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https://www.readbyqxmd.com/read/29161684/higher-versus-lower-continuous-renal-replacement-therapy-intensity-in-critically-ill-patients-with-liver-dysfunction
#1
Zachary O'Brien, Alan Cass, Louise Cole, Simon Finfer, Martin Gallagher, Colin McArthur, Shay McGuiness, John Myburgh, Rinaldo Bellomo, Johan Mårtensson
AIMS: To study the association between higher versus lower continuous renal replacement therapy (CRRT) intensity and mortality in critically ill patients with combined acute kidney injury and liver dysfunction. METHODS: Post-hoc analysis of patients with liver dysfunction (Sequential Organ Failure Assessment liver score ≥2 or diagnosis of liver failure/transplant) included in the Randomized Evaluation of Normal versus Augmented Level renal replacement therapy (RENAL) trial...
November 22, 2017: Blood Purification
https://www.readbyqxmd.com/read/29160945/lacosamide-pharmacokinetics-in-a-critically-ill-patient-receiving-continuous-venovenous-hemofiltration
#2
Miguel J Franquiz, Shamir N Kalaria, Michael J Armahizer, Mathangi Gopalakrishnan, Paul J McCarthy, Neeraj Badjatia
OBJECTIVE: Lacosamide is a new generation antiepileptic drug (AED) that is eliminated by both hepatic and renal mechanisms. Lacosamide elimination by Continuous Renal Replacement Therapy (CRRT) has never been studied. The objective of this case report was to describe lacosamide pharmacokinetics in the setting of CRRT. METHODS: Case report of a single patient admitted to the study center with status epilepticus and multi-organ failure. The patient required both continuous venovenous hemofiltration (CVVH) and several AEDs...
November 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29160109/editorial-comment-on-end-2017-0618-or-r1
#3
Mordechai Duvdevani
Percutaneous nephrolithotomy (PCNL) is currently the treatment of choice for large and complex renal calculi. One of the main advantages of PCNL is gaining a real stone-free status in a single session. However, there are several major complications that necessitate careful patient selection for this surgery (1). In this well written manuscript the authors deal with the true rates and importance of residual fragments following PCNL surgeries done in a high volume center. They reviewed 658 PCNL procedures from 2008-2013 that underwent a CT scan on post-operative day one...
November 21, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29159701/residues-of-diclofenac-in-tissues-of-vultures-in-india-a-post-ban-scenario
#4
Kanthan Nambirajan, Subramanian Muralidharan, Aditya A Roy, S Manonmani
Populations of three resident Gyps species (Indian white-backed vulture Gyps bengalensis, Indian vulture Gyps indicus, and Slender-billed vulture Gyps tenuirostris) in India have decreased by more than 90% since mid 1990s, and they continue to decline. Experimental studies showed the mortality of vultures to be due to renal failure caused by diclofenac, a nonsteroidal anti-inflammatory drug. India, Pakistan, and Nepal banned the veterinary usage of diclofenac in 2006 to prevent further decline in vulture population...
November 20, 2017: Archives of Environmental Contamination and Toxicology
https://www.readbyqxmd.com/read/29159461/severe-hyperammonemic-encephalopathy-requiring-dialysis-aggravated-by-prolonged-fasting-and-intermittent-high-fat-load-in-a-ramadan-fasting-month-in-a-patient-with-cptii-homozygous-mutation
#5
P Phowthongkum, C Ittiwut, V Shotelersuk
BACKGROUND: Carnitine palmitoyltransferase II (CPTII) deficiency is a mitochondrial fatty acid oxidation disorder that can present antenatally as congenital brain malformations, or postnatally with lethal neonatal, severe infantile, or the most common adult myopathic forms. No case of severe hyperammonemia without liver dysfunction has been reported. CASE PRESENTATION: We described a 23-year-old man who presented to the emergency department with seizures and was found to have markedly elevation of serum ammonia...
November 21, 2017: JIMD Reports
https://www.readbyqxmd.com/read/29158666/tenofovir-alafenamide-in-the-treatment-of-chronic-hepatitis-b-design-development-and-place-in-therapy
#6
REVIEW
Eiichi Ogawa, Norihiro Furusyo, Mindie H Nguyen
Tenofovir alafenamide (TAF), a novel prodrug of tenofovir (TFV), has been approved for the treatment of chronic hepatitis B virus (HBV) infection. TAF has been shown to be a potent inhibitor of HBV replication at a low dose, with high intracellular concentration and more than 90% lower systemic TFV concentration than tenofovir disoproxil fumarate (TDF). In two randomized, double-blind, multinational, Phase 3, non-inferiority trials for hepatitis B e antigen (HBeAg)-positive and -negative patients (primary analysis: 48 weeks), TAF 25 mg orally once-daily was not inferior to TDF 300 mg in achieving an HBV DNA level <29 IU/mL at week 48...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29158058/regional-cerebral-oxygen-saturation-level-predicts-30-day-mortality-rate-after-left-ventricular-assist-device-surgery
#7
Soutik Ghosal, Jaimin Trivedi, James Chen, Michael P Rogers, Allen Cheng, Mark S Slaughter, Maiying Kong, Jiapeng Huang
OBJECTIVE: Left ventricular assist device (LVAD) surgery is complex, high risk, and expensive. The authors' hypothesis is baseline regional cerebral oxygen saturation (rSO2) might be a predictor of postoperative clinical outcomes. DESIGN: Retrospective review of 210 consecutive continuous flow LVAD patients between 2008 and 2014. The primary measure is 30-day mortality rate and secondary measures include modified major adverse cardiocerebral events (MACE), length of stay (LOS), and intensive care unit (ICU) stay...
