Publications

The population epidemiology of AKI is not well described. Here, we analyzed data from the Nationwide Inpatient Sample, a nationally representative dataset, to identify cases of dialysis-requiring AKI using validated International Classification of Diseases, Ninth Revision (ICD-9) codes. From 2000 to 2009, the incidence of dialysis-requiring AKI increased from 222 to 533 cases per million person-years, averaging a 10% increase per year (incidence rate ratio=1.10, 95% CI=1.10-1.11 per year). Older age, male sex, and black race associated with higher incidence of dialysis-requiring AKI. The rapid increase in incidence was evident in all age, sex, and race subgroups examined. Temporal changes in the population distribution of age, race, and sex as well as trends of sepsis, acute heart failure, and receipt of cardiac catheterization and mechanical ventilation accounted for about one third of the observed increase in dialysis-requiring AKI among hospitalized patients. The total number of deaths associated with dialysis-requiring AKI rose from 18,000 in 2000 to nearly 39,000 in 2009. In conclusion, the incidence of dialysis-requiring AKI increased rapidly in all patient subgroups in the past decade in the United States, and the number of deaths associated with dialysis-requiring AKI more than doubled.

Trichomonas vaginalis is a parasite of the urogenital tract in men and women, with a worldwide presence and significant implications for global public health. T. vaginalis research entered the age of genomics with the publication of the first genome sequence in 2007, but subsequent utilization of other 'omics' technologies and methods has been slow. Here, we review some of the tools and approaches available to interrogate T. vaginalis biology, with an emphasis on recent advances and current limitations, and draw attention to areas where further efforts are needed to examine effectively the complex and intriguing biology of the parasite.

BACKGROUND

When used within 5 days of unprotected sex, emergency contraception (EC) can reduce the risk of pregnancy. Our objective was to explore how often women seeking clinic-based pregnancy testing who do not desire pregnancy might benefit from EC and examine variables associated with patients asking for EC when use is indicated.

STUDY DESIGN

Women seeking pregnancy testing or EC from an inner-city Title-X-funded family planning clinic between January 2011 and June 2012 were invited to complete surveys.

RESULTS

Twenty-seven percent (n=79) of respondents were seeking EC, and 73% (n=215) were seeking pregnancy testing. Of those seeking pregnancy testing, 39% might have benefited from same-day use of EC pills. Women who had never used EC and who had more than one episode of unprotected sex within the past month were less likely to request EC when use was indicated, while single women were more likely to request EC.

CONCLUSIONS

Counseling regarding EC options is particularly important for women seeking same-day pregnancy testing who do not desire pregnancy.

The emergence of new oral anticoagulants is a major development in cardiovascular medicine. In this overview, we sought to evaluate the impact of gender, heart failure, paroxysmal atrial fibrillation (AF) and diabetes on stroke prevention with warfarin and the new oral anticoagulants by conducting a semisystematic review and meta-analysis including 44,563 patients in recent contemporary Phase III trials. The new oral anticoagulants were superior to warfarin irrespective of gender or the presence of diabetes. For nonparoxysmal AF, event rates are similar with warfarin and new anticoagulants. There is some suggestion of the benefit of new oral anticoagulants in patients with paroxysmal AF. For patients without heart failure, the new drugs are superior, whereas in patients with evidence of heart failure the new drugs were similar to warfarin. In conclusion, new oral anticoagulants are better than warfarin irrespective of gender or the presence of diabetes mellitus. Patients with heart failure and nonparoxysmal AF seem not to gain additional prognostic benefit from new anticoagulants.