المؤلفون: Sarmad Said, German T. Hernandez

المصدر: Journal of Nephropathology, Vol 3, Iss 3, Pp 99-104 (2014)

مصطلحات موضوعية: cardiovascular disease, chronic kidney disease, hypertension, diabetes mellitus, Pathology, RB1-214, Internal medicine, RC31-1245, Other systems of medicine, RZ201-999

الوصف: Context: It is well known that patients with chronic kidney disease (CKD) have a strong risk of cardiovascular disease (CVD). However, the excess risk of cardiovascular disease in patients with CKD is only partially explained by the presence of traditional risk factors, such as hypertension and diabetes mellitus. Evidence. Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, EBSCO and Web of Science has been searched. Results: Chronic kidney disease even in its early stages can cause hypertension and potentiate the risk for cardiovascular disease. However, the practice of intensive blood pressure lowering was criticized in recent systematic reviews. Available evidence is inconclusive but does not prove that a blood pressure target of less than 130/80 mmHg as recommended in the guidelines improves clinical outcomes more than a target of less than 140/90 mmHg in adults with CKD. Conclusions: The association between CKD and CVD has been extensively documented in the literature. Both CKD and CVD share common traditional risk factors, such as smoking, obesity, hypertension, diabetes mellitus, and dyslipidemia. However, cardiovascular disease remains often underdiagnosed und undertreated in patients with CKD. It is imperative that as clinicians, we recognize that patients with CKD are a group at high risk for developing CVD and cardiovascular events. Additional studies devoted to further understand the risk factors for CVD in patients with CKD are necessary to develop and institute preventative and treatment strategies to reduce the high morbidity and mortality in patients with CKD.

وصف الملف: electronic resource

العلاقة: https://nephropathol.com/PDF/jnp-3-99.pdfTest; https://doaj.org/toc/2251-8363Test; https://doaj.org/toc/2251-8819Test

الوصول الحر: https://doaj.org/article/0ef6ff108ee648fb96581ae82951bcfeTest

المؤلفون: Sarmad Said, Chad J. Cooper, Azikiwe C. Nwosu, Jorge E. Bilbao, German T. Hernandez

المصدر: Journal of Nephropathology, Vol 3, Iss 2, Pp 63-68 (2014)

مصطلحات موضوعية: contrast-induced nephropathy, contrast media, percutaneous coronary intervention, Pathology, RB1-214, Internal medicine, RC31-1245, Other systems of medicine, RZ201-999

الوصف: Background: Monoclonal immunoglobulin deposition disease (MIDD) is a rare disease, usually manifesting between the 5th and 6th decades of life but can also occur earlier. Characteristic feature of MIDD is a non-fibrillar, Congo red negative deposition of monoclonal immunoglobulins in various organs, including the kidneys. Depending on the composition of the deposits, MIDD is classified into 3 types; light chain deposition disease (LCDD), which is the most common form, heavy chain deposition disease (HCDD) and light and heavy chain deposition disease (LHCDD). Kidney involvement is common in MIDD. Renal biopsy reveals nodular sclerosing glomerulopathy on light microscopy and diffuse linear staining of glomerular and tubular basement membranes on immunofluorescence (IF) microscopy. Case presentation: A 38-year-old male patient recently diagnosed with hypertension presented with lower extremity edema, shortness of breath, and fatigue. The workup that was performed in a different hospital prior to this admission, demonstrated the presence of significant proteinuria and renal failure. He was intermittently dialyzed and a renal biopsy was obtained, which showed LCDD. Further laboratory workup revealed an increase of IgM, kappa chain and ß2 microglobulin chain, in addition to proteinuria and renal insufficiency. Bone marrow biopsy demonstrated an involvement of 30% with plasma cells. The flow cytometry test showed monotypic plasma cells expressing intracytoplasmic kappa light chain restriction with kappa to lambda ratio of 35/1. The diagnosis of LCDD was established. Treatment with steroids and bortezomib was initiated. Conclusions: MIDD is an unusual disease and LCDD is the most common form of MIDD. The peak incidence is around the 5th and 6th decade of life, however, LCDD can also be found in younger patients. Renal involvement, proteinuria, hematuria, and hypertension are markers of the initial clinical presentation. Nodular sclerosing glomerulopathy is found in about 60% of the affected patients. Early diagnosis and early treatment improve the prognostic course of LCDD.

