Difelikefalin in Black/African American Hemodialysis Patients with Moderate-to-Severe Pruritus: Post hoc Analysis of KALM-1 and KALM-2.

Introduction: Black and African American (AA) people are over-represented in the kidney failure population; therefore, the safety and efficacy of difelikefalin in Black/AA patients was evaluated.

Methods: This was a post hoc, pooled exploratory subgroup analysis of the Phase 3 KALM-1 and -2 studies. Patients undergoing hemodialysis (HD) who had moderate-to-severe chronic kidney disease-associated pruritus (CKD-aP) at enrollment were stratified into self-reported Black/AA or White subgroups.

New Insights Into Dietary Approaches to Potassium Management in Chronic Kidney Disease.

Potassium disorders are one of the most common electrolyte abnormalities in patients with chronic kidney disease (CKD), contributing to poor clinical outcomes. Maintaining serum potassium levels within the physiologically normal range is critically important in these patients. Dietary potassium restriction has long been considered a core strategy for the management of chronic hyperkalemia in patients with CKD.

Can Novel Potassium Binders Liberate People with Chronic Kidney Disease from the Low-Potassium Diet? A Cautionary Tale.

The advent of new potassium binders provides an important breakthrough in the chronic management of hyperkalemia for people with CKD. In addition to the direct benefits of managing hyperkalemia, many researchers and clinicians view these new medications as a possible means to safely transition patients away from the low-potassium diet to a more healthful eating pattern. In this review, we examine the mechanisms of potassium binders in the context of hyperkalemia risk related to dietary potassium intake in people with CKD.

Risk factors for delayed colonic post-polypectomy bleeding: a systematic review and meta-analysis.

Purpose: Delayed post-polypectomy bleeding (PPB) is an infrequent but serious adverse event after colonoscopic polypectomy. Several studies have tried to identify risk factors for delayed PPB, with inconsistent results. This meta-analysis aims to identify significant risk factors for delayed PPB.

Fixation strength comparison of onlay and inset patellar implants.

Patellar implant fixation continues to be one of the most troublesome areas in total knee arthroplasty (TKA). It has been reported that patellofemoral complications in TKA are responsible for almost half of all re-operations. The literature review revealed the rate of primary all-polyethylene patellar implant loosening ranging 1%-4.

Antidepressant pharmacotherapy: considerations for the pain clinician.

Antidepressant pharmacotherapy presents many challenges to clinicians dealing with patients suffering from chronic pain. Co-existent depression and pain continues to present clinicians with a plethora of difficult treatment selections. Treated in isolation, each of these disease states can prove difficult to treat.

Integrating theories of the etiology of Crohn's disease. On the etiology of Crohn's disease: questioning the hypotheses.

The most prominent theory describes the Crohn's Syndrome as a dysregulated, inappropriate immune response to otherwise innocuous bowel flora in a genetically susceptible host. The autoimmune theory assumes that a specific infectious agent does not exist. Data from mouse models, impairment of the mucosal epithelial barrier and the influence of gut flora are used to support the autoimmune theory.

Cyclin-dependent kinase (cdk6) and p16 in pancreatic endocrine neoplasms.

Aims: p16 and p27, the inhibitors of cyclin-dependent kinases, have been reportedly decreased in certain human tumours, including a few endocrine tumours. The current study used immunocytochemical staining to compare the staining intensity of cdk6 and its inhibitor, p16, in pancreatic endocrine neoplasms with normal pancreatic islets.

Methods: Twenty-four primary pancreatic endocrine neoplasms, consisting of 12 insulinomas, one glucagomoma, three pancreatic polypeptide (PP)-omas, five gastgrinomas and three non-fuctioning tumours, were immunocytochemically studied for cdk6 and p16 compared with the adjacent non-neoplastic islets.

Clinician beliefs about opioid use and barriers in chronic nonmalignant pain.

A survey of the medical directors of multidisciplinary pain clinics and multidisciplinary pain centers listed in the American Pain Society Pain Facilities Directory was conducted to define those pain specialists' beliefs about the role of opioid analgesia in 14 types of chronic nonmalignant pain. Respondents also reported their perceptions of barriers to their prescribing opioids for chronic nonmalignant pain and what they perceived as barriers to opioid prescribing for chronic nonmalignant pain by other, non-pain specialist clinicians in their communities. The respondents are characterized by demographics, disciplines, specialties, and time in practice.

