Thrombocytopenia In End-Stage Renal Disease And Chronic Viral Hepatitis B Or C, 2018 Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 4 th Medical Department, Cluj-Napoca, Romania
Thrombocytopenia In End-Stage Renal Disease And Chronic Viral Hepatitis B Or C, Olga Hilda Orasan, Laura Urian, George Ciulei, Iulia Breaban, Andreea Maria Stefan, Sorina Cezara Secara, Adela Sitar Taut, Simina Tarmure Sarlea, Vasile Negrean, Dorel Sampelean, Ioan Mihai Patiu, Remus Aurel Orasan, Angela Cozma
Journal of Mind and Medical Sciences
Objectives. We evaluated platelet counts in end-stage renal disease and chronic viral hepatitis.
Materials and Methods. We studied 70 patients with end-stage renal disease and chronic viral hepatitis and compared them to a control group of 45 patients without hepatitis.
Results. The presence of viral hepatitis was associated with a higher prevalence of thrombocytopenia. Correlations between age, C-reactive protein, liver stiffness measurement, and platelet count were observed. C-reactive protein levels > 10 mg/dl were associated with a lower risk of thrombocytopenia in patients with end-stage renal disease and chronic viral hepatitis, yet age > 60 years, dialysis vintage > 10 years, aspartate ...
A Brief Review Of The Literature On The Malignant Ureteral Obstruction, 2018 Brasov Emergency Clinical Hospital, Faculty of Medicine, Department of Urology, Brasov, Romania
A Brief Review Of The Literature On The Malignant Ureteral Obstruction, Sorin Lupu, Adrian Brînză, Bogdan Socea, Dragos Marcu, Ileana Peride, Ana Maria Alexandra Stanescu, Tiberiu P. Neagu, Laurian Maxim
Journal of Mind and Medical Sciences
Malignant ureteral obstruction (MUO) caused by a primarily urological tumor or secondary to a late-stage malignancy can be difficult for the urologist to manage. Due to a lack of clinical data on the management of MUO, every case is particular and should be aborted individually.
Lack of specific treatment, either palliative or definitive, can severely damage renal function and lifetime expectancy in patients, causing even more damage that could otherwise be avoided.
Prompt management directed at the recovery of renal function is the main goal in such cases. Even after urinary flow is restored, life threatening post-obstructive diuresis needs to ...
Pelvic Kidney: A Review Of The Literature., 2018 Neurosurgery, Swedish Neuroscience Institute, Seattle, USA.
Pelvic Kidney: A Review Of The Literature., Seif Eid, Joe Iwanaga, Marios Loukas, Rod J Oskouian, R Shane Tubbs
Kidney development is a complex process that begins during the sixth to eighth weeks of life. Failure of ascent of the kidney will cause the kidney to remain in the pelvis i.e., pelvic kidney. Here, we review this entity in detail and illustrate such embryological derailment. In most cases, a pelvic kidney is an incidental finding and is usually asymptomatic. Anatomic variations of the renal vasculature have been reported in cases of pelvic kidneys and these are highlighted in this review. Clinicians who treat patients for renal or pelvic disease or interpret images of the pelvis should be well ...
Improving Transitions Of Care For Inpatients With An Egfr < 20ml/Min, 2018 Thomas Jefferson University
Improving Transitions Of Care For Inpatients With An Egfr < 20ml/Min, Brianna Shinn, Md, Brandon Menachem, Md, Robert Park, Md, Sarah Houtmann, Md, Zachary Lee, Md, Thomas Holden, Md, Tomoyuki Hongo, Md, Vincent Yeung, Md, Goni Katz-Greenberg, Md, Peter Burke, Do, Mba
House Staff Quality Improvement and Patient Safety Posters
In this study we conducted an analysis of 22 inpatients with an eGFR<20 that revealed there was a greater prevalence of patients without permanent AV access for HD initiation when compared to national data. These findings demonstrated the need for improved transitions of care and timely creation of AV access for this patient population, thus we sought to improve this. This is the first inpatient initiative that our group is aware with the aim of improving timely AV access and transitions of care for an inpatient population (Figure 1).
Evaluation Of A Digital Diabetes Prevention Program Adapted For The Medicaid Population: Study Design And Methods For A Non-Randomized, Controlled Trial., 2018 Providence Medical Group, Monroe Clinic, 19200 North Kelsey Street, Monroe, WA
Evaluation Of A Digital Diabetes Prevention Program Adapted For The Medicaid Population: Study Design And Methods For A Non-Randomized, Controlled Trial., Sue E Kim, Cynthia M Castro Sweet, Eliza Gibson, Erica N Madero, Barbara Rubino, Janina Morrison, Debra Rosen, Wendy Imberg, Michael R Cousineau
Previous studies have shown that lifestyle modification can successfully prevent or delay development of type 2 diabetes. This trial aimed to test if an underserved, low-income population would engage in a digital diabetes prevention program and successfully achieve lifestyle changes to reduce their risk of type 2 diabetes. Participants were recruited from three health care facilities serving low-income populations. The inclusion criteria were: a recent blood test indicating prediabetes, body mass index (BMI) > 24 kg/m
Factors Affecting Inpatient Mortality In Elderly People With Acute Kidney Injury, 2018 Aga Khan University
Factors Affecting Inpatient Mortality In Elderly People With Acute Kidney Injury, Muhammad Abdul Mabood Khalil, Safia Awan, Rabeea Azmat, Muhammad Ullah Khalil, Nazish Naseer, Jackson Tan
Section of Nephrology
Background: Acute Kidney Injury (AKI) is common in elderly people (EP). There is paucity of data on predictor of mortality in EP with AKI.
Objective: This study was done to know more about factors associated with inpatient mortality in EP with AKI.
Methods: We retrospectively reviewed medical records of patients aged 65 years or above hospitalized with a diagnosis of AKI at Aga Khan University Hospital, Karachi, between January 2005 and December 2010. Binary logistic regression models were constructed to identify factors associated with mortality in EP with AKI.
Results: 431 patients had AKI, with 341 (79.1%) having stage ...
Original Parts: Aging And Reckoning With Cystic Fibrosis Related Kidney Disease, 2018 Florida State University College of Medicine
Original Parts: Aging And Reckoning With Cystic Fibrosis Related Kidney Disease, Alexandra Ch Nowakowski
Patient Experience Journal
Kidney disease increasingly impacts people with cystic fibrosis (CF) as adult patients continue to survive longer. Yet the literature on CF related kidney disease focuses little on amplifying the voices of people aging with the condition. This article presents perspectives on CF related kidney disease from a medical sociologist who is themselves managing these issues. It (1) gives an overview of relevant literature and trends in epidemiological data on kidney disease and CF, (2) details the author’s own process of adjusting to progressive changes in renal function, and (3) outlines opportunities for clinicians to make a positive impact for ...
Evaluating The Impact Of A Standardized Education Class On A Person Diagnosed With Chronic Kidney Disease, Stage Iv, 2018 George Washington University
Evaluating The Impact Of A Standardized Education Class On A Person Diagnosed With Chronic Kidney Disease, Stage Iv, Nancy K. Uhland, Dnp, Msn, Rn, Fnp-C
Doctor of Nursing Practice Projects
Background: Chronic kidney disease (CKD) is a complex, progressive, and costly disease impacting more than 26 million Americans. Providing effective education is necessary so the patient may actively participate in managing the disease process, but the effectiveness of the delivery of education to the patient with CKD is not well-known.
Objective: To evaluate the effectiveness of a standardized education class on the basic kidney knowledge of persons diagnosed with CKD, stage IV.
Method: This pilot study, using a one-group pre and post-test design, was conducted in an outpatient nephrology clinic located in Washington, D.C. The study participants, recruited using ...
Legionnaire's Disease Presenting With Severe Rhabdomyolysis And Acute Renal Failure: A Case Report, 2018 George Washington University
Legionnaire's Disease Presenting With Severe Rhabdomyolysis And Acute Renal Failure: A Case Report, Benjamin Plotz, Victoria K. Shanmugam
GW Research Days 2016 - Present
Legionnaire's disease is caused by Legionella species, and is a recognized but rare cause of rhabdomyolysis. Legionella species live in water, and exposure to inoculated water systems leads to transmission of the disease, and commonly causes pneumonia in infected individuals. While the mechanism of muscle destruction legionella infection causes is not fully understood, the prevailing theory is that rhabdomyolysis is linked to an endotoxin released by the bacteria into the blood stream. Massive muscle necrosis manifests as limb weakness, muscle pain, swelling, and gross pigmenturia due to the release of electrolytes, myoglobin, and other sarcoplasmic proteins into the bloodstream ...