وصف الملف: electronic resource

العلاقة: https://nephropathol.com/PDF/jnp-3-63.pdfTest; https://doaj.org/toc/2251-8363Test; https://doaj.org/toc/2251-8819Test

الوصول الحر: https://doaj.org/article/69f553dbf61f4f9298cbae0f41b52749Test

المؤلفون: Brent M. Egan, Jiexiang Li, Kellee White, Douglas O. Fleming, Kenneth Connell, German T. Hernandez, Daniel W. Jones, Keith C. Ferdinand, Angelo Sinopoli

المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 5, Iss 8 (2016)

مصطلحات موضوعية: cardiovascular disease, cholesterol, epidemiology, guideline, primary prevention, secondary prevention, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: BackgroundHealthy People 2020 aim to reduce fatal atherosclerotic cardiovascular disease (ASCVD) by 20%, which translates into 310 000 fewer events annually assuming proportional reduction in fatal and nonfatal ASCVD. We estimated preventable ASCVD events by implementing the American College of Cardiology/American Heart Association (ACC/AHA) 2013 Cholesterol Guideline in all statin‐eligible adults. Absolute risk reduction (ARR) and number needed‐to‐treat (NNT) were calculated. Methods and ResultsNational Health and Nutrition Examination Survey data for 2007–2012 were analyzed for adults aged 21 to 79 years and extrapolated to the US population. Literature‐guided assumptions were used including (1) low‐density lipoprotein cholesterol falls 33% with moderate‐intensity statins and 51% with high‐intensity statins; (2) for each 39 mg/dL decline in low‐density lipoprotein cholesterol, 10‐year ASCVD10 risk would fall 21% when ASCVD10 risk was ≥20% and 33% when ASCVD10 risk was

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2047-9980Test

الوصول الحر: https://doaj.org/article/cc37d8937c704013b1cb40695872cbb8Test

المؤلفون: Chad Cooper, Jorge E. Bilbao, Sarmad Said, Haider Alkhateeb, Jorge Bizet, Ahmed Elfar, Olinamyr Davalos, Ana T. Meza, German T. Hernandez

المصدر: Journal of Nephropathology, Vol 2, Iss 3, Pp 196-200 (2013)

مصطلحات موضوعية: renal amyloidosis, acute tubulointerstitial nephritis, heroin, skin popping, Pathology, RB1-214, Internal medicine, RC31-1245, Other systems of medicine, RZ201-999

الوصف: Background: Systemic AA amyloidosis is a long-term complication of several chronic inflammatory disorders. Organ damage results from the extracellular deposition of proteolytic fragments of the acute-phase reactant serum amyloid A (SAA) as amyloid fibrils. Drug users that inject drug by a subcutaneous route ("skin popping") have a higher chance of developing secondary amyloidosis. The kidneys, liver, and spleen are the main target organs of AA amyloid deposits. More than 90% of patients with renal amyloidosis will present with proteinuria, nephrotic syndrome, or renal dysfunction. Case presentation: A 37 year-old female presented to the hospital with a one-week history of pain and redness in her right axilla. Her relevant medical history included multiple skin abscesses secondary to "skin popping", heroin abuse for 18 years, and hepatitis C. The physical examination revealed "skin popping" lesions, bilateral costovertebral angle tenderness, and bilateral knee swelling. The laboratory workup was significant for renal insufficiency with a serum creatinine of 5 mg/dL and 14.8 grams of urine protein per 1 gram of urine creatinine. The renal biopsy findings were consistent with a diagnosis of renal amyloidosis due to serum amyloid A deposition and acute tubulointerstitial nephritis. Conclusions: AA renal amyloidosis among heroin addicts seems to be associated with chronic suppurative skin infection secondary to "skin popping". It is postulated that the chronic immunologic stimulation by one or more exogenous antigens or multiple acute inflammatory episodes is an important factor in the pathogenesis of amyloidosis in these patients. Therefore, AA renal amyloidosis should always be considered in chronic heroin users presenting with proteinuria and renal impairment.

وصف الملف: electronic resource

العلاقة: https://nephropathol.com/PDF/jnp-2-196.pdfTest; https://doaj.org/toc/2251-8363Test; https://doaj.org/toc/2251-8819Test

الوصول الحر: https://doaj.org/article/bbdb58366bdd4190a553bf32dc846b04Test

المؤلفون: Rodrigo Alfaro, Nina Vasavada, Paisit Paueksakon, German T. Hernandez, George R. Aronoff

المصدر: Journal of Nephropathology, Vol 2, Iss 3, Pp 204-209 (2013)

مصطلحات موضوعية: cocaine, interstitial nephritis, acute kidney injury, Pathology, RB1-214, Internal medicine, RC31-1245, Other systems of medicine, RZ201-999

الوصف: Background: Acute tubular necrosis and pigment induced kidney injury are well described consequences of cocaine abuse. However, acute interstitial nephritis associated with cocaine use has been previously reported in only three patients. Case presentation: We present the case of a 49-year-old man who developed acute kidney injury from biopsy-proven interstitial nephritis after nasal insufflation of cocaine. Unlike prior reports, our patient remained non-oliguric and did not require renal replacement therapy. Conclusions: Interstitial nephritis should be considered as a potential cause of acute kidney injury associated with cocaine use. The approach to management of cocaine associated acute kidney injury (AKI) may be different in patients with interstitial nephritis than for those with tubular necrosis or pigment induced renal injury.

