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Patrick M. Honore, Rita Jacobs, Elisabeth De Waele, Viola Van Gorp, Olivier Joannes-Boyau, Jouke De Regt, Willem Boer and Herbert D Spapen

. Subclinical AKI--an emerging syndrome with important consequences. Nat Rev Nephrol 2012;8:735-9. 4. Ronco C, Kellum JA, Haase M. Subclinical AKI is still AKI. Crit Care 2012;16:313. 5. Ronco C, Stacul F, McCullough PA. Subclinical acute kidney injury (AKI) due to iodine-based contrast media. Eur Radiol 2013;23:319-23. 6. Kashani K, Al-Khafaji A, Ardiles T, Artigas A, Bagshaw SM, Bell M, et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Crit Care 2013;17:R25. 7. Hoste

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Alphonsus N. Onyiriuka, Chinwe A. Oguejiofor and Wilson E. Sadoh


A 16-year-old boy whose diabetes mellitus was diagnosed 3 months previously in a private hospital but was not placed on medication. The presenting complaints were fast breathing for 24 hours, weakness for 2 hours, and unresponsiveness to calls for 0.5 hours. His father was obese with type 2 diabetes mellitus and died 8 months earlier from cardiac arrest. His birthweight was low, 2.2kg. At first presentation, his weight, BMI and blood pressure were 60kg (25th-50th percentile), 19.4kg/m2 (25thpercentile) and 110/70mmHg (systolic BP 50th percentile, diastolic BP 50th-90th percentile), respectively. He was managed for diabetic ketoacidosis and was discharged on subcutaneous premixed insulin, 1 Unit/kg/day. At point of discharge, weight and BP were 60.5 kg and 120/70 mmHg, respectively. The patient defaulted but presented again 6 months later at the age of 17 years. At second presentation, his weight, BMI and BP were 89 kg (95th percentile), 27.5 kg/m2 (90th-95th percentile) and 180/80 mmHg (systolic 99th percentile; diastolic 90th percentile), respectively. His waist circumference was 98.7cm (> 90th percentile). We had no record of previous waist circumference. His lipid profile showed low HDL-cholesterol 0.7252 mmol/L [(28mg/dl); <5thpercentile]. His fasting blood glucose and HbA1C were 6.5 mmol/L (117mg/dl) and 34 mol/mol (5.3%), respectively. A diagnosis of metabolic syndrome in a patient with ketosis-prone type 2 diabetes was made. He was referred to the pediatric cardiologist for management of his hypertension. He defaulted again and was lost to follow up. Conclusion: This report illustrates the association of low birth weight and rapid weight gain with metabolic syndrome in adolescence.

Open access

Zhi-Yong Peng

. Clinicians can use these biomarkers to determine which patients might be candidates for novel therapeutic strategies intended to improve kidney outcomes. Remote ischemic preconditioning (RIPC) with upper-arm blood pressure cuff inflations prior to surgery was used to prevent or decrease ischemic reperfusion induced AKI in patients for cardiac surgery. In those who had an increase in [TIMP-2]·[IGFBP7] after RIPC and prior to cardiopulmonary bypass, the incidence of AKI was reduced compared to those who did not have elevated cell cycle arrest biomarkers.[ 12 ] This suggests

Open access

Christian Verborgh

LL, Hoedemaekers CW, Mollnes TE, van der Hoeven JG. Rewarming after hypothermia after cardiac arrest shifts the inflammatory balance. Crit Care Med 2012;40:1136-42. 7. Ju NY, Gao H, Huang W, Niu FF, Lan WX, Li F, et al. Therapeutic effect of inhaled budesonide (Pulmicort® Turbuhaler) on the inflammatory response to one-lung ventilation. Anaesthesia 2014;69:14-23. 8. Chen Q, Yu W, Shi J, Shen J, Hu Y, Gao T, et al. The effect of venovenous extra-corporeal membrane oxygenation (ECMO) therapy on immune inflammatory response of cerebral

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Luthfia Dewi, Mohammad Sulchan and Kisdjamiatun

. Suganya N, Dornadula S, Chatterjee S, Mohanram RK . Quercetin improves endothelial function in diabetic rats through inhibition of endoplasmic reticulum stress-mediated oxidative stress. Eur J Pharmacol 819: 80–88, 2018. 29. Hassan HA, Serag HM, Qadir MS, Ramadan MF . Cape gooseberry (Physalis peruviana) juice as a modulator agent for hepatocellular carcinoma-linked apoptosis and cell cycle arrest. Biomed Pharmacother 94: 1129–1137, 2017. 30. Ramadan MF . An bioactive phytochemicals, nutritional value, and functional properties of cape gooseberry

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Patrick M. Honore, Rita Jacobs, Olivier Joannes-Boyau, Willem Boer, Elisabeth De Waele, Viola Van Gorp and Herbert D. Spapen

, Artigas A, Bagshaw SM, Bell M, et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Crit Care 2013;17:R25. 27. Konrad FM, Mik EG, Bodmer SI, Ates NB, Willems HF, Klingel K, et al. Acute normovolemic hemodilution in the pig is associated with renal tissue edema, impaired renal microvascular oxygenation, and functional loss. Anesthesiology 2013;119:256-69. 28. Leal-Noval SR, Muñoz-Gómez M, Jiménez-Sánchez M, Cayuela A, Leal-Romero M, Puppo-Moreno A, et al. Red blood cell transfusion in non

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Patrick M. Honore, David De Bels, Thierry Preseau, Sebastien Redant and Herbert D. Spapen

circulation because of the dilution of extracorporeal blood returning to patients’ circulation, the replacement of calcium, and the liberation of calcium from calcium–citrate and magnesium–citrate complexes when citrate is metabolized. As a result, a systemic effect on coagulation does not occur unless specific conditions are present, such as impaired liver or skeletal muscle function ( e.g ., after a cardiac arrest). [ 1 , 2 ] Citrate is converted to citric acid in the liver, yielding three molecules of bicarbonate (although this may considerably vary depending on

Open access

Hongting Wang, Zuan-tao Lin, Yulin Yuan and Tianfu Wu

injury and renal recovery following cardiac surgery PLoS One 2014 9 e93460 18 Bihorac A, Chawla LS, Shaw AD, Al-Khafaji A, Davison DL, Demuth GE, et al . Validation of cell-cycle arrest biomarkers for acute kidney injury using clinical adjudication. Am J Respir Crit Care Med 2014; 189: 932-9. 10.1164/rccm.201401-0077OC Bihorac A Chawla LS Shaw AD Al-Khafaji A Davison DL Demuth GE et al. Validation of cell-cycle arrest biomarkers for acute kidney injury using clinical adjudication Am J Respir Crit Care Med 2014 189 932 9 19 Kitamura T, Qian BZ, Soong D, Cassetta L

Open access

Ran Zhu and Xiao-Chun Ma

, interventricular septum flattening, or right ventricular systolic abnormality. Diagnostic protocol of PE combined with ultrasonography The adoption of a diagnostic protocol can often minimize missed diagnosis and narrow down the etiology, such as the diagnosis protocol for shock or sudden cardiac arrest. There are two types of PE diagnostic protocol combined with ultrasound, one is in search for the probability of PE and the other is in search for the etiology of dyspnea. PE Diagnostic Protocol in search for PE Probability: For patients with probable PE and unstable

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Gautam Rawal, Sankalp Yadav and Raj Kumar

disability, however its exact prevalence remains unknown. Cognitive impairment: It has been reported to occur on average in 25% of ICU survivors, but few studies have shown its incidence to be significantly high, occurring in more than 3/4th of ICU survivors. [ 5 - 7 ] The major risk factors associated with it are duration of delirium in ICU, acute brain dysfunction (stroke, alcoholism), hypoxia (ARDS, cardiac arrest), hypotension (severe sepsis, trauma), glucose dysregulation, respiratory failure requiring prolonged mechanical ventilation, severe sepsis, use of renal