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https://www.readbyqxmd.com/read/28724126/comparative-outcomes-after-percutaneous-coronary-intervention-among-black-and-white-patients-treated-at-us-veterans-affairs-hospitals
#1
Taisei Kobayashi, Thomas J Glorioso, Ehrin J Armstrong, Thomas M Maddox, Mary E Plomondon, Gary K Grunwald, Steven M Bradley, Thomas T Tsai, Stephen W Waldo, Sunil V Rao, Subhash Banerjee, Brahmajee K Nallamothu, Deepak L Bhatt, A Garvey Rene, Robert L Wilensky, Peter W Groeneveld, Jay Giri
Importance: Current comparative outcomes among black and white patients treated with percutaneous coronary intervention (PCI) in the Veterans Affairs (VA) health system are not known. Objective: To compare outcomes between black and white patients undergoing PCI in the VA health system. Design, Setting, and Participants: This study compared black and white patients who underwent PCI between October 1, 2007, and September 30, 2013, at 63 VA hospitals using data recorded in the VA Clinical Assessment, Reporting, and Tracking System for Cardiac Catheterization Laboratories (CART-CL) program...
July 19, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28721327/two-catastrophes-in-one-patient-drug-reaction-with-eosinophilia-and-systemic-symptoms-and-toxic-shock-syndrome
#2
Moayed Ibrahim, Diana L Nunley
A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. She was treated with steroids and discharged after her condition improved. However, a month later, she returned to the ER, complaining of nausea, vomiting, diarrhea, dizziness, chills, and shortness of breath over the past two days...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28717983/evaluation-of-acute-kidney-injury-aki-with-rifle-akin-ck-and-kdigo-in-critically-ill-trauma-patients
#3
F Ülger, M Pehlivanlar Küçük, A O Küçük, N K İlkaya, N Murat, B Bilgiç, H Abanoz
PURPOSE: The aim of our study was to evaluate the effects of AKI development on mortality with four different classification systems (RIFLE, AKIN, CK, KDIGO) in critically ill trauma patients followed in the intensive care unit. METHODS: A retrospective review of 2034 patients in our intensive care unit was conducted between July 2010 and August 2013. A total of 198 patients with primary trauma were included in the study to evaluate the development of AKI. RESULTS: When the presence of AKI was investigated according to the four criteria (RIFLE, AKIN, CK, and KDIGO), the highest incidence of AKI was found according to the KDIGO classification (74...
July 17, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28716010/risk-scores-to-predict-decreased-glomerular-filtration-rate-at-10%C3%A2-years-in-an-asian-general-population
#4
Krittika Saranburut, Prin Vathesatogkit, Nisakron Thongmung, Anchalee Chittamma, Somlak Vanavanan, Tuangrat Tangstheanphan, Piyamitr Sritara, Chagriya Kitiyakara
BACKGROUND: Asians have among the highest prevalence of chronic kidney disease (CKD) or end-stage renal disease in the world. A risk score capable of identifying high risk individuals at the primary care level could allow targeted therapy to prevent future development of CKD. Risk scores for new CKD have been developed in US general populations, but the impact of various risks factors for development of CKD may differ in Asian subjects. In this study, we aimed to develop risk models and simplified risk scores to predict the development of decreased glomerular filtration rate (GFR) at 10 years in an Asian general population using readily obtainable clinical and laboratory parameters...
