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https://www.readbyqxmd.com/read/28427496/mortality-risk-factors-in-intensive-care-unit-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-a-retrospective-cohort-study%C3%A2
#1
Michael Schmitz, Frank P Tillmann, Ausra Paluckaite, Erich A Laufer, Brian Rayner, Lars C Rump, Peter J Heering
BACKGROUND: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. METHODS: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved...
April 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#2
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28423197/diabetic-kidney-transplant-recipients-impaired-infection-control-and-increased-alloreactivity
#3
Thomas Schachtner, Maik Stein, Petra Reinke
BACKGROUND: Posttransplantation diabetes mellitus (PTDM) has been associated with inferior patient and allograft outcomes. However, previous studies didn't identify differences in infection control and alloreactivity. METHODS: We studied 449 kidney transplant recipients (KTRs) between 2005 and 2013. 50 (11.1%) KTRs were diagnosed with PTDM and 60 (13.4%) KTRs with pre-existing diabetes. Samples were collected pretransplantation, at +1, +2, +3 months posttransplantation...
April 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28405168/the-black-evil-affecting-patients-with-diabetes-a-case-of-rhino-orbito-cerebral-mucormycosis-causing-garcin-syndrome
#4
Santhosh Narayanan, Geetha Panarkandy, Gomathy Subramaniam, Chandni Radhakrishnan, N K Thulaseedharan, Neeraj Manikath, Sreejith Ramaswamy, Suma Radhakrishnan, Danish Ekkalayil
Mucormycosis is a life-threatening infection affecting patients with diabetes. It is an angioinvasive disease often resistant to treatment with a debilitating course and high mortality. Here, we report a case of a 45 year old woman with type 2 diabetes mellitus who presented to us with history of right-sided ptosis and facial palsy, and subsequently developed loss of vision and palatal palsy. She was in diabetic ketoacidosis. Nervous system examination revealed involvement of right second, third, fourth, sixth, seventh, ninth, and tenth cranial nerves, suggestive of Garcin syndrome...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28403094/less-invasive-management-of-deep-neck-infection-and-descending-necrotizing-mediastinitis-a-single-center-retrospective-study
#5
Dong Wei, Ling Bi, Huiyong Zhu, Jianfeng He, Huiming Wang
By a 7-year retrospective review, we reported our experience in management of descending necrotizing mediastinitis (DNM) and deep neck infection (DNI). A retrospective design was used to reveal the clinical characteristics of DNI and DNM. The clinical outcome was analyzed to validate less invasive management. We reviewed 82 patients between 2009 and 2016, 12 of which were diagnosed as DNM by clinical and computed tomography findings. A total of 35 patients had relevant systemic conditions, mainly diabetes mellitus (19 patients)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28398928/anesthetic-management-of-mitochondrial-encephalopathy-with-lactic-acidosis-and-stroke-like-episodes-melas-syndrome-in-a-high-risk-pregnancy-a-case-report
#6
Josh D Bell, Kushlin Higgie, Mital Joshi, Joshua Rucker, Sahar Farzi, Naveed Siddiqui
MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered...
April 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28396715/immunomodulatory-oligonucleotide-imt504-effects-on-mesenchymal-stem-cells-as-a-first-in-class-immunoprotective-immunoregenerative-therapy
#7
REVIEW
Jorge Zorzopulos, Steven M Opal, Andrés Hernando-Insúa, Juan M Rodriguez, Fernanda Elías, Juan Fló, Ricardo A López, Norma A Chasseing, Victoria A Lux-Lantos, Maria F Coronel, Raul Franco, Alejandro D Montaner, David L Horn
The immune responses of humans and animals to insults (i.e., infections, traumas, tumoral transformation and radiation) are based on an intricate network of cells and chemical messengers. Abnormally high inflammation immediately after insult or abnormally prolonged pro-inflammatory stimuli bringing about chronic inflammation can lead to life-threatening or severely debilitating diseases. Mesenchymal stem cell (MSC) transplant has proved to be an effective therapy in preclinical studies which evaluated a vast diversity of inflammatory conditions...
March 26, 2017: World Journal of Stem Cells
https://www.readbyqxmd.com/read/28391314/continued-monitoring-of-acute-kidney-injury-survivors-might-not-be-necessary-in-those-regaining-an-estimated-glomerular-filtration-rate-60%C3%A2-ml-min-at-1-year
#8
Sokratis Stoumpos, Patrick B Mark, Emily P McQuarrie, Jamie P Traynor, Colin C Geddes
Background.: Severe acute kidney injury (AKI) among hospitalized patients often necessitates initiation of short-term dialysis. Little is known about the long-term outcome of those who recover to normal renal function. The aim of this study was to determine the long-term renal outcome of patients experiencing AKI requiring dialysis secondary to hypoperfusion injury and/or sepsis who recovered to apparently normal renal function. Methods.: All adult patients with AKI requiring dialysis in our centre between 1 January 1980 and 31 December 2010 were identified...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28391076/improvised-vacuum-assisted-closure-for-severe-neck-infection-in-poorly-equipped-conditions
#9
S Adam, H D Sama, C Chossegros, M K Bouassalo, M Y Akpoto, E Kpemissi
INTRODUCTION: Dental infections are common and are mainly due to dental caries. When left untreated, these infections can lead to severe life-threatening sepsis. CASE REPORT: The authors reported a case of a severe odontogenic deep neck space infection in a 54-year-old male. The patient was a heavy smoker with incidentally discovered diabetes. He was successfully treated by surgical drainage combined with an improvised Vacuum-Assisted Closure (VAC) system. The results of surgical drainage followed by insertion of an improvised VAC system were spectacular...