Amylin in pancreatic islets and pancreatic endocrine neoplasms.

Amylin is a chief constituent of the amyloid present in insulinomas, and is colocalized in beta islet cells. By immunocytochemical staining, all four islet cells including insulin, glucagon, somatostatin (SRIF) and pancreatic polypeptide (PP) cells were positively stained for amylin. The strongly insulin-positive cells corresponded with the strongly amylin-positive cells, and glucagon cells appeared to be strongly positive for amylin, whereas SRIF and PP cells were weakly positive for amylin.

What is the future potential for pediatric sports medicine? American and international pediatric sport perspectives.

Pediatricians are the primary care physicians for many children and adolescents that are actively participating in sports. Isn't it time that pediatric residency program directors strongly consider upgrading training levels in clinical sports medicine for their resident graduates?

Interstitial deletion of 20q in a patient with Waldenström macroglobulinemia following chemotherapy.

A 76-year-old male with a history of renal insufficiency was found to have anemia, an IgM kappa paraprotein on serum immunofixation studies, absence of lytic bone lesions, and findings in the bone marrow consistent with Waldenström macroglobulinemia (WM). Cytogenetic studies including fluorescence in situ hybridization (FISH) on the post-treatment bone marrow revealed the karyotype 46,XY,del(20)(q13.1q13.

Epidermolytic hyperkeratosis associated with melanocytic nevi: a report of 53 cases.

Epidermolytic hyperkeratosis (EH) is a unique histopathologic alteration of the skin characterized by hyperkeratosis with perinuclear vacuolization of keratinocytes primarily in the stratum granulosum and the stratum malpighii. It is seen as an incidental finding in a variety of conditions, benign and malignant, as well as sporadic and familial. Recently, it has been reported that EH may be associated with dysplastic nevi (nevus with architectural disorder [NAD]).

Recognizing and dealing with impaired clinicians: Part II--Treatment options.

Medical licensing boards and clinical societies encourage (and most boards require) physicians to report colleagues reasonably suspected of not practicing safely and competently. Failure to report unsafe, incompetent, or illegally acting clinicians can seriously damage patients, the profession, and the doctor himself/herself. Good-faith reporting is generally protected from lawsuit.

Gout, bradycardia, and hypercholesterolemia after renal transplantation.

Approximately 17,000 solid organ transplantations are done annually in the United States. Increasingly, care of these patients will be provided by primary care physicians. In this report, we illustrate the complexity of common medical problems in a patient who had cellulitis and who had had a cadaveric renal transplantation 10 years earlier.

Antagonism of central vasopressin receptors blocks hypoglycemic stress induced inhibition of luteinizing hormone release in male rhesus macaques.

The first objective of this study was to investigate whether the inhibitory effect of insulin-induced hypoglycemia (IIH) on luteinizing hormone (LH) secretion was the same in unrestrained adult male rhesus macaques as has been previously reported in restrained female macaques. Since IIH did inhibit pulsatile LH secretion in adult male macaques, and some previous studies have implicated arginine vasopressin (AVP) as a central mediator of this inhibition, the second objective was to investigate whether antagonism of AVP action could reverse the IIH-induced inhibition of LH release in males. Ten adult male rhesus macaques (Macaca mulatta) were studied during 15-h periods (07.

A report of the treatment of coronary artery aneurysm without cardiopulmonary bypass.

Coronary artery aneurysm (CAA) is a fairly rare pathologic entity whose exact incidence is unknown but has been reported from 1.4% in autopsy series [Daoud, 1963] to 4.9% in the Coronary Artery Surgery Registry [Swaye, 1984].

Popliteal pseudoaneurysm following total knee arthroplasty.

Arterial injuries complicating total knee arthroplasty are rare but may result in significant morbidity. There are three reports of popliteal artery pseudoaneurysm resulting from arterial trauma during total knee replacement. We report a case of a popliteal pseudoaneurysm with rupture into the surrounding muscle, its evaluation, and successful repair 5 months after arthroplasty.

Thoracic splenosis.

Thoracic splenosis is a rare pathologic entity resulting from seeding of splenic tissue in the pleural cavity after thoracoabdominal trauma. A 45-year-old man with a history of splenectomy secondary to abdominal trauma presented with a left lung mass and an inconclusive tissue diagnosis after needle biopsy. Thoracic splenosis was not suspected preoperatively, considered on an intraoperative frozen section, and established on permanent pathologic biopsy specimens obtained during thoracotomy.