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Dialysis world news


Aggressive fluid resuscitation in shock worsens risk of cardiovascular collapse in children in study from Africa.
EurekAlert: Prof Kathryn Maitland, from the Wellcome Trust Centre for Clinical Tropical Medicine at Imperial College London, who led this study explained, "The children who were given this treatment (boluses) initially responded well compared to the control group. However, this did not translate into a better recovery at 48 hours - more children died in the group receiving boluses. The main cause of death, rather than fluid overload, was cardiovascular collapse."

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Semaphorin A rises acutely, then falls back to baseline after acute kidney injury.
EurekAlert: The protein, which is not usually measurable in urine, was quickly detected in a group of 60 pediatric patients following cardiopulmonary bypass surgery at Cincinnati's Children's Hospital. High levels of the protein were about 90 percent accurate at identifying the 26 children with acute kidney injury. In those patients, urine levels were high within two hours, peaked at six hours and essentially normalized 12 hours after surgery.

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Cholecalciferol treatmen of African Americans with hypertension good.
EurekAlert: Vitamin D supplements significantly reduced blood pressure in the first large controlled study of African-Americans, researchers report in the American Heart Association journal Hypertension. In the prospective trial, a three-month regimen of daily vitamin D increased circulating blood levels of vitamin D and resulted in a decrease in systolic blood pressure ranging from .7 to four mmHg (depending upon the dose given), compared with no change in participants who received a placebo.

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Hospital epidemiology study suggests that 1/3 of antimicrobial drug prescriptions in dialysis patients are inappropriate.
EurekAlert: Of the 1,003 doses of antibiotics, nearly one-third of antibiotic doses were classified as inappropriate. The most common reason for inappropriate administration was that conditions for infection were not met. Blood-stream infections were the most common misdiagnosed infection based on unmet criteria. The second most common reason for inappropriate antibiotic administration was using a potent antibiotic when an equally efficacious and available antibiotic less likely to promote resistant bacteria could have been used. The antibiotics most likely to be inappropriately prescribed included vancomycin, which is commonly used for skin-related infections and infections associated with the vascular access used for dialysis, and third or fourth generation cephalosporins, which are used for a broad array of infections.

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Fluoroquinolone-resistant E. Coli strains becoming more common in elderly adults.
EurekAlert: "The finding that clonal expansion of ST131 is occurring primarily in healthcare and long-term care facilities indicates an urgent need for improved antibiotic use and infection control practices within such institutions, both to reduce selection for ST131 and to block further transmission. Efforts that focus on reducing overuse and misuse of fluoroquinolones are likely to have the greatest impact on ST131 prevalence, given the strong association between ST131 and fluoroquinolone resistance," said Banerjee.

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