Positive Surgical Margins In Nephron-Sparing Surgery; The Great Unknown, 2018 Carol Davila University of Medicine and Farmacy, Central Military Emergency University Hospital, Department of Urology
Positive Surgical Margins In Nephron-Sparing Surgery; The Great Unknown, Dan Spinu, Oana M. Bodean, Bogdan Socea, Dan Mischianu, Ioana Oprea, Radu D. Marcu
Journal of Mind and Medical Sciences
There is a currently a general trend towards organ-preserving surgery, and urology is no exception. Specifically, nephron-sparing surgery (NSS) has gained general acceptance for T1a renal cell carcinoma (guidelines recommendations). Moreover T1b, T2 and even T3 stage tumors have been included on the nephron sparing list at some centers. An unresolved issue is that of positive surgical margins (PSM), not only their detection but also the implications for follow up and treatment. This paper highlights data available on risk factors for PSM, their clinical relevance, and possible therapeutic consequences.
From the surgeon’s viewpoint, NSS is a daring and risky ...
Nephron Segment-Specific Gene Expression Using Aav Vectors., 2018 George Washington University
Nephron Segment-Specific Gene Expression Using Aav Vectors., Laureano D Asico, Santiago Cuevas, Xiaobo Ma, Pedro A Jose, Ines Armando, Prasad R Konkalmatt
Medicine Faculty Publications
AAV9 vector provides efficient gene transfer in all segments of the renal nephron, with minimum expression in non-renal cells, when administered retrogradely via the ureter. It is important to restrict the transgene expression to the desired cell type within the kidney, so that the physiological endpoints represent the function of the transgene expressed in that specific cell type within kidney. We hypothesized that segment-specific gene expression within the kidney can be accomplished using the highly efficient AAV9 vectors carrying the promoters of genes that are expressed exclusively in the desired segment of the nephron in combination with administration by retrograde ...
Cardiovascular Effects Of Metabolic Syndrome After Transplantation: Convergence Of Obesity And Transplant-Related Factors., 2018 George Washington University
Cardiovascular Effects Of Metabolic Syndrome After Transplantation: Convergence Of Obesity And Transplant-Related Factors., Kristen Sgambat, Sarah Clauss, Asha Moudgil
Pediatrics Faculty Publications
Children are at increased risk of developing metabolic syndrome (MS) after kidney transplantation, which contributes to long-term cardiovascular (CV) morbidities and decline in allograft function. While MS in the general population occurs due to excess caloric intake and physical inactivity, additional chronic kidney disease and transplant-related factors contribute to the development of MS in transplant recipients. Despite its significant health consequences, the interplay of the individual components in CV morbidity in pediatric transplant recipients is not well understood. Additionally, the optimal methods to detect early CV dysfunction are not well defined in this unique population. The quest to establish clear ...
Fluid Balance Concepts In Medicine: Principles And Practice., 2018 George Washington University
Fluid Balance Concepts In Medicine: Principles And Practice., Maria-Eleni Roumelioti, Robert H Glew, Zeid J Khitan, Helbert Rondon-Berrios, Christos P Argyropoulos, Deepak Malhotra, Dominic S Raj, Emmanuel I Agaba, Mark Rohrscheib, Glen H Murata, Joseph I Shapiro, Antonios H Tzamaloukas
Medicine Faculty Publications
The regulation of body fluid balance is a key concern in health and disease and comprises three concepts. The first concept pertains to the relationship between total body water (TBW) and total effective solute and is expressed in terms of the tonicity of the body fluids. Disturbances in tonicity are the main factor responsible for changes in cell volume, which can critically affect brain cell function and survival. Solutes distributed almost exclusively in the extracellular compartment (mainly sodium salts) and in the intracellular compartment (mainly potassium salts) contribute to tonicity, while solutes distributed in TBW have no effect on tonicity ...
Physical Therapy Considerations For Chronic Kidney Disease And Secondary Sarcopenia, 2018 George Washington University
Physical Therapy Considerations For Chronic Kidney Disease And Secondary Sarcopenia, Michael O. Harris-Love, Haniel J. Hernandez, Gideon Obamwonyi
Exercise and Nutrition Sciences Faculty Publications
Chronic kidney disease (CKD) is a progressive condition that may negatively affect musculoskeletal health. These comorbidities may include malnutrition, osteoporosis, and decreased lean body mass. Secondary sarcopenia due to CKD may be associated with mobility limitations and elevated fall risk. Physical therapists are well-positioned among the health care team to screen for secondary sarcopenia in those with CKD and for the treatment of musculoskeletal comorbid conditions that may affect functional performance. Given the consequences of both low muscle mass and low bone mineral density, appropriate and timely physical therapy is important for fall risk assessment and intervention to minimize the ...
