Comparative effectiveness of asthma interventions within a practice based research network.

Background: Asthma is a chronic lung disease that affects more than 23 million people in the United States, including 7 million children. Asthma is a difficult to manage chronic condition associated with disparities in health outcomes, poor medical compliance, and high healthcare costs. The research network coordinating this project includes hospitals, urgent care centers, and outpatient clinics within Carolinas Healthcare System that share a common electronic medical record and billing system allowing for rapid collection of clinical and demographic data.

Infection-related glomerulonephritis: understanding mechanisms.

The epidemiology of infection-related glomerulonephritis is undergoing striking changes, particularly in developed countries. The incidence of acute poststreptococcal glomerulonephritis (PSAGN) is decreasing because of the successful treatment of streptococcal infections. In contrast, because of the emergence of antibiotic-resistant staphylococcus strains, such as methicillin-resistant Staphylococcus aureus (MRSA), the incidence of Staphylococcus aureus infection-associated glomerulonephritis (SAAGN) is on the rise.

Isometric muscle strength in youth assessed by hand-held dynamometry: a feasibility, reliability, and validity study.

Purpose: To determine, with respect to measurement of maximal isometric torque (MIT) using a specific hand-held dynamometer (HHD) protocol, (1) protocol feasibility over a wide age range, (2) intra- and interrater reliability, (3) standard error of measurement, and (4) concurrent validity.

Methods: The MIT of selected upper and lower limb muscle groups was assessed (n = 74; age = 4-17.5 years) using a standardized, HHD protocol.

Relapse or worsening of nephrotic syndrome in idiopathic membranous nephropathy can occur even though the glomerular immune deposits have been eradicated.

Background: Relapse or worsening of nephrotic syndrome (NS) in idiopathic membranous nephropathy (IMN) is generally assumed to be due to recurrent disease. Here we document that often that may not be the case.

Subjects And Methods: This is a prospective study of 7 consecutive IMN patients whose renal status improved, then worsened after completing a course of immunosuppressive therapy.

Vitamin D levels in Chinese patients with systemic lupus erythematosus: relationship with disease activity, vascular risk factors and atherosclerosis.

Objectives: To study the relationship of 25(OH)D(3) level with disease activity, vascular risk factors and atherosclerosis in SLE.

Methods: Consecutive patients who fulfilled four or more ACR criteria for SLE were recruited for assay of 25(OH)D(3) level. Disease activity was assessed by the SLEDAI and physicians' global assessment (PGA).

Introduction to forensic nursing: a student's work: female genital mutilation.

This article was written by a student interested in female genital mutilation as part of a school project. The article reviews exactly what female genital mutilation entails, its history, and the role of the forensic and critical-care nurse.

A prospective population-based study of differences in elder self-neglect and mortality between black and white older adults.

Background: Self-neglect is the behavior of an elderly person that threatens his or her own health and safety, and it is associated with increased morbidity and mortality. Although report of self-neglect is more common among black older adults, the racial/ethnic differences in mortality remain unclear.

Methods: The Chicago Healthy Aging Project is a population-based cohort study conducted from 1993 to 2005.

An approach to validating criteria for proteinuric flare in systemic lupus erythematosus glomerulonephritis.

Objective: Published criteria on the degree of proteinuria increase that defines a proteinuric flare in systemic lupus erythematosus (SLE) with glomerulonephritis (GN) vary widely, likely because they are not evidence based, but are largely based on expert opinion. Ideally, the threshold for proteinuric flare should be set sufficiently high that spontaneous variation in proteinuria does not likely explain the increase, but not so high that the patient needlessly experiences prolonged severe proteinuria before a flare is declared and therapy is increased. The present study was undertaken to develop an evidence-based approach to setting the threshold for proteinuric flare, based on quantifying the spontaneous variation in the urine protein:creatinine ratio in SLE GN patients who are not experiencing SLE flare.

Warfarin-related nephropathy occurs in patients with and without chronic kidney disease and is associated with an increased mortality rate.

An acute increase in the international normalized ratio (INR; a comparison of prothrombin time to monitor the effects of warfarin) over 3 in patients with chronic kidney disease (CKD) is often associated with an unexplained acute increase in serum creatinine (SC) and an accelerated progression of CKD. Kidney biopsy in a subset of these patients showed obstruction of the renal tubule by red blood cell casts, and this appears to be the dominant mechanism of the acute kidney injury. We termed this warfarin-related nephropathy (WRN), and previously reported cases of WRN only in patients with CKD.

