The Heart and the Kidney: What One Tells You about the Other
BY ANUMEHA SINGH, MDA 56-year-old man presented to the ED with shortness of breath and pleural effusions diagnosed by an outside treating physician. The workup included urinalysis, which showed proteinuria, and the exam was consistent with myxedema and pedal edema. He had a history of rheumatoid arthritis, leukocytoclastic vasculitis and Sjögren's syndrome, diabetes, and monoclonal gammopathy of unknown significance (MGUS).The patient also had shortness of breath for a month and pleural effusions on outpatient chest x-ray. He had taken Humira, methotrexate (MTX), and steroids, but his arthritis and Sjögren's were currently well controlled without medications. His MGUS was monitored annually with no medical intervention. He felt excessive thirst, but had normal urine output. The patient appeared well, but would not stop taking sips of water in between every sentence of a conversation despite obvious myxedema.He noted face and hand swelling that morning, which gave way to more significant pedal edema at the end of the day and progressively worsening exertional dyspnea. He noted low-grade fever and loss of appetite. His initial vitals were a blood pressure of 185/96 mm Hg, oxygen saturation of 97% on room air, heart rate of 106 bpm, respiratory rate of 20 bpm, and temperature of 100.1°F.The differential diagnoses for this case included an infectious process such as viral or bacterial infiltrate and lung mass or atypical presentation of myeloma given the patie...
Publication date: November–December 2020Source: Heart &Lung, Volume 49, Issue 6Author(s): Linda Clements, Susan K. Frazier, Debra K. Moser, Terry A. Lennie, Misook L. Chung
CONCLUSIONS: Elevated plasma TMAO level in patients with heart failure is associated with poorer prognoses. This association is only partially mediated by renal dysfunction. PMID: 32959366 [PubMed - as supplied by publisher]
Publication date: Available online 21 September 2020Source: European Journal of RadiologyAuthor(s): Mohammad Hossein Tabatabaei Seyed, Rahimi Habibollah, Moghaddas Fahimeh, Rajebi Hamid
Publication date: Available online 21 September 2020Source: European Journal of RadiologyAuthor(s): Ana I. Garcia Diez, David Fuster, Laura Morata, Ferran Torres, Ruben Garcia, Daniel Poggio, Santiago Sotes, Montserrat Del Amo, Jaime Isern-Kebschull, Jaume Pomes, Alex Soriano, Laura Brugnara, Xavier Tomas
Publication date: Available online 22 September 2020Source: Journal of Orthopaedic TranslationAuthor(s): Xiangbo Meng, Sibylle Grad, Chunyi Wen, Yuxiao Lai, Mauro Alini, Ling Qin, Xinluan Wang
Abstract The optic nerve sheath (ONS) is biomechanically important. It is acted on by tension due to ocular movements, and by fluid shifts and/or alterations in intracranial pressure (ICP) in human disease, specifically in pathologies leading to intracranial hypertension. It has also been hypothesized that the ONS is acted on by altered ICP in astronauts exposed chronically to microgravity. However, a non-invasive method to quantify ONS biomechanical properties is not presently available; knowledge of such properties is desirable to allow characterization of the biomechanical forces exerted on the optic nerve head...
Publication date: Available online 21 September 2020Source: Pregnancy HypertensionAuthor(s): Kim J.C. Verschueren, Rubinah R. Paidin, Annabel Broekhuis, Olivier S.S. Ramkhelawan, Lachmi R. Kodan, Humphrey H.H. Kanhai, Joyce L. Browne, Kitty W.M. Bloemenkamp, Marcus J. Rijken
Publication date: December 2020Source: Journal of Functional Foods, Volume 75Author(s): Feixiang Li, Zhi-Hua Liu, Xueke Tian, Tengfei Liu, Hui-Li Wang, Guiran Xiao
Authors: Fogagnolo A, Taccone FS, Benetto G, Franchi F, Scolletta S, Cotoia A, Kozhevnikova I, Volta CA, Spadaro S Abstract BACKGROUND: Thrombocytopenia is associated with worse outcomes in critically ill patients. The clinical relevance of other platelets indices is less studied. We investigated the ability of the platelets distribution width (PDW) and the mean platelet volume (MPV) to predict mortality in critically ill patients. We hypothesized that the prognostic values of PDW and MPV could be different in septic and non-septic patients. METHODS: We prospectively analyzed patients with an expected ICU lengt...
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