ABSTRACT
Introduction: This study aimed to explore the clinical effects of blood purification therapy in patients with chronic renal disease, measured by renal function index and inflammation. Methodology: Data were collected from a tertiary care hospital in Pakistan between June 2022 and September 2023. Eighty-four patients undergoing maintenance hemodialysis for chronic renal failure were retrospectively included in this cohort. Results: Age, sex, BMI, course of disease, primary disease, and educational level were not related to the response to blood purification treatment. Blood purification therapy positively affected renal function, serological indices, and inflammatory factors (P<0.05). Conclusion: Blood purification therapy can improve toxin clearance and renal function and reduce inflammation. Therefore, the authors can conclude that this is an effective therapy for our population.
ABSTRACT
Acute kidney injury (AKI) is a sudden decline in renal function after cardiac surgery. It is characterized by a significant reduction in glomerular filtration rate, alterations in serum creatinine (S.Cr) levels, and urine output. This study aimed to retrospectively analyze a cohort of 704 patients selected using stringent inclusion and exclusion criteria. AKI was defined by an increase of 0.3 mg/dL in S.Cr levels compared to baseline. Data were collected from the hospital and analyzed using SPSS 16.0. Data analysis revealed that 22% (nâ =â 155) of the patients developed AKI on the second post-operative day, accompanied by a substantial increase in S.Cr levels (from 1.064â ±â 0.2504 to 1.255â ±â 0.2673, Pâ <â .000). Age and cardiopulmonary bypass duration were identified as risk factors along with ejection fraction and days of hospital stay, contributing to the development of AKI. Early renal replacement therapy can be planned when the diagnosis of AKI is established early after surgery.
Subject(s)
Acute Kidney Injury , Coronary Artery Bypass , Humans , Retrospective Studies , Tertiary Care Centers , Pakistan/epidemiology , Prevalence , Coronary Artery Bypass/adverse effects , Risk Factors , Acute Kidney Injury/diagnosis , Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology , Kidney/physiology , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Creatinine , Cardiopulmonary Bypass/adverse effectsABSTRACT
OBJECTIVES: Middle East respiratory syndrome coronavirus (MERS-CoV) is associated with significant mortality. We examined the utility of plasma MERS-CoV PCR as a prognostic indicator and compared the efficacies of IFN-α2a and IFN-ß1a when combined with ribavirin in reducing MERS-CoV-related mortality rates. METHODS: We retrospectively analysed 32 patients with confirmed MERS-CoV infection, admitted between April 2014 and June 2014, by positive respiratory sample RT-PCR. Plasma MERS-CoV RT-PCR was performed at the time of diagnosis for 19 patients. RESULTS: The overall mortality rate was 69% (22/32). Ninety percent (9/10) of patients with positive plasma MERS-CoV PCR died compared with 44% (4/9) of those with negative plasma MERS-CoV PCR. Mortality rate in patients who received IFN-α2a was 85% (11/13) compared with 64% (7/11) in those who received IFN-ß1a (Pâ=â0.24). The mortality rate in patients with renal failure (14), including 8 on haemodialysis, was 100%. Age >50 years and diabetes mellitus were found to be significantly associated with mortality (ORâ=â26.1; 95% CI 3.58-190.76; Pâ=â0.001 and ORâ=â15.74; 95% CI 2.46-100.67; Pâ=â0.004, respectively). The median duration of viral shedding in patients who recovered was 11 days (range 6-38 days). Absence of fever was noted in 5/32 patients. CONCLUSIONS: Plasma MERS-CoV RT-PCR may serve as an effective tool to predict MERS-CoV-associated mortality. Older age and comorbid conditions may have contributed to the lack of efficacy of IFN-α2a or IFN-ß1a with ribavirin in treating MERS-CoV. Absence of fever should not exclude MERS-CoV.
Subject(s)
Antiviral Agents/administration & dosage , Coronavirus Infections/drug therapy , Interferon-alpha/administration & dosage , Interferon-beta/administration & dosage , Pneumonia, Viral/drug therapy , Ribavirin/administration & dosage , Adult , Aged , Aged, 80 and over , Drug Therapy, Combination/methods , Female , Humans , Lung/virology , Male , Middle Aged , Middle East Respiratory Syndrome Coronavirus/isolation & purification , Plasma/virology , Real-Time Polymerase Chain Reaction , Retrospective Studies , Treatment Outcome , Viral LoadABSTRACT
Middle East Respiratory Syndrome Coronavirus (MERS CoV) may cause severe pneumonia with significant morbidity and mortality, particularly in patients with multiple comorbid condition. MERS CoV pneumonia has not been previously reported in patients with Human Immunodeficiency Virus (HIV). Herein, we report a case of MERS CoV pneumonia with a successful outcome in a patient recently diagnosed with HIV.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Middle East Respiratory Syndrome Coronavirus , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/drug therapy , Antiretroviral Therapy, Highly Active , Antiviral Agents/therapeutic use , Coronavirus Infections/diagnosis , Humans , Male , Middle Aged , Middle East Respiratory Syndrome Coronavirus/genetics , Pneumonia, Viral/diagnosis , Radiography, Thoracic , Steroids/therapeutic use , Treatment OutcomeABSTRACT
The returning traveler with fever presents a diagnostic challenge for the health care provider. When evaluating such a patient, the highest priority should be given to diseases that are potentially fatal or may represent public health threats. A good history is paramount and needs to include destination, time and duration of travel, type of activity, onset of fever in relation to travel, associated comorbidities, and any associated symptoms. Pretravel immunizations and chemoprophylaxis may alter the natural course of disease and should be inquired about specifically. The fever pattern, presence of a rash or eschar, organomegaly, or neurologic findings are helpful physical findings. Laboratory abnormalities are nonspecific but when corroborated with clinical and epidemiologic data may offer a clue to diagnosis.
Subject(s)
Communicable Diseases/diagnosis , Fever of Unknown Origin/etiology , Travel , Clinical Laboratory Techniques , Communicable Diseases/pathology , Communicable Diseases/physiopathology , Humans , Medical History Taking , Physical ExaminationABSTRACT
Many functional, demographic, and immunologic changes associated with aging are responsible for increasing the incidence and severity of infectious diseases in the elderly. Management is complicated by age-related organ system changes. Because many of the elderly are on multiple medications for underlying illnesses, antimicrobial therapy needs to be chosen keeping drug interactions and adverse events in mind. Common infections seen in the elderly are infections of skin and soft tissue, urinary tract, respiratory tract, and gastrointestinal tract. Organized and well-funded programs to address infectious disease issues in the elderly are the only way to improve care.
Subject(s)
Infections/epidemiology , Age Factors , Aged , Aged, 80 and over , Humans , Infections/diagnosis , Infections/therapyABSTRACT
We used hospital antibiograms to assess predominant pathogens and their patterns of in vitro antimicrobial resistance in central Illinois, USA. We found a lack of information about national guidelines for in vitro antimicrobial susceptibility testing and differences in interpretation among laboratories in the region.
