#renal replacement therapy

[lupine-publishers-juns]

Lupine Publishers | Lymphocele after Renal Transplantation: A Contemporary Review and a Modern Approach for Prevention and Treatment

Abstract

A lymphocele is a common finding after renal transplantation. The majority of patients are asymptomatic. However, once a lymphocele has become symptomatic, this condition has to be treated. Lymphoceles may originate either from the lymphatic system of the recipient or the transplanted kidney. The most sensible measures to prevent their occurrence therefore seems to be to restrict the transplant bed to the smallest permissible level with careful ligature of the lymphatic vessels in the area of the kidney hilum.

Therapy of a lymphocele after renal transplantation should commence with minimally invasive measures and continue with invasive procedures only if these are unsuccessful, namely, puncture and drainage then sclerotization, and then laparoscopic or open marsupialization.

Keywords: Lymohocele; kidney; transplantation; recipient

Introduction

Lymphocele is a well-known complication of renal transplantation occurring in 0,6% to 22% of the recipients [1- 4]. Lymphocele may require surgical intervention because of the complications they cause urinary obstruction, leg edema, deep vein thrombosis, pelvic discomfort, herniation, and lymph leakage through the wound [5]. There are many contributing factors to lymphocele occurrence after kidney transplantation. One of these is donor renal lymphatics. It has been proposed that meticulous ligation of severed lymphatics of the kidney graft in the back table especially in the laparoscopically procured kidneys may decrease the lymphatic complications after transplantation [6]. Although various methods of diagnosis, management, and prevention have been discussed in the literature, the primary focus has been on treatment and no review has summarized all issues together. The aim of this study was to summarize the current strategies for the prevention and management of lymphoceles.

Etiologies and surgery related factors

The development of lymphoceles after renal transplantation is well documented. The etiology of lymphoceles remains unclear, although they are present in all kidney transplant experiences [7]. The old controversy whether lymphocele is the result of lymph leakage from either the severed recipient iliac lymphatic vessels or the grafted kidney lymphatics seems to favor the latter [8]. A physiological review shows that lymphatic capillaries are more abundant in the kidney cortex compared to the medulla. They run along the intralobular, arcuate and interlobar arteries; not only beside theses arteries but also within their walls [9]. At the renal hilum, 2 to 5 lymphatic ducts are found in close proximity to the main vessels (renal artery and vein).

The well-known and commonly cited contributing factors for lymphocele formation include: the type of immunosuppression used [10], high dose steroid use, use of diuretics, extensive perivascular dissection of the iliac vessels, acute rejection episodes, delayed graft function, source of graft (cadaveric vs living related donor), the etiology of the patient’s renal failure such as adult polycystic kidney disease, re transplantation, and some pediatric population [2, 7, 11]. Concerning the pediatric population, in a retrospective single institution review of 241 pediatric kidney transplants performed from 2000 to 2013; Giuliani et al. showed that older age (≥11 yr), male gender, BMI percentile for age ≥95%, and multiple transplantations were Significant risk factors for lymphocele formation [12]. The formation of post-transplant lymphoceles obviously originates in the surgical transection of lymphatic ducts. As demonstrated by lymphangiography two sources of lymphatic leak have been proposed: injured lymphatics in recipient’s iliac space and injured lymphatics in the kidney graft [13,14].

A possible distinction between these two origins is feasible by analyzing their composition. In fact, reports showed higher levels of creatine kinase in lower limbs lymphatics vessels compared to renal lymphatics [15-17]. It was believed that the perivascular lymphatics dissection along the iliac vessels was a determining factor for lymphocele development, and that lymphocele could be prevented by ligation of these vessels. Despite many reports showing absence of lymphocele after an accurate ligation of the iliac lymphatics [18], things are still unclear. Many studies were published concerning the influence of some surgical aspects in decreasing the lymphocele incidence. Indeed, one prospective study suggested a cephalad implantation of the renal graft using vascular anastomoses on the common iliac vessels to minimize lymphocele incidence, but this technique has not yet gained wide exposure [11]. The same concept was reevaluated in another study. This time, a significant reduction of the incidence of lymphocele from 8.5% to 2.1% was noted in 140 patients operated with the new technique versus 140 patients in the control group operated with the standard method [14].

