A Call to Prevention

Kirsztajn, Gianna Mastroianni; Bastos, Marcus Gomes

doi:10.5935/0101-2800.20150045

Cited by 3 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Creatinine is freely filtered in the glomerulus, too. Unlike urea, 7-10% of creatinine is actively secreted in the urine [ 42 , 43 ]. However, decreased renal function causes increased concentrations of urea and serum creatinine [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Malignant Hyperthermia in Bariatric Surgery: A Case Study With Clinical, Pathophysiological, Biochemical and Biophysical Correlations

Oliveira

Marchi-Salvador

2020

J Med Cases

View full text Add to dashboard Cite

Malignant hyperthermia (MH) is an acute pharmacogenetic disorder, which while uncommon is potentially fatal. MH is a calcium channelopathy of skeletal muscle in which a constant increase of intracytoplasmic Ca 2+ concentration occurs causing a change in cellular metabolism. A hypermetabolic state develops when susceptible patients are exposed to halogenated volatile inhalational anesthetic agents and depolarizing muscle relaxants and/or extreme physical activity in hot environments. MH presents variable clinical expression. During an episode of MH, the patient may present clinical signs and laboratory findings including masseter muscle spasm, tachycardia, rise in endtidal CO 2 (EtCO 2), tachypnea, hyperthermia, cyanosis, metabolic acidosis, rhabdomyolysis, hyperkalemia, myoglobinuria, hyperlactacidemia, and acute renal failure. The aim of this case report is to describe an episode of MH associated with the use of halogenated anesthetic during bariatric surgery. A 29-year-old Brazilian man was admitted to the hospital to undergo a bariatric surgery. The patient's relevant medical history included morbid obesity grade III, allergy to sulfa-based drugs and severe obstructive sleep apnea. Preoperative evaluations with cardiopulmonary exercise testing, echocardiogram and electrocardiogram showed no anatomical and functional changes of the patient's heart. Surgical procedures lasted for 4 h, without complications, but the evolution of the patient's condition indicated oliguria and acute breathing insufficiency. Five hours after the patient was placed under mechanical ventilation in the intensive care unit, he started to present clinical signs of hypermetabolic state, with tremors, excessive sweating, and rapid body temperature increases. In the postoperative period, the patient had hyperglycemia, hypocalcemia, hypernatremia, hyperkalemia, changes in creatine phosphokinase (CPK), aspartate transaminase (AST), alanine aminotransferase (ALT), urea and creatine concentrations, and metabolic and respiratory acidosis. Urinalysis showed traces of proteinuria, presence of ketones, leukocytes, red blood cells, and urobilinogen. In our case report, MH crisis was diagnosed late; the dantrolene was not administrated because it was not available and the patient died. This detailed case report of MH episode triggered by isoflurane anesthetic during bariatric surgery allowed us to describe the severity and lethality of this hypermetabolic syndrome. Dantrolene should be mandatory in all operating rooms. Knowledge of the symptoms, an early diagnosis and an adequate treatment can prevent the death of patients in MH crisis.

show abstract

Section: Discussionmentioning

confidence: 99%

Malignant Hyperthermia in Bariatric Surgery: A Case Study With Clinical, Pathophysiological, Biochemical and Biophysical Correlations

Oliveira

Marchi-Salvador

2020

J Med Cases

View full text Add to dashboard Cite

show abstract

“…An adapted questionnaire from the PREVINA-SE (Kirsztajn & Bastos, 2015) study and the Screening for Occult Renal Disease (SCORED) study, which has already been validated for Brazil, was applied (Magacho et al, 2012) Data on socioeconomic, anthropometric, and clinical aspects, life habits, and CKD personal and family history were collected (Malachias et al, 2016).…”

Section: Methodsmentioning

confidence: 99%

Screening for Chronic Kidney Disease in Relatives of Hemodialysis Patients

2021

RHSS

View full text Add to dashboard Cite

Objective: To estimate the prevalence and socioeconomic characteristics of Chronic Kidney Disease (CKD) in first and second-degree relatives of patients on hemodialysis Method: A questionnaire was applied on socioeconomic conditions, lifestyle, and personal pathological background. The formula of CKD-EPI and/or proteinuria greater than or equal to 1+ was used to characterize CKD. Analysis using the logistic regression model. Results: 408 individuals were evaluated and 12% had CKD. 6.61% had a glomerular filtration rate (GFR) ≤ 60 mL / min / 1.73 m2 and 5.39% proteinuria in the urine. The variables associated with the presence of CKD were age (

show abstract

“…A growing global public health problem in recent years is chronic kidney disease (CKD), due to its increasing prevalence. Approximately 10% of the general global population currently suffers from CDK 1, 2, 3. In Brazil, approximately 126,583 patients underwent dialysis in 2017, 4 and a total of 5929 kidney transplantations were performed in 2017 5…”

mentioning

confidence: 99%