Dose adjustment of rheumatology and allergy/immunology medications in chronic kidney disease: awareness and knowledge among internal medicine housestaff.

Background: Patients with chronic kidney disease (CKD) are at increased risk for adverse drug events due to medication dosing errors. We studied the awareness and knowledge among internal medicine housestaff (IMHS) of proper dose adjustment of commonly used rheumatology and allergy/immunology medications for patients with CKD.

Methods: We surveyed 353 IMHS to evaluate their awareness of the need for medication dose adjustments for patients with CKD and knowledge for medication adjustment by level of glomerular filtration rate for common rheumatology and allergy/immunology medications.

MELD-Na score, Acute Physiologic and Chronic Health Evaluation II score, and SOFA score and their association with mortality in critically ill COVID-19 patients with liver injury: A retrospective single-center study.

Background: The Acute Physiologic and Chronic Health Evaluation II (APACHE-II), Sequential Organ Failure Assessment (SOFA), and Model for End-Stage Liver Disease modified for Sodium concentration (MELD-Na) scores are validated to predict disease mortality. We studied the prognostic utility of these scoring systems in critically ill coronavirus disease 2019 (COVID-19) patients with liver injury.

Methods: This was a retrospective study of 291 confirmed COVID-19 and liver injury patients requiring intensive care unit level of care.

Renal Manifestations and their Association with Mortality and Length of Stay in COVID-19 Patients at a Safety-net Hospital.

Background: Renal involvement in COVID-19 leads to severe disease and higher mortality. We study renal parameters in COVID-19 patients and their association with mortality and length of stay in hospital.

Methods: A retrospective study (n=340) of confirmed COVID-19 patients with renal involvement determined by the presence of acute kidney injury.

Respiratory involvement parameters in hospitalized COVID-19 patients and their association with mortality and length of stay.

Introduction/background: Patients with Coronavirus Disease 2019 (COVID-19) present with a spectrum of respiratory symptoms. There are no studies describing respiratory system involvement adjusted for other organ systems, oxygen saturation nadir, hospitalization days until respiratory involvement, proportion of days of respiratory system involvement, and persistent respiratory involvement at discharge in COVID-19 patients. We studied these parameters in COVID-19 patients that received respiratory therapy interventions and their association with mortality and length of stay (LOS).

Glucose dysregulation and its association with COVID-19 mortality and hospital length of stay.

Background And Aims: We investigate the impact of blood glucose on mortality and hospital length of stay (HLOS) among COVID-19 patients.

Methods: Retrospective study of 456 patients with confirmed COVID-19 and glycemic dysregulation in the New York City area.

Results: We found that impaired glucose adjusted for other organs systems involved (OR:1.

Hematologic Involvement as a Predictor of Mortality in COVID-19 Patients in a Safety Net Hospital.

Introduction: COVID-19 affects the hematologic system. This article evaluated the impact of hematologic involvement of different blood cell line parameters of white blood cells including absolute neutrophil count (ANC), hemoglobin, and platelets in COVID-19 patients and their association with hospital mortality and length of stay (LOS).

Methods: This was a retrospective study of 475 patients with confirmed positive COVID-19 infection and hematologic abnormalities in the metropolitan New York City area.

Social Support, Caregivers, and Chronic Kidney Disease.

The morbidity and mortality associated with chronic kidney disease remains unacceptably high. Psychosocial issues in CKD patients are frequently overlooked yet are often modifiable risk factors for mortality. Addressing patient perception of social support can potentially improve patient outcomes.

Awareness and Knowledge Among Internal Medicine House-Staff for Dose Adjustment of Cardiovascular Drugs in Chronic Kidney Disease.

Introduction: Patients with chronic kidney disease (CKD) are vulnerable to adverse-drug events from cardiovascular drugs.

Aim: To evaluate awareness and knowledge for appropriate dose adjustment of cardiovascular drugs in CKD patients among Internal Medicine house-staff (IMHS).

Methods: Cross-sectional convenience sample survey in Fall 2015 among 341 IMHS from multiple academic institutions in the suburban New York City metropolitan area.

Dose adjustment of antidiabetic medications in chronic kidney disease.

Purpose: The purpose of this study is to identify whether Internal Medicine house-staff (IMHS) have awareness and knowledge about the correct dosage of antidiabetic medications for patients with chronic kidney disease (CKD), as dosing errors result in adverse patient outcomes for those with diabetes mellitus (DM) and CKD.

Methods: There were 353 IMHS surveyed to evaluate incorrect level of awareness of medication dose adjustment in patients with CKD (ILA) and incorrect level of knowledge of glomerular filtration rate level for medication adjustment (ILK-GFR) for Glipizide, Pioglitazone, and Sitagliptin.

Results: Lack of awareness and knowledge was high, with the highest for Pioglitazone at 72.

Psychological and relational factors in ESRD hemodialysis treatment in an underserved community.

Objective: The researchers investigated the association of depression with treatment adherence, and examined the possible moderating roles of social support and of the physician-patient working alliance (PPWA) on treatment adherence, satisfaction with treatment, and quality of life.

Methods: The current study sampled ninety-five patients with End Stage Renal Disease who were receiving outpatient hemodialysis (HD) treatment.

Results: Findings indicated that higher levels of depression were significantly associated with lower ratings of adherence, quality of life, and social support.

Awareness and Knowledge Among Internal Medicine Resident Trainees for Dose Adjustment of Analgesics and Neuropsychotropic Medications in CKD.