July 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28711369/predicting-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-in-elderly-patients
#5
Caitlin W Hicks, Anna O'Kelly, Tammam Obeid, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: We aim to describe trends in failure to rescue (FTR) among elderly patients undergoing elective open aortic aneurysm repair (OAR) and endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: All patients aged ≥80 y recorded in the Vascular Quality Initiative database (2002-2014) undergoing nonruptured infrarenal AAA repair were included. Primary outcome was FTR, defined as percentage of deaths in patients who had a complication within 30 d of surgery...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28706103/vitamin-d-levels-in-critically-ill-patients-with-acute-kidney-injury-a-protocol-for-a-prospective-cohort-study-vid-aki
#6
Lynda Katherine Cameron, Katie Lei, Samantha Smith, Nanci Leigh Doyle, James F Doyle, Kate Flynn, Nicola Purchase, John Smith, Kathryn Chan, Farida Kamara, Nardos Ghebremedhin Kidane, Lui G Forni, Dominic Harrington, Geeta Hampson, Marlies Ostermann
INTRODUCTION: Acute kidney injury (AKI) affects more than 50% of critically ill patients. The formation of calcitriol, the active vitamin D metabolite, from the main inactive circulating form, 25-hydroxyvitamin D (25(OH)D), occurs primarily in the proximal renal tubules. This results in a theoretical basis for reduction in levels of calcitriol over the course of an AKI. Vitamin D deficiency is highly prevalent in critically ill adults, and has been associated with increased rates of sepsis, longer hospital stays and increased mortality...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28704407/variations-in-achievement-of-evidence-based-high-impact-quality-indicators-in-general-practice-an-observational-study
#7
Thomas A Willis, Robert West, Bruno Rushforth, Tim Stokes, Liz Glidewell, Paul Carder, Simon Faulkner, Robbie Foy
BACKGROUND: There are widely recognised variations in the delivery and outcomes of healthcare but an incomplete understanding of their causes. There is a growing interest in using routinely collected 'big data' in the evaluation of healthcare. We developed a set of evidence-based 'high impact' quality indicators (QIs) for primary care and examined variations in achievement of these indicators using routinely collected data in the United Kingdom (UK). METHODS: Cross-sectional analysis of routinely collected, electronic primary care data from a sample of general practices in West Yorkshire, UK (n = 89)...
2017: PloS One
https://www.readbyqxmd.com/read/28701839/a-study-of-continuous-renal-replacement-therapy-and-acute-peritoneal-dialysis-in-hemodynamic-unstable-patients
#8
Ajay Jaryal, Sanjay Vikrant
OBJECTIVE: The objective of the following study was to assess the outcome of continuous renal replacement therapy (CRRT) and acute peritoneal dialysis (PD) in dialysis-requiring renal failure in patients with hemodynamic instability. MATERIALS AND METHODS: A retrospective analysis of all the patients who received CRRT and acute PD over a period of 1 year at our institute, a tertiary care center, was done for diagnosis, type of renal replacement therapy (RRT), and survival outcome...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28700996/immunosuppressive-treatment-in-c3-glomerulopathy-is-it-really-effective
#9
Yasar Caliskan, Ege Sinan Torun, Tarik Onur Tiryaki, Aysegul Oruc, Yasemin Ozluk, Sebahat Usta Akgul, Sonay Temurhan, Nida Oztop, Isin Kilicaslan, Mehmet Sukru Sever
BACKGROUND: C3 glomerulopathy (C3GP) is a recently identified and described disease that has a high risk of progressing into end-stage renal disease. We aimed to evaluate the effects of various immunosuppressive regimens on C3GP progression because there are conflicting data on the treatment modalities. METHODS: In this retrospective study of 66 patients with C3GP, 27 patients received mycophenolate mofetil (MMF)-based treatment, 23 received non-MMF-based treatment (prednisolone or cyclophosphamide), and 16 received conservative care...
July 13, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28698169/effectiveness-of-digital-medicines-to-improve-clinical-outcomes-in-patients-with-uncontrolled-hypertension-and-type-2-diabetes-prospective-open-label-cluster-randomized-pilot-clinical-trial
#10
Juan Frias, Naunihal Virdi, Praveen Raja, Yoona Kim, George Savage, Lars Osterberg
BACKGROUND: Hypertension and type 2 diabetes mellitus are major modifiable risk factors for cardiac, cerebrovascular, and kidney diseases. Reasons for poor disease control include nonadherence, lack of patient engagement, and therapeutic inertia. OBJECTIVE: The aim of this study was to assess the impact on clinic-measured blood pressure (BP) and glycated hemoglobin (HbA1c) using a digital medicine offering (DMO) that measures medication ingestion adherence, physical activity, and rest using digital medicines (medication taken with ingestible sensor), wearable sensor patches, and a mobile device app...