Gut Microbiota And Cardiovascular Uremic Toxicities, 2018 George Washington University
Gut Microbiota And Cardiovascular Uremic Toxicities, Manuel T. Velasquez, Patricia Centron, Ian Barrows, Rama Dwivedi, Dominic S. Raj
Medicine Faculty Publications
Cardiovascular disease (CVD) remains a major cause of high morbidity and mortality in patients with chronic kidney disease (CKD). Numerous CVD risk factors in CKD patients have been described, but these do not fully explain the high pervasiveness of CVD or increased mortality rates in CKD patients. In CKD the loss of urinary excretory function results in the retention of various substances referred to as “uremic retention solutes”. Many of these molecules have been found to exert toxicity on virtually all organ systems of the human body, leading to the clinical syndrome of uremia. In recent years, an increasing body ...
Disseminated Adenovirus Nephritis After Kidney Transplantation., 2018 Department of Medicine, Providence Sacred Heart Medical Center, Spokane, Washington, USA.
Disseminated Adenovirus Nephritis After Kidney Transplantation., Timothy Hatlen, Henry Mroch, Katherine Tuttle, Okechukwu Ojogho, Michele Rooney, Sara Desmond, Samer Bani-Hani
No abstract provided.
Significant Loss Of Blood Amino Acids And Free Carnitine In Newborns Receiving Continuous Renal Replacement Therapy (Crrt), 2018 Children's Mercy Hospital
Significant Loss Of Blood Amino Acids And Free Carnitine In Newborns Receiving Continuous Renal Replacement Therapy (Crrt), Uttam Garg, Marita Thompson, Bradley A. Warady, Vimal Chadha
•Newborns with acute kidney injury (AKI) or end-stage kidney disease (ESKD) often receive prolonged CRRT when the early initiation of peritoneal dialysis is either contraindicated or unable to be performed. •These patients often receive total parenteral nutrition (TPN) to meet their nutritional goals. •Little to no information exists on the loss of blood amino acids (AA) and carnitine during CRRT in these patients. •The objective of this study was to determine the amino acids and carnitine losses in newborns receiving prolonged CRRT and TPN. Material and Methods
•Three newborns who received prolonged (> 2 weeks) CRRT and TPN were included ...
Reducing Discard Blood Draw Volumes From Subcutaneously Implanted Ports (Port) In Patients With End Stage Renal Disease (Esrd), 2018 Children's Mercy Hospital
Reducing Discard Blood Draw Volumes From Subcutaneously Implanted Ports (Port) In Patients With End Stage Renal Disease (Esrd), Uttam Garg, Tyson Moore, Renita Trujillo, Penny Monachino, Amy Wiebold, Angela Ferguson, Gabor Oroszi, Vimal Chadha
•To monitor clinical status, dialysis and transplant patients with ESRD frequently require blood draws.
•To preserve their veins and to avoid frequent intravenous access, these patients, especially young children, require PORT placement.
•The PORT is flushed with saline and filled with heparinized saline to prevent blood clotting between blood draws.
•To avoid contamination from PORT fluids, a fixed amount of blood is withdrawn and discarded before the blood sample is drawn for laboratory analyses. Currently, the recommended discard blood volume is 5 mL (five times the reservoir volume of most PORTs and attached catheters.)
•The volume of discarded blood ...
The Gift That Keeps One Living, 2017 Cuny Graduate School of Journalism
The Gift That Keeps One Living, Scott R. Axelrod
This long-form narrative feature article reports on the shortage of living kidney donors and those in desperate need of kidney transplants. It features interviews with doctors, transplant coordinators, patients, living kidney donors, and kidney recipients. The story culminates with my own personal experience as a kidney donor to my late dad over a decade ago. The presentation includes an extensive photo component capturing characters and elements from the story through a series of detailed portraits, photo essays, and infographics.
Percutaneous Externally Assembled Laparoscopic (Peal) Donor Nephrectomy: A Cohort Pain Comparison, 2017 Loma Linda University Health Department of Urology
Percutaneous Externally Assembled Laparoscopic (Peal) Donor Nephrectomy: A Cohort Pain Comparison, Tyler Miskin, Isaac Kelly, Matthew Pierce, Samuel Abourbih, Duane D. Baldwin
Loma Linda University Student Journal
Donor nephrectomies can be technically demanding. Donors also may not be fully psychologically prepared for their post-operative pain or cosmetic outcome. A novel Percutaneous Externally Assembled Laparoscopic (PEAL) paradigm was developed to decrease incisional pain and laparoscopic scars. The aim of this study is to compare the post-operative outcomes between donor nephrectomies performed with and without the PEAL instruments.