scholarly journals Clinical Characteristics and Outcomes of Exertional Rhabdomyolysis after Indoor Spinning: A Systematic Review

2021 ◽  
Author(s):  
Yoshio Masuda ◽  
Rachel Wam ◽  
Benjamin Paik ◽  
Clara L.Y. Ngoh ◽  
Andrew M.T.L Choong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Characteristics ◽  
Selection Process ◽  
Average Length ◽  
Kidney Injury ◽  
Exertional Rhabdomyolysis ◽  
Presenting Symptoms ◽  
Average Length Of Stay ◽  
Dark Urine ◽  
High Index Of Suspicion

Abstract ObjectivesMore patients are being diagnosed with exertional rhabdomyolysis secondary to indoor spinning. We conducted a systematic review to characterize the clinical characteristics of this new clinical entity.MethodsWe conducted a thorough literature search on PubMed, Embase, Web of Science, Scopus and The Cumulative Index to Nursing and Allied Health Literature (CINAHL). Articles published from inception till 23rd June 2021 were considered for inclusion. A two-stage article selection process was performed. Articles that reported clinical characteristics and outcomes for patients with SIER were included. Quality assessment was performed using the Joanna Briggs Institute checklists.ResultsThere was a total of 22 articles and 97 patients with SIER. Most patients were healthy females who had attended their first spinning session. The average time to clinical presentation was 3.1 ± 1.5 days. The most common presenting symptoms were myalgia, dark urine and muscle weakness involving the thigh. Seven patients (7.2%) developed acute kidney injury, and two patients (2.1%) required temporary inpatient haemodialysis. Four patients (4.1%) developed thigh compartment syndrome and required fasciotomies. There were no long-term sequelae or mortality observed. The average length of stay was 5.6 ± 2.9 days.ConclusionsHealthcare professionals must have a high index of suspicion of SIER if any patient presents with myalgia, dark urine or weakness after a recent episode of indoor spinning. Fitness centre owners, spinning instructors and participants should also be better educated about the clinical characteristics and manifestations of SIER.

Exertional rhabdomyolysis and acute kidney injury in endurance sports: A systematic review

2020 ◽  
pp. 1-14 ◽  
Author(s):  
Daniel Rojas-Valverde ◽  
Braulio Sánchez-Ureña ◽  
Jennifer Crowe ◽  
Rafael Timón ◽  
Guillermo J. Olcina
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Endurance Sports ◽  
Exertional Rhabdomyolysis

scholarly journals A Rare Cause of Acute Kidney Injury in a Female Patient with Breast Cancer Presenting as Renal Colic

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Roxana Jurubita ◽  
Bogdan Obrisca ◽  
Gener Ismail
Keyword(s):  
Breast Cancer ◽  
Acute Kidney Injury ◽  
Female Patient ◽  
Hepatic Metastases ◽  
Kidney Injury ◽  
Hypercoagulable State ◽  
Renal Infarction ◽  
Presenting Symptoms ◽  
Permanent Loss ◽  
High Index Of Suspicion

Renal infarction is a rare cause of acute kidney injury which could lead to permanent loss of renal function. A prompt diagnosis is necessary in order to achieve a successful revascularization of the occluded artery. Given the rarity of the disease and the paucity of the reported cases in the previous literature a high index of suspicion must be maintained not only in the classical cardiac sources of systemic emboli (atrial fibrillation, dilated cardiomyopathy, or endocarditis), but also in the situations when a hypercoagulable state is presumed. The unspecific presenting symptoms often mask the true etiology of the patient’s complaints. We present here a rare case of renal infarction that occurred in the setting of a hypercoagulable state, in a female patient with a history of breast cancer and documented hepatic metastases.

scholarly journals Risk Factors for Acute Kidney Injury in COVID-19 Patients: A Systematic Review

2021 ◽  
Vol 9 (F) ◽  
pp. 118-123
Author(s):  
Dian Daniella ◽  
Yenny Kandarini ◽  
Gede Wira Mahadita
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Sofa Score ◽  
Selection Process ◽  
Kidney Injury ◽  
Flow Diagram ◽  
Systematic Research ◽  
Cochrane Central Register ◽  
Incidence And Mortality

BACKGROUND: Acute kidney injury (AKI) in coronavirus disease-19 (COVID-19) has high incidence and mortality. Risk factors for AKI in COVID-19 patients are not well explored. This systematic review provides a combination of available evidence regarding risk factors of AKI in COVID-19 patients. METHODS: A systematic research was performed in Medline, Cochrane Central Register of Controlled Trials, and ScienceDirect journal databases from 2019 to August 2020. The study selection process was plotted using a Preferred Reporting Items for Systematic Review and Meta-Analyses flow diagram. RESULTS: Out of 553 studies found, four full-text studies met the inclusion criteria and were included in qualitative analysis. There are 2205 COVID-19 patients with AKI (36.44%) from 6051 COVID-19 patients. Age was a risk factors for AKI in two studies (odds ratio [OR] 1.03 [p < 0.001], OR 1.03 [p < 0.007]). Critical condition of patient is risk factors for AKI (OR 8.155 [p = 0.006]). Hirsch et al. stated that diabetes mellitus (OR 1.74 [p < 0.001]), cardiovascular disease (OR 1.48 [p < 0.001]), and hypertension (OR 1.25 [p = 0.02]) are also risk factors. Laboratory results such as elevated procalcitonin (PCT) and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 showed positive association to AKI in COVID-19 patients (OR 4.822 [p = 0.037]; OR 13.451 [p = 0.016]). A higher sequential organ failure assessment (SOFA) score at admission is one of the risk factors (OR 1.498 [p = 0.027]). CONCLUSION: Demographics, clinical classification of COVID-19, comorbidities, SOFA score, PCT, and eGFR can help clinicians predict AKI in COVID-19 patients.

Compulsory Admissions in a Psychiatric Inpatient Unit: A 4-year Retrospective Study

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
C. Vieira ◽  
J. Ramos ◽  
J. Alexandre ◽  
G. Cardoso
Keyword(s):  
Clinical Characteristics ◽  
Average Length ◽  
Local Population ◽  
Psychiatric Inpatient ◽  
Inpatient Unit ◽  
Socioeconomic Level ◽  
Low Socioeconomic ◽  
Admission Rates ◽  
Average Length Of Stay ◽  
Psychiatric Inpatient Unit

Introduction:Large discrepancies in psychiatric compulsory admission rates have been found in the different European countries. However, some trends seem to exist in most studies: compulsorily admitted patients are more frequently male, unemployed, with a lower level of education, are more likely to belong to racial minorities (mainly black), and the most frequent diagnosis is schizophrenia.Aims:To compare demographic and clinical characteristics of patients voluntarily and compulsorily admitted to a Portuguese psychiatric unit.Methods:Retrospective data of all the patients admitted to a psychiatric inpatient unit, from January 2004 to December 2007, were reviewed. The demographic and clinical characteristics of compulsorily and voluntarily admitted patients were compared.Results:In a total of 1434 admissions, 180 were compulsory (11.2%). Compared to voluntarily admitted patients, those admitted compulsorily were significantly younger (38.2 vs. 43.6 years), more frequently male (62.8 vs. 47.1%), and black (27.8% vs. 19.9%), received more often a diagnosis of schizophrenia (34.4 vs. 19.0%), and had a longer average length of stay (27.0 vs. 18.5 days). There were no statistically significant differences in the seasonality of admissions or the number of readmissions in both groups.Conclusion:The results are similar to those obtained in other studies, except for a higher rate of compulsory admissions. That can be explained by, among other factors, the low socioeconomic level and high percentage of immigrants in the local population. The comparison with voluntarily admitted patients helps identify characteristics associated with the two groups.

Gender Differences in Patients Admitted to Psychiatry: A 4-year Retrospective Study

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
B. Trancas ◽  
R. Ribeiro ◽  
J. Alexandre ◽  
G. Cardoso
Keyword(s):  
Gender Differences ◽  
Clinical Characteristics ◽  
Average Length ◽  
Seasonal Pattern ◽  
Psychiatric Inpatient ◽  
Lower Percentage ◽  
Biological Factors ◽  
Average Length Of Stay ◽  
Psychiatric Inpatient Unit ◽  
Gender Specific