July 11, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28695552/glycaemic-blood-pressure-and-lipid-goal-attainment-and-chronic-kidney-disease-stage-of-type-2-diabetic-patients-treated-in-primary-care-practices
#11
Antonella Corcillo, Edward Pivin, Fabrice Lalubin, Nelly Pitteloud, Michel Burnier, Anne Zanchi
INTRODUCTION: The prevalence of chronic kidney disease and diabetes is rising in Europe. These patients are at high cardiovascular and renal risk and need a challenging multifactorial therapeutic approach. METHOD: The goal of this cross-sectional study was to examine the treatment and attainments of goals related to cardiovascular risk factors within chronic kidney disease stages in type 2 diabetic patients followed up by primary care physicians in Switzerland. Each participating physician entered into a web database the anonymised data of up to 15 consecutive diabetic patients attending her/his office between December 2013 and June 2014...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28693548/using-a-linked-database-for-epidemiology-across-the-primary-and-secondary-care-divide-acute-kidney-injury
#12
M Johnson, H Hounkpatin, S Fraser, D Culliford, M Uniacke, P Roderick
BACKGROUND: NHS England has mandated the use in hospital laboratories of an automated early warning algorithm to create a consistent method for the detection of acute kidney injury (AKI). It generates an 'alert' based on changes in serum creatinine level to notify attending clinicians of a possible incident case of the condition, and to provide an assessment of its severity. We aimed to explore the feasibility of secondary data analysis to reproduce the algorithm outside of the hospital laboratory, and to describe the epidemiology of AKI across primary and secondary care within a region...
July 11, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28690174/clinical-outcomes-of-donation-after-circulatory-death-liver-transplantation-in-primary-sclerosing-cholangitis
#13
Palak J Trivedi, Irene Scalera, Emma Slaney, Richard W Laing, Bridget Gunson, Gideon M Hirschfield, Andrea Schlegel, James Ferguson, Paolo Muiesan
BACKGROUND AND AIM: Primary sclerosing cholangitis (PSC) is a progressive fibro-inflammatory cholangiopathy for which liver transplantation is the only life-extending intervention. These patients may benefit from accepting liver donation after circulatory death (DCD), however their subsequent outcome is unknown. METHODS: Clinical outcomes were prospectively evaluated in PSC patients undergoing transplantation from 2006 to 2016 stratified by donor type (DCD, n=35 vs...
July 6, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28687072/evaluating-the-feasibility-of-the-kdigo-ckd-referral-recommendations
#14
Karandeep Singh, Sushrut S Waikar, Lipika Samal
BACKGROUND: In 2012, the international nephrology organization Kidney Disease Improving Global Outcomes (KDIGO) released recommendations for nephrology referral for chronic kidney disease (CKD) patients. The feasibility of adhering to these recommendations is unknown. METHODS: We conducted a retrospective analysis of the primary care population at Brigham and Women's Hospital (BWH). We translated referral recommendations based upon serum creatinine, estimated glomerular filtration rate (eGFR), and albuminuria into a set of computable criteria in order to project referral volume if the KDIGO referral recommendations were to be implemented...
July 7, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28678988/association-of-variation-in-contrast-volume-with-acute-kidney-injury-in-patients-undergoing-percutaneous-coronary-intervention
#15
Amit P Amin, Richard G Bach, Mary L Caruso, Kevin F Kennedy, John A Spertus
Importance: Acute kidney injury (AKI) after percutaneous coronary intervention (PCI) is common, morbid, and costly; increases patients' mortality risk; and can be mitigated by limiting contrast use. Objective: To examine the national variation in AKI incidence and contrast use among US physicians and the variation's association with patients' risk of developing AKI after PCI. Design, Setting, and Participants: This cross-sectional study used the American College of Cardiology National Cardiovascular Data Registry (NCDR) CathPCI Registry to identify in-hospital care for PCI in the United States...