Genome sequence of Taylorella equigenitalis MCE9, the causative agent of contagious equine metritis.

Taylorella equigenitalis is the causative agent of contagious equine metritis (CEM), a sexually transmitted infection of horses. We herein report the genome sequence of T. equigenitalis strain MCE9, isolated in 2005 from the urethral fossa of a 4-year-old stallion in France.

Trends in the incidence and prevalence of Alzheimer's disease, dementia, and cognitive impairment in the United States.

Declines in heart disease and stroke mortality rates are conventionally attributed to reductions in cigarette smoking, recognition and treatment of hypertension and diabetes, effective medications to improve serum lipid levels and to reduce clot formation, and general lifestyle improvements. Recent evidence implicates these and other cerebrovascular factors in the development of a substantial proportion of dementia cases. Analyses were undertaken to determine whether corresponding declines in age-specific prevalence and incidence rates for dementia and cognitive impairment have occurred in recent years.

Sources of variability in estimates of the prevalence of Alzheimer's disease in the United States.

Background: The prevalence of Alzheimer's disease (AD) in the United States was estimated at 2.3 million in 2002 by the Aging, Demographics, and Memory Study (ADAMS), which is almost 50% less than the estimate of 4.5 million in 2000 derived from the Chicago Health and Aging Project.

National estimates of the prevalence of Alzheimer's disease in the United States.

Several methods of estimating prevalence of dementia are presented in this article. For both Brookmeyer and the Chicago Health and Aging project (CHAP), the estimates of prevalence are derived statistically, forward calculating from incidence and survival figures. The choice of incidence rates on which to build the estimates may be critical.

MRI of tibialis anterior skeletal muscle in myotonic dystrophy type 1.

Objective: The aim of this study was to evaluate whether magnetic resonance imaging (MRI) can be used as a noninvasive approach to assessment of disease severity and muscle damage in Myotonic Dystrophy type 1 (DM1).

Methods: The MRI findings in legs of 41 patients with DM1 were evaluated with respect to the tibialis anterior (TA) skeletal muscle impairment. Magnetic resonance imaging findings were compared with TA strength measurements obtained by quantitative manual testing, duration of the disease and with the length of the CTG repeats.

Malnutrition-inflammation modifies the relationship of cholesterol with cardiovascular disease.

In moderate and severe CKD, the association of cholesterol with subsequent cardiovascular disease (CVD) is weak. We examined whether malnutrition or inflammation (M-I) modifies the risk relationship between cholesterol levels and CVD events in African Americans with hypertensive CKD and a GFR between 20 and 65 ml/min per 1.73 m².

Intensive blood-pressure control in hypertensive chronic kidney disease.

Background: In observational studies, the relationship between blood pressure and end-stage renal disease (ESRD) is direct and progressive. The burden of hypertension-related chronic kidney disease and ESRD is especially high among black patients. Yet few trials have tested whether intensive blood-pressure control retards the progression of chronic kidney disease among black patients.

Cognitive activity and the cognitive morbidity of Alzheimer disease.

Objective: To test the hypothesis that frequent cognitive activity predicts slower cognitive decline before dementia onset in Alzheimer disease (AD) and faster decline thereafter.

Methods: As part of a longitudinal cohort study, older residents of a geographically defined population were assessed at 3-year intervals with brief cognitive performance tests from which a composite measure of global cognition was derived. After each wave of testing, a subset was sampled for clinical evaluation.

Change in risk of Alzheimer disease over time.

Objective: To assess whether the risk of incidence of Alzheimer disease (AD) varies over time. The increase in numbers of people at the oldest ages in the population will bring an increase in the number of people with AD. Projections of the size of the increase assume the risk of AD is constant.

Relationship between body mass index and proteinuria in hypertensive nephrosclerosis: results from the African American Study of Kidney Disease and Hypertension (AASK) cohort.

Background: Few studies have examined the association between obesity and markers of kidney injury in a chronic kidney disease population. We hypothesized that obesity is independently associated with proteinuria, a marker of chronic kidney disease progression.

Study Design: Observational cross-sectional analysis.

Oral cyclophosphamide is on the verge of extinction as therapy for severe autoimmune diseases (especially lupus): should nephrologists care?

Some day we will have powerful targeted therapies for autoimmune diseases. Remission will be induced efficiently. Side effects will be mere ripples.