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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
L Clifford McDonald, Dale N Gerding, Stuart Johnson, Johan S Bakken, Karen C Carroll, Susan E Coffin, Erik R Dubberke, Kevin W Garey, Carolyn V Gould, Ciaran Kelly, Vivian Loo, Julia Shaklee Sammons, Thomas J Sandora, Mark H Wilcox
A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults. The update, which has incorporated recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment), includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis...
February 15, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Lena M Napolitano
BACKGROUND: Sepsis is a global healthcare issue and continues to be the leading cause of death from infection. Early recognition and diagnosis of sepsis is required to prevent the transition into septic shock, which is associated with a mortality rate of 40% or more. DISCUSSION: New definitions for sepsis and septic shock (Third International Consensus Definitions for Sepsis and Septic Shock [Sepsis-3]) have been developed. A new screening tool for sepsis (quick Sequential Organ Failure Assessment [qSOFA]) has been proposed to predict the likelihood of poor outcome in out-of-intensive care unit (ICU) patients with clinical suspicion of sepsis...
February 2018: Surgical Infections
Xin Xu, Sheng Nie, Hanying Ding, Fan Fan Hou
The burden of disease and death attributable to environmental pollution is becoming a public health challenge worldwide, especially in developing countries. The kidney is vulnerable to environmental pollutants because most environmental toxins are concentrated by the kidney during filtration. Given the high mortality and morbidity of kidney disease, environmental risk factors and their effect on kidney disease need to be identified. In this Review, we highlight epidemiological evidence for the association between kidney disease and environmental pollutants, including air pollution, heavy metal pollution and other environmental risk factors...
February 26, 2018: Nature Reviews. Nephrology
Jonathan Stock
No abstract text is available yet for this article.
February 19, 2018: JAMA Internal Medicine
Ann M O'Hare
There is growing interest in patient-centered care, defined by the Institute of Medicine as "care that is respectful of and responsive to individual patient preferences, needs, and values." Although generally accepted as uncontroversial, the notion of "centering" care on our patients is in fact quite revolutionary. Because medical teaching, research, and practice have traditionally been organized around diseases and organ systems rather than patients, making care more patient centered would require no less than a paradigm shift in how we practice medicine...
February 9, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Rajeev Raghavan, Garabed Eknoyan
Urea was identified as a urinary salt in 1662 and was the first organic bodily product to be synthesized in vitro in 1828. This heralded the end of an era that defined disease as an imbalance between vital life forces, and catalyzed the merging of organic chemical sciences into clinical medicine. The term urée (urea) was introduced in 1803, its accumulation in blood was dubbed urémie (uremia) in 1847, and the procedure for its removal from urine across semi-permeable membranes designated dialysis in 1861...
February 16, 2018: Clinical Nephrology
William J Powers, Alejandro A Rabinstein, Teri Ackerson, Opeolu M Adeoye, Nicholas C Bambakidis, Kyra Becker, José Biller, Michael Brown, Bart M Demaerschalk, Brian Hoh, Edward C Jauch, Chelsea S Kidwell, Thabele M Leslie-Mazwi, Bruce Ovbiagele, Phillip A Scott, Kevin N Sheth, Andrew M Southerland, Deborah V Summers, David L Tirschwell
BACKGROUND AND PURPOSE: The purpose of these guidelines is to provide an up-to-date comprehensive set of recommendations for clinicians caring for adult patients with acute arterial ischemic stroke in a single document. The intended audiences are prehospital care providers, physicians, allied health professionals, and hospital administrators. These guidelines supersede the 2013 guidelines and subsequent updates. METHODS: Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee, representing various areas of medical expertise...
March 2018: Stroke; a Journal of Cerebral Circulation
Julian Wright, Kristen M Glenister, Rebecca Thwaites, Daniel Terry
Regional Australia remains a district of workforce shortage for nephrology. Thus, it is imperative that patients who have the greatest need for nephrologist services are effectively identified upon referral. The aim of this study was to assess referrals to a regional nephrology service against Australian guidelines by assessing the patient’s renal function and the information contained in the referral document at the time of first consultation. We conducted a retrospective study of all referrals to a regional Australian nephrology service between 2013 and 2015...
January 2018: Aust J Gen Pract
Ezekiel J Emanuel, Emily Gudbranson
No abstract text is available yet for this article.
January 29, 2018: JAMA: the Journal of the American Medical Association
Zorana Zupan, Alexandra Evans, Dominique-Laurent Couturier, Theresa M Marteau
No abstract text is available yet for this article.
December 13, 2017: BMJ: British Medical Journal
Kyla N Brown, Jeanna Parsons Leigh, Hasham Kamran, Sean M Bagshaw, Rob A Fowler, Peter M Dodek, Alexis F Turgeon, Alan J Forster, Francois Lamontagne, Andrea Soo, Henry T Stelfox
BACKGROUND: Little is known about documentation during transitions of patient care between clinical specialties. Therefore, we examined the focus, structure and purpose of physician progress notes for patients transferred from the intensive care unit (ICU) to hospital ward to identify opportunities to improve communication breaks. METHODS: This was a prospective cohort study in ten Canadian hospitals. We analyzed physician progress notes for consenting adult patients transferred from a medical-surgical ICU to hospital ward...
