Hand Hygiene: How Can We Improve?

Lisa Maragakis, MD, reviews in her videoblog the serious challenges of measuring and improving hand hygiene compliance in the healthcare setting.
Medscape Infectious Diseases

New study contradicts suggestions of an 'epidemic' of primary hyperaldosteronism

New study contradicts suggestions of an 'epidemic' of primary hyperaldosteronism

Nature Clinical Practice Nephrology 4, 465 (2008). doi:10.1038/ncpneph0883

Guidelines on Management of Primary Aldosteronism Issued

The Endocrine Society clinical practice guideline reviews case detection, diagnosis, and treatment of patients with primary aldosteronism.
Medscape Medical News

Age-related Blood Pressure Patterns and Blood Pressure Variability among Hemodialysis Patients

Background and objectives: Despite the high prevalence of cardiovascular disease among hemodialysis patients, the relationship between age and blood pressure (BP) is not well understood. It was postulated that the relationship of BP to age differs among hemodialysis patients versus the general population and that there is significant variability in dialysis unit BP measurements.

Design, setting, participants, & measurements: To explore this hypothesis, the patterns of systolic, diastolic, mean arterial, and pulse pressures in the general population using data from National Health and Nutrition Examination Survey participants (n = 9242) were compared with those in a cohort of hemodialysis patients (n = 9849).

Results: In contrast to the increase in systolic BP with age in the general population, systolic BP was elevated in young hemodialysis patients and declined slightly among the elderly. The inverted "U"-shape relationship between age and diastolic BP in the general population was absent in hemodialysis patients. