secondary to aortic dissection is very rare with an unclarified mechanism. We retrospectively reviewed six such cases in our center and present their outcomes herein. MATERIAL AND METHODS: Between February 2009 and April 2017, six patients (male=2, female=4; mean age, 58 ± 8, range 47-70) years) with acute aortic dissection associated with pancreatitis were admitted to our center. There were three type A and three type B dissections...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#4
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29777269/pediatric-appendicitis-severity-in-kwazulu-natal-south-africa-a-retrospective-cohort-analysis
#5
Matthew C Hernandez, Victor Y Kong, John L Bruce, Johnathon M Aho, Grant L Laing, Martin D Zielinski, Damian L Clarke
BACKGROUND: Acute appendicitis is a common pediatric surgical emergency; however, there are few grading systems to assign disease severity. The American Association for the Surgery of Trauma (AAST) recently developed a grading system for a variety of emergency surgical conditions, including appendicitis. The severity of acute appendicitis in younger patients in KwaZulu-Natal (South Africa) is unknown. We aimed to describe the disease severity in this patient population using the AAST grading system hypothesizing that the AAST grade would correlate with morbidity, management type, and duration of stay...
May 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29771702/pathogenesis-of-cerebral-edema-in-patients-with-acute-renal-and-liver-failure-and-the-role-of-the-nephrologist-in-the-management
#6
Tamim Hamdi
PURPOSE OF REVIEW: Acute liver failure (ALF) is a severe and complex illness and one of the most daunting conditions managed in the ICU. Because the renal care is intertwined with multiple disciplines, the aim of this review is to examine the multifactorial pathogenesis of cerebral edema in ALF, covering basic established facts as well as recent advances in our understanding of this condition. RECENT FINDINGS: Acetaminophen remains the most common cause of ALF in the United States and many European countries...
May 15, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29768958/bevacizumab-induced-atypical-hemolytic-uremic-syndrome-and-treatment-with-eculizumab
#7
Anusha Vakiti, Daulath Singh, Ravi Pilla, Muhamad A Moustafa, Kelly W Fitzpatrick
Bevacizumab (Avastin) is a recombinant humanized monoclonal antibody used for the management of various solid malignancies including colorectal, lung, brain, renal, and ovarian cancers as well as age-related macular degeneration of the eye. It is a vascular endothelial growth factor inhibitor which exhibits its action by blocking the growth of blood vessels in cancerous tissue. Common side effects include hypertension, fatigue, headaches, and increased risk of infections. Atypical hemolytic uremic syndrome is a serious side effect associated with bevacizumab due to its anti-angiogenic effect...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29765590/a-case-of-rhabdomyolysis-after-kidney-transplantation-successfully-managed-with-intensive-continuous-dialysis
#8
Rauf Shahbazov, Michael Fox, Jennifer L Alejo, Malik A Anjum, Feredun Azari, Alden Doyle, Avinash Agarwal, Kenneth L Brayman
Rhabdomyolysis is characterized by muscle cell death which can result in acute kidney injury from pigment nephropathy. We present a patient who developed rhabdomyolysis immediately after deceased donor kidney transplantation surgery and was managed with continuous renal replacement therapy that resulted in successful salvage of the kidney allograft. Patients who develop acute kidney failure requiring renal replacement therapy generally have a poor prognosis. It is worth noting that while continuous veno-venous hemofiltration (CVVHF) offers greater volume support and continuous clearance compared to hemodialysis (HD), recent studies have demonstrated no clinically significant improvement in clinical outcome between the two...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29765485/spontaneous-hemoperitoneum-resulting-from-segmental-arterial-mediolysis
#9
Emily Olivares, Harlan Vingan, Qiao Zhou
Segmental arterial mediolysis is a rare but potentially life-threatening arteropathy of medium to large arteries that can be managed with endovascular treatment for patients who are hemodynamically unstable. We present a case of segmental arterial mediolysis in a 73-year-old woman who developed spontaneous hemoperitoneum in the emergency department after initially presenting with unrelated upper respiratory complaints. Her initial computed tomography revealed an aneurysm arising off the right hepatic artery...
