Overuse of Hematocrit Testing After Elective General Surgery at a Veterans Affairs Medical Center.

Objective: To evaluate the clinical usefulness and costs of routine postoperative hematocrit testing after elective general surgery.

Methods: We reviewed charts of all patients who had elective general surgery at New Mexico Veterans Affairs Health Care System, Albuquerque hospital from 2011 through 2014. Demographic data and patient characteristics (eg, comorbidities, smoking/drinking history), estimated blood loss (EBL), pre- and postoperative hematocrit levels, and signs and symptoms of anemia were compared in patients who did or did not receive a blood transfusion within 72 hours of the operation.

Dialysis-associated hyperglycemia: manifestations and treatment.

Purpose: Dialysis-associated hyperglycemia (DAH), is associated with a distinct fluid and electrolyte pathophysiology. The purpose of this report was to review the pathophysiology and provide treatment guidelines for DAH.

Methods: Review of published reports on DAH.

Symptomatic Hyperglycemia in a Patient with Dialysis Ascites.

An anuric woman with ascites rapidly developed extreme hyperglycemia and seizures after hemodialysis. During development of hyperglycemia, the decrease in serum sodium concentration (Δ[Na]) was nearly twice the value predicted by a formula accounting for the degree of hyperglycemia and the intracellular-to-extracellular volume ratio. The prediction assumed that ascitic fluid is part of the extracellular volume.

Feasibility of Induced Pluripotent Stem Cell Therapies for Treatment of Type 1 Diabetes.

This review of iPSCs to treat T1D provides a current assessment of the challenges and potential for this proposed new therapy.

Principles of quantitative water and electrolyte replacement of losses from osmotic diuresis.

Osmotic diuresis results from urine loss of large amounts of solutes distributed either in total body water or in the extracellular compartment. Replacement solutions should reflect the volume and monovalent cation (sodium and potassium) content of the fluid lost. Whereas the volume of the solutions used to replace losses that occurred prior to the diagnosis of osmotic diuresis is guided by the clinical picture, the composition of these solutions is predicated on serum sodium concentration and urinary sodium and potassium concentrations at presentation.

Fluid balance concepts in medicine: Principles and practice.

The regulation of body fluid balance is a key concern in health and disease and comprises three concepts. The first concept pertains to the relationship between total body water (TBW) and total effective solute and is expressed in terms of the tonicity of the body fluids. Disturbances in tonicity are the main factor responsible for changes in cell volume, which can critically affect brain cell function and survival.

22 Years of predictive testing for Huntington's disease: the experience of the UK Huntington's Prediction Consortium.

This corrects the article DOI: 10.1038/ejhg.2016.

The function of probiotics on the treatment of ventilator-associated pneumonia (VAP): facts and gaps.

Probiotics have been used for centuries in making fermented dairy products. The health benefits related to probiotics consumption are well recognized and they are generally regarded as safe (GRAS). Their therapeutic effects are due to the production of a variety of antimicrobial compounds, such as short-chain fatty acids, organic acids (such as lactic, acetic, formic, propionic and butyric acids), ethanol, hydrogen peroxide and bacteriocins.

Reproducibility of serial creatinine excretion measurements in peritoneal dialysis.

Aim: To test whether muscle mass evaluated by creatinine excretion (EX) is maintained in patients with end-stage kidney disease (ESKD) treated by peritoneal dialysis (PD), we evaluated repeated measurements of EX in a PD population.

Methods: One hundred and sixty-six PD patients (94 male, 72 female) receiving the same PD dose for the duration of the study (up to approximately 2.5 years) had repeated determinations of total (in urine plus spent dialysate) 24-h EX (EX T) to assess the adequacy of PD by creatinine clearance.

Advanced wasting in peritoneal dialysis patients.

Aim: To identify patients with end-stage renal disease treated by peritoneal dialysis (PD) who had zero body fat (BF) as determined by analysis of body composition using anthropometric formulas estimating body water (V) and to compare nutritional parameters between these patients and PD patients whose BF was above zero.

Methods: Body weight (W) consists of fat-free mass (FFM) and BF. Anthropometric formulas for calculating V allow the calculation of FFM as V/0.

Hemodynamic Response to Upper Airway Obstruction in Hypertensive and Normotensive Pregnant Women.

Mild obstructive sleep apnea is common in pregnancy and may have an exacerbating role in gestational hypertension, although currently the interaction between these two diseases is uncertain. We analyzed 43 pregnant subjects, 28 with gestational hypertension (GH) and 15 with normal healthy pregnancy, by level I polysomnography. Additionally, diastolic and systolic blood pressure changes in response to obstructive respiratory events were measured by noninvasive beat-by-beat monitoring.

