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https://www.readbyqxmd.com/read/28319954/comparison-of-initial-vasopressors-used-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#1
Bhaskar Roy, Louise D McCullough, Rajat Dhar, James Grady, Yu-Bo Wang, Robert J Brown
BACKGROUND: The main reason for morbidity after aneurysmal subarachnoid hemorrhage (aSAH) is delayed cerebral ischemia (DCI). The mainstay of medical therapy for treating DCI is induced hypertension with vasopressors to restore cerebral perfusion. Both phenylephrine (PE) and norepinephrine (NE) are commonly used for induced hypertension, but the impact of the initial choice of vasopressor on the efficacy, adverse effects, or outcome after hemodynamic therapy for DCI is unknown. METHODS: Sixty-three patients with aSAH between January 2012 and October 2014, who developed DCI (defined as new focal deficit or decline in Glasgow Coma Score) and in which PE (n = 45) or NE (n = 18) treatment was initiated were evaluated in this retrospective study...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319322/an-analysis-of-the-survival-outcomes-of-simultaneous-pancreas-and-kidney-transplantation-compared-to-live-donor-kidney-transplantation-in-patients-with-type-1-diabetes-a-uk-transplant-registry-study
#2
Adam D Barlow, Kourosh Saeb-Parsy, Christopher J E Watson
BACKGROUND: Transplant options for patients with type 1 diabetes and end-stage renal disease (ESRD) include deceased donor kidney, live donor kidney (LDK) and simultaneous pancreas-kidney (SPK) transplantation. The aim of this study was to compare outcomes between LDK and SPK for patients with type 1 diabetes and ESRD in the UK. METHODS: Data on all SPK (n=1739) and LDK (n=385) transplants performed between January 2001 and December 2014 were obtained from the UK Transplant Registry...
March 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28318752/cystathionine-gamma-lyase-deficient-mice-are-protected-against-the-development-of-multiorgan-failure-and-exhibit-reduced-inflammatory-response-during-burn
#3
Akbar Ahmad, Nadiya Druzhyna, Csaba Szabo
Considering the role of H2S in critical illness, the aim of this study was to compare the outcome of burn in wild-type mice and in mice deficient in CSE, one of the principal mammalian H2S-generating enzymes. Animals were subjected to scald burn. Outcome variables included indices of organ injury, clinical chemistry parameters and plasma levels of inflammatory mediators. Plasma levels of H2S significantly increased in response to burn in wild-type mice, but remained unchanged in CSE(-/-) mice. Expression of the three H2S-producing enzymes (CSE, CBS and 3-MST) in the lung and liver, and the capacity of tissue homogenates to produce H2S, however, was not affected by burn...
March 15, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28318702/antibiotic-associated-diarrhea-clinical-characteristics-and-the-presence-of-clostridium-difficile
#4
A Rodríguez-Varón, O M Muñoz, J Pulido-Arenas, S B Amado, M Tobón-Trujillo
INTRODUCTION AND AIMS: Evidence in Colombia and Latin America has been insufficient for establishing the clinical characteristics of patients with antibiotic-associated diarrhea (AAD). The present study attempts to describe the clinical characteristics of patients with AAD and to determine the presence of Clostridium difficile, utilizing the polymerase chain reaction (PCR) technique. MATERIALS AND METHODS: Forty-three patients with AAD, managed at the Hospital Universitario San Ignacio in Bogota, Colombia, were evaluated...
March 15, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28318656/clinical-characteristics-and-prognosis-of-patients-admitted-for-heart-failure-a-5-year-retrospective-study-of-african-patients
#5
Kwadwo Osei Bonsu, Isaac Kofi Owusu, Kwame Ohene Buabeng, Daniel D Reidpath, Amudha Kadirvelu
BACKGROUND: Mortality associated with heart failure (HF) remains high. There are limited clinical data on mortality among HF patients from African populations. We examined the clinical characteristics, long-term outcomes, and prognostic factors of African HF patients with preserved, mid-range or reduced left ventricular ejection fraction (LVEF). METHODS AND RESULTS: We conducted a retrospective longitudinal cohort study of individuals aged ≥18years discharged from first HF admission between January 1, 2009 and December 31, 2013 from the Cardiac Clinic, Directorate of Medicine of the Komfo Anokye Teaching Hospital, Ghana...