June 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29760854/peritoneal-dialysis-in-austere-environments-an-emergent-approach-to-renal-failure-management
#10
REVIEW
Chad Gorbatkin, John Bass, Fredric O Finkelstein, Steven M Gorbatkin
Peritoneal dialysis (PD) is a means of renal replacement therapy (RRT) that can be performed in remote settings with limited resources, including regions that lack electrical power. PD is a mainstay of end-stage renal disease (ESRD) therapy worldwide, and the ease of initiation and maintenance has enabled it to flourish in both resource-limited and resource-abundant settings. In natural disaster scenarios, military conflicts, and other austere areas, PD may be the only available life-saving measure for acute kidney injury (AKI) or ESRD...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29743722/management-of-patients-with-acute-promyelocytic-leukemia
#11
REVIEW
Sabine Kayser, Richard F Schlenk, Uwe Platzbecker
With the introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) acute promyelocytic leukemia (APL) has become from a detrimental to one of the most curable malignant diseases in humans. In particular, the chemotherapy-free regimen with ATO/ATRA has been proven to be highly effective in de novo APL and has become standard first-line therapy in younger adult, non-high-risk patients. Nevertheless, early death is still a major issue in APL, particularly in older patients, emphasizing the need of rapid diagnostics and supportive care together with immediate access to ATRA-based therapy...
April 24, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/29733100/does-nalbuphine-have-a-niche-in-managing-pain
#12
Mellar P Davis, Carlos Fernandez, Sally Regel, Mary Lynn McPherson
Nalbuphine has been commercially available for 40 years for the treatment of acute pain; few studies have centered on management of chronic pain. Nalbuphine unique pharmacology is an advantage in pain management. It is µ antagonist, partial κ agonist for G-proteins and beta-arrestin-2. Benefits are related to G-protein interactions resulting in less nausea, pruritus, and respiratory depression than morphine. At low doses, nalbuphine reduces side effects particularly respiratory depression without loss of analgesia when combined with potent opioids...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29731241/validation-of-renal-risk-score-models-for-coronary-artery-bypass-surgery-in-diabetic-patients
#13
Mehmet Kalender, Taylan Adademir, Deniz Çevirme, Mehmet Atay, Kamil Boyacioglu, Mehmet Tasar, Fuat Buyukbayrak
BACKGROUND: Coronary artery bypass grafting is applicable with very low mortality and morbidity rates around the world. However, exposure to even one of the risk factors increases mortality and morbidity significantly. There are three acute kidney injury definitions, and classification methods are applicable (Kidney Disease: Improving Global Outcomes (KDIGO); Risk, Injury, and Failure; and Loss; and End-stage kidney disease (RIFLE); and Acute Kidney Injury Network (AKIN)), for understanding and grading of renal impairment...
April 18, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29725932/light-chain-cast-nephropathy-practical-considerations-in-the-management-of-myeloma-kidney-what-we-know-and-what-the-future-may-hold
#14
REVIEW
Sandhya Manohar, Samih H Nasr, Nelson Leung
PURPOSE OF REVIEW: To update and evaluate the current knowledge on pathogenesis and management of light chain cast nephropathy. Light chain cast nephropathy (LCCN) is the leading cause of acute renal failure in patients with multiple myeloma and is currently recognized as a myeloma defining event. RECENT FINDINGS: The immunoglobulin free light chain plays an integral role in the pathogenesis of LCCN. The level of free light chain (FLC) in the blood and urine is directly associated with the risk of developing LCCN...
