Anomalous Origin of the Right Coronary Artery From the Mid-Portion of the Left Anterior Descending Artery.

Coronary artery anomalies (CAAs) are rare findings and usually diagnosed incidentally on coronary angiograms for other cardiac conditions in most cases. However, coronary anomalies are being increasingly reported with the invention of more advanced cardiac imaging techniques. The CT of the heart structure is the best modality to diagnose and track the exact course of the anomalous artery and to guide in proper management.

Cardiovascular disease risk profiles comparison among dialysis patients.

This study was performed to assess the cardiovascular disease (CVD) risk factors in the prevalent peritoneal dialysis (PD) and hemodialysis (HD) patients and their association with cardiovascular events (CVEs) in a Saudi end-stage renal disease cohort. This was a prospective, observational, single-center study. A total of 192 patients were screened of which 157 patients were eligible (HD = 121, PD = 36).

IFN-α2a or IFN-β1a in combination with ribavirin to treat Middle East respiratory syndrome coronavirus pneumonia: a retrospective study.

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-β1a 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.

Rituximab as a rescue therapy in patients with glomerulonephritis.

To evaluate the use of rituximab in the treatment of severe glomerulonephritis (GN) in order to prevent progression of kidney disease toward the end stage, we designed a multicenter, retrospective study in Saudi Arabia about the efficacy and safety of the use of "off label" rituximab in a variety of severe refractory GN to conventional treatment and the progression of kidney disease for at least one year of follow-up. All the patients had kidney biopsies before treatment with rituximab, and proteinuria and glomerular filtration rate (GFR) were followed-up for the period of the study. The immediate side-effect at the time of administration of rituximab included itching in three patients, hypotension in one patient and anaphylaxis in one patient (dropped out from the study).

Peritonitis caused by Mycobacterium abscesses in patients on continuous ambulatory peritoneal dialysis.

Nontuberculous mycobacteria are an uncommon cause of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. We report two cases of peritonitis caused by Mycobacterium abscesses from a single center, which were successfully treated. In endemic areas of tuberculosis, Zeil Neilsen staining should be part of the initial evaluation to allow early detection.

Asymmetric focal pericardial thickening causing physiologically significant constrictive pericarditis.

A 34-year-old woman presented with refractory ascites and edema. Echocardiography revealed normal left ventricular function with a restrictive diastolic filling pattern. Tissue Doppler velocities of the mitral annulus were normal.

Transcatheter closure of a mechanical perivalvular leak using real-time three-dimensional transesophageal echocardiography guidance.

A 47-year-old female with symptomatic mitral stenosis from a prior undersized mitral annuloplasty ring underwent mitral valve replacement with a mechanical valve. Later, she developed heart failure from a severe paravalvular leak (PVL). Because of the excessive mortality risks from a possible third open heart procedure, the patient was instead referred for transcatheter PVL closure.

The effect of use of dates on serum potassium in nondiabetic hemodialysis patients.

Hyperkalemia is common in patients with ESRD and may contribute to mortality. Dates have been reported to be high in potassium content. One of the concerns on hemodialysis (HD) is convincing patients to give up ingestion of dates as a part of their diet.

Adjunct thrombus aspiration reduces mortality in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction with high-risk angiographic characteristics.

Routine aspiration thrombectomy (AT) in percutaneous coronary intervention for patients with ST-segment elevation myocardial infarction (STEMI) has not proved effective in randomized trials. However, in patients undergoing primary percutaneous coronary intervention with severely reduced flow or visible thrombus, AT remains an intuitively attractive option. The use of adjunctive AT in a high-risk cohort of 158 consecutive patients with STEMI and Thrombolysis In Myocardial Infarction (TIMI) 0 to 1 flow or visible thrombus on baseline angiography was examined.

Nonconvulsive status epilepticus: high incidence in dialysis-dependent patients.

Nonconvulsive status epilepticus is defined as a mental status change from baseline of at least a 30-min duration associated with constant or near-continuous ictal discharges on an electroencephalogram (EEG). Nonconvulsive status epilepticus is an often-overlooked diagnosis as a cause of acute confusional state. There are few case reports in dialysis patients.

Clinical risk factors associated with bleeding after native kidney biopsy.

Purpose: To determine the effect of various risk factors on postbiopsy bleeding (PBB).

Procedure: A retrospective review of 645 native kidney biopsies carried out from 1981 to 2001 was conducted. Data regarding age, gender, race, prebiopsy blood pressure, history of hypertension, pre- and postbiopsy haemoglobin/haematocrit, serum creatinine and blood urea nitrogen (BUN) were collected.

Refractory acute kidney transplant rejection with CD20 graft infiltrates and successful therapy with rituximab.

Acute rejection is an expected event after transplantation and has been associated with poor long-term kidney transplant outcome. The presence of B cells in the kidney graft with acute rejection is thought to be an omnious sign, as it has been associated with poor graft outcome. There is no definitive treatment for acute rejection with B cells in the graft.

Similar risk profiles for post-transplant renal dysfunction and long-term graft failure: UNOS/OPTN database analysis.

Background: Renal dysfunction measured by serum creatinine (>1.5 mg/dL) at 1 year post-transplant correlates with long-term kidney graft survival. The purpose of this study was to compare the risk factors for elevated serum creatinine (SCr) >1.

Humanized anti-CD20 monoclonal antibody (Rituximab) treatment for post-transplant lymphoproliferative disorder.

Introduction: Post-transplant lymphoproliferative disorders (PTLD) is a consequence of Epstein-Barr virus (EBV) infection and is a B-cell hyperplasia with CD-20 positive lymphocytes. The treatment of PTLD includes reduction/withdrawal of immunosuppression and chemotherapy. This study reports our center experience with humanized monoclonal antibody against CD-20 (Rituximab) for the treatment of PTLD.

Proteinuria: how to evaluate an important finding.

Proteinuria is a common laboratory finding in outpatients and should not be discounted. When it is due to a glomerular disease, early diagnosis is important to prevent further renal damage. Proteinuria may also be a marker for progressive atherosclerosis.

Gender differences in burden and depression among informal caregivers of demented elders in the community.

Background: Earlier studies have yielded inconsistent findings regarding gender differences with respect to burden and depression among informal community caregivers of dementia patients.

Objectives: The aim of the study was to determine whether or not there were gender differences in the prevalence of burden and depression among informal caregivers of community-residing dementia patients.

Methods: Data from 259 female and 68 male caregivers who were part of the Canadian Study of Health and Aging were analyzed.