April 5, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28381819/purulent-pericarditis-an-uncommon-presentation-of-a-common-organism
#10
Muhammad Kashif, Henish Raiyani, Masooma Niazi, Kamalakkannan Gayathri, Trupti Vakde
BACKGROUND In the modern antibiotic era, Streptococcus agalactiae infection of the endocardium and pericardial space is a rare occurrence. However, once the disease spreads it can lead to life-threatening illness despite advances in diagnostic and treatment modalities, partly because the symptoms and signs associated with pericarditis are frequently missing, and due to the rarity of the disease, diagnosis is often overlooked. We report an extremely rare case of purulent pericarditis caused by Streptococcus agalactiae...
April 6, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28371470/role-of-renal-vascular-potassium-channels-in-physiology-and-pathophysiology
#11
REVIEW
Max Salomonsson, Jens Christian Brasen, Charlotte M Sorensen
The control of renal vascular tone is important for the regulation of salt and water balance, blood pressure and the protection against damaging elevated glomerular pressure. The K(+) conductance is a major factor in the regulation of the membrane potential (Vm ) in vascular smooth muscle (VSMC) and endothelial cells (EC). The vascular tone is controlled by Vm via its effect on the opening probability of voltage operated Ca(2+) channels (VOCC) in VSMC. When K(+) conductance increases Vm becomes more negative and vasodilation follows, while deactivation of K(+) channels leads to depolarization and vasoconstriction...
March 30, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28356659/the-effect-of-resolution-time-of-acute-kidney-injury-on-clinical-outcomes
#12
J S Chavez-Iñiguez, G Garcia-Garcia, J Briseño-Ramirez, R Medina-Gonzalez, M Jimenez-Cornejo
Acute kidney injury (AKI) is a frequent and complex disease. It is not clearly defined whether its duration is related to adverse outcomes. We determined the effect of AKI resolution time on patient's clinical outcomes. A prospective cohort of hospitalized patients with AKI by AKI network (AKIN) creatinine criteria was included. Variables for prognosis and follow-up were analyzed. One hundred and thirteen patients were included in the study. Seventy-seven (68.1%) were males, mean age 55 years (range, 16-76 years), and 48 (42...
March 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28353658/development-of-a-glycosaminoglycan-derived-selectin-targeting-anti-adhesive-coating-to-treat-endothelial-cell-dysfunction
#13
James R Wodicka, Andrea M Chambers, Gurneet S Sangha, Craig J Goergen, Alyssa Panitch
Endothelial cell (EC) dysfunction is associated with many disease states including deep vein thrombosis (DVT), chronic kidney disease, sepsis and diabetes. Loss of the glycocalyx, a thin glycosaminoglycan (GAG)-rich layer on the EC surface, is a key feature of endothelial dysfunction and increases exposure of EC adhesion molecules such as selectins, which are involved in platelet binding to ECs. Once bound, platelets cause thrombus formation and an increased inflammatory response. We have developed a GAG derived, selectin targeting anti-adhesive coating (termed EC-SEAL) consisting of a dermatan sulfate backbone and multiple selectin-binding peptides designed to bind to inflamed endothelium and prevent platelet binding to create a more quiescent endothelial state...
March 29, 2017: Pharmaceuticals
https://www.readbyqxmd.com/read/28352008/spectrum-of-renal-injury-in-pregnancy-induced-hypertension-experience-from-a-single-center-in-india
#14
Mahesh Eswarappa, Madhyastha Rakesh, Puri Sonika, K Snigdha, M Midhun, K Kaushik, Gurudev Konana Chennabasappa, Bande Sujeeth
Pregnancy-induced hypertension (PIH) is a known complication of late pregnancy and is an important cause of maternal and fetal morbidity and mortality. Data on clinical profile, especially renal profile of preeclampsia and eclampsia in Indian women are lacking. The aim of our study was to examine the renal profile and clinical outcomes of patients diagnosed with PIH in our institution with a focus on the spectrum of acute kidney injury (AKI). In this prospective, observational study, 347 patients with a diagnosis of preeclampsia-eclampsia, who were undergoing treatment at the M...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28341493/procalcitonin-as-a-biomarker-for-predicting-amputation-level-in-lower-extremity-infections
#15
Matthew M Reiner, Wissam E Khoury, Michael B Canales, Richard A Chmielewski, Kartick Patel, Mark C Razzante, Coleman O Cloughtery, Douglas Y Rowland
Inflammatory markers are essential tools in the decision-making process for lower extremity infections. When coupled with objective findings, clinicians can more accurately diagnose and treat these entities. Typically, markers such as the white blood cell count, erythrocyte sedimentation rate, and C-reactive protein are used to initially assess these patients or monitor the progression of medical or surgical therapy. Procalcitonin is a newer inflammatory marker that is specific for an infectious process. Originally, procalcitonin was used to monitor antibiotic therapy and sepsis for patients in the intensive care setting, but it has now been expanded to other facets of medicine...
