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Improving Renal Protection in Chronic Kidney Disease Associated with Type 2 Diabetes: The Role of Finerenone.
Endocr Metab Immune Disord Drug Targets
January 2025
Department of Internal Medicine, Division of Nephrology and Hypertension, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia.
Chronic kidney disease (CKD) is a major complication of type 2 diabetes mellitus (T2D), which often leads to diabetic kidney disease (DKD). Traditional therapies, including renin- angiotensin-aldosterone system inhibitors and sodium-glucose cotransporter-2 inhibitors, are effective in slowing CKD progression. However, these approaches are insufficient to comprehensively inhibit mineralocorticoid receptor (MR) overactivation in the kidneys, which remains a significant driver of inflammation, fibrosis, and oxidative stress.
View Article and Find Full Text PDFFluid Management in Critical Care: New Insights Into Optimal Fluid Therapy.
Cureus
December 2024
Critical Care Medicine, Star Care Multispeciality Hospital, Kozhikode, IND.
Background: Fluid management is a crucial critical care component, influencing outcomes such as organ function, renal integrity, and survival in critically ill patients. Recent evidence suggests that balanced crystalloids may offer advantages over isotonic saline, particularly in reducing the risk of acute kidney injury (AKI) and other complications. This study aimed to evaluate the impact of balanced crystalloids versus isotonic saline on clinical outcomes in the intensive care unit (ICU), focusing on AKI, renal replacement therapy (RRT), and mortality.
View Article and Find Full Text PDFHemophagocytic Lymphohistiocytosis in a Critically Ill Patient: A Case Report of a Potentially Fatal Entity.
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Oakland University William Beaumont School of Medicine, Rochester Hills, MI.
Background: Hemophagocytic lymphohistiocytosis (HLH) is a non-neoplastic proliferation and macrophage activation that induces cytokine-mediated bone marrow suppression and features of intense phagocytosis in the bone marrow and liver, leading to multi-organ dysfunction and ultimate failure. The diagnosis of HLH in an intensive care setting is challenging, and it is associated with high morbidity and mortality. HLH-94 is the standard protocol for treatment, consisting of dexamethasone and chemotherapy like etoposide.
View Article and Find Full Text PDFDeterminants of Surgical Outcomes in Tricuspid Valve Endocarditis.
Ann Thorac Surg Short Rep
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HCA Healthcare Research Institute, HCA Healthcare, Nashville, Tennessee.
Background: Current treatment guidelines for infective endocarditis focus on left-sided infective endocarditis. Because right-sided infective endocarditis has different presentations and outcomes, it is crucial to further delineate surgical outcomes for isolated tricuspid valve endocarditis (TVE).
Methods: This retrospective study reviewed 374 surgically treated patients with isolated TVE from January 2012 through April 2022 who underwent isolated tricuspid valve surgical procedures.
Operative Repair of Type A Aortic Dissection in Jehovah's Witnesses: Insights From a Case Series.
Ann Thorac Surg Short Rep
March 2024
Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Background: Jehovah's Witnesses are known to refuse allogeneic blood products. Consequently, many surgeons will decline to perform aortic surgery on this patient group, given their higher risk. We present here a case series describing operative repair of type A aortic dissection without the use of allogeneic blood products.
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