Pneumonia Due To Pan-resistant Acinetobactor Baumannii &
General & Internal Medicine; Respiratory System
Elahee M; Talat A; Khalid M; Shah M; Bailey R S
American Journal of Respiratory and Critical Care Medicine
2018
2018
Journal Article or Conference Abstract Publication
n/a
A Leaky Situation: Gadolinium Contrast Induced Neurotoxicity from Intrathecal Contrast
General & Internal Medicine; Respiratory System
Sese D; Blaha T; Khurana R; Wachsman A; Al-Ali F; Murray T; Cucci A R
American Journal of Respiratory and Critical Care Medicine
2018
2018
Journal Article
n/a
The risk of prescribing antibiotics “just-in-case” there is infection.
Patient Safety; Antibiotic Prophylaxis; Drugs; Professional Knowledge; Drug Resistance; Microbial; Adverse Drug Event; Inappropriate Prescribing; Prescribing Patterns; Antibiotics – Adverse Effects; Prescription
The habit of prescribing antibiotics “just-in-case” there is infection is based on the misguided perception that antibiotics are “safe” drugs and therefore pose little risk to patients. Surgeons need to dispel this myth. One in five patients experience an antibiotic adverse drug event. The risk of overprescribing antibiotics far outweighs the perceived benefit and contributes to antibiotic resistance that not only threatens the efficacy of prophylaxis it also threatens the practice of surgery. Every unnecessary antibiotic contributes to a scenario in which patients who need surgery can no longer be protected from infections by antibiotic prophylaxis. Surgeons need to be fully engaged in antibiotic stewardship.
Goff Debra A; JrFile Thomas M
Seminars in Colon & Rectal Surgery
2018
2018-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1053/j.scrs.2017.09.008" target="_blank" rel="noreferrer noopener">10.1053/j.scrs.2017.09.008</a>
SAFETY AND EFFICACY OF ACTHAR GEL IN AN OUTPATIENT DIALYSIS POPULATION.
Purpose/Hypothesis: The purpose of this study was to determine the safety and effectiveness of a 6 month regime of H.P Acthar Gel (Mallinckrodt Pharmaceuticals, Hazelwood, MO) to improved nutritional, biochemical, physical performance and quality of life in Non-Diabetic Hemodialysis (NDHD) outpatients. Number of Subjects: Five. Materials/Methods: Repeated measures within-subject design. Subjects were included if they were non-diabetic ambulatory adults (18-80 years old) having \textless5 years receiving dialysis at an outpatient center. Subjects received a 6 month regime of Acthar gel (40 or 80 units subcutaneously injected 2X weekly). Dependent variables were examined at baseline, 3 and 6 months. Nutritional outcomes included dry body weight and body mass index, lean body mass, pre-albumin, albumin and relevant laboratory values. The Food Frequency Questionnaire was used to track dietary intake. Muscle strength and physical performance measures (10 Meter Gait Speed Test, Timed Up and Go (TUG) Test, Short Physical Performance Battery (SPPB) score, 10X Sit-To-Stand Test, and 2 Minute Walk Test) were completed. P-values \textless .05 were considered statistically significant, and Tukey post-hoc adjustments were made to pairwise comparisons between time points. Results: Seventy-six subjects were screened and 5 individuals completed the trial. Participants were 38 to 69 years of age (X = 48.4), with dialysis duration 5 to 60 months (X = 26.2). After 6 months, there was a significant (P \textless .05) increase in mean prealbumin (25.60 vs 35.40 mg/dL) and lean body mass (58.18 vs 60.00 kg) with a non-significant increase in mean dry body weight (95.99 vs 101.15 kg). Timed Up and Go walking performance also significantly improved (11.83-9.92 seconds) suggesting a reduced risk for falls. Conclusions: This report provides evidence (improved prealbumin and lean body mass) that Acthar gel may be helpful to NDHD patients who are new to dialysis but have a failure to thrive. Future studies should examine lower doses for longer time periods in a sample of 30 subjects. The TUG significantly improved suggesting a potentially positive measure to convey change in subjects who are higher functioning. Future research may consider examining effects of Acthar to improve TUG in older individuals. Clinical Relevance: Use of Acthar Gel in those with NDHD may help increase lean body mass, improved prealbumin levels and result in increased physical functioning with decreased risk of falls.
S Giuffre; J Wetzel; R Guy; R Pohle-Krauza; E Sarac
Cardiopulmonary Physical Therapy Journal (Lippincott Williams & Wilkins)
2018
2018-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Management of Phenobarbital and Apixaban Interaction in Recurrent Cardioembolic Stroke.
King Philip K; Stump Trevor A; Walkama Allyn M; Ash Benjamin M; Bowling Susana M
Annals of Pharmacotherapy
2018
2018-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1060028018759938" target="_blank" rel="noreferrer noopener">10.1177/1060028018759938</a>
LEFT VENTRICULAR LONGITUDINAL FIBER DYSFUNCTION IN LEFT VENTRICULAR NON-COMPACTION CARDIOMYOPATHY.
Tandon Navdeep; Morgenstern Daniel; Mikolich Brandon; Mikolich J Ronald
Journal of the American College of Cardiology (JACC)
2018
2018-03-21
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/S0735-1097(18)31275-0" target="_blank" rel="noreferrer noopener">10.1016/S0735-1097(18)31275-0</a>
DETECTION OF ANEURYSM OF THE ASCENDING AORTA IN PATIENTS WITH AORTIC REGURGITATION.
Tondapu Venkat; Long Jordan; Boland Sebastian; Raghavendran Rohith; Mikolich J Ronald
Journal of the American College of Cardiology (JACC)
2018
2018-03-21
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/S0735-1097(18)32556-7" target="_blank" rel="noreferrer noopener">10.1016/S0735-1097(18)32556-7</a>
DETECTION OF ANEURYSM OF THE ASCENDING AORTA IN HYPERTENSIVE PATIENTS.
