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https://www.readbyqxmd.com/read/27914358/defining-the-role-of-perioperative-statin-treatment-in-patients-after-cardiac-surgery-a-meta-analysis-and-systematic-review-of-20-randomized-controlled-trials
#1
Xin Yuan, Jianlin Du, Qi Liu, Ling Zhang
BACKGROUND: Although statin use has been indicated to prevent atrial fibrillation in previous observational and experimental trials, the issue remains inadequately and insufficiently explored. We therefore performed this meta-analysis to evaluate the effects of perioperative statin therapy on complications and short-term prognosis following cardiac surgery. METHODS: A search of the PubMed, EMBASE and the Cochrane database of controlled trials was performed from inception to June 2016 to identify relevant randomized controlled trials (RCTs)...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27903048/resistance-exercise-induced-rhabdomyolysis-need-for-immediate-intervention-and-proper-counselling
#2
Maysaa A Khalil, Basem R Saab
BACKGROUND: Rhabdomyolysis results from damage to skeletal muscle. Improper resistance training may result in rhabdomyolysis, which can cause acute kidney injury, serious metabolic abnormalities, compartmental syndrome and even death. Proper counselling for athletes may prevent this condition. OBJECTIVE: We present two patients with unilateral swelling after resistance exercise. The workup revealed rhabdomyolysis. We highlight the importance of counselling to prevent rhabdomyolysis secondary to resistance exercise...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27899498/association-of-visit-to-visit-variability-of-systolic-blood-pressure-with-cardiovascular-disease-and-mortality-in-primary-care-chinese-patients-with-type-2-diabetes-mellitus-a-retrospective-population-based-cohort-study
#3
Eric Yuk Fai Wan, Colman Siu Cheung Fung, Esther Yee Tak Yu, Daniel Yee Tak Fong, Julie Yun Chen, Cindy Lo Kuen Lam
OBJECTIVE: This study aimed to evaluate the impact of visit-to-visit variability (VVV) of systolic blood pressure (SBP) on cardiovascular disease (CVD) and mortality among primary care Chinese patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: A retrospective cohort study was conducted in 124,105 Chinese adult primary care patients with T2DM and without prior diagnosed CVD from August 2008 to December 2009. The VVV of SBP was evaluated using SDs of SBP over 24 months...
November 29, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27881565/low-dose-aspirin-for-primary-prevention-of-cardiovascular-events-in-patients-with-type-2-diabetes-10-year-follow-up-of-a-randomized-controlled-trial
#4
Yoshihiko Saito, Sadanori Okada, Hisao Ogawa, Hirofumi Soejima, Mio Sakuma, Masafumi Nakayama, Naofumi Doi, Hideaki Jinnouchi, Masako Waki, Izuru Masuda, Takeshi Morimoto
BACKGROUND: -The long-term efficacy and safety of low-dose aspirin for primary prevention of cardiovascular events in patients with type 2 diabetes are still inconclusive. METHODS: -The Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial was a randomized, open-label, standard-care controlled trial examining whether low-dose aspirin affected cardiovascular events in 2539 Japanese patients with type 2 diabetes and without pre-existing cardiovascular disease...
November 15, 2016: Circulation
https://www.readbyqxmd.com/read/27881268/antithrombotic-therapy-and-direct-medical-costs-in-patients-with-acute-coronary-syndrome-in-shanghai-china
#5
Jeff J Guo, Yun Chen, Wenmin Du, Hongying Peng, Rui Wang, Ying Xia, Ping Xin, Patricia R Wigle, Emmanuel A Papadimitropoulos
BACKGROUND: Acute coronary syndrome (ACS) is a leading cause of morbidity and mortality worldwide. OBJECTIVES: To describe patient profile, treatment patterns, and disease burden for patients with ACS. METHODS: A retrospective descriptive cohort study was conducted. Data were obtained from electronic medical records from seven Shanghai medical centers. Patients with at least one primary diagnosis of ACS from 2006 to 2012 were included. Patient ACS-related antithrombotic medication use, laboratory tests, key comorbidities, health care utilization, and direct medical costs were examined...
May 2016: Value in Health Regional Issues
https://www.readbyqxmd.com/read/27881247/pain-management-in-ckd-a-guide-for-nephrology-providers
#6
Holly M Koncicki, Mark Unruh, Jane O Schell
Although pain is one of the most commonly experienced symptoms by patients with chronic kidney disease, it is under-recognized, the severity is underestimated, and the treatment is inadequate. Pain management is one of the general primary palliative care competencies for medical providers. This review provides nephrology providers with basic skills for pain management. These skills include recognition of types of pain (nociceptive and neuropathic) syndromes and appropriate history-taking skills. Through this history, providers can identify clinical circumstances in which specialist referral is beneficial, including those who are at high risk for addiction, at risk for adverse effects to medications, and those with complicated care needs such as patients with a limited prognosis...
November 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27876432/routine-deferred-computed-tomography-for-patients-with-suspected-urolithiasis-is-low-value-healthcare
#7
Ingvild M Rosenlund, Olav H Førde, Arthur Revhaug
OBJECTIVE: The aim of this study was to investigate the benefits of deferred routine computed tomography of the kidneys, ureters and bladder (CT KUB) for patients with a self-limiting episode of suspected urolithiasis. MATERIALS AND METHODS: The study comprised a case series of consecutive patients examined with deferred routine CT KUB for control of suspected urolithiasis. Patients examined with CT KUB at the University Hospital of North Norway, between 1 January 2010 and 31 December 2013, were included...
November 23, 2016: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/27867184/a-rare-case-of-tubulointerstitial-nephritis-and-uveitis-syndrome-treated-with-a-multi-specialty-approach
#8
Boonkit Purt, Siri Hiremath, Sarah Smith, Sergul Erzurum, Erdal Sarac
BACKGROUND It is important for an ophthalmologist and nephrologist to look for hidden causes of uveitis and nephritis, respectively. Delay in diagnosis leads to increased morbidity and failure to systemically manage the patient results in future recurrence of disease. It is likely that TINU remains underdiagnosed and could potentially account for some of the cases of idiopathic uveitis, especially when greater than 50% of uveitis cases have no identifiable cause. Fewer than 300 cases of tubulointerstitial nephritis and uveitis (TINU) syndrome have been reported...
November 21, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27861708/high-dose-monthly-vitamin-d-for-prevention-of-acute-respiratory-infection-in-older-long-term-care-residents-a-randomized-clinical-trial
#9
Adit A Ginde, Patrick Blatchford, Keith Breese, Lida Zarrabi, Sunny A Linnebur, Jeffrey I Wallace, Robert S Schwartz
OBJECTIVES: To determine the efficacy and safety of high-dose vitamin D supplementation for prevention of acute respiratory infection (ARI) in older long-term care residents. DESIGN: Randomized controlled trial investigating high-dose vs standard-dose vitamin D from 2010 to 2014. SETTING: Colorado long-term care facilities. PARTICIPANTS: Long-term care residents aged 60 and older (n = 107). INTERVENTION: The high-dose group received monthly supplement of vitamin D3 100,000 IU, the standard-dose group received a monthly placebo (for participants taking 400-1,000 IU/d as part of usual care) or a monthly supplement of 12,000 IU of vitamin D3 (for participants taking <400 IU/d as part of usual care)...
November 16, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27846810/competing-risk-of-death-and-end-stage-renal-disease-in-incident-chronic-kidney-disease-stages-3-to-5-the-epiran-community-based-study
#10
Carole Ayav, Jean-Baptiste Beuscart, Serge Briançon, Alain Duhamel, Luc Frimat, Michèle Kessler
BACKGROUND: Although chronic kidney disease (CKD) affects a growing number of people, epidemiologic data on incident CKD in the general population are scarce. Screening strategies to increase early CKD detection have been developed. METHODS: From a community-based sample of 4,409 individuals residing in a well-defined geographical area, we determined the number of patients having a first serum creatinine value ≥1.7 mg/dL and present for at least 3 months that allowed us to calculate an annual incidence rate of CKD (stages 3 to 5)...
