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A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 4 years ago
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A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 4 years ago
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0
1

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 4 years ago
Preview
0
1

A 65 year old man with macroscopic haematuria and acute kidney injury

A 65 year old man who presented to his general practitioner with a three day history of bright red, painless, macroscopic haematuria was found to have a raised serum creatinine of 461 μmol/L (reference range 60-105) (estimated glomerular filtration rate 11 mL/min/1.73 m2). His baseline serum creatinine had been stable (~120 μmol/L) for five years until one month earlier, when he had an episode of acute kidney injury while in hospital for cellulitis of the right leg. After discharge the cellulitis had resolved but his serum creatinine had remained raised at 252 μmol/L. He denied any recent respiratory infections, weight loss, night sweats, lethargy, or haematuria.  
feeds.bmj.com
over 4 years ago
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Comparison of Test Results for Zika Virus RNA in Urine, Serum, and Saliva Specimens from Persons with Travel-Associated Zika Virus Disease — Florida, 2016 | MMWR

The Morbidity and Mortality Weekly Report (MMWR) Series is prepared by the Centers for Disease Control and Prevention (CDC).  
cdc.gov
over 4 years ago
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Urine Better Than Blood for Zika Testing, CDC Says

The CDC updated its interim diagnostic testing guidance for Zika virus to recommend testing urine specimens obtained within 14 days of illness onset and serum obtained within 7 days of illness.  
medscape.com
over 4 years ago
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Do we need to perform a digital rectal exam in injured children?

If you work in a trauma center you will see injured children. Most of the serious injuries to children are blunt. Diagnostic workup often includes labs and imaging – but begins with a focused physical assessment underpinned by ATLS. The digital rectal exam can help assess for rectal tone in spinal cord injuries and gross blood in bowel injuries and thus, in severely injured children (think GCS <8) is a no-brainer. For others however, it can be invasive and downright scary. I was wondering whether or not it was absolutely necessary to perform a rectal exam would add any diagnostic utility. Let’s take a look at two studies shall we?  
pemcincinnati.com
over 4 years ago
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Testing for Zika Virus RNA in Urine, Serum, and Saliva

Might urine and/or saliva specimens be appropriate alternatives to serum for evaluating Zika virus disease?  
medscape.com
over 4 years ago
63c492613ab5aec159c9f772c7bd56a172998f3b8296762458240818
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Introduction to Microbiology Culture Techniques

Get an overview of basic microbiology and the concepts involved, including the bacterial growth curve and classifying organisms based on morphologies. This lecture describes blood, urine and skin/soft tissue cultures, focusing on the types of media, sample collection processes, culture procedures, as well as speciation and susceptibility testing.  
youtube.com
over 4 years ago
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Colon Cancer Screening Made Easier

What do you do when a patient refuses a colonoscopy? Dr David Johnson offers commentary on a new blood-based screening test for colon cancer.  
medscape.com
over 4 years ago
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Sepsis: pathophysiology and clinical management

Sepsis, severe sepsis, and septic shock represent increasingly severe systemic inflammatory responses to infection. Sepsis is common in the aging population, and it disproportionately affects patients with cancer and underlying immunosuppression. In its most severe form, sepsis causes multiple organ dysfunction that can produce a state of chronic critical illness characterized by severe immune dysfunction and catabolism. Much has been learnt about the pathogenesis of sepsis at the molecular, cell, and intact organ level. Despite uncertainties in hemodynamic management and several treatments that have failed in clinical trials, investigational therapies increasingly target sepsis induced organ and immune dysfunction. Outcomes in sepsis have greatly improved overall, probably because of an enhanced focus on early diagnosis and fluid resuscitation, the rapid delivery of effective antibiotics, and other improvements in supportive care for critically ill patients. These improvements include lung protective ventilation, more judicious use of blood products, and strategies to reduce nosocomial infections.  
feeds.bmj.com
over 4 years ago
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Sepsis: pathophysiology and clinical management