Long Jordan; Burley Michael; Morgenstern Daniel; Saikumar Rohith; Mikolich J Ronald
Journal of the American College of Cardiology (JACC)
2018
2018-03-21
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/S0735-1097(18)32139-9" target="_blank" rel="noreferrer noopener">10.1016/S0735-1097(18)32139-9</a>
DERM: A Four-Step Dermatology Education Digital Tool Kit for Nondermatologists.
Background and Objectives: Dermatology is often an overlooked and underemphasized area of training in postgraduate primary care medical education, with an abundance of dermatological educational resources available, but no clear guidelines on how to best take advantage of them. The objective of this study was to develop a dermatology digital tool kit designed to describe, evaluate, recognize, and manage (DERM) common dermatological conditions in primary care residency education and to evaluate potential improvement in clinical confidence.Methods: A total of 14 family medicine (FM) and 33 internal medicine (IM) residents were given the DERM tool kit to complete over 7 weeks. Effects on residents' self-reported comfort with dermatology and resources used were measured by voluntary anonymous surveys distributed before and after DERM completion.Results: A response rate of 100% (14/14) for FM residents and 52% (17/33) for IM residents was achieved. The majority of residents (61%) recalled minimal dermatology education-less than 2 weeks-in medical school and 71% agreed that there is not enough dermatology in their residency curriculum. A statistically significant increase in resident comfort with describing (P=0.002), recognizing and diagnosing (P\textless0.001), and managing (P=0.001) dermatologic conditions was observed postcompletion. Residents reported they would recommend this tool to other primary care residents.Conclusions: Implementing the DERM digital tool kit is feasible with primary care residents and appears to improve comfort with describing, recognizing and diagnosing, and managing dermatologic conditions.
Giesey Rachel; Narively Doria; Mostow Eliot; Davidson Elliot; Mullen Chanda
Family medicine
2018
2018-08-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.22454/FamMed.2018.504756" target="_blank" rel="noreferrer noopener">10.22454/FamMed.2018.504756</a>
Digital strategies for dermatology patient education.
Humans; Physician-Patient Relations; Communication; Dermatology/*methods; Patient Education as Topic/*methods; Technology/*methods
Giesey Rachel; Mostow Eliot; Lloyd Jenifer
Cutis
2018
2018-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Biochemistry, Hemoglobin Synthesis
Hemoglobin is an oxygen-binding protein found in erythrocytes which transports oxygen from the lungs to tissues. Each hemoglobin molecule is a tetramer made of four polypeptide globin chains. Each globin subunit contains a heme moiety formed of an organic protoporphyrin ring and a central iron ion in the ferrous state (Fe2+). The iron molecule in each heme moiety can bind and unbind oxygen, allowing for oxygen transport in the body. The most common type of hemoglobin in the adult is HbA, which comprises two alpha-globin and two beta-globin subunits. Different globin genes encode each type of globin subunit.[1] The two main components of hemoglobin synthesis are globin production and heme synthesis. Globin chain production occurs in the cytosol of erythrocytes and occurs by genetic transcription and translation. Many studies have shown that the presence of heme induces globin gene transcription. Genes for the alpha chain are on chromosome 16 and genes for the beta chain are on chromosome 11. Heme synthesis occurs in both the cytosol and the mitochondria of erythrocytes. It begins with glycine and succinyl coenzyme A and ends with the production of a protoporphyrin IX ring. Binding of the protoporphyrin to an Fe2+ ion forms the final heme molecule.[2]
Farid Yostina; Lecat Paul
StatPearls
2018
2018-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pregnancy-related Hemophagocytic Lymphohistiocytosis Associated with Herpes Simplex Virus-2 Infection: A Diagnostic Dilemma.
hemophagocytic lymphohistiocytosis; hsv; pregnancy
Hemophagocytic lymphohistiocytosis (HLH) is a severe inflammatory disorder characterized by the uncontrolled proliferation of lymphocytes and histiocytes with hemophagocytic activity in the bone marrow. To our knowledge, there have been a few reported cases of pregnancy-related HLH. This case highlights the importance of considering HLH in a pregnant woman along with other diagnoses, such as HELLP (which stands for hemolysis, elevated liver enzyme levels, and low platelet levels) syndrome and hemolytic anemias. It points to the challenges of diagnosing and managing pregnancy-related HLH due to a similarity in presentation with other conditions.
Nasser M Farhan; Sharma Shorabh; Albers Elizabeth; Sharma Sapna; Duggal Anurag
Cureus
2018
2018-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.7759/cureus.2352" target="_blank" rel="noreferrer noopener">10.7759/cureus.2352</a>
Palliative care for acute kidney injury patients in the intensive care unit.
Acute kidney injury; Advance directives; Dialysis; Intensive care unit; Palliative care
Patients with acute kidney injury (AKI) in the intensive care unit (ICU) are often suitable for palliative care due to the high symptom burden. The role of palliative medicine in this patient population is not well defined and there is a lack of established guidelines to address this issue. Because of this, patients in the ICU with AKI deprived of the most comprehensive or appropriate care. The reasons for this are multifactorial including lack of palliative care training among nephrologists. However, palliative care in these patients can help alleviate symptoms, improve quality of life, and decrease suffering. Palliative care physicians can determine the appropriateness and model of palliative care. In addition to shared decision-making, advance directives should be established with patients early on, with specific instructions regarding dialysis, and those advance directives should be respected.
Krishnappa Vinod; Hein William; DelloStritto Daniel; Gupta Mona; Raina Rupesh
World journal of nephrology
2018
2018-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.5527/wjn.v7.i8.148" target="_blank" rel="noreferrer noopener">10.5527/wjn.v7.i8.148</a>
Osborne waves in the hot summer.
Arrhythmias; hypothermia; J-waves; Osborn waves; summer
Osborn waves are produced when the J-point deviates from baseline. While there are many known causes of Osborne waves, hypothermia remains the most common. Previous studies have been inconsistent about the risk of Osborne waves progressing to a deadly arrhythmia. Commonly, once patients are rewarmed, they no longer exhibit Osborne waves or experience cardiac arrhythmias. This patient presented with hypothermia on a hot, humid August day demonstrating two factors known to cause Osborne waves - hypothermia and hypocalcemia. While replenishing the calcium was beneficial, providing ventilator support and active rewarming remained the mainstays of treatment.
Diyaolu Modupeola; Shaub Ted; Firstenberg Michael S
International journal of critical illness and injury science
2018
2018-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.4103/IJCIIS.IJCIIS_59_18" target="_blank" rel="noreferrer noopener">10.4103/IJCIIS.IJCIIS_59_18</a>
Mechanical Ventilation Boot Camp Curriculum.
Humans; Curriculum; Internship and Residency/methods/*organization & administration; Respiratory Therapy/*education; Simulation Training; Respiration; Artificial/*methods
Medical management of mechanically ventilated patients is challenging to novice providers. Incorrect management of this population may lead to increased morbidity and mortality. A three-day simulation-based boot camp serves to provide one-on-one instruction with a critical care provider. These intensivists may dispense personalized immediate feedback as learners engage in hands-on practice with a real mechanical ventilator. Multiple different pathologies can be reviewed that may not be encountered in the clinical setting. Learners can visualize immediate consequences of their actions and may troubleshoot and ask questions, all while in a safe learning environment. We describe the use of human-patient simulators connected to breathing simulators and mechanical ventilators. Potential curriculum executors should be aware of the cost of the equipment and the time needed to dedicate to boot camp execution; however, this intensive interactive training has been shown to increase provider competency, knowledge, and confidence in ventilator management. This curriculum outline provides guidance on how to execute a simulation-based boot camp to train providers on the management of mechanically ventilated patients.
Yee Jennifer; Benner Alma; Hammond Jared; Malone Bethany; Fuenning Charles; George Richard; Ahmed Rami A
Journal of Visualized Experiments
2018
2018-03
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<a href="http://doi.org/10.3791/57303" target="_blank" rel="noreferrer noopener">10.3791/57303</a>
Fluid Overload in Critically Ill Children.
acute kidney injury; critical care; fluid overload; intensive care; pediatric nephrology
Background: A common practice in the management of critically ill patients is fluid resuscitation. An excessive administration of fluids can lead to an imbalance in fluid homeostasis and cause fluid overload (FO). In pediatric critical care patients, FO can lead to a multitude of adverse effects and increased risk of morbidity. Objectives: To review the literature highlighting impact of FO on a multitude of outcomes in critically-ill children, causative vs. associative relationship of FO with critical illness and current pediatric fluid management guidelines. Data Sources: A literature search was conducted using PubMed/Medline and Embase databases from the earliest available date until June 2017. Data Extraction: Two authors independently reviewed the titles and abstracts of all articles which were assessed for inclusion. The manuscripts of studies deemed relevant to the objectives of this review were then retrieved and associated reference lists hand-searched. Data Synthesis: Articles were segregated into various categories namely pathophysiology and sequelae of fluid overload, assessment techniques, epidemiology and fluid management. Each author reviewed the selected articles in categories assigned to them. All authors participated in the final review process. Conclusions: Recent evidence has purported a relationship between mortality and FO, which can be validated by prospective RCTs (randomized controlled trials). The current literature demonstrates that "clinically significant" degree of FO could be below 10%. The lack of a standardized method to assess FB (fluid balance) and a universal definition of FO are issues that need to be addressed. To date, the impact of early goal directed therapy and utility of hemodynamic parameters in predicting fluid responsiveness remains underexplored in pediatric resuscitation.
Raina Rupesh; Sethi Sidharth Kumar; Wadhwani Nikita; Vemuganti Meghana; Krishnappa Vinod; Bansal Shyam B
Frontiers in pediatrics
2018
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.3389/fped.2018.00306" target="_blank" rel="noreferrer noopener">10.3389/fped.2018.00306</a>
Atrial Metastasis of Renal Cell Carcinoma: A Rare Presentation.
Inferior vena cava; Metastasis; Renal cell carcinoma; Right atrial mass
Renal cell carcinoma (RCC) is an aggressive and lethal tumor that has a high frequency of metastatic spread to unpredictable sites. One quarter of patients have either distant metastases or significant local-regional disease with atypical symptoms on presentation. We present a 41-year-old patient with symptoms of right heart failure and was found to have metastatic renal cell carcinoma with enhancing tumor from left renal vein up to right atrium.
Shah Shilpi; Vinod Poornima; Khayata Mohamed; Lane Jason L; Hegde Vinayak; Raina Rupesh
Cardiology research
2018
2018-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.14740/cr690w" target="_blank" rel="noreferrer noopener">10.14740/cr690w</a>
Heparin free dialysis in critically sick children using sustained low efficiency dialysis (SLEDD-f): A new hybrid therapy for dialysis in developing world.
Humans; Adolescent; Retrospective Studies; Child; Infant; *Critical Care/methods; Acute Kidney Injury/blood/mortality/*therapy; Critical Illness/*therapy; Developing Countries; Feasibility Studies; Follow-Up Studies; Length of Stay; Renal Dialysis/adverse effects/instrumentation/*methods; Treatment Outcome; Preschool
BACKGROUND: In critically sick adults, sustained low efficiency dialysis [SLED] appears to be better tolerated hemodynamically and outcomes seem to be comparable to CRRT. However, there is paucity of data in critically sick children. In children, two recent studies from Taiwan (n = 11) and India (n = 68) showed benefits of SLED in critically sick children. AIMS AND OBJECTIVES: The objective of the study was to look at the feasibility and tolerability of sustained low efficiency daily dialysis-filtration [SLEDD-f] in critically sick pediatric patients. MATERIAL AND METHODS: Design: Retrospective study Inclusion criteria: All pediatric patients who had undergone heparin free SLEDD-f from January 2012 to October 2017. Measurements: Data collected included demographic details, vital signs, PRISM III at admission, ventilator parameters (where applicable), number of inotropes, blood gas and electrolytes before, during, and on conclusion of SLED therapy. Technical information was gathered regarding SLEDD-f prescription and complications. RESULTS: Between 2012-2017, a total of 242 sessions of SLEDD-f were performed on 70 patients, out of which 40 children survived. The median age of patients in years was 12 (range 0.8-17 years), and the median weight was 39 kg (range 8.5-66 kg). The mean PRISM score at admission was 8.77+/-7.22. SLEDD-f sessions were well tolerated, with marked improvement in fluid status and acidosis. Premature terminations had to be done in 23 (9.5%) of the sessions. There were 21 sessions (8.6%) terminated due to hypotension and 2 sessions (0.8%) terminated due to circuit clotting. Post- SLEDD-f hypocalcemia occurred in 15 sessions (6.2%), post- SLEDD-f hypophosphatemia occurred in 1 session (0.4%), and post- SLEDD-f hypokalemia occurred in 17 sessions (7.0%). CONCLUSIONS: This study is the largest compiled data on pediatric SLEDD-f use in critically ill patients. Our study confirms the feasibility of heparin free SLEDD-f in a larger pediatric population, and even in children weighing \textless20 kg on inotropic support.
Sethi Sidharth Kumar; Bansal Shyam B; Khare Anshika; Dhaliwal Maninder; Raghunathan Veena; Wadhwani Nikita; Nandwani Ashish; Yadav Dinesh Kumar; Mahapatra Amit Kumar; Raina Rupesh
PloS one
2018
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1371/journal.pone.0195536" target="_blank" rel="noreferrer noopener">10.1371/journal.pone.0195536</a>
Effect of Immunosuppressive Therapy on the Occurrence of Atypical Hemolytic Uremic Syndrome in Renal Transplant Recipients.
Adult; Female; Humans; Male; Middle Aged; Adrenal Cortex Hormones/adverse effects; Atypical Hemolytic Uremic Syndrome/*epidemiology/etiology; Immunosuppression/adverse effects; Immunosuppressive Agents/*adverse effects; Incidence; Kidney Transplantation/*adverse effects; Postoperative Complications/*epidemiology/etiology; Retrospective Studies; Sirolimus/adverse effects; Transplant Recipients; Kidney Failure; Chronic/*surgery
BACKGROUND Atypical hemolytic uremic syndrome (aHUS), a rare thrombotic microangiopathy, is characterized by hemolytic anemia, thrombocytopenia, and acute renal failure. Caused by genetic mutations in the alternative complement cascade, aHUS often will culminate in end-stage renal disease and occasionally death. Renal transplantation in aHUS patients has been contraindicated in the past due to the recurrence risk, with certain immunosuppressive regimens being commonly attributed. In this study, we analyzed the association between aHUS and immunosuppressive agents so as to offer evidence for the use of certain immunosuppressive regimens in renal transplant recipients. MATERIAL AND METHODS Our study is a retrospective analysis using data from the United States Renal Data System from 2004 to 2012. A cohort of renal transplantation patients diagnosed with aHUS were identified to include in the study. The primary endpoint was the determination of aHUS incidence in renal transplant recipients due to various immunosuppressive agents. The secondary endpoints were to check the relationship between the drug type as well as the demographic variables that increase the risk for aHUS. RESULTS It was found that there was a higher usage of sirolimus (P=0.015) and corticosteroids (P=0.030) in the aHUS patients compared to patients in other diagnoses group. CONCLUSIONS There was a higher usage of sirolimus and corticosteroids in renal transplantation patients diagnosed with aHUS. Unfortunately, due to the rarity of this disease, the sample size was small (n=14). Despite the small sample size, this data analysis throws light on the relationship between aHUS and immunosuppressive agents in renal transplant recipients, although we still have much to learn.
Raina Rupesh; Chauvin Abigail; Fox Kelli; Kesav Natasha; Ascha Mustafa S; Vachharajani Tushar J; Krishnappa Vinod
Annals of transplantation
2018
2018-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.12659/AOT.909781" target="_blank" rel="noreferrer noopener">10.12659/AOT.909781</a>
Raising concerns about the Sepsis-3 definitions.
*Data Accuracy; *Infections; *Organ dysfunction; *Sepsis; *Septic shock; *Severity of Illness Index; Arterial Pressure; Consensus; Glasgow Coma Scale; Humans; Infection; Organ Dysfunction Scores; Publishing; Sensitivity and Specificity; Sepsis; Sepsis/*classification/mortality; Validation Studies
The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.
Sartelli Massimo; Kluger Yoram; Ansaloni Luca; Hardcastle Timothy C; Rello Jordi; Watkins Richard R; Bassetti Matteo; Giamarellou Eleni; Coccolini Federico; Abu-Zidan Fikri M; Adesunkanmi Abdulrashid K; Augustin Goran; Baiocchi Gian L; Bala Miklosh; Baraket Oussema; Beltran Marcelo A; Jusoh Asri Che; Demetrashvili Zaza; De Simone Belinda; de Souza Hamilton P; Cui Yunfeng; Davies R Justin; Dhingra Sameer; Diaz Jose J; Di Saverio Salomone; Dogjani Agron; Elmangory Mutasim M; Enani Mushira A; Ferrada Paula; Fraga Gustavo P; Frattima Sabrina; Ghnnam Wagih; Gomes Carlos A; Kanj Souha S; Karamarkovic Aleksandar; Kenig Jakub; Khamis Faryal; Khokha Vladimir; Koike Kaoru; Kok Kenneth Y Y; Isik Arda; Labricciosa Francesco M; Latifi Rifat; Lee Jae G; Litvin Andrey; Machain Gustavo M; Manzano-Nunez Ramiro; Major Piotr; Marwah Sanjay; McFarlane Michael; Memish Ziad A; Mesina Cristian; Moore Ernest E; Moore Frederick A; Naidoo Noel; Negoi Ionut; Ofori-Asenso Richard; Olaoye Iyiade; Ordonez Carlos A; Ouadii Mouaqit; Paolillo Ciro; Picetti Edoardo; Pintar Tadeja; Ponce-de-Leon Alfredo; Pupelis Guntars; Reis Tarcisio; Sakakushev Boris; Kafil Hossein Samadi; Sato Norio; Shah Jay N; Siribumrungwong Boonying; Talving Peep; Trana Cristian; Ulrych Jan; Yuan Kuo-Ching; Catena Fausto
World journal of emergency surgery : WJES
2018
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1186/s13017-018-0165-6" target="_blank" rel="noreferrer noopener">10.1186/s13017-018-0165-6</a>
The use of eculizumab in gemcitabine induced thrombotic microangiopathy.