Another retrospective study done by Saidi et al, evaluated the impact of laparoscopic living donor nephrectomy on lymphatic complications after kidney transplantation. They concluded that the incidence of prolonged lymphatic leak is higher in recipients who received kidney grafts procured laparoscopically. These observations may indicate that the major source of persistent lymphatic leakage is lymphatics of the allograft rather than severed recipient lymphatics. More meticulous ligation of severed lymphatics of the kidney graft in the back table, especially in the laparoscopically procured kidneys, may decrease the lymphatic complications after kidney transplantation [13]. To our date, many researchers are still questioning whether surgical preparation of the kidney with accurate ligature of the hilar lymphatic vessels would effectively reduce its incidence. Hence, a clear answer is reported in our study favoring lymphatic vessels ligation over non preparation of the kidney graft on lymphocele incidence. Indeed, acute rejection rates dropped significantly from 15 to 6.3%, and incidence of symptomatic lymphocele decreased from 17.5% to 0%.

Diagnosis and Clinical Aspects

Ultrasound is currently the preferred method for diagnosis of lymphoceles after the renal transplantation. In complicated cases, radioisotope imaging, computed tomography and magnetic resonance imaging are additional methodologies commonly used [5]. Lymphoceles may lead to deterioration of renal function and the patient with a lymphocele may be inappropriately treated for allograft rejection. Other clinical findings associated with lymphoceles in renal allograft recipients include lower abdominal swelling or mass, edema over the allograft or of the ipsilateral leg, hypertension, drainage from the incision, enlarged allograft, fever without an obvious source of infections, urinary frequency, ipsilateral ileo femoral thrombo phlebitis, and weight gain [4].

Prevention

Prevention of lymphocele formation primarily involves the best method for controlling perivascular lymphatic leaks. A study comparing surgical ties to ultrasonic devices in the surgical dissection technique for control of lymphatics failed to show a statistical advantage to either technique when groups were compared based on patient age, gender, graft source, or repeat transplant [19]. Berardinelli et al. demonstrated the effectiveness of a synthetic polyethylenglycol(PEG) sealant to prevent lymphocele formation after kidney transplantation [20].

Treatment

Lymphoceles are usually asymptomatic and diagnosed incidentally by ultrasound. In most cases, lymphocele disappear spontaneously without any need for a treatment. Several important factors can guide our choice of treatment: severity of the symptoms, lesion size, potential post-therapeutic complications, and the clinical condition of the patient. For the conservative treatment of posttransplant lymphoceles, percutaneous needle aspiration, continuous drainage over a period of time via various kinds of catheters, and sclerotherapy with various agents have been proposed [21].

Aspiration

Ultrasound-guided aspiration can be used as a diagnostic tool or treatment. to both diagnose and treat a lymphocele. It can be used as the initial treatment modality to relieve urinary obstruction, recover kidney function, and prevent emergency situations. Although simple, safe, and economical, a repeated treatment may be necessary with a low a low risk of infection in each aspiration. A systematic review by Lucewicz et al. [4] looking at over 20 studies, reported that simple aspiration alone has a recurrence rate ranging between 10% and 95% [ 22].

External drain placement

A lymphocele can also be treated by external drainage by placing a drain. However, this procedure takes a long time and can cause problems related to major fluid loss and secondary infection (particularly in immunosuppressed transplant recipients). External drainage has an efficacy of 50% and a recurrence rate of 20%–60% [23].

Sclerotherapy

The instillation of a sclerosing agent is another treatment approach. These include povidone iodine, fibrin glue, 95% ethanol, fibrinogen, bovine protease inhibitor, human thrombin, calcium chloride, gentamy sodium tetradecyl sulphate and tetracycline]. The sclerosing agent has been instilled and kept in situ for varying periods ranging from 5 min to 24 h [24,25]. Tasar et al., reported a mean therapy duration of 17 days and a mean alcohol volume of 30 cm3 per session. Out of 18 cases, there was one recurrence, one graft loss, and ten minor complications including local discomfort and low- grade fever. The authors concluded that this method of sclerotherapy was safe and cost effective [25]. Another analysis of 30 lymphocele patients demonstrated that alcohol injection was a safe and cost-effective treatment, with a success rate of 94%. The authors reported two cases of recurrence and all complications were minor, including catheter-induced infections and catheter displacements [26]. Povidone iodine has been used also as a sclerotherapy agent with a failure rate of less than11%, but it takes 20–30 days for leaking to cease and iodine induced acute kidney failure may occur [27]. Limited success has been reported using tetracycline as a sclerosing agent [28].