January 28, 2018: Critical Care: the Official Journal of the Critical Care Forum
Toshiyuki Makino, Yoshitatsu Ohara, Namiko Kobayashi, Yohei Kono, Ayumu Nomizu, Mariko Ichijo, Yutaro Mori, Noriaki Matsui, Dai Kishida, Takayuki Toda
Familial Mediterranean Fever (FMF) is usually an autosomal recessive autoinflammatory disease characterized by recurrent attacks of fever and serositis. FMF develops before the age of 20 years in 90% of patients. It has intervals of 1 week to several years between attacks, which leads to renal dysfunction-amyloidosis. We report a case of atypical FMF that developed in a long-term hemodialysis patient. A 65-year-old Japanese female undergoing hemodialysis for 32 years was referred to our hospital with a fever of unknown origin (FUO) following cervical laminoplasty...
January 18, 2018: Hemodialysis International
Matt Foy, C John Sperati
The End-Stage Renal Disease (ESRD) program now serves approximately 675,000 individuals in the United States at a cost of $26.1 billion to the Medicare system. Given the size of this population, healthcare providers from all disciplines will deliver care to patients on dialysis. Mortality remains high among patients on chronic dialysis, with 42.3% surviving 5 years. As this is a vulnerable population, it is important in the care of ESRD patients that non-nephrologists have a working knowledge of issues germane to dialysis...
January 15, 2018: Seminars in Dialysis
Meng-Ting Wang, Jun-Ting Liou, Chen Wei Lin, Chen-Liang Tsai, Yun-Han Wang, Yu-Juei Hsu, Jyun-Heng Lai
Importance: The associations between cardiovascular disease (CVD) and inhaled long-acting β2-agonists (LABAs) or long-acting antimuscarinic antagonists (LAMAs) in chronic obstructive pulmonary disease (COPD) are greatly debated. Pivotal and relevant randomized clinical trials included prior LABA or LAMA users and excluded patients with baseline CVD; therefore, cardiovascular events arising from first-time LABA or LAMA use, if any, could not be observed. There is an urgent need to examine whether new use of and duration since initiating LABAs and LAMAs could act as important determinants of cardiovascular events...
January 2, 2018: JAMA Internal Medicine
Clyde W Yancy, James L Januzzi, Larry A Allen, Javed Butler, Leslie L Davis, Gregg C Fonarow, Nasrien E Ibrahim, Mariell Jessup, JoAnn Lindenfeld, Thomas M Maddox, Frederick A Masoudi, Shweta R Motiwala, J Herbert Patterson, Mary Norine Walsh, Alan Wasserman
No abstract text is available yet for this article.
January 16, 2018: Journal of the American College of Cardiology
James S Goodwin, Habeeb Salameh, Jie Zhou, Siddhartha Singh, Yong-Fang Kuo, Ann B Nattinger
Importance: Substantial numbers of hospitalists are fresh graduates of residency training programs. Current data about the effect of hospitalist years of experience on patient outcomes are lacking. Objective: To describe the association of hospitalist years of experience with 30-day mortality and hospital mortality of their patients. Design, Setting, and Participants: We used a 5% sample of national Medicare data of patient and hospital characteristics to build a multilevel logistic regression model to predict mortality as a function of years of experience of the hospitalists...
December 26, 2017: JAMA Internal Medicine
Rebecca Smith-Bindman
No abstract text is available yet for this article.
February 1, 2018: JAMA Internal Medicine
Catherine Bell
No abstract text is available yet for this article.
December 11, 2017: BMJ: British Medical Journal
María José Buj Pradilla, Teresa Martí Ballesté, Roser Torra, Felipe Villacampa Aubá
Renal angiomyolipomas are found in up to 80% of tuberous sclerosis complex (TSC) patients. Although these tumours are usually asymptomatic, lesions >3 cm in diameter are prone to bleeding and up to 10% of TSC patients may experience a massive and potentially fatal retroperitoneal haemorrhage. Diagnosis can be complicated because of the initial lack of symptoms and the fat-poor content of atypical renal angiomyolipomas. After diagnosis, tumour growth and the emergence of new tumours must be monitored. Treatment with mammalian target of rapamycin (mTOR) inhibitors can reduce tumour size and is indicated in patients with TSC-associated renal angiomyolipomas >3 cm in diameter...
December 2017: Clinical Kidney Journal
Ming-Chun Chen, Jen-Hung Wang, Chia-Hsiang Chu, Ching-Feng Cheng
BACKGROUND: Pediatric hematuria/proteinuria is a risk factor for chronic kidney disease in later life, and school urinary screening can detect asymptomatic glomerulonephritis in the early stage. This study aimed to evaluate the prevalence of hematuria/proteinuria and its association with different socio-demographic factors among school children in 2013 in Hualien, Taiwan. METHODS: A cross-sectional study was conducted among first, fourth, and seventh graders. Health examination results and urinalysis data were analyzed...
November 21, 2017: Pediatrics and Neonatology
2017-12-12 08:16:06
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