August 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29157741/biventricular-support-with-intracorporeal-continuous-flow-centrifugal-ventricular-assist-devices
#8
Francisco A Arabía, Carmelo A Milano, Claudius Mahr, Edwin C McGee, Nahush A Mokadam, J Eduardo Rame, Jaime D Moriguchi, Danny Ramzy, David C Naftel, Susan L Myers, James K Kirklin
BACKGROUND: The incidence of right ventricular dysfunction requiring right ventricular assist device after left ventricular assist device placement has been reported between 10% to 30%. The mortality rate is higher compared with patients who require left ventricular assist device only; the most effective and safest biventricular assist device remains unknown. We aimed to determine the survival outcomes and frequency of adverse events in patients with two durable, intracorporeal, continuous flow centrifugal pumps for support...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29155498/global-impact-of-nephropathies
#9
REVIEW
Philip Kam-Tao Li, Terry King-Wing Ma
The global burden of chronic kidney disease (CKD) has increased substantially in recent years, partly attributed to the global epidemic of diabetes mellitus. In many countries including China, glomerulonephritis was the most common cause of end stage renal disease (ESRD). The mortality rate of dialysis patients can be as high as patients with colon, breast and prostate cancers. CKD has important socio-economic impact on the healthcare system and society. Increasing awareness and early detection of CKD cannot be overemphasized...
December 2017: Nephrology
https://www.readbyqxmd.com/read/29154381/interhospital-transfer-and-receipt-of-specialty-procedures
#10
Stephanie K Mueller, Jie Zheng, John Orav, Jeffrey L Schnipper
The practice of transferring patients between acute care hospitals is variable and largely nonstandardized. Although often-cited reasons for transfer include providing patients access to specialty services only available at the receiving institution, little is known about whether and when patients receive such specialty care during the transfer continuum. We performed a retrospective analysis using 2013 100% Master Beneficiary Summary and Inpatient claims files from Centers for Medicare and Medicaid Services...
November 8, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29153738/pregnancy-outcomes-following-cardiac-transplantation
#11
Rohan D'Souza, Elisabeth Soete, Candice K Silversides, Nusrat Zaffar, Tim Van Mieghem, Johan Van Cleemput, Catriona Bhagra, Mathew Sermer, Heather Ross
OBJECTIVE: This study sought to report pregnancy outcomes in women following cardiac transplantation. METHODS: This was a descriptive retrospective cohort study of women with pregnancies following cardiac transplantation managed at two large tertiary centres in Canada and Belgium between 2001 and 2017. RESULTS: Sixteen women had 17 singleton pregnancies following cardiac transplantation. The mean maternal age was 28 ± 5.8, and the transplant-to-pregnancy interval was 7...
November 15, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29151569/what-kind-of-incision-should-be-made-to-reduce-the-risk-of-incisional-hernia-in-kidney-transplantation
#12
Ihsan Yildız, Yavuz Savas Koca
BACKGROUND The incidence of incisional hernia following renal transplantation is 1.1% to 3.8%. The risk factors are immunosuppressive medications, impaired tissue quality, neuromuscular trauma due to the operation, and denervation. The incidence has been decreasing based on the shift from hockey-stick incision method to inguinal oblique incision method. The aim of this study was to minimize the development of incisional hernias due to renal transplantation. MATERIAL AND METHODS Twenty-four patients who underwent renal transplantation in 2015-2017 were retrospectively examined...
November 20, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29151020/complications-of-regional-citrate-anticoagulation-accumulation-or-overload
#13
Antoine G Schneider, Didier Journois, Thomas Rimmelé
Regional citrate anticoagulation (RCA) is now recommended over systemic heparin for continuous renal replacement therapy in patients without contraindications. Its use is likely to increase throughout the world. However, in the absence of citrate blood level monitoring, the diagnosis of citrate accumulation, the most feared complication of RCA, remains relatively complex. It is therefore commonly mistaken with other conditions. This review aims at providing clarifications on RCA-associated acid-base disturbances and their management at the bedside...
November 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29148592/oral-anticoagulants-in-german-nursing-home-residents-drug-use-patterns-and-predictors-for-treatment-choice
#14
Kathrin Jobski, Falk Hoffmann, Stefan Herget-Rosenthal, Michael Dörks
AIMS: Information on utilization of oral anticoagulants (OACs) in nursing homes is scarce. This study aimed to (i) describe OAC use in German nursing home residents, (ii) examine factors influencing whether treatment is initiated with vitamin K antagonists (VKAs) or non-VKA oral anticoagulants (NOACs) and (iii) assess which conditions predict switching to NOAC instead of continuing VKA. METHODS: Using claims data (2010-2014), we studied a cohort of new nursing home residents aged ≥ 65 years receiving OAC...