Instillation of sclerosing agents improves the rate of success of percutaneous management; however, it may cause a dense scar around the renal transplant with potential problems in the longterm [21]. Continuous drainage as well as repeated instilling of sclerosants could be done if needed, by placing a percutaneous drain. However, the main problem encountered during repeated installation of sclerosants is the risk of introducing infection. Furthermore, several case reports have reported direct graft injury and graft loss as a result of sclerosant installation [25]. Hence, with the cost of repetition, it is worthwhile emphasizing that external drainage or sclerosing therapy are not correct options. Post-transplant lymphoceles have also been treated with a combination of percutaneous aspiration and sclerotherapy. Although this reduced the recurrence rate, recurrences were still reported in 20% of cases [22].

-Surgery: Byron et al. [29] first described open surgical internal drainage in 1966, and these techniques have successfully been used in many patients; however, they still reflect an invasive procedure. The operative strategy is to perform a peritoneal fenestration through a laparotomy, minilaparotomy, or via a laparoscopic approach. Some authors suggest the use of an omentum flap to decrease the risk of lymphocele relapse, but others do not [30]. Open surgical drainage of lymphocele is required in the presence of infection (external drainage) or where laparoscopic fenestration is not possible (internal drainage to the peritoneum). The open procedure is safe and 100% effective because the lymphocele can be localized accurately. However, the recurrence rate is still 15%. This may be attributed to the high rate of lymph vessel injuries incurred during the open method. The recurrence rate of the laparoscopic method is lower (0%– 10%) because the rate of lymph vessel injuries is lower. Also, the hospitalization period is shorter in this method [31]. In a meta-analysis, Lucewicz et al reported that 12% of laparoscopic operations had to be converted to open surgery, due to technical difficulty in reaching the lymphocele, peritoneal adhesions, thick, impenetrable lymphocele capsule and injury to abdominal viscus [21]. Indeed, it would be helpful in some cases to use an intra-operative ultrasound can avoid organ injury during laparoscopy. Schips et al reported a technique by which the lymphocele was laparoscopically fenestrated under diaphanoscopic guidance and the lymphocele cavity was dilated through the injection of a sterile fluid. Using this approach, the authors were able to determine the exact site of the incision by detecting the light of the cystoscope [32]. Laparoscopic fenestration can cause intestinal herniation into the peritoneal window leading sometimes to strangulation requiring urgent intervention. However, in this era of laparoscopy, open drainage is only of historical importance. in addition, the effectiveness of the laparoscopic approach along with its, low recurrence rate, and low complication rate make it the treatment of choice when other methods fail [28].

Conclusions

Lymphoceles are common and well-known complications that occur in up to 26% of kidney transplant recipients. The cause of lymphocele formation is unclear, but it is believed to result from transection of the lymphatic vessels accompanying the external iliac vessels during transplantation surgery and subsequent lymph accumulation in a nonepithelialized cavity in the extra-peritoneal plane adjacent to the transplanted kidney. In order to prevent the formation of a lymphocele, preparative steps should be kept to the necessary minimum, and lymph vessels in the vicinity of the kidney hilus carefully ligatured. Therapy of a lymphocele after renal transplantation should commence with minimally invasive measures and continue with invasive procedures only if these are unsuccessful, namely, puncture and drainage then sclerotization, and then laparoscopic or open marsupialization.

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#lupinepublishers #lupine journals #journal of urology & nephrology studies #renal replacement therapy #diabetic nephropathy #Dialysis #hemofiltration #submissions #articles #open access journals

[sarcasticbabywhispererjess]

This was a nice float assignment. I told the CICU charge that I’d come back if they needed me another night I was working.

A nice, chill one-baby assignment that keeps you busy enough. Hopefully the ND won’t fall out at the start of my shift again though. That was an unplanned task I had to add to the busy start of my shift trying to get my kid ready to go onto CRRT. Got it in on the first try and got their feeds restarted in less than 75mins.