Introduction:Gender differences in mental health disorders may serve as a useful heuristic for integrating epidemiological and psychobiological data. The vast majority of mental disorders may express major gender-related variations in prevalence, natural history, symptoms, prognosis, and treatment outcome.Aims:To compare demographic and clinical characteristics of women and men admitted to a psychiatric unit.Methods:Retrospective data of all the patients admitted to a psychiatric inpatient unit, from January 2004 to December 2007, were reviewed. The demographic and clinical characteristics of the two genders were compared.Results:Of a total of 1114 patients admitted, 53.1% were women. They differed significantly from male inpatients in being older (46.7 vs. 40.7 years), less frequently black (14.6 vs. 25.4%), more frequently diagnosed with bipolar and delusional disorders, and in receiving fewer diagnosis of schizophrenia. Women had a longer average length of stay, a different seasonal pattern in admissions, with a much lower rate of admissions than men in December (38.6 vs. 61.4%), and a lower percentage of patients with three or more readmissions. Only 37.2% of the 180 compulsory admissions were of women.Conclusion:There are significant differences in clinical and demographic characteristics of female and male psychiatric inpatients. While some results may be explained by gender specific biological factors (as in the type of diagnosis), others are probably associated with different gender roles (as in the seasonality of admissions).

scholarly journals Exercise-induced exertional rhabdomyolysis

2018 ◽  
Vol 6 (23) ◽  
pp. 12-16 ◽  
Author(s):  
Angela Rao
Keyword(s):  
Creatine Kinase ◽  
Drug Exposure ◽  
Kidney Injury ◽  
Electrolyte Imbalance ◽  
Minimal Risk ◽  
Renal Disorder ◽  
Exertional Rhabdomyolysis ◽  
Dark Urine ◽  
Muscle Breakdown ◽  
Exercise Induced

Rhabdomyolysis is a condition resulting from skeletal muscle breakdown that can present in several ways, ranging from no symptoms to a life threatening renal disorder. A variety of insults, including trauma, toxins, drugs, infections, and exercise, can lead to muscle breakdown. Complications include compartment syndrome, electrolyte imbalance, and cardiac arrest. Rhabdomyolysis is a clinical challenge due to the range of its presentations. We report a 22-year-old male college student who came to the emergency department with mild thigh soreness and dark urine. A full work-up showed his serum creatine kinase was significantly elevated to 178,786 U/L and he had acute kidney injury. Our patient had no toxin or drug exposure, no infection, no trauma, and no crush injuries, but he had attended a 45-minute spinning class several days prior to admission, indicating a case of exercise-induced exertional rhabdomyolysis. He was hospitalized and treated with IV hydration to protect his kidneys. After eight days of conservative treatment with IV fluids, the patient’s creatine kinase level normalized. This case illustrates that even patients with minimal risk factors for rhabdomyolysis can present with severe kidney injury requiring prolonged hospitalization.

scholarly journals Clinical characteristics of imported malaria: An 11-year experience in a Serbian referral center

2016 ◽  
Vol 10 (07) ◽  
pp. 770-776 ◽  
Author(s):  
Jasmina Poluga ◽  
Ivana Milosevic ◽  
Jelena Jordovic ◽  
Zorica Dakic ◽  
Lidija Lavadinovic ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Laboratory Data ◽  
Rank Correlation ◽  
Plasmodium Species ◽  
Neurological Complications ◽  
Imported Malaria ◽  
Spearman’S Rank Correlation ◽  
Dark Urine ◽  
Chi Squared ◽  
High Index Of Suspicion

Introduction: Due to intercontinental traffic, population migration trends, natural disasters, and climate change, imported malaria remains important to consider in a febrile returning traveler. This study aims to raise awareness about malaria and help European clinicians maintain a working knowledge of this disease by reviewing the most important clinical characteristics in a non-endemic setting. Methodology: Using medical records, a retrospective study was performed on clinical and laboratory data in order to analyze 103 malaria cases managed at the Clinic for Infectious and Tropical Diseases in Belgrade, from 2000 to 2010. Descriptive statistics, Chi-squared test, Spearman's rank correlation, and analysis of variance were used. Results: Patients were predominantly male (89.3%) with a mean age of 46.66 ± 12.45 years, and most (98.06%) returned from Africa without having taken chemoprophylaxis (72.88%). Fever, arthralgia, myalgia, headache, vomiting, dark urine, and cough were common at presentation. Hepatosplenomegaly, jaundice, neurological and pulmonary findings, and thrombocytopenia were dominant findings on physical and laboratory examinations. Most (73.48%) were infected with P. falciparum. Few patients (17.55%) who were hyperparasitemic had significantly higher values of bilirubin and more frequent neurological complications. All patients were treated with artemisinin-based drug combinations regardless of Plasmodium species. Three (2.9%) patients succumbed to P. falciparum malaria. Conclusion: We suggest a high index of suspicion of malaria be maintained when evaluating febrile patients returning from endemic regions, especially if thrombocytopenia and hemolysis are present. Hyperparasitemia, high bilirubin levels, and neurological symptoms are associated with severe malaria. The importance of adequate malaria chemoprophylaxis cannot be overstated.

