Search results for "Replacement"

Nutrition in Pediatric Kidney Disease

2018

AbstractNutrition has a major impact on the health of children with chronic kidney disease (CKD). Special diets and additional replacement therapies may be chosen according to the specific renal disease. Persistent low-grade inflammation, which contributes to CKD-associated cardiovascular and all-cause mortality, protein-energy wasting, oxidative stress, acidosis, chronic and recurrent infections, and altered metabolism of adipose tissue may result from dietary deficits and are important targets for nutritive intervention. Therefore, many guidelines have been developed regarding nutrient intake adequation to assist pediatricians treating these children. Acute kidney injury (AKI) has multifa…

Delayed versus early initiation of renal replacement therapy for severe acute kidney injury: a systematic review and individual patient data meta-ana…

2020

Summary Background The timing of renal replacement therapy (RRT) for severe acute kidney injury is highly debated when no life-threatening complications are present. We assessed whether a strategy of delayed versus early RRT initiation affects 28-day survival in critically ill adults with severe acute kidney injury. Methods In this systematic review and individual patient data meta-analysis, we searched MEDLINE (via PubMed), Embase, and the Cochrane Central Register of Controlled Trials for randomised trials published from April 1, 2008, to Dec 20, 2019, that compared delayed and early RRT initiation strategies in patients with severe acute kidney injury. Trials were eligible for inclusion …

Optimizing ceftolozane-tazobactam dosage during continuous renal replacement therapy: some nuances

2020

Cervical Disc Arthroplasty -Efficacy and Indications. Single Center Long-Term Cohort Study Compared to Rcts’ Results

2019

Purpose: This study aims to compare CTDR and ACDF functional outcomes and to determine whether our criterion to exclude patient from the CTDR cohort positively affects the results. Methods: We have conducted a single-center, prospective, observational study of two cohorts: CTDR n=88, and ACDF n=90. The choice of the method for the particular patient was not fully random – it depended on the assumed disqualification criterion for CTDR the lack of intra-operatively determined mobility. Both cohorts were clinically followed over the long-term (average: 8 years). Our results were summarized with the results of large randomized studies subjected by our team to a meta-analysis reported in full in…

Smoking Cessation in Individuals with Depression

1999

Current, historical and subclinical depression have been linked to a high incidence of cigarette smoking and smoking cessation relapse. This review discusses the efficacy, suitability and other treatment issues involved in using nicotine replacement therapy, antidepressant treatment and cognitive-behavioural interventions to help depressed smokers quit smoking. It is recommended that prior to choosing a smoking cessation treatment regimen, assessment should be made of: (i) current and past history of depression; (ii) nicotine dependency; and (iii) other risk factors (e.g. family history of depression, past difficulty in quitting) for relapse. For those individuals who are highly nicotine de…

Ceftolozane/Tazobactam for Treatment of Severe ESBL-Producing

2020

Abstract Background Few data are reported in the literature about the outcome of patients with severe extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) infections treated with ceftolozane/tazobactam (C/T), in empiric or definitive therapy. Methods A multicenter retrospective study was performed in Italy (June 2016–June 2019). Successful clinical outcome was defined as complete resolution of clinical signs/symptoms related to ESBL-E infection and lack of microbiological evidence of infection. The primary end point was to identify predictors of clinical failure of C/T therapy. Results C/T treatment was documented in 153 patients: pneumonia was the most common diagnosis (n = 46…

Transfemoral Transcatheter Tricuspid Valve Replacement With the EVOQUE System

2021

Abstract Objectives The purpose of this observational first-in-human experience was to investigate the feasibility and safety of the EVOQUE tricuspid valve replacement system and its impact on short-term clinical outcomes. Background Transcatheter tricuspid intervention is a promising option for selected patients with severe tricuspid regurgitation (TR). Although transcatheter leaflet repair is an option for some, transcatheter tricuspid valve replacement (TTVR) may be applicable to a broader population. Methods Twenty-five patients with severe TR underwent EVOQUE TTVR in a compassionate-use experience. The primary outcome was technical success, with NYHA (NYHA) functional class, TR grade, …

Usefulness and limitations of contractile reserve evaluation in patients with low-flow, low-gradient aortic stenosis eligible for cardiac resynchroni…

2014

Aims In low-flow, low-gradient aortic stenosis (LF/LG AS), the assessment of contractile reserve (CR) by dobutamine stress echocardiography (DSE) is recommended for risk stratification and treatment strategy. However, DSE may show limitations in cases of left ventricular dyssynchrony (LVD). The impact of LVD in LF/LG AS, and the feasibility of CRT in this setting have never been evaluated. We aimed to assess: (i) the proportion of LF/LG AS patients with LVD; (ii) the influence of LVD on CR at DSE; and (iii) the effects of CRT in these patients. Methods and results Thirty consecutive patients with LF/LG AS underwent DSE with study of CR. The operative risk for aortic valve replacement (AVR) …

ACTIVATION (PercutAneous Coronary inTervention prIor to transcatheter aortic VAlve implantaTION)

2021

Abstract Objectives This study sought to determine if percutaneous coronary intervention (PCI) prior to transcatheter aortic valve replacement (TAVR) in patients with significant coronary artery disease would produce noninferior clinical results when compared with no PCI (control arm). Background PCI in patients undergoing TAVR is not without risk, and there are no randomized data to inform clinical practice. Methods Patients with severe symptomatic aortic stenosis and significant coronary artery disease with Canadian Cardiovascular Society class ≤2 angina were randomly assigned to receive PCI or no PCI prior to TAVR. The primary endpoint was a composite of all-cause death or rehospitalizat…

Determinants of elevated carbohydrate antigen 125 in patients with severe symptomatic aortic valve stenosis referred for transcatheter aortic valve i…

2018

Elevated carbohydrate antigen 125 (CA125) predicts adverse outcome after transcatheter aortic valve implantation (TAVI). While known underlying pathophysiological mechanisms of elevated CA125 include serosal effusions and inflammatory stimuli, clinical determinants associated with elevated CA125 in patients referred for TAVI remain unknown. Therefore, we investigated clinical, laboratory and echocardiographic determinants of elevated CA125 in patients with severe aortic valve stenosis referred for TAVI.This study includes 650 patients with severe aortic stenosis referred for TAVI. Baseline CA125 was determined by an immunoassay and dichotomized (elevated versus normal) based on the manufact…