#CICU = cardiac intensive care unit #hlhs = hypoplastic left heart syndrome #they had the first of 3 planned heart surgeries #which will probably be more #hearts are tricky #aki = acute kidney injury #CRRT = continuous renal replacement therapy aka continuous dialysis #nurblr #NICU #the assignment is chill #the baby is chill #the parents don’t sleep at the bedside #the best #5⭐️s would float here again

[alicetleibowitz]

Continuous Renal Replacement Therapy is revolutionizing kidney care worldwide. Discover how this innovative technology is improving patient outcomes and shaping the future of renal treatment.

#Continuous Renal Replacement Therapy #Continuous Renal Replacement Therapy market #Continuous Renal Replacement Therapy Industry #Continuous Renal Replacement Therapy market size #Continuous Renal Replacement Therapy market share #Continuous Renal Replacement Therapy market demands #Continuous Renal Replacement Therapy market key players

[research-89]

https://cynochat.com/read-blog/180364_continuous-renal-replacement-therapy-market-analysis-size-share-and-forecast-203.html

#Continuous Renal Replacement Therapy Market Share #Continuous Renal Replacement Therapy Market Size

[vijayananth]

#Continuous Renal Replacement Therapy Market #Continuous Renal Replacement Therapy Market size #Continuous Renal Replacement Therapy Market share #Continuous Renal Replacement Therapy Market trends #Continuous Renal Replacement Therapy Market analysis

[medi-techinsights]

Global Continuous Renal Replacement Therapy Market is poised to grow at a CAGR of 7 to 9% by 2027

Continuous Renal Replacement Therapy (CRRT) is a slow and gentle form of dialysis which removes excessive fluids and waste products from the blood in a continuous manner, similar to the manner the kidneys functions in healthy people.

Adoption of Continuous Renal Replacement Therapy for the Treatment of Sick Patients with Acute Kidney Injury (AKI) Disorder

AKI is a global disorder and is very common among sick patients. It is projected that approximately 13.3 million people globally are affected by AKI yearly, ~85% of whom live in developing regions. The major objectives of CRRT for sick patients suffering from AKI include maintaining fluid, electrolyte, acid-base, and solute balance, supporting renal recovery, and allowing other supportive interventions to proceed without any further complications.

Major Benefits Associated with CRRT Fuels the Growth of the Continuous Renal Replacement Therapy Market

Hemodynamic instability is common among sick patients with AKI receiving RRT. CRRT may have a better hemodynamic profile as compared to other intermittent therapies, including intermittent hemodialysis (IHD) and sustained low-efficiency dialysis. Among the major benefits offered by CRRT, comparative to other RRT, is the prevention of changes in intracerebral water. CRRT is considered much safer than IHD in patients at risk of cerebral edema.

Increasing Awareness on Kidney Health & Prevention Program Triggers the Growth of the CRRT Market

Presently, a large number of kidney health & prevention programs are run by organizations such as National Kidney Foundation (NKF), The National Kidney Disease Education Program (NKDEP), and local governments across the globe to raise awareness on the evidence-based interventions to enhance understanding, detection, and management of various kidney diseases.

Impact of Covid-19 Pandemic on the Continuous Renal Replacement Therapy Market

Globally, all the healthcare systems have been impacted by the COVID-19 pandemic. During covid-19, approximately 15% to 30% of patients affected with COVID-19 virus admitted to the ICU were showing signs of kidney failure and they required CRRT. In such scenarios, CRRT acted as a life-sustaining and as a life-saving therapy.

Upcoming Market Challenges: Continuous Renal Replacement Therapy Market

The higher costs associated with the CRRT procedures and the risks & complications associated with CRRT such as catheter-related complications, blood loss, infection or access failure, fluctuations in salt balance, hemodialysis-related complications, coagulopathy, and venous thrombosis are likely to impact the growth of the CRRT market in the coming years.

North America Accounts for the Larger Market Share in the CRRT Market

From a geographical outlook, North America accounts for the larger market share in the global continuous renal replacement therapy market. This can be mainly attributed to the growing cases of AKI, rapid innovations in continuous renal replacement therapy products, and a surge in the number of diabetic patients in North America.