November 15, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27837448/consensus-on-the-statin-of-choice-in-patients-with-impaired-glucose-metabolism-results-of-the-diana-study
#11
Jesús Millán Núñez-Cortés, Aleix Cases Amenós, Juan Francisco Ascaso Gimilio, Vivencio Barrios Alonso, Vicente Pascual Fuster, Juan Carles Pedro-Botet Montoya, Xavier Pintó Sala, Adalberto Serrano Cumplido
INTRODUCTION AND OBJECTIVES: Despite the recognized clinical benefit of statins on cardiovascular prevention, providing correct management of hypercholesterolaemia, possible adverse effects of their use cannot be disregarded. Previously published data shows that there is a risk of developing diabetes mellitus or experiencing changes in glucose metabolism in statin-treated patients. The possible determining factors are the drug characteristics (potency, dose), patient characteristics (kidney function, age, cardiovascular risk and polypharmacy because of multiple disorders) and the pre-diabetic state...
November 11, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/27830927/observational-clinical-study-on-organ-dysfunction-associated-with-dosing-of-antibiotics-in-a-paediatric-intensive-care-unit
#12
Sascha Tafelski, Alexander Gratopp, Florian Richter, Sylvia Kramer, Claudia Spies, Klaus D Wernecke, Irit Nachtigall
BACKGROUND: Medication errors are of concern especially in paediatric patients. This study investigates impact of dosing errors of antibiotics on outcome in critically ill paediatric patients. METHODS: Retrospective study including all consecutive patients admitted to one university paediatric intensive care unit (PICU) in 2010 with length of PICU stay >24hrs, age <18 years and antibiotic therapy. Antibiotic dosages were evaluated for compliance with recommended dosing individually adapted for bodyweight, age and organ function...
November 10, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27829716/association-of-hyponatremia-with-in-hospital-outcomes-in-infective-endocarditis-a-5-year-review-from-an-indian-intensive-care-unit
#13
Saraschandra Vallabhajosyula, Muralidhar D Varma, Shashaank Vallabhajosyula, Saarwaani Vallabhajosyula
Hyponatremia is commonly noted with cardiovascular disorders, but its role in infective endocarditis (IE) is limited to being a marker of increased morbidity in IE patients with intravenous drug use. This was a 5-year retrospective review from an Indian Intensive Care Unit (ICU). Patients >18 years with IE and available serum sodium levels were included in the study. Pediatric and pregnant patients were excluded from the study. Hyponatremia was defined as admission sodium <135 mmol/L. Detailed data were abstracted from the medical records...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27825313/using-pharmacists-to-improve-risk-stratification-and-management-of-stage-3a-chronic-kidney-disease-a-feasibility-study
#14
Alex R Chang, Michael Evans, Christina Yule, Larissa Bohn, Amanda Young, Meredith Lewis, Elisabeth Graboski, Bethany Gerdy, William Ehmann, Jonathan Brady, Leah Lawrence, Natacha Antunes, Jamie Green, Susan Snyder, H Lester Kirchner, Morgan Grams, Robert Perkins
BACKGROUND: Measurement of albuminuria to stratify risk in chronic kidney disease (CKD) is not done universally in the primary care setting despite recommendation in KDIGO (Kidney Disease Improving Global Outcomes) guidelines. Pharmacist medication therapy management (MTM) may be helpful in improving CKD risk stratification and management. METHODS: We conducted a pragmatic, cluster-randomized trial using seven primary care clinic sites in the Geisinger Health System to evaluate the feasibility of pharmacist MTM in patients with estimated glomerular filtration rate (eGFR) 45-59 ml/min/1...