وصف الملف: electronic resource

العلاقة: https://nephropathol.com/PDF/jnp-2-204.pdfTest; https://doaj.org/toc/2251-8363Test; https://doaj.org/toc/2251-8819Test

الوصول الحر: https://doaj.org/article/c7d5722c8be4402e878fd01440ea87abTest

المؤلفون: Tarek Alhamad, Jimena Blandon, Ana T. Meza, Jorge E. Bilbao, German T. Hernandez

المصدر: Journal of Nephropathology, Vol 2, Iss 2, Pp 139-143 (2013)

مصطلحات موضوعية: acute kidney injury, oxalate nephropathy, ethylene glycol, normal serum osmolal gap, Pathology, RB1-214, Internal medicine, RC31-1245, Other systems of medicine, RZ201-999

الوصف: Background: Ethylene glycol ingestion can lead to acute kidney injury from tubular deposition of oxalate crystals. The diagnosis of ethylene glycol intoxication is based on a history of ingestion, clinical examination, high anion gap metabolic acidosis, high osmolal gap, and a measured serum level of ethylene glycol. However, depending on the delay in time from ingestion to arrival to a hospital, the osmolal gap may become normal, thereby creating a confusing clinic picture for the treating clinician. Case: A 71 year-old man with a history of alcohol abuse had been unconscious for an unknown period of time. Upon hospitalization, he was found to have a high anion gap metabolic acidosis but a normal serum osmolal gap and subsequently developed acute kidney injury. The serum lactic acid and glucose levels were unremarkable, and there were no ketones in the serum. Urine analysis showed numerous red blood cells and calcium oxalate crystals. The renal biopsy showed multiple oxalate crystals in the renal tubules demonstrating birefringence under polarized light. Given the history of alcohol abuse, the clinical presentation, the unexplained high anion gap metabolic acidosis, and the biopsy findings, ethylene glycol intoxication was deemed the most likely diagnosis. Conclusions: In cases of ethylene glycol intoxication, a high serum osmolal gap is supportive of ethylene glycol intoxication, but a normal serum osmolal gap does not exclude the diagnosis, especially when the time of ingestion is unknown. Physicians should be aware of potentially normal serum osmolal gap values in cases of ethylene glycol intoxication.

وصف الملف: electronic resource

العلاقة: https://nephropathol.com/PDF/jnp-2-139.pdfTest; https://doaj.org/toc/2251-8363Test; https://doaj.org/toc/2251-8819Test

الوصول الحر: https://doaj.org/article/a11948975f7e45ca9701bc75cfe623ddTest

المؤلفون: Sarmad Said, Chad J. Cooper, Haider Alkhateeb, Juan M. Galvis, German T. Hernandez, Hasan J. Salameh

المصدر: Neurology International, Vol 6, Iss 2 (2014)

مصطلحات موضوعية: moyamoya disease, moyamoya syndrome, stroke, Hispanic population, Medicine, Internal medicine, RC31-1245, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571

الوصف: Moyamoya disease was first described in 1957 as hypoplasia of the bilateral internal carotid arteries, the characteristic appearance of the associated network of abnormally dilated collateral vessels on angiography was later likened to something hazy, like a puff of cigarette smoke, which, in Japanese, is moyamoya. This paper describes two cases of moyamoya presentations, including moyamoya disease and moyamoya syndrome. Moyamoya may rarely occur in North American Hispanic patients. The presentation can vary significantly and ranges bwtween fulminant outcome and prolonged survival. Awareness about moyamoya and its different presentations may be beneficial for the patients and can improve the outcome.

وصف الملف: electronic resource

العلاقة: http://www.pagepress.org/journals/index.php/ni/article/view/5369Test; https://doaj.org/toc/2035-8385Test; https://doaj.org/toc/2035-8377Test

الوصول الحر: https://doaj.org/article/0fda55e8ba024775ad975aefce9b799cTest

المؤلفون: Chad J. Cooper, Sarmad Said, German T. Hernandez

المصدر: Case Reports in Immunology, Vol 2014 (2014)