March 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28318633/capillary-leak-syndrome-etiologies-pathophysiology-and-management
#6
REVIEW
Eric Siddall, Minesh Khatri, Jai Radhakrishnan
In various human diseases, an increase in capillary permeability to proteins leads to the loss of protein-rich fluid from the intravascular to the interstitial space. Although sepsis is the disease most commonly associated with this phenomenon, many other diseases can lead to a "sepsis-like" syndrome with manifestations of diffuse pitting edema, exudative serous cavity effusions, noncardiogenic pulmonary edema, hypotension, and, in some cases, hypovolemic shock with multiple-organ failure. The term capillary leak syndrome has been used to describe this constellation of disease manifestations associated with an increased capillary permeability to proteins...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28318176/fluid-overload-and-kidney-failure-in-children-with-severe-sepsis-and-septic-shock-a-cohort-study
#7
Omar E Naveda Romero, Andrea F Naveda Meléndez
INTRODUCTION: In children with sepsis, fluid overload as a result of an aggressive fluid replacement or excessive fluid administration may result in kidney impairment and increased mortality. Objective. To determine the association between fluid overload and the rate of kidney failure in a group of children with severe sepsis and septic shock. POPULATION AND METHODS: This was a prospective cohort study conducted in the intensive care unit of Hospital Universitario de Pediatría “Dr...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28314825/increased-plasma-exposures-of-conjugated-metabolites-of-morinidazole-in-renal-failure-patients-a-critical-role-of-uremic-toxins
#8
Fandi Kong, Xiaoyan Pang, Kan Zhong, Zitao Guo, Xiuli Li, Dafang Zhong, Xiaoyan Chen
Morinidazole is a 5-nitroimidazole drug. Its sulfate conjugate M7 was a sensitive substrate of organic anion transporter 1 (OAT1) and OAT3, whereas N+-glucuronides M8-1 and M8-2 were only OAT3 substrates. In chronic renal failure (CRF) patients, plasma exposures of the three conjugates increased by 15-fold, which were also found in 5/6 nephrectomized (5/6 Nx) rats in this study. Although the transcriptions of Oat1 and Oat3 in 5/6 Nx rat kidneys decreased by 50%, no difference was observed on the three conjugate uptakes between control and 5/6 Nx rat kidney slices...
March 17, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28314806/the-use-of-a-multidimensional-measure-of-dialysis-adequacy-moving-beyond-small-solute-kinetics
#9
REVIEW
Jeffrey Perl, Laura M Dember, Joanne M Bargman, Teri Browne, David M Charytan, Jennifer E Flythe, LaTonya J Hickson, Adriana M Hung, Michel Jadoul, Timmy Chang Lee, Klemens B Meyer, Hamid Moradi, Tariq Shafi, Isaac Teitelbaum, Leslie P Wong, Christopher T Chan
Urea removal has become a key measure of the intensity of dialysis treatment for kidney failure. Small solute removal, exemplified by Kt/Vurea, has been broadly applied as a means to quantify the dose of thrice weekly hemodialysis. Yet, the reliance on small solute clearances alone as a measure of dialysis adequacy fails fully to quantify the intended clinical effects of dialysis therapy. This review aims to (1) understand the strengths and limitations of small solute kinetics as a surrogate marker of dialysis dose, and (2) present the prospect of a more comprehensive construct for dialysis dose, one that considers more broadly the goals of ESRD care to maximize both quality of life and survival...
March 17, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28314486/insulin-provision-therapy-and-mortality-in-older-adults-with-diabetes-mellitus-and-stable-ischemic-heart-disease-insights-from-bari-2d-trial
#10
Abdulla A Damluji, Erin R Cohen, Mauro Moscucci, Robert J Myerburg, Mauricio G Cohen, Maria M Brooks, Michael W Rich, Daniel E Forman
IMPORTANCE: Optimal strategies for glucose control in very old adults with diabetes and stable ischemic heart disease (SIHD) are unclear. OBJECTIVE: To compare the effects of insulin provision (IP) therapy versus insulin sensitizing (IS) therapy for glycemic control in older (≥75years) and younger (<75years) adults with type II diabetes (DM) and SIHD. DESIGN, SETTING, AND PARTICIPANTS: Adults enrolled in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) were studied...
