Background: Critical illness refers to a wide spectrum of life-threatening medical or surgical conditions usually requiring an intensive care unit level of care. In most of these patients a common pathophysiological process is often present, namely infection, trauma, or major surgery. These factors initiate an inflammatory cascade leading to activation of regulatory mechanisms in order to control the intensity of the inflammatory response. The prognosis of critically ill patients usually depends on illness severity, intensity of the biological inflammatory response and nutritional status. Objective and Methodology: This analytical cross-sectional study of 82 mechanically ventilated critically-ill patients with hypoalbiminemia admitted in the ICU and NCCU of St. Luke’s Medical Center from January 1 to December 31, 2008, aimed at determining the odds ratio between hypoalbuminemia and those with albumin >3mg/dl in terms of failure in weaning. Also it seeks to determine the prevalence of hypoalbuminemia among mechanically ventilated patients in the ICU; characterize the patients involved in the study in terms of age, sex, APACHE II score, and co-morbidities/ underlying illness; and to determine the manner of serum albumin correction. A 2x2 table analysis was computed to measure the odds ratio. Chi-Square for qualitative dichotomous variables and unpaired t-test for continuous variables are the statistical tools employed to interpret the present data. Results: Eighty-two of the 109 of patients had hypoalbuminemia, giving a prevalence of 0.75. Of the 82 hypoalbuminemic patients, 26 subjects failed to be weaned off mechanical ventilator support compared to two subjects of 27 patients with no hypoalbuminemia. An odds ratio of 5.8 was obtained. Patient’s demographics of both groups did not significantly differ except for hypertension. The biochemical parameters prior to weaning (hemoglobin, sodium, potassium, calcium and magnesium) were not significantly different between hypoalbuminemic and non hypoalbuminemic patients. From our results, 22.6% of the patients were started on albumin IV infusion at a level of <2.4g/dL. The rest did their correction through diet. Conclusion: Hypoalbuminemia with a serum albumin level of <3mg/dl is associated with negative outcome of weaning from mechanical ventilation. The odds that a patient will have failure in weaning was 6 times more likely in subjects with serum albumin <3 mg/dl.

OBJECTIVE: Measurement of kidney size by ultrasonography is an important parameter in the renal evaluation of patients. This study aims to establish the average size of kidneys of healthy adult Filipinos and examine the factors that influence it.
DESIGN: Cross-sectional, observational study
SETTING: Section of Nephrology, Department of Medicine and Department of Radiology, UP-PGH Medical Center, a tertiary government hospital
PARTICIPANTS: 264 healthy Filipino adults underwent kidney ultrasound after preliminary screening by history, physical examination, urinalysis, and serum creatinine
RESULTS: Renal sizes and volume were measured by ultrasound in 105 males and 159 females, with ages ranging from 18 to 75 years old. The left kidney was significantly larger than the right for mean length but not for width or thickness. Except for cortical thickness, renal length (L=98 mm, R=96mm vs. L=95mm, R=93mm), width (L=48mm, R=49mmvs. L=46mm,R=46mm), and thickness (L=43mm, R=42 mm vs. L=39 mm, R=39 mm) were significantly larger in males compared to females. While the gender differences persisted when corrected for age and body mass index, this disappeared when corrected for total body area. With advancing age, there was minimal shortening but significant increases in width and thickness (renal shape index)
CONCLUSION: Our study provides estimates of the average kidney size for normal adult Filipinos. The average kidney size of Filipinos is smaller than that of Caucasians for length (L=96mm vs. 112 mm, R=94mm vs. 109mm) and for width (L=47mm vs. 58mm, R=48mm vs. 57mm). Males have larger kidneys than females but the gender difference disappeared when corrected for total body area. Height but not weight has a significant influence on kidney size. With advancing age, kidneys tend to increase in width and thickness with no significant decrease in length or volume.

Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Kidney ; Radiology ; Adult ; Ultrasonography ; Patients

OBJECTIVE: To determine the incidence of contrast-induced nephropathy (CIN) among patients undergoing fundus fluorescein angiography (FFA) METHODS: One hundred fifty-nine (159) patients from the Ophthalmology out-patient department were enrolled in this prospective, observational study. Serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were measured within 7 days before and 48 to 72 hours after FFA. Subjects were stratified into low-, intermediate-, and high-risk groups for developing CIN according to baseline eGFR. CIN was defined by an increase in SCr by more than 25% or by 0.5 mg/dL within 72 hours of intravascular administration of contrast media. The incidence of CIN, changes in SCr levels, and changes in eGFR were analyzed. RESULTS: Of the 144 subjects who completed the study, 106 (73.6%) were females, 105 (72.9 %) were diabetics, and 57 (39.6%) had elevated baseline SCr. Four (4 or 2.8%) patients developed CIN after FFA, all of whom had normal baseline SCr and were stratified as low-risks. Overall, there were no significant changes in the means of SCr (1.18 ± 0.56 vs 1.16 ± 0.52, p = 0.13) and eGFR (64.53 ± 26.05 vs 64.94 ± 24.88, p = 0.64) before and after FFA. In the low-risk group, the means of SCr and eGFR remained unchanged after FFA (p = 0.06 and p = 0.15, respectively). In the intermediate-risk group, no significant change was appreciated in SCr levels (p = 0.07) however a significant improvement in eGFR (p = 0.006) was seen. Interestingly, a significant decrease in SCr levels (p = 0.004) as well as a significant improvement in eGFR (p = 0.02) was noted after FFA in the high-risk group. CONCLUSION: The incidence of CIN among patients undergoing FFA in our cohort was 2.8%. There was no prolonged or serious worsening of renal function based on SCr and eGFR before and after FFA overall, and among low-, moderate-, and high-risk groups.
Creatinine ; Glomerular Filtration Rate ; Contrast Media ; Incidence ; Fluorescein Angiography ; Acute Kidney Injury ; Drug-Related Side Effects and Adverse Reactions