*Gemcitabine; *Hemolytic uremic syndrome; *Pancreatic cancer; *Renal failure; *Thrombotic microangiopathy; Antibodies; Antimetabolites; Antineoplastic – Adverse Effects; Antineoplastic/*adverse effects; Deoxycytidine; Deoxycytidine – Adverse Effects; Deoxycytidine/adverse effects/*analogs & derivatives; Female; Humanized/*therapeutic use; Humans; Middle Age; Middle Aged; Monoclonal; Monoclonal – Therapeutic Use; Scales; Thrombocytopenia – Chemically Induced; Thrombocytopenia – Diagnosis; Thrombocytopenia – Drug Therapy; Thrombotic Microangiopathies/*chemically induced/diagnosis/*drug therapy
BACKGROUND: Thrombotic microangiopathy (TMA) secondary to gemcitabine therapy (GiTMA) is a very rare pathology that carries a poor prognosis, with nearly half of the cases progressing to end stage renal disease. GiTMA is most commonly associated with adenocarcinomas, most notably pancreatic cancers. The mainstay of management is withdrawal of the offending drug and supportive care. Plasmapheresis has a limited role and hemodialysis may help in the management of fluid overload secondary to renal failure. Furthermore, a C5 inhibitor, eculizumab, has been successfully used in the treatment of GiTMA. CASE PRESENTATION: A 64-year-old Caucasian female with history of pancreatic adenocarcinoma on gemcitabine chemotherapy presented with signs and symptoms of fluid overload and was found to have abnormal kidney function. Her BP was 195/110 mmHg, serum creatinine 4.48 mg/dl, hemoglobin 8.2 g/dl, platelets 53 x 10(3)/cmm, lactate dehydrogenase 540 IU/L, and was found to have schistocytes on blood film. A diagnosis of TMA secondary to gemcitabine therapy was suspected. Hemodialysis for volume overload and daily plasmapheresis were initiated. After six days of plasmapheresis, renal function did not improve. Further work up revealed ADAMTS 13 activity \textgreater15%, low C3, and stool culture and Shiga-toxin PCR were negative. Renal biopsy was consistent with TMA. Gemcitabine was discontinued, but renal function failed to improve and eculizumab therapy was considered due to suspicion of aHUS. Serum creatinine \textgreater2.26 mg/dl and a platelet count of \textgreater/= 30 x 10(9)/L is highly suggestive of aHUS, while TTP is more likely when creatinine is \textless2.26 mg/dl and platelet count of \textless30 x 10(9)/L. She received intravenous eculizumab for eight months, which resulted in significant improvement of renal function. Other markers of hemolysis, namely LDH and bilirubin, also rapidly improved following eculizumab therapy. Plasmapheresis and hemodialysis were discontinued after two and eight weeks of initiation respectively. CONCLUSION: Chemotherapy induced TMA is very rare and requires a high index of clinical suspicion for timely diagnosis. Discontinuation of the offending drug and supportive care is the main stay of treatment; however, eculizumab has been shown to be beneficial in GiTMA. Further research is required to validate this approach.
Krishnappa Vinod; Gupta Mohit; Shah Haikoo; Das Abhijit; Tanphaichitr Natthavat; Novak Robert; Raina Rupesh
BMC nephrology
2018
2018-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1186/s12882-018-0812-x" target="_blank" rel="noreferrer noopener">10.1186/s12882-018-0812-x</a>
Antibiotic Dosing in Sustained Low-Efficiency Dialysis in Critically Ill Patients.
antibiotics; extended daily dialysis; pharmacokinetics; SLED; sustained low-efficiency dialysis
Purpose of review: Sustained low-efficiency dialysis (SLED) is increasingly used as a renal replacement modality in critically ill patients with acute kidney injury (AKI) and hemodynamic instability. There is, therefore, a greater need for the understanding of the antibiotic dosage and pharmacokinetics in these patients, to provide them with optimal therapy. Sources of information: PubMed/Medline, Embase, and Google Scholar. Methods: PubMed/Medline, Embase, and Google Scholar databases were searched using a combination of key words: dialysis, end stage renal disease, renal failure, sustained low efficiency dialysis, extended daily dialysis, prolonged intermittent renal replacement therapy (PIRRT), and antibiotic dosing. Studies that investigated antibiotic dosing and pharmacokinetics during SLED/extended daily dialysis/PIRRT were selected for this review. Key findings: Eleven studies met inclusion criteria and selected for data extraction. The data with regard to dialysis specifications, type of antibiotic including dosages, drug clearances, and dosage recommendations are summarized in Table 1. It is a challenge to find therapeutic doses for antibiotics during SLED therapy because, in general, only aminoglycosides and vancomycin can be assayed in clinical laboratories. Limitations: Although current studies on antibiotic dosing in SLED are limited due to diverse and undersized patient populations, antibiotic dosage adjustments for patients receiving SLED discussed here will serve as a valuable guide. Future large-scale research should focus on establishing guidelines for antibiotic dosage in SLED. Implications: Pharmacokinetic principles should be taken into consideration for the appropriate dosing of drugs during SLED, yet it is vital to monitor response to drug to make sure therapeutic goals are achieved. Antibiotic dosing and timing relative to the initiation of SLED may be important to maximize either the time above the minimum inhibitory concentration (MIC) (time-dependent) or the peak to MIC ratio (concentration-dependent), balancing efficacy and toxicity concerns. Critical care physicians should liaise with nephrologists to make decisions regarding appropriate antibiotic dosing in patients undergoing SLED.
Sethi Sidharth Kumar; Krishnappa Vinod; Nangethu Nisha; Nemer Paul; Frazee Lawrence A; Raina Rupesh
Canadian journal of kidney health and disease
2018
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/2054358118792229" target="_blank" rel="noreferrer noopener">10.1177/2054358118792229</a>
Oxybutynin 3% gel for the treatment of primary focal hyperhidrosis in adolescents and young adults.
