Aim: Acute kidney injury (AKI) is a known complication of patients undergoing cardiac catheterization or percutaneous coronary interventions (PCI).The Mehran score was developed to identify patients at risk for AKI after cardiac catheterization or PCI, but its use of contrast volume as part of the score calculation limits its application prior to the procedure. In this study, we evaluated the utility of a modified Mehran score that utilizes only pre-procedural data by excluding contrast volume. Methods: This was done in a retrospective fashion using data from patients who received PCI at our institution between July 2015 and December 2017 by evaluating the discriminative ability of the scoring systems for predicting outcomes through a receiver-operator characteristic curve analysis. Results: One thousand five hundred and seven patients were included in the study. A total of 70 (4.6%) patients developed AKI. The removal of contrast volume from the Mehran score resulted in a small loss of discrimination with AUROC 0.73 vs 0.74, P = .01 for the pre-procedural Mehran and the original Mehran, respectively. When compared to the original score, the pre-procedural Mehran score had a four-category net discrimination index (NRI) of-0.10 and an integrated discrimination index (IDI) for of −0.12. Conclusion: Despite a small loss in discrimination, there was no difference in the four-category net discrimination index between the two scores. The pre-procedural modified Mehran score is a useful clinical predictor of the risk of AKI in patients undergoing PCI. K E Y W O R D S acute kidney injury, cardiac catheterizations, Mehran score, percutaneous coronary interventions More than two million cardiac catheterizations and percutaneous coronary interventions (PCI) are performed in the United States each year. 1 Acute kidney injury (AKI) is a common complication in these patients, affecting 3% to 14% of cases. 2 AKI after PCI is associated with increased mortality, increased risk of cardiac events, and progression of chronic kidney disease (CKD), prolonged hospital stay, and higher healthcare costs. 3-8 The National Quality Forum established a patient safety objective to reduce the prevalence of AKI related to contrast administration 9 and the Kidney Disease Improving Global Outcomes (KDIGO) published guidelines for AKI prevention, which include screening for patients at risk and initiating volume expansion in those at high risk. 10 Multiple scores have been developed to identify patients at risk for AKI after cardiac catheterization or PCI. The Mehran score is one

Nocardia brasiliensis is the most common cause of cutaneous nocardiosis. Nocardia pseudobrasiliensis is an emerging species responsible for invasive and disseminated disease in immunocompromised patients. We describe a case of a 67-year-old immunocompetent patient without significant past medical history diagnosed with primary cutaneous nocardiosis with N pseudobrasiliensis as the causative organism. In our opinion, we report the first case of primary cutaneous nocardiosis in an immunocompetent patient with N pseudobrasiliensis being the causative agent.