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https://www.readbyqxmd.com/read/29780030/effect-of-multimorbidity-on-survival-of-patients-diagnosed-with-heart-failure-a-retrospective-cohort-study-in-singapore
#1
Palvinder Kaur, Nakul Saxena, Alex Xiaobin You, Raymond C C Wong, Choon Pin Lim, Seet Yoong Loh, Pradeep Paul George
OBJECTIVE: Multimorbidity in patients with heart failure (HF) results in poor prognosis and is an increasing public health concern. We aim to examine the effect of multimorbidity focusing on type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) on all-cause and cardiovascular disease (CVD)-specific mortality among patients diagnosed with HF in Singapore. DESIGN: Retrospective cohort study. SETTING: Primary and tertiary care in three (out of six) Regional Health Systems in Singapore...
May 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29779672/modifiable-risk-factors-to-reduce-renal-cell-carcinoma-incidence-insight-from-the-plco-trial
#2
Jonathan Gelfond, Osamah Al-Bayati, Aashish Kabra, Kevan Iffrig, Dharam Kaushik, Michael A Liss
INTRODUCTION: Identify modifiable factors contributing to renal cell carcinoma in the PCLO to target disease prevention and reduce health care costs. METHODS: The prostate, lung, colorectal, and ovarian database were queried for the primary outcome of kidney cancer. Demographics were investigated, specifically focusing on modifiable risk factors. Statistical analysis includes the Student t-test for continuous variables, chi-squared or Fisher's exact tests for dichotomous and categorical variables for bivariate analysis...
May 17, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29778331/goal-directed-perfusion-to-reduce-acute-kidney-injury-a-randomized-trial
#3
Marco Ranucci, Ian Johnson, Timothy Willcox, Robert A Baker, Christa Boer, Andreas Baumann, George A Justison, Filip de Somer, Paul Exton, Seema Agarwal, Rachael Parke, Richard F Newland, Renard G Haumann, Dirk Buchwald, Nathaen Weitzel, Rajamiyer Venkateswaran, Valeria Pistuddi
OBJECTIVE: To determine whether a goal-directed perfusion (GDP) strategy aimed at maintaining oxygen delivery (DO2 ) at ≥280 mL·min-1 ·m-2 reduces the incidence of acute kidney injury (AKI). METHODS: This multicenter randomized trial enrolled a total of 350 patients undergoing cardiac surgery in 9 institutions. Patients were randomized to receive either GDP or conventional perfusion. A total of 326 patients completed the study and were analyzed. Patients in the treatment arm were treated with a GDP strategy during cardiopulmonary bypass (CPB) aimed to maintain DO2 at ≥280 mL·min-1 ·m-2 ...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29776895/islet-transplantation-versus-insulin-therapy-in-patients-with-type-1-diabetes-with-severe-hypoglycaemia-or-poorly-controlled-glycaemia-after-kidney-transplantation-trimeco-a-multicentre-randomised-controlled-trial
#4
Sandrine Lablanche, Marie-Christine Vantyghem, Laurence Kessler, Anne Wojtusciszyn, Sophie Borot, Charles Thivolet, Sophie Girerd, Domenico Bosco, Jean-Luc Bosson, Cyrille Colin, Rachel Tetaz, Sophie Logerot, Julie Kerr-Conte, Eric Renard, Alfred Penfornis, Emmanuel Morelon, Fanny Buron, Kristina Skaare, Gwen Grguric, Coralie Camillo-Brault, Harald Egelhofer, Kanza Benomar, Lionel Badet, Thierry Berney, François Pattou, Pierre-Yves Benhamou
BACKGROUND: Islet transplantation is indicated for patients with type 1 diabetes with severe hypoglycaemia or after kidney transplantation. We did a randomised trial to assess the efficacy and safety of islet transplantation compared with insulin therapy in these patients. METHODS: In this multicentre, open-label, randomised controlled trial, we randomly assigned (1:1) patients with type 1 diabetes at 15 university hospitals to receive immediate islet transplantation or intensive insulin therapy (followed by delayed islet transplantation)...
May 15, 2018: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29775451/-recurrent-urolithiasis-as-a-symptom-of-primary-hyperparathyroidism-in-a-16-year-old-boy
#5
Monika Wojciechowska, Beata Bieniaś, Aleksandra Sobieszczańska-Droździel, Anna Wieczorkiewicz-Płaza, Iwona Beń-Skowronek, Przemysław Sikora
Primary hyperparathyroidism is one of the most common endocrine diseases, however, it is rare in children. In most cases, it is caused by adenoma of these organs. Its most common complications include urolithiasis, nephrocalcinosis and osteoporosis. CASE REPORT: A 16-year-old patient was admitted to our Clinic because of his first-ever renal colic. The ultrasound examination revealed rightsided hydronephrosis caused by the presence of 9 mm stone in the upper part of the right ureter. In addition, the presence of 8 mm stone in the middle calyx of the left kidney was found...