March 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28314442/-adult-congenital-heart-disease-medical-and-psychosocial-issues
#11
Magalie Ladouceur, Florence Pontnau, Laurence Iserin
The population of adults with congenital heart disease (ACHD) is continuously increasing with now a higher prevalence than that of the pediatric population. This concerns above all complex congenital heart diseases. Heart failure is the primary cause of death followed by arrhythmia, which is very common in ACHD. A specialized follow-up by dedicated centers is significantly associated with an improvement of survival of ACHD patients compared to non-expert follow-up. Extracardiac disorders (liver, kidney, respiratory) are frequent and require an accurate and specific management...
March 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28306749/cigarette-smoking-and-cardio-renal-events-in-patients-with-atherosclerotic-renal-artery-stenosis
#12
Christopher A Drummond, Pamela S Brewster, Wencan He, Kaili Ren, Yanmei Xie, Katherine R Tuttle, Steven T Haller, Kenneth Jamerson, Lance D Dworkin, Donald E Cutlip, Timothy P Murphy, Ralph B D'Agostino, William L Henrich, Jiang Tian, Joseph I Shapiro, Christopher J Cooper
Cigarette smoking causes cardiovascular disease and is associated with poor kidney function in individuals with diabetes mellitus and primary kidney diseases. However, the association of smoking on patients with atherosclerotic renal artery stenosis has not been studied. The current study utilized data from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL, NCT00081731) clinical trial to evaluate the effects of smoking on the risk of cardio-renal events and kidney function in this population...
2017: PloS One
https://www.readbyqxmd.com/read/28306518/biochemical-testing-in-a-laboratory-tent-and-semi-intensive-care-of-ebola-patients-on-site-in-a-remote-part-of-guinea-a-paradigm-shift-based-on-a-bleach-sensitive-point-of-care-device
#13
Leonid M Irenge, Jean-Michel Dindart, Jean-Luc Gala
BACKGROUND: During the West Africa Ebola virus disease (EVD) outbreak, a Belgian laboratory was deployed for supporting the Ebola treatment unit (ETU) of N'Zerekore, Guinea. Besides diagnosis of EVD and malaria, biochemical parameters were tested and used to guide supportive treatment of EVD. METHODS: To preserve analytes stability, lithium-heparin blood samples were analyzed using the i-STAT® point-of-care testing (POCT) handheld device without the viral inactivation step...
March 15, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28303771/epidemiology-and-outcome-of-acute-kidney-injury-in-children-a-single-center-study
#14
Werner Keenswijk, Jill Vanmassenhove, Ann Raes, Evelyn Dhont, Johan VandeWalle
BACKGROUND: Information on the epidemiology of Acute Kidney Injury (AKI) in children is scarce. We performed a single center retrospective cohort study to analyze the incidence of AKI, the male/female ratio, the underlying etiology, and age at presentation. We also aimed to assess outcome measured by mortality, duration of PICU stay, and development of Chronic Kidney Disease (CKD). METHODS: Records were searched for children presenting with or developing AKI between 1st January 2008 and 1st January 2015...