Competitive Landscape Analysis: CRRT Market

Some of the leading and promising players operating in the global continuous renal replacement therapy market are Baxter, B. Braun, Fresenius Medical Care AG, Medtronic, Nipro Corporation, etc.

Get Detailed Insights on Continuous Renal Replacement Therapy Market @ https://meditechinsights.com/continuous-renal-replacement-therapy-market/

#Continuous Renal Replacement Therapy Market #CRRT #Continuous Renal Replacement Therapy #CRRT Market #CRRT Market Size #CRRT Market Share #CRRT Market Growth #healthcare

[kdmarket]

Continuous Renal Replacement Therapy Market: Overview, Growth Drivers, Challenges, Segmentation, and Regional Analysis

[27th June, 2023], [New York] - The global market for continuous renal replacement therapy (CRRT) is growing rapidly due to a number of factors that are propelling the demand for effective renal replacement therapies. CRRT has become a crucial treatment option for patients with acute kidney injury and critically ill patients who require hemodynamic stability. Significant technological advancements, a growing prevalence of renal disorders, and increasing investments in healthcare infrastructure are influencing the market. These factors are driving the global market for continuous renal replacement therapy forward.

Continuous renal replacement therapy is a blood purification method used to treat patients with acute kidney injury who are critically unwell. Unlike intermittent hemodialysis, CRRT provides a continuous, slow-paced treatment, which is ideal for patients with hemodynamic instability. The therapy entails the continuous removal of waste products, excess fluids, and electrolytes from the circulation in critically ill patients, thereby ensuring proper renal function. This method provides benefits such as enhanced hemodynamic stability, improved fluid management, and a reduction in treatment-related complications.

Globally, the incidence of acute kidney injury (AKI) is on the rise, which is a major factor in the expansion of the continuous renal replacement therapy market. Recent studies indicate that AKI affects millions of people worldwide, and its prevalence is continuously increasing. The increasing prevalence of chronic diseases such as diabetes and hypertension contribute to the rising incidence of acute kidney injury (AKI). In addition, the increasing number of surgeries, especially cardiac and significant abdominal procedures, increases the risk of AKI, thereby increasing the need for continuous renal replacement therapy.

In addition, technological advances in continuous renal replacement therapy systems have a positive effect on market expansion. Manufacturers are concentrating on creating innovative, user-friendly CRRT systems with improved therapeutic efficacy. The incorporation of automation, intelligent alarms, and real-time monitoring has increased the safety and effectiveness of CRRT. In addition, the development of efficient filter membranes and dialysis solutions has increased the performance and effectiveness of continuous renal replacement therapy systems.

To ensure sustained growth in the continuous renal replacement therapy market, however, it is necessary to address certain obstacles. Especially in developing regions, the high cost of CRRT treatment and apparatus presents a significant obstacle. The adoption of CRRT is hindered by the lack of knowledge among medical professionals and patients regarding its benefits. In addition, stringent regulatory requirements for CRRT systems and a dearth of qualified professionals can hinder market expansion.

The market for continuous renal replacement therapy is segmented by modality, product, end-user, and region. The market is divided into slow continuous ultrafiltration (SCUF), continuous venovenous hemofiltration (CVVH), continuous venovenous hemodialysis (CVVHD), and continuous venovenous hemodiafiltration (CVVHDF) based on modality. The market is segmented into consumables and CRRT systems based on product type. Hospitals, clinics, and home care settings are the end-users of continuous renal replacement therapy.

Geographically, the market for continuous renal replacement therapy is segmented as follows: North America, Europe, Asia-Pacific, Latin America, and the Middle East and Africa. Due to its well-established healthcare infrastructure, higher adoption of advanced medical technologies, and the presence of significant market players, North America is expected to dominate the market. However, Asia Pacific is expected to experience significant growth over the forecast period due to the increasing prevalence of renal disorders, rising healthcare expenditures, and improved accessibility to healthcare facilities. Baxter International Inc., Fresenius Medical Care AG & Co. KGaA, Nikkiso Co., Ltd., Medtronic Plc, B. Braun Melsungen AG, NIPRO Medical Corporation, Asahi Kasei Corporation, and NxStage are key participants in the continuous renal replacement therapy market.