April 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29774749/excess-costs-of-non-infectious-comorbidities-among-people-living-with-hiv-estimates-from-denmark-and-sweden
#6
Frida Hjalte, Paul S Calara, Anders Blaxhult, Marie Helleberg, Karoline Wallace, Peter Lindgren
People living with HIV have an increased risk of comorbidities with non-communicable diseases such as cardiovascular disease, chronic kidney disease and osteoporotic fractures, compared to the general population. The burden of these comorbidities is expected to rise as the HIV-infected population ages. This development may require additional health care resources and it is relevant to ascertain the costs associated with these comorbidities. The population attributed risk approach was applied to estimate excess costs associated with the higher rates of comorbidities among HIV patients in Denmark and Sweden compared to their respective general populations...
May 18, 2018: AIDS Care
https://www.readbyqxmd.com/read/29771700/the-effect-of-iv-amino-acid-supplementation-on-mortality-in-icu-patients-may-be-dependent-on-kidney-function-post-hoc-subgroup-analyses-of-a-multicenter-randomized-trial
#7
Ran Zhu, Matilde J Allingstrup, Anders Perner, Gordon S Doig
OBJECTIVES: We investigated whether preexisting kidney function determines if ICU patients may benefit from increased (2.0 g/kg/d) protein intake. DESIGN: Post hoc, hypothesis-generating, subgroup analysis of a multicenter, phase 2, randomized clinical trial. All analyses were conducted by intention to treat and maintained group allocation. Ninety-day mortality was the primary outcome. SETTING: ICUs of 16 hospitals throughout Australia and New Zealand...
May 15, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29770702/characterization-of-potentially-unsafe-ambulatory-antibiotic-use-and-associated-outcomes-in-an-adult-kidney-transplant-population
#8
Lindsay M Avery, Cory E Fominaya, Rena C Crawford, Katherine P Pleasants, David J Taber
BACKGROUND: Antibiotics are frequently prescribed to kidney transplant (KTX) recipients in the outpatient setting, but there are limited data assessing the safety and outcomes associated with this practice. OBJECTIVE: The primary objective of this study was to describe ambulatory antibiotic prescribing in a large cohort of adult KTX recipients. The secondary objective was to assess the outcomes associated with potentially unsafe antibiotic use in this population...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29766216/impact-of-angiotensin-converting-enzyme-inhibitors-or-receptor-blockers-on-post-icu-discharge-outcome-in-patients-with-acute-kidney-injury
#9
Etienne Gayat, Alexa Hollinger, Alain Cariou, Nicolas Deye, Antoine Vieillard-Baron, Samir Jaber, Benjamin G Chousterman, Qin Lu, Pierre François Laterre, Xavier Monnet, Michael Darmon, Marc Leone, Bertrand Guidet, Romain Sonneville, Jean-Yves Lefrant, Marie-Céline Fournier, Matthieu Resche-Rigon, Alexandre Mebazaa, Matthieu Legrand
PURPOSE: Acute kidney injury (AKI) is associated with the activation of the renin-angiotensin system. Whether angiotensin-converting enzyme inhibitors (ACEi) or angiotensin-receptor blockers (ARB) improve outcome in patients recovering from AKI remains unexplored. The purpose was to investigate the association between prescription of ACEi/ARB at intensive care unit (ICU) discharge and 1-year outcome in patients recovering from AKI. METHODS: Association between ACEi/ARB and 1-year mortality rate was explored in 1551 patients discharged from 21 European ICUs in an observational cohort...