July 5, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28678146/contrast-induced-kidney-injury-how-does-it-affect-long-term-cardiac-mortality
#16
Alessandro Andreis, Carlo Budano, Mario Levis, Paolo Garrone, Tullio Usmiani, Fabrizio D'Ascenzo, Ovidio De Filippo, Maurizio D'Amico, Laura Bergamasco, Luigi Biancone, Sebastiano Marra, Antonio Colombo, Fiorenzo Gaita
AIMS: Contrast-induced acute kidney injury (CIAKI) is a common complication after coronary angiography or percutaneous revascularization (PCI). This study aimed to investigate the association of CIAKI with long-term cardiovascular adverse events. METHODS: In total, 980 patients undergoing coronary angiography/PCI were assessed in this prospective cohort study. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE) and cardiac death (CVD) during an 8-year follow-up...
July 3, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28674612/acute-kidney-injury-improving-the-communication-from-secondary-to-primary-care
#17
Clemency Nye, Suzanna Lake
Acute kidney injury (AKI) is a common but preventable event in secondary care. It is known to be associated with poorer outcomes for the patient's future health. Patients therefore require specific after-care in the community following an AKI, both in the short and long term. However, information about an inpatient AKI is often not communicated to primary care at discharge. Only 11.0% of discharge summaries contained full information about an AKI (including stage of AKI, changes to medications and follow-up required) in August 2015...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28672282/increasing-incidence-of-multiply-recurrent-clostridium-difficile-infection-in-the-united-states-a-cohort-study
#18
Gene K Ma, Colleen M Brensinger, Qufei Wu, James D Lewis
Background: Clostridium difficile infection (CDI), the most common health care-associated infection, often recurs. Fecal microbiota transplantation is increasingly used to treat multiply recurrent CDI (mrCDI). Objective: To determine whether the incidence of mrCDI is increasing in proportion to CDI and to identify risk factors for mrCDI. Design: Retrospective cohort study. Setting: United States. Participants: 38 911 718 commercially insured patients in the OptumInsight Clinformatics Database, of whom 45 341 developed CDI...
July 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28665496/limitations-of-the-interpretation-and-extrapolation-of-clinical-trial-data-in-kidney-transplant-recipients
#19
N I Oliveira, M I Paula, C R Felipe, H Tedesco-Silva, J O Medina-Pestana
OBJECTIVE: The risks and benefits of the participation of kidney transplant recipients in Randomized Clinical Trials (RCT) investigating new immunosuppressive therapies is unknown. DESIGN AND SETTING: We included patients from 12 prospective phase II/III RCT randomized to the experimental (G1, n=319) or standard of care internal control group (G2, n=118). We constructed two additional external control groups with (G3, n=319) or without (G4, n=319) matching inclusion/exclusion criteria based on transplant date...
June 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28663062/community-pharmacist-training-and-communication-network-and-drug-related-problems-in-patients-with-ckd-a-multicenter-cluster-randomized-controlled-trial
#20
Lyne Lalonde, Patricia Quintana-Bárcena, Anne Lord, Robert Bell, Valérie Clément, Anne-Marie Daigneault, Marie-Ève Legris, Sara Letendre, Marie Mouchbahani, Ghaya Jouini, Joëlle Azar, Élisabeth Martin, Djamal Berbiche, Stephanie Beaulieu, Sébastien Beaunoyer, Émilie Bertin, Marianne Bouvrette, Noémie Charbonneau-Séguin, Jean-François Desrochers, Katherine Desforges, Ariane Dumoulin-Charette, Sébastien Dupuis, Maryame El Bouchikhi, Roxanne Forget, Marianne Guay, Jean-Phillippe Lemieux, Claudia Morin-Bélanger, Isabelle Noël, Stephanie Ricard, Patricia Sauvé, François Ste-Marie Paradis
BACKGROUND: Appropriate training for community pharmacists may improve the quality of medication use. Few studies have reported the impact of such programs on medication management for patients with chronic kidney disease (CKD). STUDY DESIGN: Multicenter, cluster-randomized, controlled trial. SETTING & PARTICIPANTS: Patients with CKD stage 3a, 3b, or 4 from 6 CKD clinics (Quebec, Canada) and their community pharmacies. INTERVENTION: Each cluster (a pharmacy and its patients) was randomly assigned to either ProFiL, a training-and-communication network program, or the control group...
June 26, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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