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https://www.readbyqxmd.com/read/29457046/acute-on-chronic-liver-failure-a-portuguese-single-center-reference-review
#1
Miguel Verdelho, Rui Perdigoto, João Machado, Élia Mateus, Paulo Marcelino, Rui Pereira, Philip Fortuna, Luís Bagulho, Luís Bento, Francisco Ribeiro, Fernando Nolasco, Américo Martins, Eduardo Barroso
Acute-on-chronic liver failure (ACLF) is a syndrome characterized by an acute deterioration of a patient with cirrhosis, frequently associated with multi-organ failure and a high short-term mortality rate. We present a retrospective study that aims to characterize the presentation, evolution, and outcome of patients diagnosed with ACLF at our center over the last 3 years, with a comparative analysis between the group of patients that had ACLF precipitated by infectious insults of bacterial origin and the group of those with ACLF triggered by a nonbacterial infectious insult; the incidence of acute kidney injury and its impact on the prognosis of ACLF was also analyzed...
January 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29456216/the-cardiovascular-risk-factor-profiles-among-end-stage-renal-failure-patients-treated-with-continuous-ambulatory-peritoneal-dialysis-and-intermittent-hemodialysis
#2
S A K Sharifah Zamiah, Che Rosle Draman, Mohd Ramli Seman, A Fariz Safhan, R Rozalina, N I Nik Ruzni
Cardiovascular (CV) event is the most common cause of death in dialysis patients. Both traditional and nontraditional CV risk factors related to malnutrition, inflammation, and anemia are commonly found in this population. This study was conducted to evaluate the burden factors of CV risk factors and its management in our regularly dialyzed patients. It was a single-center, cross-sectional analysis of prevalent intermittent hemodialysis (IHD) and continuous ambulatory peritoneal dialysis (CAPD) patients followed up in our hospital...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29455784/complications-after-elective-percutaneous-coronary-interventions-a-comparison-between-public-and-private-hospitals
#3
Roberto Muniz Ferreira, Nelson Albuquerque de Souza E Silva, Lúcia Helena Alvares Salis
OBJECTIVE: Complications after percutaneous coronary interventions (PCI) are associated with significant morbidity and mortality, although institutional discrepancies can occur when public and private hospitals coexist within the healthcare system. The aim of this study was to compare the in-hospital complication rates and mortality in addition to long-term survival following elective PCI in two reference public and private cardiology hospitals in Rio de Janeiro, Brazil. METHODS: From January 1st 2013 to December 31st 2014, a total of 440 procedures were identified in both hospitals (public: 328 vs...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29454380/quality-of-life-satisfaction-and-outcomes-after-ministernotomy-versus-full-sternotomy-isolated-aortic-valve-replacement-quality-avr-study-protocol-for-a-randomised-controlled-trial
#4
Emiliano A Rodríguez-Caulo, Ana Guijarro-Contreras, Juan Otero-Forero, María José Mataró, Gemma Sánchez-Espín, Arantza Guzón, Carlos Porras, Miguel Such, Antonio Ordóñez, José María Melero-Tejedor, Manuel Jiménez-Navarro
BACKGROUND: During the last decade, the use of ministernotomy in cardiac surgery has increased. Quality of life and patient satisfaction after ministernotomy have never been compared to conventional full sternotomy in randomised trials. The aim of the study is to determine if this minimally invasive approach improves quality of life, satisfaction and clinical morbimortality outcomes. METHODS/DESIGN: The QUALITY-AVR trial is a single-blind, single-centre, independent, and pragmatic randomised clinical trial comparing ministernotomy ("J" shaped upper hemisternotomy toward right 4th intercostal space) to full sternotomy in patients with isolated severe aortic stenosis scheduled for elective aortic valve replacement...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29454306/record-4-multicenter-phase-2-trial-of-second-line-everolimus-in-patients-with-metastatic-renal-cell-carcinoma-asian-versus-non-asian-population-subanalysis
#5
Lin Yang, Anna Alyasova, Dingwei Ye, Antonia Ridolfi, Luca Dezzani, Robert J Motzer
BACKGROUND: RECORD-4 assessed everolimus in patients with metastatic renal cell carcinoma (mRCC) who progressed after 1 prior anti-vascular endothelial growth factor (VEGF) or cytokine and reinforced the clinical benefit of second-line everolimus. Because of the high percentage of patients from China enrolled in RECORD-4 (41%) and some reported differences in responses to certain targeted agents between Chinese and Western patients, this subanalysis evaluated outcomes in Asian versus non-Asian patients...
February 17, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29453374/cardiovascular-and-renal-protective-role-of-angiotensin-blockade-in-hypertension-with-advanced-ckd-a-subgroup-analysis-of-attempt-cvd-randomized-trial
#6
Shokei Kim-Mitsuyama, Hirofumi Soejima, Osamu Yasuda, Koichi Node, Hideaki Jinnouchi, Eiichiro Yamamoto, Taiji Sekigami, Hisao Ogawa, Kunihiko Matsui
The ATTEMPT-CVD study was prospective randomized active-controlled trial and the main findings had been reported. According to baseline GFR and albuminuria categories, we divided the patients of the ATTEMPT-CVD study into 2 subgroups: (Group 1) the patients with at least one of eGFR of <45 ml/min per 1.73 m 2 and UACR of ≥300 mg/g creatinine, defined as G3b and/or A3; (Group 2) the patients except for Group 1, defined as the other patients. In patients with G3b and/or A3, the incidence of cardiovascular events was significantly less in ARB group than in non-ARB group (11 vs 22, respectively) (HR = 0...
February 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29451350/an-economic-assessment-of-contemporary-kidney-transplant-practice
#7
David Axelrod, Mark A Schnitzler, Huiling Xiao, William Irish, Elizabeth Tuttle-Newhall, Su-Hsin Chang, Bertram L Kasiske, Tarek Alhamad, Krista L Lentine
Kidney transplant is the optimal therapy for end stage renal disease, prolonging survival and reducing healthcare spending. Prior economic analyses of kidney transplant using Markov models, have generally assumed compatible, low risk, donors. The economic implications of using deceased donor kidneys with high kidney donor profile index (KPDI) scores, ABO incompatible or HLA incompatible living donors has not been assessed. The costs of transplant and dialysis were compared using discrete event simulation over a 10-year period, using data from the United States Renal Data System, Vizient ™ (Irving, Texas), and literature review...
February 16, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29451181/the-use-of-nonselective-beta-blockers-is-a-risk-factor-for-portal-vein-thrombosis-in-cirrhotic-patients
#8
Rosa Zampino, Rita Lebano, Nicola Coppola, Margherita Macera, Anna Grandone, Luca Rinaldi, Ilario De Sio, Antonella Tufano, Gianfranca Stornaiuolo, Luigi E Adinolfi, Emanuele Durante-Mangoni, Gaeta G Battista, Alferio Niglio
Background/Aim: A reduction in portal vein inflow velocity seems to predispose to the emergence of portal vein thrombosis (PVT). Nonselective β-blockers (NSBBs), used to prevent variceal bleeding, may increase the development of PVT by reducing portal vein inflow velocity. In this retrospective case-control study, we evaluated the risk factors and clinical features of a first event of PVT in 130 cirrhotics, 19 (15%) with (PVT group) and 111 (85%) without PVT (non-PVT group). Patients and Methods: Patient evaluation and NNBB treatment were carried out according to the AASLD guidelines...
January 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29450636/comparing-the-efficacy-of-low-dose-vs-high-dose-cyclophosphamide-regimen-as-induction-therapy-in-the-treatment-of-proliferative-lupus-nephritis-a-single-center-study
#9
Sonal Mehra, Jignesh B Usdadiya, Vikramraj K Jain, Durga Prasanna Misra, Vir Singh Negi
Cyclophosphamide (CYC) has been the backbone immunosuppressive drug to achieve sustained remission in lupus nephritis (LN). The aim was to evaluate the efficacy and compare adverse effects of low and high dose intravenous CYC therapy in Indian patients with proliferative lupus nephritis. An open-label, parallel group, randomized controlled trial involving 75 patients with class III/IV LN was conducted after obtaining informed consent. The low dose group (n = 38) received 6 × 500 mg CYC fortnightly and high dose group (n = 37) received 6 × 750 mg/m 2 CYC four-weekly followed by azathioprine...
