Association of metabolic acidosis with bovine milk-based human milk fortifiers.

Objective: To compare the incidence of metabolic acidosis and feeding intolerance associated with powdered or acidified liquid human milk fortifier (HMF).

Study Design: This retrospective study evaluated infants ⩽ 32 weeks gestational age or ⩽ 1500 g birth weight who received human milk with either powdered or acidified liquid HMF (50 consecutively born infants per group). Primary outcomes tracked were metabolic acidosis (base excess less than -4 mmol l(-1) or bicarbonate less than 18 mmol l(-1)), feeding intolerance (gastric residual > 50% feed volume, > 3 loose stools or emesis per day, abdominal tenderness or distention), necrotizing enterocolitis, late-onset infection, death, length of hospital stay and ability to remain on HMF.

Early clinical complications after ABO-incompatible live-donor kidney transplantation: a national study of Medicare-insured recipients.

Background: Descriptions of the sequelae of ABO-incompatible (ABOi) kidney transplantation are limited to single-center reports, which may lack power to detect important effects.

Methods: We examined U.S.

The methotrexate polyglutamate assay supports the efficacy of methotrexate for severe inflammatory skin disease in children.

Background: The methotrexate (MTX) polyglutamate assay has been validated in adults with arthritis.

Objective: We sought to assess clinical response rates and the value of the methotrexate polyglutamate assay in MTX-treated children with inflammatory skin diseases.

Methods: In this retrospective review, 46 MTX-treated children with a diagnosis of atopic dermatitis, psoriasis, or psoriasis-eczema overlap were serially assessed with the methotrexate polyglutamate assay.

Consistency of racial variation in medical outcomes among publicly and privately insured living kidney donors.

Background: Racial disparities in health outcomes after living donation have been reported, but generalizability is not known.

Methods: We linked Organ Procurement and Transplantation Network (OPTN) registry data for 4,007 living kidney donors in 1987 to 2008 with Medicare billing claims (2000-2008). Cox regression with left and right censoring was used to estimate the frequencies and relative risks of postdonation medical diagnoses according to race.

Racial differences in beliefs of physician prescribing practices for low-cost pharmacy options.

Background: Previous studies have reported that certain populations are sensitive to high out-of-pocket drug costs, and drug noncompliance leads to poorer health outcomes.

Objective: Our aim was to measure patient awareness of discount pharmacy options, cost barriers to medication access, and beliefs about health care provider's use of low-cost medications.

Methods: This cross-sectional 17-item survey was administered to patients in the emergency department of an urban trauma center in February 2011.

The implications of acute rejection and reduced allograft function on health care expenditures in contemporary US kidney transplantation.

Background: The economic ramifications of acute rejection (AR) are not well characterized in a contemporary population of kidney transplant recipients.

Methods: Data for Medicare-insured transplant recipients in 2000 to 2007 (n=45,250) were drawn from the United States Renal Data System. AR events were ascertained from the Organ Procurement and Transplantation Network reports covering months 0 to 12 (yr1), 13 to 24 (yr2), and 25 to 36 (yr3) after transplantation.

The implications of acute rejection for allograft survival in contemporary U.S. kidney transplantation.

Background: We examined the frequency and clinical impact of acute rejection (AR) in contemporary U.S. kidney transplantation.

Depression diagnoses after living kidney donation: linking U.S. Registry data and administrative claims.

Background: Limited data exist on correlates of psychological outcomes after kidney donation.

Methods: We used a database integrating Organ Procurement and Transplantation Network registrations for 4650 living kidney donors from 1987 to 2007 with administrative data of a U.S.

Use of 12-month renal function and baseline clinical factors to predict long-term graft survival: application to BENEFIT and BENEFIT-EXT trials.

Background: Innovation in renal transplant management would benefit from identification of early markers that accurately predict long-term graft survival.

Methods: Data from the United States Renal Data System for kidney transplant recipients (1995-2004) were analyzed to develop prediction models for all-cause graft survival based on estimated glomerular filtration rate (eGFR), the presence or absence of acute rejection within 1 year, and recipient and donor demographic characteristics. The prediction models were applied to participants in the Belatacept Evaluation of Nephroprotection and Efficacy as First-line Immunosuppression Trial and Belatacept Evaluation of Nephroprotection and Efficacy as First-line Immunosuppression Trial--EXTended criteria donors trials comparing belatacept with cyclosporine in standard criteria donor (SCD) and expanded criteria donor (ECD) graft recipients, respectively, as an external validation of the model predictions in a diverse population.

The economic impact of addressing the organ shortage with clinically high-risk allografts.

Expanding gaps between the number of patients awaiting transplantation and the number who receive organs in the United States has been associated with heightened disease severity among transplant candidates and more common use of organs from non-standard donors. We summarize data on the economic consequences of liver and renal allograft quality in contemporary practice. Policy makers and providers must work together to ensure that financial disincentives do not lead to wastage of lifesaving organs.

Agreement of immunosuppression regimens described in Medicare pharmacy claims with the Organ Procurement and Transplantation Network survey.

The Organ Procurement and Transplantation Network (OPTN) collects intermittent survey data on immunosuppressive medication use that are studied frequently as research measures. Pharmacy billing claims may provide an accurate measure of immunosuppression use over time. Herein is characterized the agreement of Medicare pharmacy claims for immunosuppressive medications with OPTN reports.

Associations of serologic markers of infection and inflammation with vascular disease events and mortality in American dialysis patients.

Background: Inflammatory markers predict cardiovascular risk and mortality in endstage renal disease. The relationship of chronic infections to inflammation and vascular disease events has not been reported among American dialysis patients.

Methods: We performed a cross-sectional and prospective study of a multiracial cohort of 97 chronic hemodialysis patients in California.

Do on-site patient satisfaction surveys bias results?

Background: Response rates, patient sample characteristics, and patient satisfaction ratings were compared between two surveying methods: (1) surveys completed at the physician office site (on-site surveying), and (2) surveys mailed to patient homes following the encounter (mail-out/mail-back).

Methods: Surveying was completed at three physician practices within a 214-physician medical practice. Patients with physician appointments during four-hour time blocks were randomly split to receive either on-site or mail-based satisfaction surveys.

Incidence and predictors of myocardial infarction after kidney transplantation.

The risk and predictors of post-kidney transplantation myocardial infarction (PTMI) are not well described. Registry data collected by the United States Renal Data System were used to investigate retrospectively PTMI among adult first renal allograft recipients who received a transplant in 1995 to 2000 and had Medicare as the primary payer. PTMI events were ascertained from billing and death records, and participants were followed for up to 3 yr after transplant or until the end of observation (December 31, 2000).