March 17, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28303647/ratio-of-systolic-blood-pressure-to-left-ventricular-end-diastolic-pressure-at-the-time-of-primary-percutaneous-coronary-intervention-predicts-in-hospital-mortality-in-patients-with-st-elevation-myocardial-infarction
#15
Michael Sola, Kiran Venkatesh, Melissa Caughey, Robert Rayson, Xuming Dai, George A Stouffer, Michael Yeung
OBJECTIVE: To determine the ability of simple hemodynamic parameters obtained at the time of cardiac catheterization to predict in-hospital mortality following ST-elevation myocardial infarction (STEMI). BACKGROUND: Hemodynamic parameters measured at the time of primary percutaneous coronary intervention (PPCI) could potentially identify high-risk patients who would benefit from aggressive hemodynamic support in the Cardiac Catheterization laboratory. METHODS: This is a retrospective single-center study of 219 consecutive patients with STEMI...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28303335/treatment-selection-for-urolithiasis-percutaneous-nephrolithomy-ureteroscopy-shock-wave-lithotripsy-and-active-monitoring
#16
Mahesh Desai, Yinghao Sun, Noor Buchholz, Andrew Fuller, Tadashi Matsuda, Brian Matlaga, Nicole Miller, Damien Bolton, Mohammad Alomar, Arvind Ganpule
Urolithiasis is a significant worldwide source of morbidity, constituting a common urological disease that affects between 10 and 15% of the world population. Recent technological and surgical advances have replaced the need for open surgery with less invasive procedures. The factors which determine the indications for percutaneous nephrolithotomy include stone factors (stone size, stone composition, and stone location), patient factors (habitus and renal anomalies), and failure of other treatment modalities (ESWL and flexible ureteroscopy)...
March 16, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28303073/acute-kidney-injury-definition-pathophysiology-and-clinical-phenotypes
#17
REVIEW
Konstantinos Makris, Loukia Spanou
Acute kidney injury (AKI) is a clinical syndrome that complicates the course and worsens the outcome in a significant number of hospitalised patients. Recent advances in clinical and basic research will help with a more accurate definition of this syndrome and in the elucidation of its pathogenesis. With this knowledge we will be able to conduct more accurate epidemiologic studies in an effort to gain a better understanding of the impact of this syndrome. AKI is a syndrome that rarely has a sole and distinct pathophysiology...
May 2016: Clinical Biochemist. Reviews
https://www.readbyqxmd.com/read/28302554/structure-based-analysis-of-single-nucleotide-variants-in-the-renin-angiotensinogen-complex
#18
REVIEW
David K Brown, Olivier Sheik Amamuddy, Özlem Tastan Bishop
The renin-angiotensin system (RAS) plays an important role in regulating blood pressure and controlling sodium levels in the blood. Hyperactivity of this system has been linked to numerous conditions including hypertension, kidney disease, and congestive heart failure. As such, various classes of drugs have been developed to inhibit this system. These drugs are aimed at preventing angiotensin II from performing its function by inhibiting angiotensin II receptors or inhibiting angiotensin-converting enzyme from converting angiotensin I to angiotensin II...
March 13, 2017: Global Heart
https://www.readbyqxmd.com/read/28302065/lamivudine-dolutegravir-dual-therapy-in-hiv-infected-virologically-suppressed-patients
#19
Franco Maggiolo, Roberto Gulminetti, Layla Pagnucco, Margherita Digaetano, Simone Benatti, Daniela Valenti, Annapaola Callegaro, Diego Ripamonti, Cristina Mussini
BACKGROUND: Little is known about the applicability of dual treatments based on integrase inhibitors. We explored the combination of lamivudine + dolutegravir as an option when switching from standard cART in virologically suppressed patients. METHODS: In this prospective cohort we enrolled patients previously switched to 3TC + DTG who were 18 years or older, with no previous resistance mutations to the used drugs, having a HIV-RNA <50 copies/ml for 6 months or longer, negative for HBsAg and on a stable (>6 months) cART...
March 16, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28301835/fistula-and-survival-outcomes-after-fistula-creation-among-predialysis-chronic-kidney-disease-stage-5-patients
#20
Masahito Miyamoto, Noriaki Kurita, Kotaro Suemitsu, Masaaki Murakami
BACKGROUND: Most guidelines recommend the creation of arteriovenous fistula (AVF) in patients with chronic kidney disease (CKD) stage 4. However, an increasing number of studies suggest that early AVF creation leads to high rates of AVF failure and death before dialysis commencement. Only the Japanese guideline recommends AVF creation at CKD stage 5; however, no data are available regarding access-related outcomes at this stage. METHOD: This was a multicenter cohort study involving Japanese CKD stage 5 patients who underwent preemptive AVF creation from 2009 to 2013...
March 17, 2017: American Journal of Nephrology
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