Administration; Adolescent; Female; Humans; hyperhidrosis; Hyperhidrosis/*drug therapy; Male; Mandelic Acids/*administration & dosage/adverse effects; oxybutynin; Parasympatholytics/*administration & dosage/adverse effects; pharmacology; Pilot Projects; Prospective Studies; quality of life; Quality of Life; Severity of Illness Index; therapy-topical; Topical; Treatment Outcome; Young Adult
BACKGROUND/OBJECTIVES: There are no reliably effective, well-tolerated topical agents for the treatment of hyperhidrosis. We sought to evaluate the efficacy and tolerability of oxybutynin 3% gel in adolescents and young adults with primary focal hyperhidrosis. METHODS: Patients with severe axillary hyperhidrosis were treated with topical oxybutynin 3% gel for 4 weeks. Response to treatment was assessed by calculating change in Hyperhidrosis Disease Severity Score from baseline to weeks 1 and 4. Change in health-related quality of life was assessed using the Children's Dermatology Life Quality Index or the Dermatology Life Quality Index. Adverse effects were evaluated using patient diaries, investigator global review, and physical examination. RESULTS: Of 10 patients aged 13-24 enrolled, seven completed the study. Of those who completed the study, four (57.1%) reported reduction in axillary Hyperhidrosis Disease Severity Score at week 1 and all seven (100%) at week 4. Six patients (85.7%) reported reduction in Children's Dermatology Life Quality Index or Dermatology Life Quality Index score. Anticholinergic adverse effects were infrequent. The majority of treatment-related adverse events were mild to moderate in severity. One patient experienced a severe adverse event. CONCLUSION: Oxybutynin 3% gel reduced hyperhidrosis severity and improved health-related quality of life in this small pilot study. Safety and efficacy should be further evaluated in a large, prospective, placebo-controlled study.
Nguyen Nicholas V; Gralla Jane; Abbott James; Bruckner Anna L
Pediatric dermatology
2018
2018-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/pde.13404" target="_blank" rel="noreferrer noopener">10.1111/pde.13404</a>
Successful Treatment of a Renal Abscess Caused by Mycobacterium chelonae: A Case Report.
Verghese Elizabeth; Jabr Ahmad; Watkins Richard R
Open forum infectious diseases
2018
2018-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/ofid/ofy196" target="_blank" rel="noreferrer noopener">10.1093/ofid/ofy196</a>
Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza.
These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic. This document addresses new information regarding diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza. It is intended for use by primary care clinicians, obstetricians, emergency medicine providers, hospitalists, laboratorians, and infectious disease specialists, as well as other clinicians managing patients with suspected or laboratory-confirmed influenza. The guidelines consider the care of children and adults, including special populations such as pregnant and postpartum women and immunocompromised patients.
Uyeki Timothy M; Bernstein Henry H; Bradley John S; Englund Janet A; File Thomas M Jr; Fry Alicia M; Gravenstein Stefan; Hayden Frederick G; Harper Scott A; Hirshon Jon Mark; Ison Michael G; Johnston B Lynn; Knight Shandra L; McGeer Allison; Riley Laura E; Wolfe Cameron R; Alexander Paul E; Pavia Andrew T
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
2018
2018-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/cid/ciy866" target="_blank" rel="noreferrer noopener">10.1093/cid/ciy866</a>
Colistin Versus Ceftazidime-Avibactam in the Treatment of Infections Due to Carbapenem-Resistant Enterobacteriaceae.
benefit-risk; carbapenem-resistant Enterobacteriaceae; Carbapenems; Ceftazidime – Therapeutic Use; ceftazidime-avibactam; colistin; Colistin – Therapeutic Use; Comparative Studies; Drug Resistance; Enterobacteriaceae Infections – Drug Therapy; Human; In Vitro Studies; Klebsiella Infections; Klebsiella pneumoniae
Background: The efficacy of ceftazidime-avibactam-a cephalosporin-beta-lactamase inhibitor combination with in vitro activity against Klebsiella pneumoniae carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CRE)-compared with colistin remains unknown. Methods: Patients initially treated with either ceftazidime-avibactam or colistin for CRE infections were selected from the Consortium on Resistance Against Carbapenems in Klebsiella and other Enterobacteriaceae (CRACKLE), a prospective, multicenter, observational study. Efficacy, safety, and benefit-risk analyses were performed using intent-to-treat analyses with partial credit and the desirability of outcome ranking approaches. The ordinal efficacy outcome was based on disposition at day 30 after starting treatment (home vs not home but not observed to die in the hospital vs hospital death). All analyses were adjusted for confounding using inverse probability of treatment weighting (IPTW). Results: Thirty-eight patients were treated first with ceftazidime-avibactam and 99 with colistin. Most patients received additional anti-CRE agents as part of their treatment. Bloodstream (n = 63; 46%) and respiratory (n = 30; 22%) infections were most common. In patients treated with ceftazidime-avibactam versus colistin, IPTW-adjusted all-cause hospital mortality 30 days after starting treatment was 9% versus 32%, respectively (difference, 23%; 95% bootstrap confidence interval, 9%-35%; P = .001). In an analysis of disposition at 30 days, patients treated with ceftazidime-avibactam, compared with those treated within colistin, had an IPTW-adjusted probability of a better outcome of 64% (95% confidence interval, 57%-71%). Partial credit analyses indicated uniform superiority of ceftazidime-avibactam to colistin. Conclusions: Ceftazidime-avibactam may be a reasonable alternative to colistin in the treatment of K. pneumoniae carbapenemase-producing CRE infections. These findings require confirmation in a randomized controlled trial.
van Duin David; Lok Judith J; Earley Michelle; Cober Eric; Richter Sandra S; Perez Federico; Salata Robert A; Kalayjian Robert C; Watkins Richard R; Doi Yohei; Kaye Keith S; Fowler Vance G Jr; Paterson David L; Bonomo Robert A; Evans Scott
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
2018
2018-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1093/cid/cix783" target="_blank" rel="noreferrer noopener">10.1093/cid/cix783</a>
Rapidly progressive dyspnea in gastrointestinal stromal tumor (GIST) with imatinib cardiac toxicity.
