Renal failure
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Gall stone ileus is a rare serious complication of cholelithiasis. We report a case of cholecystoduodenal fistula presenting as gall stone ileus with acute kidney injury which was managed successfully.
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This study investigated the effect of injection of rocuronium or sugammadex alone and rocuronium + sugammadex on urea, creatinine, electrolyte levels, and histopathological findings in rats. ⋯ The elimination half-life of the rocuronium-sugammadex complex was found to be greater than that of free rocuronium or sugammadex, which led to marginal histopathological changes in the kidney without affecting any renal functions.
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Comparative Study
Aggressive surgical intervention in end-stage renal disease patients with spinal epidural abscess.
Despite advances in imaging, as well as antibiotic and surgical treatment, spinal epidural abscess (SEA) remains a challenging problem in end-stage renal disease (ESRD) patients. This investigation assesses the influence of ESRD on clinical manifestations, complications, and outcomes in patients with SEA. ⋯ ESRD is a risk factor for repeat surgery in patients with SEA. This investigation suggests that ESRD patients with SEA may require aggressive surgical intervention despite ESRD not affecting their long-term prognosis.
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There is a paucity of outcome data for critically ill patients with combined acute liver and kidney injury secondary to paracetamol overdose (POD) requiring renal replacement therapy (RRT). We retrospectively reviewed all admissions over a 6-year period to the intensive care unit (ICU) at a university teaching hospital which supports an active liver transplant program. Of the 5582 admissions over this period, 73 patients were admitted with combined liver and kidney injury requiring RRT, and of these 10 patients went on to receive a liver transplant. ⋯ Combined severe acute liver and kidney injury secondary to POD requiring RRT is associated with a high mortality. The majority of survivors recover independent kidney function by 1 month. Standard disease severity scores appear to reflect prognosis in these patients.
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Creative writing has gained some interest in the medical profession in the last decade. There have been a fair amount of publications of using creative writing in the health-care setting as a teaching tool in humanism and doctoring of medicine. As an adjunctive effort, our institution has been experimenting with creative writing exercises to encourage reading in an entertaining way in nephrology. We present a description of two creative tools that we have used to teach renal medicine along with a small pilot study illustrating that the tools were useful in residency education.