Positive Predictive Value of a Single Assessment of Estimated GFR in the Diagnosis of Chronic Kidney Disease.

Objectives: The positive predictive value (PPV) of a single assessment of estimated glomerular filtration rate (eGFR) in the diagnosis of chronic kidney disease (CKD) is not known. Our objective was to determine the PPV of a single assessment of eGFR among adults with at least one eGFR <60 mL/min in their lifetime, using the Distributed Area Research and Therapeutics Network CKD natural history dataset.

Methods: In all, 47,104 adults who were cared for by 113 practices in the United States were included.

Inaccuracy of ICD-9 Codes for Chronic Kidney Disease: A Study from Two Practice-based Research Networks (PBRNs).

Background: Inaccurate use of International Classification of Diseases, Ninth Revision (ICD-9), codes obfuscates registries used for research, resulting in unreliable data and inaccurate measurement of outcomes, and it may contribute to mismanagement of patients. Thus it is important to understand the prevalence of ICD-9 code misuse. We chose chronic kidney disease (CKD) as a condition of interest after several patients recruited for a previous study indicated they did not have the disease, despite the presence of the ICD-9 code (585.

Reflective impressions of a precepted clinical experience caring for people with disabilities.

There is evidence that early and frequent encounters with people with disabilities can improve medical students' knowledge, skills, and attitudes about disability. As part of a 4-year integrated curriculum in caring for patients with disabilities, third-year medical students (n = 144) in a Family Medicine clerkship participated in a day-long precepted clinical experience at a medical facility serving people with disabilities, predominantly developmental disabilities, where they met patients and worked with clinicians. At the conclusion of the program, students completed a reflective survey about their experience.

Attitudes of healthcare students and professionals toward patients with physical disability: a systematic review.

Objective: Negative healthcare provider attitudes toward patients with physical disabilities may challenge the delivery of quality care to patients. The objective of this study was to systematically review published studies examining the attitudes of healthcare students and professionals toward patients with physical disabilities.

Design: In October 2011, we searched four electronic databases using the OVID platform.

Utility of pre-operative serum CA-125 in the management of uterine papillary serous carcinoma.

Objective: To evaluate the usefulness of pre-operative serum CA-125 in the management of women diagnosed with uterine papillary serous carcinoma (UPSC). We hypothesized that elevated pre-operative levels of serum CA-125 correlate with higher disease stage and poorer prognosis.

Methods: Patients diagnosed with UPSC and managed in our institution were identified over a period of 10 years, 1995 to 2005.

Resident performance on the in-training and board examinations in obstetrics and gynecology: implications for the ACGME Outcome Project.

Background: The Accreditation Council on Graduate Medical Education (ACGME) Outcomes Project has endorsed the in-training examination (ITE) as an example of a multiple-choice question examination that is a valid measure of a resident's attainment of medical knowledge. An outcome measure for performance on the ITE would be the subsequent performance on the board certification examination. However, there are few reports that attempt to correlate a resident's performance on the ITE to subsequent performance on the board certification examination.

An unusual presentation of endometrial cancer: a case report and literature review.

Background: The purpose of this case report is to describe the failure of standard diagnostic work up in the presence of an advanced stage endometrial cancer and briefly review the literature about the efficacy of the currently utilized diagnostic tools in the evaluation of women with postmenopausal bleeding (PMB).

Case: A 71-year-old normal weight lady presented with an unprovoked PMB. Initial evaluation consisted of pelvic ultrasound followed by office hysteroscopy and directed endometrial biopsy.

Young patients with endometrial carcinoma selected for conservative treatment: a need for vigilance for synchronous ovarian carcinomas, case report and literature review.

Background: The aim of this paper is to report a case of synchronous ovarian malignancy in a very young patient with early endometrial cancer who desired fertility-sparing management.

Case: Twenty one-year-old patient presented with an apparent early stage endometrial cancer and desiring conservative management. After failure of conservative management for 3 years, surgery was performed.

Central fetal monitoring: effect on perinatal outcomes and cesarean section rate.

Background: In a trend similar to continuous electronic fetal monitoring, many hospitals are incorporating central fetal monitoring into labor and delivery suites. The objective of this study was to investigate whether the use of central fetal monitoring had an effect on neonatal outcomes or cesarean section rate.

Methods: This retrospective study involved patient data from deliveries occurring at Women and Children's Hospital of Buffalo, Buffalo, New York, between the years 2000 and 2003.

Resident selection process and prediction of clinical performance in an obstetrics and gynecology program.

Background: To date, there is no published data showing a correlation between the National Residency Matching Program Ranklist position and performance in residency.

Purpose: The background was to assess whether a residency applicant selection process is able to predict the subsequent performance of candidates during residency.

Methods: Over a period of 3 academic years, resident candidates were invited to a structured interview process.

Is there gender bias toward male residents in an obstetrics and gynecology training program?

Objective: To assess whether male obstetric and gynecologic residents experience gender bias in training for vaginal deliveries.

Study Design: We compared male and female resident training experiences in vaginal deliveries in a community hospital. Three analyses were performed: (1) total number of deliveries performed by male and female residents, (2) percentage of deliveries that male and female residents performed with female attendings, and (3) percentage of attending deliveries performed by male residents.

Mastalgia: a review of management.

Mastalgia affects up to two-thirds of women at some time during their reproductive lives. It is usually benign, but thefear of underlying breast cancer is why many women present for evaluation. Mastalgia can be associated with premenstrual syndrome, fibrocystic breast disease, psychologic disturbance and, rarely, breast cancer.

Primary primitive neuroectodermal tumor of the uterus: a report of two cases and review of the literature.

Background: Primary primitive neuroectodermal (pPNET) tumors rarely occur in adults, and they very rarely present as primary tumors of the uterus. Only 12 reported cases of pPNET of the uterus have been published in the English literature. We report two additional cases treated at the Roswell Park Cancer Institute, Buffalo, NY, between 1999 and 2002.