Objectives: Errors in drug dosing lead to poor patient outcomes and are common in patients with chronic kidney disease (CKD). Because the majority of patients with CKD are being treated by physicians specializing in internal medicine, we studied the awareness and knowledge that internal medicine resident trainees (IMRTs) have regarding the correct dosage of commonly used analgesic and neuropsychotropic medications for patients with CKD.

Methods: We surveyed 353 IMRTs about their awareness of whether a medication needs dose adjustment in patients with CKD and knowledge for medication adjustment by level of glomerular filtration rate.

Awareness and knowledge among internal medicine house-staff for dose adjustment of commonly used medications in patients with CKD.

Background: Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD.

Methods: A cross-sectional survey was performed and included 341 participants.

Icodextrin-induced acute pancreatitis in a peritoneal dialysis patient: a case report and literature review .

The 7.5% icodextrin solution is widely used for long-dwell in peritoneal dialysis (PD) regimens as an alternative osmotic agent to glucose. It has been defined as a biocompatible agent because of its iso-osmolarity and is generally safe and well tolerated.

The Physician-Patient Working Alliance in Hemodialysis Treatment.

Over the past 20 years, the role of psychological and social factors, including the physician-patient working alliance, have emerged as integral components of medical care for patients with a myriad of health conditions. The current study examines a model comprised of psychological-interpersonal factors and the extent to which it explains patient satisfaction with and adherence to hemodialysis treatment. One hundred and seven adults with end-stage renal disease who were receiving regular outpatient hemodialysis participated in the study.

Facial disfigurement due to osteitis fibrosa cystica or brown tumor from secondary hyperparathyroidism in patients on dialysis: A systematic review and an illustrative case report.

Osteitis fibrosa cystica (OFC) is the most frequent type of osseous change in renal osteodystrophy affecting the majority of dialysis patients. Brown tumors are a severe form of OFC. The involvement of the craniofacial skeleton causing facial disfigurement in patients on dialysis appears to be limited to case reports.

Hypercalcemia and renal failure in a young man: lessons in diagnosis.

Hypercalcemia is a common clinical problem. Morbidity and mortality associated with hypercalcemia are directly related to its underlying cause, making identification of the correct underlying etiology vital. When hypercalcemia is combined with acute kidney injury it points towards very specific diagnoses.

Fulminant hepatic failure with virtually undetectable serum alkaline phosphatase.

Wilson's disease presenting as fulminant hepatic failure is a rare presentation that carries a high morbidity and mortality. We report a young patient who developed fulminant hepatic failure as the initial manifestation of Wilson's disease. Virtually undetectable serum alkaline phosphatase provided the first clue to the diagnosis.

Changes in osmol gap in chronic kidney disease: an exploratory study.

Aim: There is no data on osmol gap (OG) in chronic kidney disease (CKD) by stage and limited data on OG in adults on maintenance hemodialysis (HD). We aimed to examine the OG between different stages of CKD and to compare the OG pre- and post-HD in those on maintenance HD.

Methods: We conducted a cross-sectional study of 67 patients.

Occupational risk and chronic kidney disease: a population-based study in the United States adult population.

Objective: Previous studies on occupational risk for chronic kidney disease (CKD) have analyzed a limited range of occupations and focused on nephrotoxins. The primary purpose of this study was to examine the relative risk for the occurrence of CKD between different occupations in the US adult population.

Materials And Methods: This was a population-based survey study of 91,340 participants in the US, who completed the National Health Interview Survey, 2004 through 2008.

Early use of hemodialysis for active rewarming in severe hypothermia: a case report and review of literature.

Deep accidental hypothermia (body temperature below 28°C) is rare. Even with modern supportive care of active external and internal rewarming techniques it is associated with a high mortality rate. We report the early and successful use of hemodialysis (HD) for active rewarming of a middle-aged alcoholic man with severe deep accidental hypothermia after failure of initial efforts of rewarming using conventional strategies.

Toll-like receptor 9 and vascular endothelial growth factor levels in human kidneys from lupus nephritis patients.

Background: In the lupus mouse and systemic lupus erythematosus (SLE) patients, DNA fragments isolated from plasma may mimic microbial DNA and trigger Toll-like receptor 9 (TLR9) signaling with formation of autoantibodies against DNA fragments and nucleosomes. Vascular endothelial growth factor (VEGF) is a tightly regulated angiogenic cytokine in the kidney. The present study investigated glomerular and tubular expression of both TLR9 and VEGF in biopsies from human subjects with lupus nephritis (LN) and normal controls.

Autonomic dysfunction as a delayed sequelae of acute ethylene glycol ingestion : a case report and review of the literature.

Ethylene glycol poisoning is a common form of poisoning worldwide. The clinical course of ethylene glycol poisoning usually follows a three-stage progression, although these stages may overlap. A fourth stage of delayed neurological dysfunction consisting of cranial neuropathies has been suggested in several case reports.

Permanent hearing loss with iopamidol following aortic angiography in a hemodialysis patient: a case report and review of the literature.

Nonionic low-osmolar contrast agents are considered safe for intravenous or intra-arterial administration and are used widely in the general population, as well as in patients on hemodialysis therapy. There are data limited to case reports for contrast-induced hearing loss; however, the ototoxicity induced by contrast agents in patients with chronic kidney disease has never been described. We report a case of permanent sensorineural deafness after abdominal aortic angiography with iopamidol in a woman with end-stage renal disease on hemodialysis therapy and review the literature relating to contrast use with the development of hearing impairment.