Hypertension, end-stage renal disease and mesangiocapillary glomerulonephritis in methamphetamine users

BACKGROUND: Methamphetamine abuse has risen dramatically in South Africa. The chronic effects of abuse on the kidneys and blood pressure have not been documented. This study reviewed patients referred for evaluation of kidney disease and/or hypertension, who had been abusing methamphetamines. METHODS: The records of patients referred to the renal unit between 2005 and 2013 who had been using methamphetamines were retrospectively reviewed. Patient demographics, biophysical parameters, blood pressure, renal function, renal ultrasound and biopsy findings, complications of chronic kidney disease and comorbidities were recorded. RESULTS: Forty-seven patients were included in the study. Their mean age was 29 years. Hypertension was present in 42 (89.4%) of patients, with malignant hypertension in 21 (44.7%). Forty-five (95.7%) had chronic kidney disease (CKD), and 26 (55.3%) had end-stage renal disease. Renal biopsies were performed in 24 patients. Twelve (50.0%) of the biopsies showed hypertensive changes and 14 (58.3%) mesangiocapillary glomerulonephritis type 1, with deposition of IgM and C3 complement. CONCLUSION: Methamphetamine use is associated with severe hypertension, mesangiocapillary glomerulonephritis and CKD

Hypertension, end-stage renal disease and mesangiocapillary glomerulonephritis in methamphetamine users

Background. Methamphetamine abuse has risen dramatically in South Africa. The chronic effects of abuse on the kidneys and blood pressure have not been documented. This study reviewed patients referred for evaluation of kidney disease and/or hypertension, who had been abusing methamphetamines.Methods. The records of patients referred to the renal unit between 2005 and 2013 who had been using methamphetamines were retrospectively reviewed. Patient demographics, biophysical parameters, blood pressure, renal function, renal ultrasound and biopsy findings, complications of chronic kidney disease and comorbidities were recorded.Results. Forty-seven patients were included in the study. Their mean age was 29 years. Hypertension was present in 42 (89.4%) of patients, with malignant hypertension in 21 (44.7%). Forty-five (95.7%) had chronic kidney disease (CKD), and 26 (55.3%) had end-stage renal disease. Renal biopsies were performed in 24 patients. Twelve (50.0%) of the biopsies showed hypertensive changes and 14 (58.3%) mesangiocapillary glomerulonephritis type 1, with deposition of IgM and C3 complement.Conclusion. Methamphetamine use is associated with severe hypertension, mesangiocapillary glomerulonephritis and CKD

Electronic Medical Record Inaccuracies: Multicenter Analysis of Challenges with Modified Lung Cancer Screening Criteria.

The National Comprehensive Cancer Network expanded their lung cancer screening (LCS) criteria to comprise one additional clinical risk factor, including chronic obstructive pulmonary disease (COPD). The electronic medical record (EMR) is a source of clinical information that could identify high-risk populations for LCS, including a diagnosis of COPD; however, an unsubstantiated COPD diagnosis in the EMR may lead to inappropriate LCS referrals. We aimed to detect the prevalence of unsubstantiated COPD diagnosis in the EMR for LCS referrals, to determine the efficacy of utilizing the EMR as an accurate population-based eligibility screening trigger using modified clinical criteria. We performed a multicenter review of all individuals referred to three LCS programs from 2012 to 2015. Each individual\u27s EMR was searched for COPD diagnostic terms and the presence of a diagnostic pulmonary functionality test (PFT). An unsubstantiated COPD diagnosis was defined by an individual\u27s EMR containing a COPD term with no PFTs present, or the presence of PFTs without evidence of obstruction. A total of 2834 referred individuals were identified, of which 30% (840/2834) had a COPD term present in their EMR. Of these, 68% (571/840) were considered unsubstantiated diagnoses: 86% (489/571) due to absent PFTs and 14% (82/571) due to PFTs demonstrating no evidence of postbronchodilation obstruction. A large proportion of individuals referred for LCS may have an unsubstantiated COPD diagnosis within their EMR. Thus, utilizing the EMR as a population-based eligibility screening tool, employing expanded criteria, may lead to individuals being referred, potentially, inappropriately for LCS