November 8, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27822135/chronic-kidney-disease-identification-and-management-in-primary-care
#15
REVIEW
Simon Ds Fraser, Tom Blakeman
Chronic kidney disease (CKD) is an important and common noncommunicable condition globally. In national and international guidelines, CKD is defined and staged according to measures of kidney function that allow for a degree of risk stratification using commonly available markers. It is often asymptomatic in its early stages, and early detection is important to reduce future risk. The risk of cardiovascular outcomes is greater than the risk of progression to end-stage kidney disease for most people with CKD...
2016: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/27822078/acute-kidney-injury-adjusted-to-volume-status-in-critically-ill-patients-recognition-of-delayed-diagnosis-restaging-and-associated-outcomes
#16
Harout Yacoub, Leen Khoury, Youssef El Douaihy, Chadi Salmane, Jeanne Kamal, Marc Saad, Patricia Nasr, Jared Radbel, Elie El-Charabaty, Suzanne El-Sayegh
Critically ill patients receive a significant amount of fluids leading to a positive fluid balance; this dilutes serum creatinine resulting in an overestimated glomerular filtration rate. The goal of our study is to identify undiagnosed or underestimated acute kidney injury (AKI) in the intensive care unit (ICU). It will also identify the morbidity and mortality associated with an underestimated AKI. We reviewed records of patients admitted to our institution (Staten Island University Hospital) between 2012 and 2013 for more than 2 days...
2016: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27822057/exploring-knowledge-attitudes-and-practices-toward-older-adults-with-hypertension-in-primary-care
#17
Luckwirun Chotisiri, Khemika Yamarat, Surasak Taneepanichskul
PURPOSE: High blood pressure increases the risk of cardiovascular and kidney diseases. The purpose of this study was to explore a baseline of hypertension knowledge, attitudes, and practices among older adults with hypertension at a sub-district Health Promoting Hospital in the Pathum Thani province of Thailand. PATIENTS AND METHODS: A cross-sectional study was conducted at the outpatient clinic of the sub-district Health Promoting Hospital, one of the primary care sectors, between January and March 2015, and a total of 144 cases were recruited...
2016: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/27821636/potentially-preventable-hospitalization-among-patients-with-ckd-and-high-inpatient-use
#18
Paul E Ronksley, Brenda R Hemmelgarn, Braden J Manns, James Wick, Matthew T James, Pietro Ravani, Robert R Quinn, Nairne Scott-Douglas, Richard Lewanczuk, Marcello Tonelli
BACKGROUND AND OBJECTIVES: Although patients with CKD are commonly hospitalized, little is known about those with frequent hospitalization and/or longer lengths of stay (high inpatient use). The objective of this study was to explore clinical characteristics, patterns of hospital use, and potentially preventable acute care encounters among patients with CKD with at least one hospitalization. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We identified all adults with nondialysis CKD (eGFR<60 ml/min per 1...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27812962/implications-of-the-empa-reg-trial-for-clinical-care-and-research
#19
REVIEW
Angeliki M Stamatouli, Silvio E Inzucchi
EMPA-REG OUTCOME was a multicenter, randomized placebo-controlled trial that examined the effect of empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor in addition to standard of care in patients with type 2 diabetes and established cardiovascular (CV) disease. The primary goal was to assess CV safety, as mandated by the US Food and Drug Administration since 2008 for all new glucose-lowering agents. Secondary goals were to examine the effects of empagliflozin on microvascular outcomes and, in particular, kidney disease...
December 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/27805505/challenges-for-renal-retransplant-an-overview
#20
Mohamed Adel Bakr, Ahmed Abdelfattah Denewar, Mohamed Hamed Abbas
Despite many achievements in renal transplant in the past few years regarding immunosuppression and tissue matching, the rates of early and late graft loss and return to dialysis are still high. Many of those with primary graft failure will be listed for a kidney retransplant, as this allows for better quality of life than dialysis. Many challenges face those requiring renal retransplant, including first graft nephrectomy and whether site of retransplant should be ipsilateral or contralateral, whether to conduct preemptive retransplant or wait while on dialysis, additional immunologic factors, immunosuppression after retransplant, cancer risk, BK virus infection, and retransplant in pediatrics...
November 2016: Experimental and Clinical Transplantation
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