The American journal of the medical sciences
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Case Reports
Pseudomyocardial infarction caused by expansion of colonic tube used for esophageal reconstruction.
Electrocardiography (ECG) is a useful tool for detecting ischemic heart disease. However, it has been pointed out that those ECG abnormalities resembling myocardial ischemia may be induced by extracardiac factors. ⋯ Coronary angiography revealed no stenosis of arteries. Decompression of the colonic tube by the nasogastric tube resulted in normalization of the ECG.
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Prosthetic vascular graft infection (PVGI) is an infrequent and potentially fatal complication of abdominal aortic aneurysm surgery and occlusive vascular disease. The predictive value of blood cultures in accurately identifying the causative pathogen (or pathogens) has not been determined. ⋯ The yield of blood cultures in late-onset abdominal PVGIs is low. Presence of microorganisms in blood cultures does not necessarily indicate a causal relationship with graft infection. An empirical broad-spectrum antimicrobial therapy is advised in all suspected cases until a definitive etiology has been made.
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Podocytes play an important role in the pathogenesis and progression of glomerulosclerosis. Various elements of the renin-angiotensin-aldosterone system can induce podocyte apoptosis. However, little is known about the direct effects of renin on podocytes. ⋯ The authors conclude that the effects of renin are mediated through the activation of rennin receptor and are independent of angiotensin II generation.
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Comparative Study
A comparison of acute kidney injury classifications in patients with severe sepsis and septic shock.
Acute kidney injury (AKI) is a common and serious complication in patients with severe sepsis and septic shock. AKI can be classified using the RIFLE (Risk, Injury, Failure, Loss and End-stage) and/or the Acute Kidney Injury Network (AKIN) criteria. The aim of this study was to determine which of the 2 systems better predicted 28-day mortality in patients with severe sepsis and septic shock. ⋯ The incidence of AKI in patients with sepsis and septic shock was slightly higher using AKIN than RIFLE criteria. However, using the AKIN criteria did not enhance the ability of AKI to predict 28-day mortality in such patients.
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Frailty syndrome is frequently encountered in elderly populations. Frailty has been defined as a geriatric syndrome of increased vulnerability to environmental factors. Although knowledge of this syndrome continues to develop, there are still many areas of uncertainty. ⋯ Preventative strategies need to be studied. The role of specific biomarkers in early detection of frailty needs to be defined. Clinical trials are needed to find better interventions for this syndrome.