Design and baseline characteristics for the aminoguanidine Clinical Trial in Overt Type 2 Diabetic Nephropathy (ACTION II).

Advanced glycosylation endproduct (AGE) formation has been implicated in the development and progression of nephropathy in type 2 diabetes mellitus. In diabetic animals, aminoguanidine inhibits AGE-mediated cross-linking of proteins in vascular and renal tissue and slows the progression of renal disease. ACTION II is a randomized, double-blind, placebo-controlled trial comparing two dose levels of aminoguanidine with placebo on the progression of nephropathy in 599 type 2 diabetic patients with renal disease from 84 centers in the United States and Canada.

A peer review of a peer review organization.

Under Medicare, one of the federally required objectives of peer review organizations is to reduce inappropriate and unnecessary admissions. We reevaluated 32 admissions approved and 32 denied by the Arizona peer review organization, Health Services Advisory Group (HSAG), in a "blind" manner to determine whether practicing physicians in the community agree with the local peer review organization. Overall, physicians at the Scottsdale Memorial Hospital (SMH) approved 72% of HSAG-approved and denied 61% of HSAG-denied admissions.

Recognition and treatment of hypercholesterolemia in a family practice center.

Elevated levels of serum cholesterol are a major risk factor for coronary artery disease, yet few studies have investigated the extent to which practicing physicians recognize and treat their patients with hyperlipidemia. A retrospective chart review was performed on 93 patients who had documented cholesterol levels greater than or equal to 6.20 mmol/L (240 mg/dL) in an outpatient setting to determine the degree of recognition and treatment of hypercholesterolemia.

Digital subtraction angiography for localization of parathyroid lesions.

Transvenous digital subtraction angiography was used before surgery to evaluate seven patients with chemical evidence of hyperparathyroidism. Digital subtraction angiography identified parathyroid adenomas in six of the seven patients. This technique is a sensitive, although not specific, method to identify small vascular tumors.

Postoperative wound infections detected during hospitalization and after discharge in a community hospital.

Postoperative wound infections were evaluated in 1271 patients who had 1389 surgical procedures. There were 49 postoperative wound infections identified, of which 26 (53%) were discovered after discharge. Wound infections varied from 2.