A Rare and Painful Byproduct of ESRD

​BY HABIR MANDAIR; KEYUR KURANI; &KHALID MALIK, MDA 62-year-old obese woman with end-stage renal disease (ESRD) who was on hemodialysis, hypertension, diabetes mellitus, and chronically elevated serum calcium levels presented to the ED with altered mental status. Nursing home staff stated that she was unable to answer questions coherently and seemed confused.Her vitals were within normal limits except for a body temperature of 99.9°F. Several necrotic lesions of various sizes were found on her left and right buttocks and the medial aspects of both thighs. The patient also had severe necrosis of the third finger on her left hand and the second on her right hand. Calciphylaxis was suspected because of her history and the unique characteristics of the lesions.Lab results showed a serum calcium level of 13.6 mg/dL, a PTH of 102.2 pg/mL, and elevated vitamin D levels. The patient was admitted and treated by wound care, nephrology, and endocrinology. Medications and dialysis regimen were also adjusted to achieve adequate serum calcium control.Recognition and Risk FactorsCalcific uremic arteriopathy (CUA), the more accurate name for calciphylaxis, is a rare disorder resulting from impaired calcium and phosphate homeostasis most often found in ESRD patients. Metastatic calcification of blood vessels isn't uncommon in ESRD patients, but CUA is distinctly different because it selectively targets dermal and subcutaneous arterioles in areas of high adiposity, as seen in the thi...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research

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Abstract Chikungunya virus (CHIKV) a re-emerging mosquito-borne alpha virus causes significant distress which is further accentuated in the lack of specific therapeutics or a preventive vaccine, mandating accelerated research for anti-CHIKV therapeutics. In recent years, drug repositioning has gained recognition for the curative interventions for its cost and time efficacy. CHIKV envelope proteins are considered to be the promising targets for drug discovery because of their essential role in viral attachment and entry in the host cells. In the current study, we propose structure-based virtual screening of drug mo...
Source: Bioinformation - Category: Bioinformatics Authors: Tags: Bioinformation Source Type: research
Conclusion: Theoretical results and simulations show that our designed UFR profiles can remove the target amount of fluid in a given time period while keeping the hematocrit below a specified critical profile. Significance: Individualization of UFR profiles is now feasible using current HD technology and may reduce the incidence of intradialytic hypotension.
Source: IEEE Transactions on Biomedical Engineering - Category: Biomedical Engineering Source Type: research
Conclusion: Our results support the hypothesis that the proposed photoelectric method for neural stimulation is effective. Significance: Photoelectric stimulation is precise and avoids the need for a potentially destructive tether, making- it a promising alternative to electrical stimulation.
Source: IEEE Transactions on Biomedical Engineering - Category: Biomedical Engineering Source Type: research
Publication date: Available online 18 July 2019Source: International Review of NeurobiologyAuthor(s): Dafin Fior Muresanu, Aruna Sharma, Ranjana Patnaik, Preeti K. Menon, Herbert Mössler, Hari Shanker SharmaAbstractThere is a growing trend of hypertension among military and civilian populations due to lifetime stressful situations. If hypertension is uncontrolled it leads to development of diabetes and serious neurological complications. Most of the World populations live in temperate zone across the World. Thus, a possibility exists that these hypertensive and diabetic people may have external heat as potential risk ...
Source: International Review of Neurobiology - Category: Neuroscience Source Type: research
Abstract A significant obstacle to the study of human cancer biology and the testing of human specific immunotherapeutics is the paucity of translational models that recapitulate both the growth of human tumors and the functionality of human immune systems. Humanized mice engrafted with human hematopoietic stem cells (HSC) and patient-derived xenografts (PDX) enable preclinical investigation of the interactions between the human immune system and human cancer. We use immunodeficient non-obese diabetic (NOD, scid, gamma) NSG™ or NSG™-SGM3 mice as hosts for establishment of human immunity following HSC i...
Source: Mol Biol Cell - Category: Molecular Biology Authors: Tags: Methods Mol Biol Source Type: research
Authors: Ha JK, Hwang CJ, Lee DH, Lee MY, Yoon SJ, Lee CS Abstract The purpose of this study was to compare various sagittal spinopelvic parameters between patients with and without degenerative lumbar spondylolisthesis (DLS). A total of 165 patients who underwent surgery for low back and/or radicular pain were divided into two groups: those without DLS (non-DLS group; n = 85) and those with DLS (DLS group; n = 80). In all sagittal spinopelvic parameters, no significant difference was found between the non-DLS and DLS groups. The mean pelvic incidence (PI) value of the DLS group (56.4°) was almost similar to th...
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
We present the 10 years results of 33 patients operated on between April 2002 and May 2006 diagnosed with a "sports hernia". The injury was treated with a bilateral abdominal procedure according to Nesovic combined with a bilateral adductor release after unsuccessful conservative treatment of at least 2 months. There were 32 male patients between 18 and 43 years and one female patient aged 25 years with a mean age of 28.8 at time of surgery. All procedures were bilateral. Patients were seen in the postoperative clinic and a questionnaire was collected after 2 years and 10 years. Within 16 weeks, 30 patients (90,9...
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
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Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
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Source: Ocular Immunology and Inflammation - Category: Allergy & Immunology Tags: Ocul Immunol Inflamm Source Type: research
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Source: Ocular Immunology and Inflammation - Category: Allergy & Immunology Tags: Ocul Immunol Inflamm Source Type: research
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