May 15, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29765209/using-the-frailty-assessment-for-care-planning-tool-fact-to-screen-elderly-chronic-kidney-disease-patients-for-frailty-the-nurse-experience
#10
Heather Moffatt, Paige Moorhouse, Laurie Mallery, David Landry, Karthik Tennankore
Purpose: Recent evidence supports the prognostic significance of frailty for functional decline and poor health outcomes in patients with chronic kidney disease. Yet, despite the development of clinical tools to screen for frailty, little is known about the experiential impact of screening for frailty in this setting. The Frailty Assessment for Care Planning Tool (FACT) evaluates frailty across 4 domains: mobility, function, social circumstances, and cognition. The purpose of this qualitative study was as follows: 1) explore the nurse experience of screening for frailty using the FACT tool in a specialized outpatient renal clinic; 2) determine how, if at all, provider perceptions of frailty changed after implementation of the frailty screening tool; and 3) determine the perceived factors that influence uptake and administration of the FACT screening tool in a specialized clinical setting...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29764436/prevalence-and-incidence-of-complications-at-diagnosis-of-t2dm-and-during-follow-up-by-bmi-and-ethnicity-a-matched-case-control-analysis
#11
Ebenezer S Owusu Adjah, Srikanth Bellary, Wasim Hanif, Kiran Patel, Kamlesh Khunti, Sanjoy K Paul
AIMS: To estimate the risk of developing long-term major cardiovascular and renal complications in relation to levels of body mass index (BMI) in a population of White European (WE), African-Caribbean (AC), and South Asian (SA) patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: Patients with new diagnosis of T2DM, aged ≥ 18 years from January 2000 (n = 69,436) and their age-sex-ethnicity matched non-diabetic controls (n = 272,190) were identified from UK primary care database...
May 15, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29757901/revascularization-time-in-liver-transplantation-independent-prediction-of-inferior-short-and-long-term-outcomes-by-prolonged-graft-implantation
#12
Bettina M Buchholz, Undine A Gerlach, Vishnu V Chandrabalan, James Hodson, Bridget K Gunson, Hynek Mergental, Paolo Muiesan, John R Isaac, Keith J Roberts, Darius F Mirza, M Thamara Pr Perera
BACKGROUND: Strategies for successful transplantation are much needed in the era of organ shortage and there has been a resurgence of interest on the impact of revascularization time (RT) on outcomes in liver transplantation (LT). METHODS: All primary LT performed in Birmingham between 2009 and 2014 (n=678) with portal reperfusion first were stratified according to RT (<44 vs. ≥44 min) and graft quality (SLG, Donor risk index [DRI] <2.3 vs. MLG, DRI ≥2...
May 2, 2018: Transplantation
https://www.readbyqxmd.com/read/29751751/primary-synovial-sarcoma-of-the-kidney-a-case-report-of-complete-pathological-response-at-a-lebanese-tertiary-care-center
#13
Alissar El Chediak, Deborah Mukherji, Sally Temraz, Samer Nassif, Sara Sinno, Rami Mahfouz, Ali Shamseddine
BACKGROUND: Primary synovial sarcoma of the kidney is a rare type of soft tissue sarcoma. Its presenting features can resemble those of other renal tumors; rendering its early diagnosis, a dilemma. Several cases of renal synovial sarcoma have been reported in the literature with varying treatment options and outcomes. This article describes a rare case of primary renal synovial sarcoma and reviews all cases in the literature. CASE PRESENTATION: A 26-year-old male presented with flank pain and hematuria...
May 11, 2018: BMC Urology
https://www.readbyqxmd.com/read/29747650/hospital-financing-of-ischaemic-stroke-determinants-of-funding-and-usefulness-of-drg-subcategories-based-on-severity-of-illness
#14
Sarah Dewilde, Lieven Annemans, Hilde Pincé, Vincent Thijs
BACKGROUND: Several Western and Arab countries, as well as over 30 States in the US are using the "All-Patient Refined Diagnosis-Related Groups" (APR-DRGs) with four severity-of-illness (SOI) subcategories as a model for hospital funding. The aim of this study is to verify whether this is an adequate model for funding stroke hospital admissions, and to explore which risk factors and complications may influence the amount of funding. METHODS: A bottom-up analysis of 2496 ischaemic stroke admissions in Belgium compares detailed in-hospital resource use (including length of stay, imaging, lab tests, visits and drugs) per SOI category and calculates total hospitalisation costs...
May 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29747292/-the-timing-of-renal-replacement-therapy-on-mortality-in-patients-with-acute-renal-injury-a-reanalysis-of-two-recently-published-randomized-control-trials
#15
J W Han, J T Liu, P L Ma
To investigate the sources of inconsistent findings between two randomized control trials["initiation strategies for renal-replacement therapy in the intensive care unit"(AKIKI trial) vs"effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury"(ELAIN trial) ], regarding"timing of renal replacement therapy (RRT) on mortality in patients with acute kidney injury (AKI). By reanalysis of the published data, it was found that demographics, severity of primary disease and stage of AKI before initiation of RRT were quite different between AKIKI and ELAIN trials...