مصطلحات موضوعية: Immunologic diseases. Allergy, RC581-607

الوصف: Background. Hyper IgE is a rare systemic disease characterized by the clinical triad of high serum levels of IgE (>2000 IU/mL), eczema, and recurrent staphylococcal skin and lung infections. The presentation of hyper IgE syndrome is highly variable, which makes it easy to confuse the diagnosis with that of severe atopy or other rare immunodeficiency disorders. Case Report. A 23-year-old Hispanic presented with history of frequent respiratory and gastrointestinal infections as a child and multiple episodes of skin and lung infections (abscess) with Staphylococcus aureus throughout his adult life. He had multiple eczematous lesions and folliculitis over his entire body, oral/esophageal candidiasis, and retention of his primary teeth. The IgE was elevated (>5000 IU/mL). Genetic mutation analysis revealed a mutation affecting the transactivation domain of the STAT3 gene. Conclusion. The hallmark of hyper IgE syndrome is serum IgE of >2000 IU/mL. Hyper IgE syndrome is a genetic disorder that is either autosomal dominant or recessive. A definite diagnosis can be made with genetic mutation analysis, and in this case, it revealed a very rare finding of the transactivation domain STAT3 mutation. Hyper IgE syndrome is a challenge for clinicians in establishing a diagnosis in suspected cases.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2090-6609Test; https://doaj.org/toc/2090-6617Test

الوصول الحر: https://doaj.org/article/54a0a8c2b0984ba195c2cc11b05b4c23Test

المؤلفون: Robert Lynn, Fang Xie, Adu Ntoso, German T Hernandez, Jeffrey J Connaire, Kimberly Erby, Robert S. Janssen, Lisa Rich, Kiranjit Dhillon, Heather Henderson, Ahmed M Awad, Randall N. Hyer

المصدر: Vaccine. 39(25)

مصطلحات موضوعية: Adult, HBsAg, medicine.medical_specialty, Hepatitis B vaccine, Adolescent, medicine.medical_treatment, 030231 tropical medicine, Population, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, Multicenter trial, Internal medicine, medicine, Clinical endpoint, Humans, Hepatitis B Vaccines, 030212 general & internal medicine, Hepatitis B Antibodies, education, Hepatitis B virus, education.field_of_study, Hepatitis B Surface Antigens, General Veterinary, General Immunology and Microbiology, business.industry, Immunogenicity, Public Health, Environmental and Occupational Health, Hepatitis B, Infectious Diseases, Molecular Medicine, Hemodialysis, business

الوصف: Background Hemodialysis patients are at increased risk of hepatitis B virus (HBV) infection and are poorly responsive to HBV vaccines. Current vaccine recommendations for hemodialysis patients utilize more than twice the amount of hepatitis B surface antigen (HBsAg) used for healthy adults and achieve lower immune responses. Methods An open-label, single-arm, multicenter trial was conducted among adults 18 years of age and older who were initiating or undergoing hemodialysis who had not previously received hepatitis B vaccine. Participants received four doses of HepB-CpG (HEPLISAV-B®) (20 mcg rHBsAg + 3000 mcg CpG 1018, a Toll-like receptor 9 agonist) administered at 0, 4, 8, and 16 weeks. Participants are being followed for 68 weeks. This paper reports the final immunogenicity analysis of the primary endpoint at study week 20 and an interim safety analysis. Results We enrolled 119 participants receiving hemodialysis who were followed for a median of 47.4 weeks. Of the 119 participants, 75 were in the per-protocol population. At week 20, the seroprotection rate (% with antibodies to hepatitis B surface antigen [anti-HBs] ≥ 10 mIU/mL) was 89.3% and the percentage of participants with anti-HBs ≥ 100 mIU/mL was 81.3%. The anti-HBs geometric mean concentration was 1061.8 mIU/mL. HepB-CpG was well tolerated with no observed safety concerns. Conclusion In patients receiving hemodialysis, HepB-CpG given as four doses was well tolerated and induced very high anti-HBs concentrations and seroprotection in a very high proportion of recipients.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::97a7b5e45918dd0e8cd71ecdbf79e40eTest
https://pubmed.ncbi.nlm.nih.gov/34001345Test

المؤلفون: Ramin Tolouian, German T Hernandez

المصدر: Journal of Nephropathology, Vol 2, Iss 1, Pp 4-5 (2013)

مصطلحات موضوعية: diabetes mellitus, diabetic kidney disease, microalbuminuria, Pathology, RB1-214, Internal medicine, RC31-1245, Other systems of medicine, RZ201-999

العلاقة: https://nephropathol.com/PDF/JNP-2-4.pdfTest; https://doaj.org/toc/2251-8363Test; https://doaj.org/toc/2251-8819Test; https://doaj.org/article/216687427f50440f9fdb58b83923dc8aTest

الإتاحة: https://doi.org/10.5812/nephropathol.8966Test
https://doaj.org/article/216687427f50440f9fdb58b83923dc8aTest