February 15, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29448882/multitarget-therapy-of-mycophenolate-mofetil-and-cyclosporine-a-for-induction-treatment-of-refractory-lupus-nephritis
#10
D Jesus, M Rodrigues, J A P da Silva, L Inês
Standard induction therapy for lupus nephritis (LN) with mycophenolate mofetil (MMF) or cyclophosphamide (CYC) is often ineffective. Evidence on rescue induction regimens is scarce. We analyzed efficacy and tolerability of multitarget immunosuppression with MMF and cyclosporine A (CsA) as induction treatment for LN (class III/IV/V) refractory to CYC and/or MMF. We included all six refractory LN patients (class IV = 3, class V = 2, class III = 1) from our 400-patient tertiary Lupus Clinic observed between 2012 and 2015...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29448207/ferulic-acid-protects-lipopolysaccharide-induced-acute-kidney-injury-by-suppressing-inflammatory-events-and-upregulating-antioxidant-defenses-in-balb-c-mice
#11
Salma Mukhtar Mir, Halley Gora Ravuri, Raj Kumar Pradhan, Sairam Narra, Jerald Mahesh Kumar, Madhusudana Kuncha, Sanjit Kanjilal, Ramakrishna Sistla
Sepsis-induced acute kidney injury (AKI) is responsible for 70-80% mortality in intensive care patients due to elevated levels of endotoxin, Lipopolysaccharide (LPS) caused by gram-negative infections. Ferulic acid (FA), a phenolic phytochemical is known for its renal protection on various induced models of nephrotoxicity. However, the curative effect of FA in LPS-induced AKI is not well studied. This study aimed to investigate the effect of FA on LPS-induced AKI in mice model and to understand the protective mechanisms involved, to provide evidence for FA in the treatment of AKI...
February 12, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29447769/apixaban-following-acute-coronary-syndromes-in-patients-with-prior-stroke-insights-from-the-appraise-2-trial
#12
Matthew W Sherwood, Renato D Lopes, Jie Lena Sun, Danny Liaw, Robert A Harrington, Lars Wallentin, Daniel T Laskowitz, Stefan K James, Shaun G Goodman, Harald Darius, Basil S Lewis, C Michael Gibson, Karen S Pieper, John H Alexander
BACKGROUND AND PURPOSE: Patients with prior stroke are at greater risk for recurrent cardiovascular events post-acute coronary syndromes (ACS) and may have a different risk/benefit profile with antithrombotic therapy than patients without prior stroke. METHODS: We studied 7391 patients with ACS from APPRAISE-2, stratified by the presence or absence of prior stroke. Baseline characteristics and outcomes of cardiovascular death, myocardial infarction (MI), or stroke were compared between groups...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29446172/measuring-the-prevalence-of-intradialytic-hypotension-in-a-satellite-dialysis-clinic-are-we-too-complacent
#13
Ulrich Steinwandel, Nick Gibson, Mandy Towell, Richard Parsons, James Rippey, Johan Rosman
AIMS AND OBJECTIVES: Measuring the prevalence of symptomatic (S-IDH) and asymptomatic intradialytic hypotension (A-IDH) or post-dialysis overhydration in a satellite haemodialysis clinic in Western Australia. BACKGROUND: Intradialytic hypotension is one of the most common side-effects of haemodialysis caused by ultrafiltration provoking a temporary volume depletion. The prevalence of asymptomatic hypotension during dialysis has been rarely reported, but is considered to have the same negative consequences as symptomatic hypotension on various end organs like the brain and the gastro-intestinal tract...
February 15, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29446010/phosphaturic-mesenchymal-tumors-what-an-endocrinologist-should-know
#14
REVIEW
J M Boland, P J Tebben, A L Folpe
Tumor-induced osteomalacia (TIO), also known as "oncogenic osteomalacia", is a rare cause of osteomalacia. TIO often has an insidious onset characterized clinically by progressive muscle weakness and bone pain with fractures. The hallmark biochemical finding is a persistent low serum phosphorus concentration due to renal phosphate wasting. The vast majority of cases of TIO result from production of the phosphaturic hormone fibroblast growth factor 23 (FGF23) by a histologically distinctive mesenchymal tumor, termed "phosphaturic mesenchymal tumor" (PMT)...
February 14, 2018: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29443696/intravenous-lidocaine-for-intractable-renal-colic-unresponsive-to-standard-therapy
#15
Billy Sin, John Cao, David Yang, Karen Ambert, Sheena Punnapuzha
CLINICAL FEATURES: Renal colic is defined as a flank pain radiating to the groin caused by kidney stones in the ureter (urolithiasis). Renal colic is a frequent cause of Emergency Department visits. Most renal colic cases present as acute distress and severe back and/or abdominal pain that require prompt treatment with analgesics. THERAPEUTIC CHALLENGE: Nonsteroidal anti-inflammatory drugs and opioids are traditionally used for renal colic in the Emergency Department...