May 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29742967/restrictive-versus-liberal-fluid-therapy-for-major-abdominal-surgery
#16
Paul S Myles, Rinaldo Bellomo, Tomas Corcoran, Andrew Forbes, Philip Peyton, David Story, Chris Christophi, Kate Leslie, Shay McGuinness, Rachael Parke, Jonathan Serpell, Matthew T V Chan, Thomas Painter, Stuart McCluskey, Gary Minto, Sophie Wallace
Background Guidelines to promote the early recovery of patients undergoing major surgery recommend a restrictive intravenous-fluid strategy for abdominal surgery. However, the supporting evidence is limited, and there is concern about impaired organ perfusion. Methods In a pragmatic, international trial, we randomly assigned 3000 patients who had an increased risk of complications while undergoing major abdominal surgery to receive a restrictive or liberal intravenous-fluid regimen during and up to 24 hours after surgery...
May 9, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29741271/new-onset-diabetes-mellitus-among-patients-with-glomerular-diseases
#17
Cynthia C Lim, Maggie Wy Wong, Hui Ling Koh, Yok Mooi Chin, Irene Yj Mok, Jason Cj Choo
BACKGROUND: Glomerulonephritis commonly causes kidney failure. Immunosuppressant treatment may be diabetogenic but data on hyperglycemia in glomerulonephritis treated with usual clinical care is scanty. AIM: We aimed to assess the epidemiology, risk factors and outcomes for New-Onset Diabetes among patients with Glomerular disease (NODAG). METHODS: Single-centre retrospective cohort of non-diabetic adults diagnosed with glomerulonephritis between January 2011 and July 2015...
May 9, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29739781/multiple-risk-factor-control-mortality-and-cardiovascular-events-in-type-2-diabetes-and-chronic-kidney-disease-a-population-based-cohort-study
#18
Shota Hamada, Martin C Gulliford
OBJECTIVES: This study aimed to evaluate the effectiveness of multiple risk factor control (MRFC) at reducing mortality and cardiovascular events in diabetes and chronic kidney disease (CKD) in clinical practice. DESIGN: Population-based cohort study. SETTING: Primary care database in the UK, linked with inpatient and mortality data. PARTICIPANTS: Participants aged 40-79 years with type 2 diabetes and valid serum creatinine measurements, including 11 431 participants with CKD (estimated glomerular filtration rate: eGFR 15-59 mL/min/1...
May 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29738576/distinct-characteristics-and-outcomes-in-elderly-onset-iga-vasculitis-henoch-sch%C3%A3-nlein-purpura-with-nephritis-nationwide-cohort-study-of-data-from-the-japan-renal-biopsy-registry-j-rbr
#19
Hiroyuki Komatsu, Shouichi Fujimoto, Shoichi Maruyama, Masashi Mukoyama, Hitoshi Sugiyama, Kazuhiko Tsuruya, Hiroshi Sato, Jun Soma, Junko Yano, Seiji Itano, Tomoya Nishino, Toshinobu Sato, Ichiei Narita, Hitoshi Yokoyama
BACKGROUND: The clinical presentation and prognosis of adult and elderly patients with IgA vasculitis (Henoch-Schönlein purpura) accompanied by nephritis (IgAV-N) have not been investigated in detail. We therefore surveyed the features and outcomes of IgAV-N based on nationwide data derived from the Japan Renal Biopsy Registry (J-RBR). METHODS: This multi-center cohort study compared the clinicopathological parameters at diagnosis, initial therapies and outcomes between 106 adult (age 19-64 years) and 46 elderly (≥65 years) patients with IgAV-N who were registered in the J-RBR between 2007 and 2012...
2018: PloS One
https://www.readbyqxmd.com/read/29738004/kidney-cancer-in-saudi-arabia-a-25-year-analysis-of-epidemiology-and-risk-factors-in-a-tertiary-center
#20
Sultan S Alkhateeb, Ali S Alothman, Abdulmalik M Addar, Raed A Alqahtani, Tarek M Mansi, Emad M Masuadi
OBJECTIVES: To evaluate available epidemiological data and risk factors for kidney cancer in a tertiary care center in Riyadh, Saudi Arabia, over a period of 25 years. METHODS: This retrospective study conducted in a tertiary care center included all adult patients with primary kidney cancer who presented and were managed between 1990 and 2015. Based on this information, we forecast the incidence of the disease in our center over the next 5 years (2016 to 2020)...
May 2018: Saudi Medical Journal
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