I was intrigued by the topic of the article in this month’s issue by Posteraro and Pasupathy on the potential loss of distinction for the patient of the expanding number of doctoral degrees in the healthcare profession and the possible impact upon the patient from confusion and misunderstanding.1 Secondary to…
Objectives: Heart failure (HF) is a leading cause of hospitalization in the United States. With the population trend shifting to a higher volume of elderly adults, the efficient management of HF will become increasingly essential. The development and implementation of The Patient Protection and Affordable Care Act and subsequent changes…
Percutaneous renal biopsy (PRB) is an important procedure in nephrology practice, and pathology studies of the kidney tissue obtained by PRB can provide important diagnostic and prognostic information. Because the kidneys contain numerous vascular structures, the major complications of PRB are associated with hemorrhage. Although most complications resolve spontaneously, up…
Obesity constitutes a strong risk factor for the development of chronic kidney disease. This review examines the epidemiology, clinicopathologic presentation, and proposed mechanisms for chronic kidney disease in the obese patient. Obesity-associated nephropathy displays a continuum that evolves from glomerulomegaly to glomerulosclerosis and from mild to severe proteinuria in the…
Objective: We investigated an apparent increase in acute lymphoblastic leukemia (ALL) referrals from northern Georgia to a tertiary care center located in Atlanta. Methods: Cases reported to the Georgia Comprehensive Cancer Registry and the national Surveillance Epidemiology and End Results cancer registry between 1999 and 2008 were analyzed. Age-adjusted incidence…
Objectives: Community violence is associated with health-compromising behaviors (HCBs) and adverse general health and pregnancy outcomes. It is unknown whether these effects persist after adjusting for health behaviors. Methods: Retrospective cohort study of 36,637 pregnancies, 2005–2009, using birth certificate/hospital discharge databases. Community violence rate = (nonaccidental injuries/total injuries) × 100%….
Objective: To analyze female breast cancer data for Mississippi from 2005 to 2009 to test whether race and/or geography had an impact on the stage of breast cancer at the time of diagnosis. Methods: A cross-sectional design for data was developed and collected by the Mississippi Cancer Registry (MCR). The…
Healthy People 2020 is a program that has identified specific objectives in 42 topic areas, with goals for improving the health of all Americans.1 Goals established for infants include reducing the rate of fetal deaths at >20 weeks’ gestation, as well as total preterm, low-birth-weight, and very-low-birth-weight births. An increase…
More than 1 million patients with heart failure (HF) are hospitalized every year in the United States and approximately one-fourth of them will be readmitted to the hospital within 30 days of their discharge. In 2009, the estimated direct and indirect costs for treating HF exceeded $37 billion.1 According to…
Objectives: The safety and efficacy of percutaneous renal biopsy (PKB) are relatively little studied in a training setting. We sought to review our recent experience with bedside PKB in our training program. Methods: We performed a retrospective cohort review of our consecutive 2.5-year renal biopsy experience (May 2007–November 2009) at…
Obesity and being overweight are associated with many comorbid conditions and are major contributing factors to cardiovascular disease. The increased proportion of overweight and obese people in Western societies has been attributed largely to behaviors that include sedentary lifestyle and dietary excess. Women are at particular risk during perimenopause, when hormones change and metabolism slows….
Objectives: Cross-sectional and longitudinal studies have demonstrated that short sleep periods increase the likelihood of obesity in children. This study was designed to identify other less-clearly defined sleep and behavioral patterns associated with changes in body mass index (BMI) in obese children referred for interventions. Methods: We retrospectively reviewed the…
Clarity in identification is a hallmark of medicine, in reference to the identification of patients, laboratory results, medications, and so forth. So, why, in the critical environment in which health care is delivered, are the roles and authority of healthcare providers not identifiable?
Chronic low back pain is one of the most common complaints addressed by primary care physicians. When conservative approaches fail, minimally invasive interventional procedures such as epidural steroid injections are often used. These injections are generally well tolerated; however, serious adverse effects can occur. The outbreak of fungal meningitis in…
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