May 3, 2018: Current Hematologic Malignancy Reports
https://www.readbyqxmd.com/read/29725741/-metabolic-management-and-nutrition-in-critically-ill-patients-with-renal-dysfunction-recommendations-from-the-renal-section-of-the-dgiin-%C3%A3-giain-and-divi
#15
W Druml, M Joannidis, S John, A Jörres, M Schmitz, J Kielstein, D Kindgen-Milles, M Oppert, V Schwenger, C Willam, A Zarbock
BACKGROUND: Intensive care patients with renal failure or insufficiency comprise a heterogeneous group of subjects with widely differing metabolic patterns and nutritional requirements. They include subjects with various stages of acute kidney injury (AKI), acute-on-chronic renal failure (A-CKD), without/with renal replacement therapy (RRT), chronic kidney disease (CKD), and subjects on regular hemodialysis or peritoneal dialysis therapy (HD/PD). GOALS: Development of recommendations by the renal section of DGIIN (Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichische Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin) for the metabolic management and the planning, indication, implementation, and monitoring of nutrition therapy in this heterogeneous group of patients...
May 3, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29725637/cystatin-c-predicts-renal-recovery-earlier-than-creatinine-among-patients-with-acute-kidney-injury
#16
Kamel A Gharaibeh, Abdurrahman M Hamadah, Ziad M El-Zoghby, John C Lieske, Timothy S Larson, Nelson Leung
Introduction: Serum cystatin C increases earlier than creatinine during acute kidney injury. However, whether cystatin C decreases earlier during recovery is unknown. This retrospective study aimed to determine the temporal trend between creatinine and cystatin C in acute kidney injury. Methods: We identified hospitalized patients with nonoliguric acute kidney injury who had serial creatinine and cystatin C values measured between May 2015 and May 2016. Demographic and laboratory data, causes of acute kidney injury, and relevant comorbidity data were collected through chart review...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29712518/unruptured-aneurysms-in-the-elderly-perioperative-outcomes-and-cost-analysis-of-endovascular-coiling-and-surgical-clipping
#17
Nicole A Silva, Belinda Shao, Michael J Sylvester, Jean Anderson Eloy, Chirag D Gandhi
OBJECTIVE Observation and neurosurgical intervention for unruptured intracranial aneurysms (UIAs) in the elderly population is rapidly increasing. Cerebral aneurysm coiling (CACo) is favored over cerebral aneurysm clipping (CAC) in elderly patients, yet some elderly individuals still undergo CAC. The cost-effectiveness of treating UIAs requires further exploration. Understanding the effect of intervention on hospital charges and length of stay (LOS) as well as perioperative mortality and complications can further shed light on its economic impact...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29709681/class-iii-obesity-is-a-risk-factor-for-the-development-of-acute-on-chronic-liver-failure-in-patients-with-decompensated-cirrhosis
#18
Vinay Sundaram, Rajiv Jalan, Joseph C Ahn, Michael R Charlton, David S Goldberg, Constantine J Karvellas, Mazen Noureddin, Robert Wong
BACKGROUND AND AIMS: Acute on chronic liver failure (ACLF) is a syndrome of systemic inflammation and organ failures. Obesity, also characterized by chronic inflammation, is a risk factor among patients with cirrhosis for decompensation, infection, and mortality. Our aim was to test the hypothesis that obesity predisposes to ACLF development in patients with decompensated cirrhosis. METHODS: We examined the United Network for Organ Sharing (UNOS) database, from 2005-2016, characterizing patients at wait-listing as non-obese (BMI < 30), obese class I-II (BMI 30-39...
April 27, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29703972/critically-ill-allogenic-hsct-patients-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis-of-prognostic-factors-of-mortality
#19
Colombe Saillard, Michael Darmon, Magali Bisbal, Antoine Sannini, Laurent Chow-Chine, Marion Faucher, Etienne Lengline, Norbert Vey, Didier Blaise, Elie Azoulay, Djamel Mokart
Outcome of patients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT) has improved. To investigate if this improvement can be transposed to the ICU setting, we conducted a systematic review and meta-analysis to assess short-term mortality of critically ill allo-HSCT patients admitted to the ICU and to identify prognostic factors of mortality. Public-domain electronic databases, including Medline via PubMed and the Cochrane Library were searched. All full-text articles written-English studies published from 2006 to 2016, including allo-HSCT adults transferred to the ICU were included...
April 27, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29686909/spontaneous-bacterial-peritonitis-due-to-lactobacillus-paracasei-in-cirrhosis
#20
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
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