#market research #kd market insights #Continuous Renal Replacement Therapy Market

[market-insider]

COVID-19 Outbreak Expanded Demand For Continuous Renal Replacement Therapy (CRRT) Market

The global continuous renal replacement therapy market size is anticipated to reach USD 2.6 billion by 2030, according to a new report by Grand View Research, Inc. The market is expected to expand at a CAGR of 8.5% from 2022 to 2030. The primary driving factors for market growth are increasing prevalence of congestive heart failure and acute renal failure. The COVID-19 is expected to have a positive impact on market due to increasing prevalence of acute kidney injury. According to a WHO, acute kidney injury, a potentially life-threatening condition in which the kidneys cease working and uremic and fluid toxins build up in the body, is one of the many COVID-19 side effects. As a result, as the COVID-19 outbreak expands, demand for CRRT will continue to climb.

Gain deeper insights on the market and receive your free copy with TOC now @: Continuous Renal Replacement Therapy Market Report

Over the forecast period, technological advancements are expected to be a crucial driver in the growth of the market. For example, in August 2020, Baxter International Inc., a global leader in acute care, announced that Regiocit, the company's replacement solution containing citrate for extracorporeal circuit regional citrate anticoagulation, has acquired an Emergency Use Authorization (EUA) from the U.S Food and Drug Administration (FDA). Regiocit is exclusively approved for use as a replacement solution in adult patients receiving Continuous Renal Replacement Therapy (CRRT) and who require regional citrate anticoagulation during the COVID-19 pandemic, according to the EUA.

#Continuous Renal Replacement Therapy Market Size & Share #Continuous Renal Replacement Therapy Market Latest Trends #Continuous Renal Replacement Therapy Market Growth Forecast #COVID-19 Impacts On Continuous Renal Replacement Therapy Market #Continuous Renal Replacement Therapy Market Revenue Value #Global Continuous Renal Replacement Therapy Market

[researchprecedence45]

According to recent research study, the U.S. Continuous Renal Replacement Therapy market size & share is expected to grow at a CAGR of 7.9% between 2022 and 2030. The U.S. Continuous Renal Replacement Therapy industry revenue of USD 995.7 million in 2021 is expected to grow up to USD 1.2 Billion by 2030.

#U.S. Continuous Renal Replacement Therapy market size

[vijayanger12]

The global continuous renal replacement therapy (CRRT) market was valued at ~US$ 865 Mn in 2021. It is projected to expand at a high CAGR of ~7% from 2022 to 2030.

#Continuous Renal Replacement Therapy Market-Size

[healthcare-domain]

According to the International Society of Nephrology (INR), an estimated 13.3 million cases of AKI are registered annually worldwide. This is anticipated to boost the adoption of continuous renal replacement therapy at a rapid rate. With the rapid growth in the geriatric population globally, the prevalence of kidney-related diseases is expected to increase significantly.

#CRRT #Renal #Replacement #Therapy #Health

[feminist-pussycat]

Why does lupus affect more women than men?

“Lupus is a complex autoimmune disease that primarily affects people assigned female gender at birth, but it can occur in all people. Research suggests the higher prevalence in people assigned female gender at birth is due to the effect of estrogen on the immune system.All people with lupus experience similar lupus-related symptoms, but symptoms may be more severe in men.

“Lupus can affect all people, but it is significantly more common in people assigned female gender at birth. In places, we refer to “women” as compared to “men” in this post, because the research and data we quote use these binary terms.”

Problema Numero Uno: The term “assigned female gender at birth” is SO incorrect. You are not assigned anything, you are observed. You are not assigned a gender, you are assigned a sex.

Problema Numero Dos: Women have to be “assigned female gender at birth”  but men can be men.

Problema Numero Tres: I have a strong feeling this “estrogen” effect is nonsense. They just say this because they think any problem that is more prevalent in women must be due to their mysterious women hormones.

Problema Numero Cuatro: What a cute little disclaimer. Gotta stave off the perpetually offended at seeing the word “woman” instead of blah blah assigned babymaker at birth! It’s not our fault folx, it’s just that all the research is bigoted and uses outdated terms!!!

