Vishesh Kumar

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BACKGROUND The 2008 appropriate use criteria (AUC) for stress echocardiographic (SE) examinations were revised in 2011 to cover a wider range of scenarios of use. Data comparing the 2008 and 2011 AUC for SE are limited. METHODS A retrospective chart review of SE studies performed at an academic medical center was conducted, and ordering of SE studies was(More)
n engl j med 364;10 nejm.org march 10, 2011 956 A 56-year-old woman with hypertension underwent an evaluation for recurrent syncope. On physical examination, the blood pressure and heart rate were normal, with no observed bradycardia or pauses on telemetry, and the respiratory rate and oxygen saturation were normal. The funduscopic examination was normal,(More)
Renal artery stenosis (RAS) due to atherosclerosis continues to be a major cause of secondary hypertension. It can also lead to renal dysfunction due to ischemic nephropathy. While major clinical trials have emphasized that medical management should be preferred over angioplasty and stenting for the treatment of renal artery stenosis, clinical scenarios(More)
Hyponatremia is associated with increased morbidity and mortality. Water restriction is usually the prescribed treatment for most forms of asymptomatic hyponatremia. An oral vasopressin V2-receptor antagonist, tolvaptan has been successfully used in the treatment of asymptomatic hyponatremia. In this retrospective study, tolvaptan (n=40) and a control group(More)
A retrospective study evaluating the pattern of blood pressure and its related complications before, during, and after percutaneous hemodialysis interventions was performed in patients presenting with asymptomatic hypertension. Hemodialysis patients undergoing percutaneous interventions including tunneled hemodialysis catheter insertion, percutaneous(More)
Hand ischemia has multiple causes. In this article, we report an additional factor that can induce hand ischemia in hemodialysis patients. A 64-year-old white man with coronary artery disease underwent a coronary artery bypass graft procedure using the left radial artery as the bypass graft. Several months later, a left extremity Gracz fistula was created(More)
A 73-year-old man was admitted to the hospital with an extremely painful lesion on his glans penis that had developed over the previous 2 weeks after initiation of hemodialysis. His other medical history included type-2 diabetes mellitus and atrial fibrillation on warfarin. His vital signs were stable and on examination an extremely tender, violaceous,(More)
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