22 Years of predictive testing for Huntington's disease: the experience of the UK Huntington's Prediction Consortium.

Huntington's disease (HD) is a progressive neurodegenerative condition. At-risk individuals have accessed predictive testing via direct mutation testing since 1993. The UK Huntington's Prediction Consortium has collected anonymised data on UK predictive tests, annually, from 1993 to 2014: 9407 predictive tests were performed across 23 UK centres.

An analytic approach for describing and prioritizing health inequalities at the local level in Canada: a descriptive study.

Background: We present the health inequalities analytic approach used by the Saskatoon Health Region to examine health equity. Our aim was to develop a method that will enable health regions to prioritize action on health inequalities.

Methods: Data from admissions to hospital, physician billing, reportable diseases, vital statistics and childhood immunizations in the city of Saskatoon were analyzed for the years ranging from 1995 to 2011.

Fatty acid composition of achenes of Cirsium taxa (Asteraceae, Carduoideae) from Turkey.

The fatty acid compositions and total oil contents in achenes of 22 Cirsium taxa collected from different natural habitats in Turkey were investigated. The range of total fat in the taxa varied from 1.7% to 13.

Leiomyosarcoma of the Inferior Vena Cava: A Case Series and Review of the Literature.

Background: Leiomyosarcoma of the inferior vena cava (IVC) is an exceedingly rare smooth muscle sarcoma. Approximately 300 cases have been described in the literature, and further research is needed to understand the disease and guide its management. Surgery remains the only potential curative measure.

Indices of serum tonicity in clinical practice.

Although disturbances of serum tonicity (effective osmolality) may have dire consequences, only surrogate indices of tonicity are available in practice. This report identifies the appropriate index for expressing clinical states of dystonicity. Serum sodium concentration ([Na]S) and osmolality ([Osm]S) may be incongruent.

Renal systems biology of patients with systemic inflammatory response syndrome.

A systems biology approach was used to comprehensively examine the impact of renal disease and hemodialysis (HD) on patient response during critical illness. To achieve this, we examined the metabolome, proteome, and transcriptome of 150 patients with critical illness, stratified by renal function. Quantification of plasma metabolites indicated greater change as renal function declined, with the greatest derangements in patients receiving chronic HD.

Omega-3 dietary Fatty Acid status of healthy older adults in Tasmania, Australia: an observational study.

Objectives: To determine the dietary and supplement intake of omega-3 (n-3) polyunsaturated fatty acids (PUFA) of older Tasmanian adults; their plasma n-3 PUFA status and the relationship between n-3 PUFA intake and plasma status.

Design: Cross-sectional study.

Setting: Launceston and surrounding regions, Tasmania, Australia.

Nephropathy in dietary hyperoxaluria: A potentially preventable acute or chronic kidney disease.

Hyperoxaluria can cause not only nephrolithiasis and nephrocalcinosis, but also renal parenchymal disease histologically characterized by deposition of calcium oxalate crystals throughout the renal parenchyma, profound tubular damage and interstitial inflammation and fibrosis. Hyperoxaluric nephropathy presents clinically as acute or chronic renal failure that may progress to end-stage renal disease (ESRD). This sequence of events, well recognized in the past in primary and enteric hyperoxalurias, has also been documented in a few cases of dietary hyperoxaluria.

Management of severe hyponatremia: infusion of hypertonic saline and desmopressin or infusion of vasopressin inhibitors?

Rapid correction of severe hyponatremia carries the risk of osmotic demyelination. Two recently introduced methods of correction of hyponatremia have diametrically opposite effects on aquaresis. Inhibitors of vasopressin V2 receptor (vaptans) lead to the production of dilute urine, whereas infusion of desmopressin causes urinary concentration.

Quality properties, fatty acids, and biogenic amines profile of fresh tilapia stored in ice.

This work determines quality properties and fatty acids content of Nile tilapia (Oreochromis niloticus) stored in ice for 21 d. The quality properties consist of thiobarbituic acid (TBA), total volatile basic nitrogen (TVB-N), trimethylamine (TMA), and microbiological analysis (total viable count (TVC), total coliform, Salmonella and Staphylococcus aureus) and determination of biogenic amines content (histamine, cadaverine, putrescine, spermine, spermidine, 2-phenylethylamine, agmatine, tyramine, and ammonia). Moreover, the fat, moisture, and ash composition as well as fatty acids profile have also been analyzed.

The importance of community in academic health centers.

Background: A strong sense of community in any organization, whether it is a small business or a large academic medical center, positively impacts on productivity, efficiency, and morale and makes for an enjoyable workplace. Striking a balance between institutional interests and those of the individual is an ongoing challenge that demands vigilance on the part of faculty and administrators. A faculty comprising self-absorbed individuals, no matter how accomplished they are, will eventually devolve into dysfunction.