cardiac toxicity; fluid retention; Gastrointestinal stromal tumors; GISTs; heart failure; imatinib; imatinib toxicity; LV dysfunction; rare
Gastrointestinal stromal tumors (GISTs) are rare and current estimates range from 4,000 to 6,000 number of GIST cases in the USA annually. Imatinib, a tyrosine kinase inhibitor, has shown a survival benefit in GISTs, and the presence of KIT mutation status is predictive of response. The current case discusses rapidly progressive dyspnea and heart failure in an elderly male with metastatic GIST who was started on imatinib. Although reported as a rare and sporadic side effect of imatinib, the current case illustrates rapidity and the clinical significance of cardiotoxicity, with onset at 2 weeks. Cases of imatinib-induced cardiotoxicity can range from being mild ventricular dysfunction to overt heart failure. Prior to starting imatinib, our patient had a history of hypertension. He subsequently ended up developing heart failure as acknowledged by the echocardiogram (ECHO). In general, elderly with preexisting cardiovascular comorbidity are at greater risk. The goal in such situations is immediate discontinuation or reduction of the imatinib dosage. The case prompts for awareness of imatinib cardiotoxicity. Moreover, a pretreatment cardiac assessment along with monitoring throughout therapy is therefore advisable. Also, imatinib-induced cardiotoxicity should be differentiated from imatinib-associated fluid retention, in which ECHO findings can be normal. This case report raises the concern for accelerated cardiotoxicity profile of imatinib. Further prospective studies with multidisciplinary input are needed to establish this association further.
Ghias Adnan Asif Parvez; Bhayani Shahzeem; Gemmel David J; Garg Sudershan K
Journal of community hospital internal medicine perspectives
2018
1905-07
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<a href="http://doi.org/10.1080/20009666.2018.1454787" target="_blank" rel="noreferrer noopener">10.1080/20009666.2018.1454787</a>
A formidable foe: carbapenem-resistant Acinetobacter baumannii and emerging nonantibiotic therapies.
*Carbapenem-resistant Acinetobacter baumannii; *decolonization; *hospital-acquired infections; *therapies; *vaccination; Acinetobacter baumannii/drug effects/*isolation & purification; Acinetobacter Infections – Microbiology; Acinetobacter Infections – Therapy; Acinetobacter Infections/microbiology/*therapy; Animals; Anti-Bacterial Agents/pharmacology; Antibiotics – Pharmacodynamics; Bacterial; Carbapenems – Pharmacodynamics; Carbapenems/pharmacology; Drug Resistance; Gram-Negative Aerobic Bacteria; Gram-Negative Aerobic Bacteria – Drug Effects; Humans; Microbial; Microbial Culture and Sensitivity Tests; Microbial Sensitivity Tests
Watkins Richard R
Expert review of anti-infective therapy
2018
2018-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/14787210.2018.1503054" target="_blank" rel="noreferrer noopener">10.1080/14787210.2018.1503054</a>
Neonatal renal cystic diseases.
*Polycystic Kidney; Autosomal Dominant; Autosomal dominant polycystic kidney disease; Autosomal Recessive; autosomal recessive polycystic kidney disease; Humans; Impact of Events Scale; Infant; multicystic dysplastic kidney; neonatal renal cystic diseases; Newborn; Polycystic Kidney
PURPOSE: Neonatal renal cystic diseases have a great impact on the morbidity and mortality of the affected neonates and infants. A good insight into the pathophysiology, diagnosis and treatment options of various neonatal renal cystic diseases aid in early diagnosis and intervention, thereby preventing complications. METHODS: PubMed search was done for articles on "neonatal renal cystic diseases" and relevant publications including reviews were considered for our article. RESULTS: Both hereditary and nonhereditary causes of cystic kidney diseases can result in severe morbidity and mortality. The main diagnostic modality is ultrasound imaging and most of the neonatal renal cystic diseases are detected during prenatal ultrasound screening. Commonly encountered neonatal renal cystic diseases are autosomal dominant polycystic kidney disease, autosomal recessive polycystic kidney disease and multicystic dysplastic kidney. CONCLUSIONS: A thorough knowledge of various renal cystic diseases can be of extreme prognostic value. Physicians should be aware of the impact of early diagnosis and intervention on the lives of those affected. Further research about treatment of these diseases is ongoing and can result in breakthrough therapies for these patients.
Khare Anshika; Krishnappa Vinod; Kumar Deepak; Raina Rupesh
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
2018
2018-11
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/14767058.2017.1358263" target="_blank" rel="noreferrer noopener">10.1080/14767058.2017.1358263</a>
Safe Readministration of Intravenous Thrombolysis in Recurrent Basilar Thrombosis.
Aged; Basilar Artery; Basilar Artery – Drug Effects; Basilar Artery – Physiopathology; Basilar Artery/diagnostic imaging/*drug effects/physiopathology; Cerebral Angiography – Methods; Cerebral Angiography/methods; Computed Tomography Angiography; Drug Administration Schedule; Fibrinolytic Agents – Administration and Dosage; Fibrinolytic Agents – Adverse Effects; Fibrinolytic Agents/*administration & dosage/adverse effects; Humans; Infusions; Intracranial Thrombosis; Intracranial Thrombosis – Drug Therapy; Intracranial Thrombosis – Physiopathology; Intracranial Thrombosis/diagnostic imaging/*drug therapy/physiopathology; Intravenous; Magnetic Resonance Imaging; Male; medication safety; Recombinant Proteins – Administration and Dosage; Recombinant Proteins/administration & dosage; Recurrence; recurrent stroke; Repeat Procedures; Retreatment; thrombolysis; Thrombolytic Therapy – Adverse Effects; Thrombolytic Therapy – Methods; Thrombolytic Therapy/adverse effects/*methods; Thrombosis; Time Factors; Tissue Plasminogen Activator – Administration and Dosage; Tissue Plasminogen Activator – Adverse Effects; Tissue Plasminogen Activator/*administration & dosage/adverse effects; Treatment Outcome; Treatment Outcomes
We report a patient who had recurrence of stroke in the basilar artery territory because of repeat thrombosis, and was administered intravenous recombinant tissue plasminogen activator (IV-rtPA) twice within a span of 3 weeks without any adverse events, with radiological evidence of successful thrombolysis. Because of minor and improving stroke symptoms with IV-rtPA, endovascular therapy was not performed and there was radiological evidence of recanalization with IV-rtPA alone. This report adds to the very limited literature on the topic demonstrating safe and successful use of repeat IV thrombolysis following a previous recent stroke.