Oh god, it continues to be shitty.

“Many autoimmune diseases tend to affect people assigned female gender at birth more. Why? One theory suggests this is due to chromosomal differences between people of different sex.”

You JUST said you were going to say women! Cowards.

“Research has found that in lupus, the immune system may be abnormally activated by estrogen.“

What so-called research is this? It links to this study that finds that males have more severe lupus, and are more likely to get worse nephritis and progress to renal failure.

They actually say the quiet part out loud: “The increased rate of SLE in females implicates hormones as essential in disease manifestations”.

They think any problem that is more prevalent in women must be due to their mysterious women hormones. The study they linked to has its own full set of problems, so I won’t get into that here.

“Some research suggests there may be a link between oral contraceptives (“the pill”) and post-menopausal hormone replacement therapy and an increased risk of lupus. However, other research has not. Also, studies have not shown an increased risk of lupus flares from oral contraceptives or hormone replacement therapy... clearly, more research is needed to explain how hormones like estrogen affect a person’s risk for autoimmune disease.”

So it seems like you don’t actually know all that well that the lady hormones have anything to do with it.

“it is commonly believed that men cannot develop lupus. This may lead to them receiving their diagnosis much later and potentially when their disease is more severe. In fact, lupus has been linked to more severe organ damage in men and faster disease progression.“

I can’t actually find anything supporting the assumption that men think they can’t get lupus and so that’s why they get diagnosed later than women. Maybe they should think critically and wonder if the conclusion that “men get it worse than women” contradicts their “it comes from female hormones” assertion. You know what I can find though?

“However, the diagnosis of lupus can be delayed in women - that is, it takes less time for men to be diagnosed with lupus once they present with symptoms... late onset lupus affects a higher percentage of men.

Biological sex differences in immune function, especially those induced by sex hormones, are less likely explanations of sex differences. Recent studies suggest chromosomal basis and environmental exposure differences for the sex differences in the incidence of lupus.”

Anyway I hate the medical field’s treatment of women.

#lupus #medical misogyny #feminism #radfem #radical feminism

[research-89]

#Continuous Renal Replacement Therapy Market Share #Continuous Renal Replacement Therapy Market Size

[faerune]

anyways the last two nights I had my first patient on CRRT (continuous renal replacement therapy - dialysis for people who are too sick to tolerate large amounts of fluid being pulled off all at once) and it went really well!!

#emily.txt

[aryasing]

Leading Health Services in Jaipur

Shalby Hospital Jaipur is a leading multi-specialty hospital in Rajasthan offering comprehensive medical care across various specialties. With advanced infrastructure and dedication to clinical excellence, the hospital provides accessible and affordable tertiary healthcare.

Facilities and Services:

Sprawls over half a million square feet with 300 beds, ICUs, emergency services, modular OTs and sophisticated diagnostic services.

Houses 40+ specialties including cardiology, cardiothoracic surgery, neurology, oncology, orthopedics, gastroenterology, urology, nephrology and organ transplants.

24x7 accident and emergency department equipped with modern ICUs and NICU. Critical care by experienced intensivists.

Advanced Cath labs, MRI, CT scan, ultrasound, mammography, nuclear medicine and other diagnostics.

Minimally invasive surgeries like arthroscopy, laparoscopy, endoscopy offered in dedicated OTs.

Robotic surgeries offered in certain specialties like urology and gynecology.

Full-fledged dialysis unit providing round-the-clock renal replacement therapies.

Facilities like in-house pharmacy, blood bank, ATM, cafeteria and ample parking space.

Quality and Safety:

Highly qualified and experienced doctors supported by skilled nurses and paramedical staff.

Stringent infection control and quality protocols followed.

Continued medical education and training to update clinical skills and knowledge.

Cutting-edge medical technology used for diagnostic and therapeutic procedures.

Part of quality accreditations like NABH to maintain excellent healthcare standards.

With advanced infrastructure, technology and clinical expertise, Shalby Hospital Jaipur is committed to delivering the highest quality of ethical and patient-centric care.

#hospital #healthcare #health

[obakanosandoitchi]

renal replacement therapy

#med studyblr #medblog #medblr #flashcards #mnemonics