February 13, 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29443369/relation-of-renal-dysfunction-to-quality-of-anticoagulation-control-in-patients-with-atrial-fibrillation-the-fantasiia-registry
#16
María Asunción Esteve-Pastor, José Miguel Rivera-Caravaca, Inmaculada Roldán-Rabadán, Vanessa Roldán, Javier Muñiz, Paula Raña-Míguez, Martín Ruiz-Ortiz, Ángel Cequier, Vicente Bertomeu-Martínez, Lina Badimón, Manuel Anguita, Gregory Y H Lip, Francisco Marín
BACKGROUND: One-third of atrial fibrillation (AF) patients have chronic kidney disease (CKD), a condition that itself increases thromboembolic and major bleeding risks, especially in patients with severe CKD. Bleeding would be accentuated by suboptimal anticoagulation control with vitamin K antagonists (VKA). PURPOSE: This article aimed to investigate the incidence of cardiovascular events, mortality and quality of anticoagulation in relation to CKD in a 'real-world' prospective cohort of AF patients included in the FANTASIIA registry...
February 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29441984/direct-oral-anticoagulants-in-real-clinical-practice-analysis-of-patient-characteristics-and-prescribing-patterns-in-a-large-teaching-hospital
#17
B Kováčová, J Červeňová
Direct oral anticoagulants (DOACs) became rapidly accepted as an alternative to warfarin in the prevention of stroke in atrial fibrillation and prophylaxis of thromboembolic events. Their safety and efficacy have been well documented in several studies, however, as with any new drug, use in real-world population often reveals risk factors that may affect treatment outcomes. The aim of the study was to determine the prescribing patterns and analyse patient characteristics to identify incidence of selected factors (age, weight, comorbidities and interacting medication) that may affect DOAC safety and efficacy...
September 1, 2017: Die Pharmazie
https://www.readbyqxmd.com/read/29441437/immune-checkpoint-blockade-the-new-frontier-in-cancer-treatment
#18
Jeffrey M Clarke, Daniel J George, Stacey Lisi, April K S Salama
Immune checkpoint blockers have revolutionized cancer treatment in recent years. These agents are now approved for the treatment of several malignancies, including melanoma, squamous and non-squamous non-small cell lung cancer, renal cell carcinoma, urothelial carcinoma, and head and neck squamous cell carcinoma. Studies have demonstrated the significant impact of immunotherapy versus standard of care on patient outcomes, including durable response and extended survival. The use of immunotherapy-based combination therapy has been shown to further extend duration of response and survival...
February 13, 2018: Targeted Oncology
https://www.readbyqxmd.com/read/29440481/prospective-evaluation-of-medication-related-clinical-decision-support-over-rides-in-the-intensive-care-unit
#19
Adrian Wong, Mary G Amato, Diane L Seger, Christine Rehr, Adam Wright, Sarah P Slight, Patrick E Beeler, E John Orav, David W Bates
BACKGROUND: Clinical decision support (CDS) displayed in electronic health records has been found to reduce the incidence of medication errors and adverse drug events (ADE). Recent data suggested that medication-related CDS alerts were frequently over-ridden, often inappropriately. Patients in the intensive care unit (ICU) are at an increased risk of ADEs; however, limited data exist on the benefits of CDS in the ICU. This study aims to evaluate potential harm associated with medication-related CDS over-rides in the ICU...
February 9, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29439857/axitinib-in-combination-with-pembrolizumab-in-patients-with-advanced-renal-cell-cancer-a-non-randomised-open-label-dose-finding-and-dose-expansion-phase-1b-trial
#20
Michael B Atkins, Elizabeth R Plimack, Igor Puzanov, Mayer N Fishman, David F McDermott, Daniel C Cho, Ulka Vaishampayan, Saby George, Thomas E Olencki, Jamal C Tarazi, Brad Rosbrook, Kathrine C Fernandez, Mariajose Lechuga, Toni K Choueiri
BACKGROUND: Previous studies combining PD-1 checkpoint inhibitors with tyrosine kinase inhibitors of the VEGF pathway have been characterised by excess toxicity, precluding further development. We hypothesised that axitinib, a more selective VEGF inhibitor than others previously tested, could be combined safely with pembrolizumab (anti-PD-1) and yield antitumour activity in patients with treatment-naive advanced renal cell carcinoma. METHODS: In this ongoing, open-label, phase 1b study, which was done at ten centres in the USA, we enrolled patients aged 18 years or older who had advanced renal cell carcinoma (predominantly clear cell subtype) with their primary tumour resected, and at least one measureable lesion, Eastern Cooperative Oncology Group performance status 0-1, controlled hypertension, and no previous systemic therapy for renal cell carcinoma...
February 9, 2018: Lancet Oncology
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