Metastatic calcinosis cutis in a dialysis patient

Metastatic calcinosis cutis is an uncommon complication of end-stage kidney disease but has severe and disabling effects. Its development is attributed to disorders of calcium and phosphate metabolism associated with secondary hyperparathyroidism. The mainstay of treatment remains medical therapy; however, in refractory cases a parathyroidectomy is indicated. We describe the case of a 22-year-old female with refractory hyperparathyroidism treated with a subtotal parathyroidectomy resulting in complete resolution of metastatic calcinosis cutis of the hands. Clinicians should be aware that this complication can occur soon after the initiation of dialysis and that rapid complete resolution can be achieved with parathyroidectomy

Successful pregnancy in a South African patient with end-stage renal disease with the use of thrice-weekly nocturnal haemodialysis

Pregnancy outcomes in patients on chronic dialysis have improved as a result of the intensification of dialysis and improved perinatal care. We report the successful outcome of a pregnancy in a patient on chronic haemodialysis in Cape Town, South Africa. With intensification of her therapy using thrice-weekly, nocturnal haemodialysis the pregnancy  was maintained until 34 weeks at which time a 1.86 kg baby boy was delivered by elective caesarean section. One year later the patient was doing well on maintenance haemodialysis and the baby was achieving his developmental milestones. This report highlights our ability to employ a multi-disciplinary approach and prolonged, nocturnal haemodialysis to support pregnant dialysis patients in the South African setting and achieve good outcomes for both mother and baby

Severe acute renal failure at Groote Schuur Hospital

Bibliography: leaves 52-56.Acute renal failure (ARF) is a syndrome occurring over hours to days of renal dysfunction with a reduction in glomerular filtration rate (GFR) resulting in a failure to excrete nitrogenous waste products

2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC).

The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their publication. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of healthcare or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment, as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies; however, the ESC Guidelines do not override, in any way whatsoever, the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and, where appropriate and/or necessary, the patient's caregiver. Nor do the ESC Guidelines exempt health professionals from taking into full and careful consideration the relevant official updated recommendations or guidelines issued by the competent public health authorities, in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription