In this article, we describe our experience with myoglobinuric AKI in these border crossers. Records from all patients in the custody of the border

selleck products patrol from 1 June 2010 to 30 June 2011, who had AKI defined by the Acute Kidney Injury Network (AKIN) criteria and a CK > 1000 IU/L, were reviewed. The age, gender, temperature, days in the desert, initial serum creatinine, CK on presentation, need for dialysis, length of hospital stay, and serum creatinine at discharge were recorded and analyzed. Forty-two patients developed myoglobinuric AKI with a mean age of 32.5 years. Among them, 38 were males and four females. There was a mean of 4.2 days in the desert. Seven had stage 1 AKI, 10 stage 2, and 25 stage 3.5 patients required hemodialysis. Only one patient had a temperature SB273005 >100.6 degrees F on arrival. CKs ranged between 1101 and 447,966 IU/L. Mean length of stay was 4 days. Two patients were discharged on hemodialysis and eight were discharged with serum creatinine levels of >1.3 mg/dL. This is the largest series of myoglobinuric AKI reported

in border crossers. The kidney injury is presumably due to the excessive heat combined with volume depletion. We have coined the term “border crossers’ nephropathy” for this disorder. This is a serious problem that has both political and economic consequences on both sides of the border.”
“Both automated and auscultatory blood pressure (BP) devices have their

strengths and accuracy limitations. Hybrid devices, such as the Nissei DM-3000, are mercury free and provide both automated and auscultatory measurement modes. The aim of this study was to validate all measurement modes of the Nissei DM-3000 device according to the European Society of Hypertension (ESH) protocol, as well as CA4P to develop and validate a ‘blinded’ auscultatory measurement mode. Different measurement modes were developed and evaluated in separate studies. Nine sequential same-arm BP measurements were taken alternating between simultaneous mercury sphygmomanometer readings and the device. The latter seven measurements were analysed according to the requirements of the ESH protocol. All measurement modes of the device passed the ESH protocol. The blinded mode achieved the best results with a mean difference +/- s.d. of -0.1 +/- 2.6 and 0.04 +/- 2.4 mm Hg for systolic BP (SBP) and diastolic BP (DBP), respectively. The most accurate auscultatory measurement results were obtained with a deflation rate of 2.5 mm Hg s(-1) achieving a mean difference +/- s.d. of -0.6 +/- 4.4 (for SBP) and -1.4 +/- 2.8 mm Hg (for DBP). The automated mode achieved a mean difference +/- s.d. of -0.8 +/- 6.0 (SBP) and 0.8 +/- 4.8 mm Hg (DBP). The Nissei DM-3000 device is a suitable replacement for the mercury sphygmomanometer. Journal of Human Hypertension (2010) 24, 609-616; doi:10.1038/jhh.2009.