Outcomes of Hospital-Acquired Hypernatremia.

Background: Hospital-acquired hypernatremia is highly prevalent, overlooked, and associated with unfavorable consequences. There are limited studies examining the outcomes and discharge dispositions of various levels of hospital-acquired hypernatremia in patients with or without CKD.

Methods: We conducted an observational retrospective cohort study, and we analyzed the data of 1,728,141 patients extracted from the Cerner Health Facts database (January 1, 2000, to June 30, 2018).

A Novel Interventional Approach to LV Pseudoaneurysm Compressing on LAD by Utilizing LAA Closure Device.

We describe the novel transcatheter approach, with off-label application of LAA closure device, coiling, and concurrent left anterior descending stenting in the setting of left ventricular (LV) pseudoaneurysm. This case underlines collaboration among interventional cardiology, cardiothoracic, and neurosurgery teams in a challenging, nonsurgical candidate with high risk of LV pseudoaneurysm rupture, and death. ().

Hypernatremia in Hospitalized Patients: A Large Population-Based Study.

Background: Hypernatremia is a frequently encountered electrolyte disorder in hospitalized patients. Controversies still exist over the relationship between hypernatremia and its outcomes in hospitalized patients. This study examines the relationship of hypernatremia to outcomes among hospitalized patients and the extent to which this relationship varies by kidney function and age.

Dysnatremias in Chronic Kidney Disease: Pathophysiology, Manifestations, and Treatment.

The decreased ability of the kidney to regulate water and monovalent cation excretion predisposes patients with chronic kidney disease (CKD) to dysnatremias. In this report, we describe the clinical associations and methods of management of dysnatremias in this patient population by reviewing publications on hyponatremia and hypernatremia in patients with CKD not on dialysis, and those on maintenance hemodialysis or peritoneal dialysis. The prevalence of both hyponatremia and hypernatremia has been reported to be higher in patients with CKD than in the general population.

High performance implementation of the hierarchical likelihood for generalized linear mixed models: an application to estimate the potassium reference range in massive electronic health records datasets.

Background: Converting electronic health record (EHR) entries to useful clinical inferences requires one to address the poor scalability of existing implementations of Generalized Linear Mixed Models (GLMM) for repeated measures. The major computational bottleneck concerns the numerical evaluation of multivariable integrals, which even for the simplest EHR analyses may involve millions of dimensions (one for each patient). The hierarchical likelihood (h-lik) approach to GLMMs is a methodologically rigorous framework for the estimation of GLMMs that is based on the Laplace Approximation (LA), which replaces integration with numerical optimization, and thus scales very well with dimensionality.

American Indian chronic Renal insufficiency cohort study (AI-CRIC study).

Background: Chronic kidney disease (CKD) is an increasing epidemic globally that is associated with adverse health outcomes including end stage kidney disease (ESKD), cardiovascular disease (CVD), and death. American Indians (AIs) have a higher prevalence of CKD than most other racial/ethnic groups, due in part to a high prevalence of type 2 diabetes. Other genetic and environmental factors not yet identified may also contribute to the disproportionate burden of CKD in AIs.

Itch and Ache on Dialysis: New Approaches to Manage Uremic Pruritus and Restless Legs.

Background: Uremic pruritus (UP) and restless legs syndrome (RLS) are highly prevalent complaints among patients with end-stage renal disease (ESRD) undergoing chronic dialysis. These chronic troublesome symptoms lead to a significant decrease in quality of life (QOL) and increase in mortality rate. Despite their distressing characteristics, these symptoms usually remain under-recognized by healthcare providers.

Bacterial pericarditis and antimicrobial resistance at the Tehran Heart Center, Iran.

Introduction: When bacterial pericarditis is suspected, urgent pericardial drainage combined with intravenous antibacterial therapy is mandatory to avert devastating, life-threatening complications. There have been scanty results on antimicrobial susceptibility of common causative microorganisms of bacterial pericarditis; most studies had small sample sizes and were performed decades ago.

Methodology: This prospective study surveyed the causative bacteria in infectious pericardial effusions and their antimicrobial susceptibility among 320 consecutive cardiac patients who underwent pericardiocentesis at Tehran Heart Center between 2007 and 2012, using the European Society of Cardiology (ESC)'s criteria.

Association between Physical Activity and Metabolic Risk Factors in Adolescents: Tehran Lipid and Glucose Study.

Background: Physical activity (PA) is associated with the metabolic syndrome (MetS) and its components. This study aimed to examine the association between PA and MetS and its components among normal weight and overweight/obese adolescent in Tehran Lipid and Glucose Study (TLGS).

Methods: This cross-sectional study includes 777 adolescents, aged 12-18 years, who were selected by multi-stage random cluster sampling from among TLGS participants.