The American journal of the medical sciences
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Prosthetic vascular graft infection (PVGI) is an infrequent and potentially fatal complication of abdominal aortic aneurysm surgery and occlusive vascular disease. The predictive value of blood cultures in accurately identifying the causative pathogen (or pathogens) has not been determined. ⋯ The yield of blood cultures in late-onset abdominal PVGIs is low. Presence of microorganisms in blood cultures does not necessarily indicate a causal relationship with graft infection. An empirical broad-spectrum antimicrobial therapy is advised in all suspected cases until a definitive etiology has been made.
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Review Meta Analysis
Efficacy and safety of mTOR inhibitor therapy in patients with early-stage autosomal dominant polycystic kidney disease: a meta-analysis of randomized controlled trials.
The objective of this study was to conduct a meta-analysis of randomized controlled trials (RCTs) to present a profound review and an objective appraisal of the efficacy and safety of the mammalian target of rapamycin (mTOR) inhibitor therapy in patients with autosomal dominant polycystic kidney disease (ADPKD). ⋯ Based on the current limited clinical trials, this study suggests that short-duration mTOR inhibitor therapy is relatively safe to slow down the increase in kidney volume in patients with early-stage ADPKD, but it has limited impact on slowing down the decrease in GFR.
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Pleural effusions in ovarian hyperstimulation syndrome, whether transudative or exudative, can occur in up to 30% of cases. This disorder is always reversible but may have various clinical presentations and degrees of severity. Although assessing for risk factors to predict clinical severity is helpful, it is rare for ovarian hyperstimulation syndrome to present as a massive pleural effusion requiring emergent intervention. In this study, such a case is reported.
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Podocytes play an important role in the pathogenesis and progression of glomerulosclerosis. Various elements of the renin-angiotensin-aldosterone system can induce podocyte apoptosis. However, little is known about the direct effects of renin on podocytes. ⋯ The authors conclude that the effects of renin are mediated through the activation of rennin receptor and are independent of angiotensin II generation.
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Frailty syndrome is frequently encountered in elderly populations. Frailty has been defined as a geriatric syndrome of increased vulnerability to environmental factors. Although knowledge of this syndrome continues to develop, there are still many areas of uncertainty. ⋯ Preventative strategies need to be studied. The role of specific biomarkers in early detection of frailty needs to be defined. Clinical trials are needed to find better interventions for this syndrome.