IN-HOSPITAL MORTALITY OF ACUTE KIDNEY INJURY: AN EXPERIENCE FROM SOUTH RAJASTHAN.

2021 ◽  
pp. 1-8
Author(s):  
Jagdish Vishnoi ◽  
Priyanka Paul ◽  
Kalu Ram Sharma ◽  
Surendra Kumar Verma
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Average Length ◽  
Kidney Injury ◽  
Primary Diagnosis ◽  
Medical College ◽  
Presenting Symptoms ◽  
Acute Dialysis ◽  
Dence Interval ◽  
Primary Hospital

INTRODUCTION: There are few studies on in-hospital mortality among medical intensive care unit (MICU) patients with acute kidney injury (AKI). We assessed the clinical characteristics of AKI at MICU admission, its impact on mortality during the current hospitalization, and whether the inuence of AKI varied in subgroups of AKI patients. METHODS: We identied all adult aged 12 years and above having medical etiology related community acquired AKI who were admitted to MICU at Pacic Medical College and Hospital, Udaipur, India; from 2015 to 2019. AKI was dened based on the Kidney Disease Improving Global Outcomes (KDIGO) criteria; based on serum creatinine (SCr). Dialysis requiring AKI (D-AKI) was dened as needing acute dialysis at or after MICU admission. Among 2440 MICU patients; 516 patients (21.1%) had AKI. We analyzed in-hospital mortality for subgroups of AKI: stage1, stage2 and stage3: with different etiology, comorbidity levels, acute risk factors, primary hospital diagnosis, and treatment with mechanical ventilation, vasopressors and dialysis. RESULTS: Maximum number of AKI patients (57.8%) were in KDIGO Stage3, while stage1 and stage2 had 17.8% and 24.4% respectively. 51.4% patients were male, median age was 54.81 years and average length of ICU stay was 11.73 days. The most common primary diagnosis and etiology was sepsis (31.4%), the most common acute risk factor was hypovolemia (18.8%), the common chronic comorbidity were diabetes (17.0%) and hypertension (10.0%). The most common presenting symptoms was oliguria (43.8 %), while commonest sign on admission was edema (28.1%). Common indications for dialysis were oliguria (75%), hyperkalemia (38.2%), refractory uid overload (36.2%) and metabolic acidosis (35.2%). Overall common critical care treatment required in AKI patients were acute dialysis (58.9%), vasopressor support (16.5%) and ventilator support (14%). The requirement of dialysis was 0.0%, 4.8% and 100%; among stage1, stage2 and stage3 respectively. The overall AKI mortality was 9.9% (95% condence interval (CI) 7% to 12% ). The associations between AKI and mortality were 10.87% (95% CI 5% to 17%) for the AKI-stage1, 13.49% (95% CI 8% to 19% ) for the AKI-stage2 and 8.05% (95% CI 5% to 11%) for the AKI-stage3. The mortality in D-AKI group was 8.6% (95% CI 5 % to 12 %) compared to the mortality in ND-AKI group 11.8% (95% CI 7 % to 16 %). The association between AKI and in-hospital mortality was evident in all subgroups of AKI; association was more pronounced in stage2 AKI, mostly due to worsening of complications which suggests that KDIGO stage2 AKI is a transition zone among D-AKI and ND-AKI groups. Further, it may be needed to lower the threshold for dialysis criteria in AKI. CONCLUSIONS: Any degree of AKI was associated with increased mortality. Timely and early initiation of dialysis in AKI was an important prognostic factor for the reduction of in-hospital mortality.

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