The American journal of the medical sciences
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Extreme obesity may hamper successful peritoneal dialysis (PD) delivery. Among our PD patients, we have identified 15 markedly obese (class 2-3 obesity: body mass index [BMI] ≥35kg/m2) and 20 lean (BMI: 20-25kg/m2) dialysis patients and reviewed multiple clinical, laboratory and dialysis-related parameters. Extreme outliers of obesity (BMI > 40; 6 subjects) received detailed review. ⋯ Serum albumin, calcium, phosphorus, hemoglobin and parathyroid hormone levels did not differ, either. Analogous results have been obtained for extremely obese subjects (BMI 44.3 ± 4.2kg/m2; range: 40.2-51.6). Our study shows only limited effect of class ≥2 obesity for successful PD in this predominantly African American cohort.
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To describe the incidence of discordant exudate (DE) effusions, their underlying etiologies and their effect on the accuracy of the Light's criteria to diagnose exudate effusions. ⋯ In a significant percentage of patients, there is discordancy between the results of the PFA and the final clinical diagnosis. DE decreased the accuracy of Light's criteria to identify exudate PE, increasing the risk of misclassifying a transudate as an exudate. Concordant exudates almost universally established the presence of an exudative PE.
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Amiodarone can cause toxicity in several organs, including amiodarone-induced pulmonary toxicity which is a subacute or chronic complication. Amiodarone-induced acute respiratory distress syndrome (ARDS) in postoperative patients is a rare acute complication. The PubMed and Google Scholar databases were searched. ⋯ Most operations involved cardiothoracic surgery. Elderly patients on high-dose and long-term amiodarone treatment were at increased risk. This diagnosis is challenging owing to the lack of definite diagnostic criteria; careful clinical evaluation and early drug withdrawal may reduce the severity of this complication.