Sepsis, severe sepsis, and septic shock represent increasingly severe systemic inflammatory responses to infection. Sepsis is common in the aging population, and it disproportionately affects patients with cancer and underlying immunosuppression. In its most severe form, sepsis causes multiple organ dysfunction that can produce a state of chronic critical illness characterized by severe immune dysfunction and catabolism. Much has been learnt about the pathogenesis of sepsis at the molecular, cell, and intact organ level. Despite uncertainties in hemodynamic management and several treatments that have failed in clinical trials, investigational therapies increasingly target sepsis induced organ and immune dysfunction. Outcomes in sepsis have greatly improved overall, probably because of an enhanced focus on early diagnosis and fluid resuscitation, the rapid delivery of effective antibiotics, and other improvements in supportive care for critically ill patients. These improvements include lung protective ventilation, more judicious use of blood products, and strategies to reduce nosocomial infections.  
feeds.bmj.com
over 4 years ago
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'Thousands miss out' on surgery for type-2 diabetes - BBC News

Thousands of people with type-2 diabetes in the UK are missing out on obesity surgery that would slash blood sugars and even lead to remission in some cases, a team of experts say.  
bbc.co.uk
over 4 years ago
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Theranos Voids 2 Years of Edison Test Results: WSJ

Blood-testing firm Theranos Inc notified the U.S. federal health regulators that it voided results from its Edison blood-testing devices for two years, the Wall Street Journal reported on Wednesday, citing a person familiar with the matter.  
medscape.com
over 4 years ago
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Peak Lactate, Patient Outcome After Gastrointestinal Surgery

A new study looks at the association between blood lactate levels and in-hospital mortality among high-risk gastrointestinal surgical patients.  
medscape.com
over 4 years ago
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Theranos Sued Over Blood Tests, in Proposed Class Action

Blood-testing company Theranos Inc was sued on Thursday, accused of endangering customer health through "massive failures" that misrepresented the accuracy and quality of its blood tests, according to court papers.  
medscape.com
over 4 years ago
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Diagnosis and Management of Community-Acquired Pneumonia in Adults - American Family Physician

Community-acquired pneumonia is diagnosed by clinical features (e.g., cough, fever, pleuritic chest pain) and by lung imaging, usually an infiltrate seen on chest radiography. Initial evaluation should determine the need for hospitalization versus outpatient management using validated mortality or severity prediction scores. Selected diagnostic laboratory testing, such as sputum and blood cultures, is indicated for inpatients with severe illness but is rarely useful for outpatients. Initial outpatient therapy should include a macrolide or doxycycline. For outpatients with comorbidities or who have used antibiotics within the previous three months, a respiratory fluoroquinolone (levofloxacin, gemifloxacin, or moxifloxacin), or an oral beta-lactam antibiotic plus a macrolide should be used. Inpatients not admitted to an intensive care unit should receive a respiratory fluoroquinolone, or a beta-lactam antibiotic plus a macrolide. Patients with severe community-acquired pneumonia or who are admitted to the intensive care unit should be treated with a beta-lactam antibiotic, plus azithromycin or a respiratory fluoroquinolone. Those with risk factors for Pseudomonas should be treated with a beta-lactam antibiotic (piperacillin/tazobactam, imipenem/cilastatin, meropenem, doripenem, or cefepime), plus an aminoglycoside and azithromycin or an antipseudomonal fluoroquinolone (levofloxacin or ciprofloxacin). Those with risk factors for methicillin-resistant Staphylococcus aureus should be given vancomycin or linezolid. Hospitalized patients may be switched from intravenous to oral antibiotics after they have clinical improvement and are able to tolerate oral medications, typically in the first three days. Adherence to the Infectious Diseases Society of America/American Thoracic Society guidelines for the management of community-acquired pneumonia has been shown to improve patient outcomes. Physicians should promote pneumococcal and influenza vaccination as a means to prevent community-acquired pneumonia and pneumococcal bacteremia.  
aafp.org
over 4 years ago
8490c0338bde8478f2baa8c9160fdded56c7c53106930143110740972
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CHADS2VAS

Quick evaluation regarding need for blood thinners  
Daniel Kissane
over 4 years ago
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Loss of Y Chromosome Linked to Alzheimer's in Men

Lifetime-acquired loss of Y chromosome (LOY) in blood in men may increase the risk of Alzheimer's disease (AD) and may explain why men live shorter lives than women on average, according to new research.  
medscape.com
over 4 years ago
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FDA OKs First Liquid Biopsy for Lung Cancer Mutation

The blood-based genetic test is a companion diagnostic for erlotinib and for use in patients with non-small cell lung cancer.  
medscape.com
over 4 years ago