Khan Alina; Itrat Ahmed
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
2018
2018-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jstrokecerebrovasdis.2017.09.066" target="_blank" rel="noreferrer noopener">10.1016/j.jstrokecerebrovasdis.2017.09.066</a>
DISC: Describing Infections of the Spine treated with Ceftaroline.
Ceftaroline; Discitis; Epidural abscess; MRSA; Vertebral osteomyelitis
OBJECTIVES: Infections of the spine lead to considerable morbidity and a high cost to the global healthcare system. Currently, evidence for using ceftaroline, an advanced-generation cephalosporin active against methicillin-resistant Staphylococcus aureus (MRSA), in spine infections is limited. METHODS: Describing Infections of the Spine treated with Ceftaroline (DISC) is a multicentre, retrospective, cohort study that evaluated ceftaroline for treating spine infections. Patients were included if they were aged \textgreater/=18 years, diagnosed with a spine infection and treated with ceftaroline for \textgreater/=28 days. A control group was identified with the same inclusion criteria as the study population except they were treated with a comparator antibiotic for \textgreater/=28 days. RESULTS: Thirty-seven patients were included each in the ceftaroline and control groups. MRSA was the most commonly identified pathogen. With no differences between groups in age, sex, race or co-morbidities (with the exception of chronic kidney disease), treatment with ceftaroline led to similar clinical success compared with the control group. Multivariate regression analysis did not show a significant difference between the two groups in terms of clinical success after controlling for other covariates (adjusted odds ratio=1.49; P=0.711). More patients who received ceftaroline were discharged to an extended-care or rehabilitation facility than home compared with controls (81% vs. 54%, respectively; P=0.024). Side effects and toxicities were rare, including one case of eosinophilic pneumonia in the ceftaroline group. CONCLUSIONS: Ceftaroline appears to be a safe and effective therapy for infections of the spine, including from MRSA.
Watkins Richard R; Yendewa George; Burdette Steven D; Horattas Sophia; Haller Nairmeen Awad; Mangira Caroline; Salata Robert A; Bonomo Robert A
Journal of global antimicrobial resistance
2018
2018-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jgar.2018.01.001" target="_blank" rel="noreferrer noopener">10.1016/j.jgar.2018.01.001</a>
Introducing a curriculum in ethics and professionalism for dermatology residencies.
*Accreditation; Accreditation; Curriculum; Dermatology – Education; Dermatology/*education; Education; Ethics; Female; Graduate/*methods; Humans; Internship and Residency; Internship and Residency/*methods; Male; Medical; Medical – Education; Medical/*education; Professionalism/*education; Questionnaires; United States
There is general agreement on what constitutes ethical reasoning and professional behavior, but standardized methods to teach these skills in dermatology residency are currently unavailable. We introduce a model curriculum designed to impart the knowledge and skills to meet the Accreditation Council for Graduate Medical Education Dermatology Milestones for Professionalism over a 3-year cycle.
Stoff Benjamin K; Grant-Kels Jane M; Brodell Robert T; Paller Amy S; Perlis Clifford S; Mostow Eliot; Pariser David; Bercovitch Lionel
Journal of the American Academy of Dermatology
2018
2018-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jaad.2017.04.1121" target="_blank" rel="noreferrer noopener">10.1016/j.jaad.2017.04.1121</a>
Overcoming missed opportunities in diabetes management to improve outcomes for hospitalized patients with diabetes.
Aged; Blood Glucose/*metabolism; Cohort Studies; Diabetes Mellitus; Female; Glycated Hemoglobin A/*metabolism; Hospitalization; Humans; Male; Middle Aged; Retrospective Studies; Treatment Outcome; Type 2/*drug therapy
AIMS: The purpose of this study is to assess the impact of hospitalization on
Oravec Michael; Salem James; Kunz Jason; Cudnik Michelle L; Clough Lynn; Woods Robert; Elavsky Megan
Diabetes research and clinical practice
2018
2018-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.diabres.2018.04.020" target="_blank" rel="noreferrer noopener">10.1016/j.diabres.2018.04.020</a>
An update on LDL apheresis for nephrotic syndrome.
Focal segmental glomerulosclerosis; Hyperlipidemia; Liposorber(R) LA-15 System; Low-density lipoprotein apheresis; Nephrotic syndrome; Podocyte injury
Low-density lipoprotein (LDL) apheresis has been used increasingly in clinical practice for the treatment of renal diseases with nephrotic syndrome (NS), specifically focal segmental glomerulosclerosis (FSGS). Persistent hyperlipidemia for prolonged periods is nephrotoxic and leads to chronic progressive glomerular and tubulointerstitial injury. Effective management of hyperlipidemia with
Raina Rupesh; Krishnappa Vinod
Pediatric nephrology (Berlin, Germany)
2018
2018-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s00467-018-4061-9" target="_blank" rel="noreferrer noopener">10.1007/s00467-018-4061-9</a>
Idiopathic pulmonary vein thrombosis?
*CT scan; *idiopathic; *pulmonary vein thrombus
Idiopathic pulmonary vein thrombosis (PVT) is a rare disease which is likely under-diagnosed because of nebulous presentations. Accurate diagnosis is essential to prevent complications.
Barreiro Timothy J; Kollipara Venkateswara K; Gemmel David J
Respirology case reports
2018
2018-01
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<a href="http://doi.org/10.1002/rcr2.277" target="_blank" rel="noreferrer noopener">10.1002/rcr2.277</a>
Depression Screening in Dermatology-Think Isotretinoin.
Schrom Kory Patrick; Mostow Eliot N; Nagy Terri
JAMA dermatology
2018
2018-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1001/jamadermatol.2018.0085" target="_blank" rel="noreferrer noopener">10.1001/jamadermatol.2018.0085</a>