The present vascular calcification scoring represents a simple tool for the assessment of cardiovascular risk related with vascular calcifications in chronic HD patients.

Background: Necrotizing soft tissue infections are associated with high morbidity and mortality, even when the correct treatment is initiated. The diagnosis of these conditions is hard and the most sensitive methods are time-consuming, expensive and not readily available. Point-of-care ultrasound can complement clinical evaluation to increase the diagnostic accuracy. Case presentation: We bring a case of a woman, without comorbidities, who presented to the emergency department with signs of soft tissue infection. Bedside ultrasound showed subcutaneous tissue thickening, with fluid accumulation, and subcutaneous gas in the affected area. Based on the clinical suspicion and the ultrasound findings, the patient underwent prompt medical treatment and surgical debridement. Conclusions: This case shows the utility of bedside ultrasound for the decision-making process in a disease where an early diagnosis is important. This information should always be used together with the clinical judgement, as it has a relative low sensitivity.

Inflammation plays an important role in the atherosclerotic process 1 , and C-reactive protein (CRP) as an index of low-grade inflammation has been established as an independent predictor of cardiovascular events both in healthy individuals 2 and in patients with acute coronary syndromes (ACS) 3 . In stable individuals, values of CRP exceeding 0.3 mg/ dL are associated with a high risk of cardiovascular events 4 . Therefore, a highly sensitive method, such as nephelometry, is necessary to discriminate among such low values of CRP. During ACS, an augmentation of inflammatory activity takes place, and the distribution of CRP values shifts upward 5 . Therefore, turbidimetry, although typically less sensitive than nephelometry, has the potential to be useful in such a patient population.To evaluate the performance of the turbidimetric method of CRP as an index of low-grade inflammation in subjects with ACS, we correlated measurements by turbidimetry with measurements by nephelometry, both performed on the same plasma samples from patients with unstable angina or non-ST elevation acute myocardial infarction. MethodsPatients admitted to the coronary care unit of our hospital because of unstable angina or non-ST elevation acute myocardial infarction between December 2000 and January 2002 were evaluated as study candidates. Inclusion criteria were defined as onset of chest discomfort in the prior 48 hours in patients with ECG changes consisting of transient ST-segment depression (≥0.5mm) or T wave inversion (≥1.0mm), and/or positive troponin I (>1.0ng/dL). Infarction at admission was defined by a positive troponin test. Patients with infarction and ST-segment elevation or left bundle-branch block were not included. Objective -To evaluate the performance of the turbidimetric method of C-reactive protein (CRP) as a measure of low-grade inflammation in patients admitted with non-ST elevation acute coronary syndromes (ACS). Methods -Serum samples obtained at hospital arrival from 68 patients (66±11 years, 40 men), admitted with unstable angina or non-ST elevation acute myocardial infarction were used to measure CRP by the methods of nephelometry and turbidimetry. Results -

Background Extracorporeal shock wave lithotripsy is widely used to treat symptomatic nephrolithiasis. Complications of this procedure can occur and point-of-care ultrasound can help to diagnose and manage some of these cases. Case presentation A 61-year-old man was admitted to the hospital with intense right lumbar pain 24 h after being submitted to a extracorporeal shock wave lithotripsy. Bedside ultrasound showed a hyperechoic subcapsular lesion along the right kidney. This finding, along with the clinical examination, suggested the diagnosis of subcapsular renal hematoma. The patient was managed conservatively with clinical and ultrasound reassessments. Conclusions This case shows the use of bedside ultrasound to diagnose a subcapsular renal hematoma as a complication of extracorporeal shock wave lithotripsy. However, the sensitivity is low and other image methods can be necessary to make the diagnosis.

To discuss and share knowledge about advances in the care of patients with thrombotic disorders, the Ninth International Symposium of Thrombosis and Anticoagulation was held in Salvador, Bahia, Brazil, on October 15, 2016. This scientific program was developed by clinicians for clinicians and was promoted by two major clinical research institutes-the Brazilian Clinical Research Institute and the Duke Clinical Research Institute of the Duke University School of Medicine. Comprising academic presentations and open discussion, the symposium had as its primary goal to educate, motivate, and inspire internists, cardiologists, hematologists, and other physicians by convening national and international visionaries, thought-leaders, and dedicated clinician-scientists. This paper summarizes the symposium proceedings.