The Lantern, 2014-2015

• The Retreat • Part of Eve\u27s Discussion • Buchanan • Hypotheticals • The Baby Hippo • Sertraline and Cheerios • Margins • Anatomy of Me • Orange • Ode to Mathematics • Garden Path • Periphery • 10n Power=Our Maybe Domains • Hillside • Baltimore//Analogues • Work is a Religion • At the Bridal Shower • November • Revisionist History • Cold Front • Lung (for D. Avitabile) • Tether • Hold Still • Reverb • An Almost English Major and His Daughter • Clocks • In the Kitchen on a Sunday Afternoon • Amy • Nine • Customary Thoughts • Showers • Te Encuentro • I Find You • Literary Analysis • The Diamond on My Face • Catherine • Hunsberger Woods, 11:42 on a School Night • Cabbage • After Class • For Chell • To Whom It May Concern • Contra • Shards • Smoke and Roses • Polaroid • Spring\u27s Debut • The Deadline • A Previous Life • Wet Canvas • Obsessions and Compulsions • For Xandra • The Seagulls of 17th Street • No Man\u27s Land • Summer Flowers • Float • Dana Reads • A Barcelona Moment • Business Meeting • Posted • Champagnehttps://digitalcommons.ursinus.edu/lantern/1181/thumbnail.jp

A New Methodology for Long Term Creep Data Generation for Power Plant Components

Using stress rupture results openly available for Grade 91 steel, three features of a new methodology for creep data analysis are summarized. Firstly, in contrast to traditional power law and parametric methods, 100,000 h creep strengths of power plant steels are predicted accurately by extended extrapolation of creep lives from tests lasting a maximum of 5000 h. Secondly, related approaches rationalize creep ductility measurements in a manner which provides information relevant to creep damage evolution in operational plant. Finally, reference is made to a set of new relationships developed to offer a physically-meaningful foundation not only for rationalization and extrapolation but also for interpretation of the creep and creep fracture properties of metals and alloys.JRC.F.ADV01-Adviser for science strateg

A New Approach to Creep Data Assessment

New relationships, incorporating the activation energy for matrix diffusion (300 kJ mol-1) and the ultimate tensile strength values at the creep temperature, allow effective rationalization of the multi-batch stress rupture properties for Grade 92 steel (9Cr-0.5Mo-1.8W-V-Nb). These approaches lead to straightforward procedures for extrapolation of short-term results, with creep life measurements from tests lasting up to only 5000 h providing reasonable estimates of 100,000 h rupture strengths. Validation of this new methodology would therefore offer the prospect of cost-effective acquisition of long-term creep design data.JRC.F.ADV01-Adviser on scientific strateg

Patients with multiple nodules and a dominant lung adenocarcinoma have similar outcomes and survival compared with patients who have a solitary adenocarcinoma

n/

Tri-comparison of Laparoscopic Nissen, Hill, and Nissen-Hill Hybrid Repairs for Uncomplicated Gastroesophageal Reflux Disease.

BACKGROUND: A randomized controlled trial (RCT) showed that laparoscopic Nissen fundoplication (LNF) and Hill (LHR) repairs are equivalent in treating uncomplicated GERD. We combined both repairs to create a laparoscopic Nissen-Hill Hybrid repair (HYB). The purpose of this study is to compare clinical and objective outcomes of a matched group of HYB to the two cohorts of the RCT. METHODS: A retrospective analysis of prospectively collected data from the RCT and a prospectively collected data base was performed. Data were collected preoperatively, postoperatively short-term (ST) at 6 weeks and mid-term (MT) at 6-12 months. Evaluation was standardized according to the RCT and included three quality of life metrics (QOLRAD, GERD-HRQL, Dysphagia), endoscopy, manometry, pH testing, and barium swallow. RESULTS: There were 51 HYB, 46 LNF, and 56 LHR patients. Age, BMI, follow-up, and gender were comparable. QOLRAD, HRQL, PPI use, DeMeester scores, and pH% timeLNF, four LHR, and two HYB patients. Reoperations were performed in three LHR, two LNF, and zero HYB patients. CONCLUSION: Tri-comparison shows that HYB is a promising alternative to LHR and LNF. Side effects were not increased and there were fewer reoperations for failure