November 17, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29148253/quantification-of-vascular-damage-in-acute-kidney-injury-with-fluorine-magnetic-resonance-imaging-and-spectroscopy
#15
Jeremy K Moore, Junjie Chen, Hua Pan, Joseph P Gaut, Sanjay Jain, Samuel A Wickline
PURPOSE: To design a fluorine MRI/MR spectroscopy approach to quantify renal vascular damage after ischemia-reperfusion injury, and the therapeutic response to antithrombin nanoparticles (NPs) to protect kidney function. METHODS: A total of 53 rats underwent 45 min of bilateral renal artery occlusion and were treated at reperfusion with either plain perfluorocarbon NPs or NPs functionalized with a direct thrombin inhibitor (PPACK:phenyalanine-proline-arginine-chloromethylketone)...
November 16, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29147917/recommendations-for-perioperative-management-of-lung-cancer-patients-with-comorbidities
#16
REVIEW
Hiroyoshi Tsubochi, Tomoki Shibano, Shunsuke Endo
OBJECTIVES: To improve surgical outcomes, clinicians must provide optimal perioperative care for comorbidities identified as significant factors in risk models for patients undergoing lung cancer surgery. METHODS: We reviewed trends in perioperative care for idiopathic pulmonary fibrosis, cardiovascular diseases, and end-stage renal diseases in patients undergoing lung cancer surgery, as large clinical databases indicate that these comorbidities are significant risk factors for lung cancer surgery...
November 16, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29146277/lowering-ldl-cholesterol-reduces-cardiovascular-risk-independently-of-presence-of-inflammation
#17
Benjamin C Storey, Natalie Staplin, Richard Haynes, Christina Reith, Jonathan Emberson, William G Herrington, David C Wheeler, Robert Walker, Bengt Fellström, Christoph Wanner, Martin J Landray, Colin Baigent
Markers of inflammation, including plasma C-reactive protein (CRP), are associated with an increased risk of cardiovascular disease, and it has been suggested that this association is causal. However, the relationship between inflammation and cardiovascular disease has not been extensively studied in patients with chronic kidney disease. To evaluate this, we used data from the Study of Heart and Renal Protection (SHARP) to assess associations between circulating CRP and LDL cholesterol levels and the risk of vascular and non-vascular outcomes...
November 14, 2017: Kidney International
https://www.readbyqxmd.com/read/29145282/autosomal-dominant-polycystic-kidney-disease-combined-with-hypertrophic-cardiomyopathy-a-case-report
#18
Yingjing Shen, Chenggang Xu
INTRODUCTION: This report describes the novel sampling of autosomal dominant polycystic kidney disease (ADPKD) combined with hypertrophic cardiomyopathy (HCM). SYMPTOMS AND CLINICAL FINDINGS: A 48-year-old Chinese man presented with anasarca, hypourocrinia, gross hematuria, and weight gain by 10 kg subsequently developed acute kidney injury after struck by acute respiratory distress syndrome, really a threat to his heart. DIAGNOSES: Abdominal ultrasound revealed multiple small cysts in both kidneys, with the right kidney measuring 11...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145251/renal-osteodystrophy-presenting-as-a-metabolic-superscan-on-f-18-fdg-pet-ct-a-case-report
#19
Ismaheel Lawal, Alfred Ankrah, Kehinde Ololade, Moshe Modiselle, Mike Sathekge
RATIONALE: F-18 Fluoro Deoxyglucose positron emission tomography and computed tomography (F-18 FDG PET/CT) is a useful modality in the evaluation of patients with malignancies. Increased incidence of lympho-proliferative disorders has been reported in individuals with long-standing end-stage renal disorders treated with renal replacement therapy. PATIENT CONCERNS: A 30-year-old male on peritoneal dialysis on account of end-stage renal disease. He had acute rejection of an earlier transplanted renal allograft...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29143140/impact-of-conventional-medical-therapy-on-bone-mineral-density-and-bone-turnover-in-adult-patients-with-x-linked-hypophosphatemia-a-6-year-prospective-cohort-study
#20
Vikram Vinod Shanbhogue, Stinus Hansen, Niklas Rye Jørgensen, Signe Sparre Beck-Nielsen
X-linked hypophosphatemia (XLH) is a rare, inheritable disorder manifesting as rickets in children and osteomalacia in adults. While conventional medical treatment with oral phosphate and alfacalcidol is recommended in childhood, it is undecided whether adults should continue therapy. The aim of this 6-year prospective study was to determine the impact of conventional medical treatment on areal bone mineral density (aBMD), bone turnover markers (BTMs) and measures of calcium homeostasis in 27 adult patients with XLH, 11 of whom received medical treatment...
November 15, 2017: Calcified Tissue International
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