March 21, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28333140/metabolic-and-molecular-insights-into-an-essential-role-of-nicotinamide-phosphoribosyltransferase
#16
Li Q Zhang, Leon Van Haandel, Min Xiong, Peixin Huang, Daniel P Heruth, Charlie Bi, Roger Gaedigk, Xun Jiang, Ding-You Li, Gerald Wyckoff, Dmitry N Grigoryev, Li Gao, Linheng Li, Min Wu, J Steven Leeder, Shui Qing Ye
Nicotinamide phosphoribosyltransferase (NAMPT) is a pleiotropic protein implicated in the pathogenesis of acute respiratory distress syndrome, aging, cancer, coronary heart diseases, diabetes, nonalcoholic fatty liver disease, obesity, rheumatoid arthritis, and sepsis. However, the underlying molecular mechanisms of NAMPT in these physiological and pathological processes are not fully understood. Here, we provide experimental evidence that a Nampt gene homozygous knockout (Nampt(-/-)) resulted in lethality at an early stage of mouse embryonic development and death within 5-10 days in adult mice accompanied by a 25...
March 23, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28318952/glycaemic-variability-in-patients-with-severe-sepsis-or-septic-shock-admitted-to-an-intensive-care-unit
#17
L M Silveira, A Basile-Filho, E A Nicolini, C A M Dessotte, G C S Aguiar, A M Stabile
BACKGROUND: Sepsis is associated with morbidity and mortality, which implies high costs to the global health system. Metabolic alterations that increase glycaemia and glycaemic variability occur during sepsis. OBJECTIVE: To verify mean body glucose levels and glycaemic variability in Intensive Care Unit (ICU) patients with severe sepsis or septic shock. METHOD: Retrospective and exploratory study that involved collection of patients' sociodemographic and clinical data and calculation of severity scores...
March 15, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28314763/endothelial-dysfunction-inhibits-the-ability-of-haptoglobin-to-prevent-hemoglobin-induced-hypertension
#18
Jan A Graw, Binglan Yu, Emanuele Rezoagli, H Shaw Warren, Emmanuel S Buys, Donald B Bloch, Warren M Zapol
BACKGROUND: Intravascular hemolysis produces injury in a variety of human diseases including hemoglobinopathies, malaria, and sepsis. The adverse effects of increased plasma hemoglobin are partly mediated by depletion of nitric oxide (NO) and result in vasoconstriction. Circulating plasma proteins haptoglobin and hemopexin scavenge extracellular hemoglobin and cell-free heme, respectively. METHODS: The ability of human haptoglobin or hemopexin to inhibit the adverse effects of NO-scavenging by circulating murine hemoglobin was tested in C57Bl/6 mice...
March 17, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28314653/assessment-of-risk-factors-for-candidemia-in-non-neutropenic-patients-hospitalized-in-internal-medicine-wards-a-multicenter-study
#19
M Falcone, G Tiseo, C Tascini, A Russo, E Sozio, G Raponi, C Rosin, P Pignatelli, P Carfagna, A Farcomeni, R Luzzati, F Violi, F Menichetti, M Venditti
BACKGROUND: An increasing prevalence of candidemia has been reported in Internal Medicine wards (IMWs). The aim of our study was to identify risk factors for candidemia among non-neutropenic patients hospitalized in IMWs. METHODS: A multicenter case-control study was performed in three hospitals in Italy. Patients developing candidemia (cases) were compared to patients without candidemia (controls) matched by age, time of admission and duration of hospitalization...
March 14, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28296884/increased-von-willebrand-factor-decreased-adamts13-and-thrombocytopenia-in-melioidosis
#20
Emma Birnie, Gavin C K W Koh, Ester C Löwenberg, Joost C M Meijers, Rapeephan R Maude, Nicholas P J Day, Sharon J Peacock, Tom van der Poll, W Joost Wiersinga
BACKGROUND: Melioidosis, caused by bioterror treat agent Burkholderia pseudomallei, is an important cause of community-acquired Gram-negative sepsis in Southeast Asia and Northern Australia. New insights into the pathogenesis of melioidosis may help improve treatment and decrease mortality rates from this dreadful disease. We hypothesized that changes in Von Willebrand factor (VWF) function should occur in melioidosis, based on the presence of endothelial stimulation by endotoxin, pro-inflammatory cytokines and thrombin in melioidosis, and investigated whether this impacted on outcome...
March 2017: PLoS Neglected Tropical Diseases
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