Striking rural-urban disparities observed in acute stroke care capacity and services in the pacific northwest: implications and recommendations.

Background And Purpose: The age-adjusted stroke death rate in adults aged ≥45 years is significantly higher in the Northwest region than in the rest of the United States. Alaska, Idaho, Montana, Oregon, and Washington have substantial rural and frontier areas with unique characteristics and complexities that pose challenges to timely acute stroke care and ultimately affect the patient.

Methods: A regional needs assessment was conducted to assess acute stroke care capacity and services in the Northwest region.

Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes.

Objective: The purpose of this study was to investigate the effect of periodontitis on development of overt nephropathy, defined as macroalbuminuria, and end-stage renal disease (ESRD) in type 2 diabetes.

Research Design And Methods: Individuals residing in the Gila River Indian Community aged > or =25 years with type 2 diabetes, one or more periodontal examination, estimated glomerular filtration rate > or =60 ml/min per 1.73 m(2), and no macroalbuminuria (urinary albumin-to-creatinine ratio > or =300 mg/g) were identified.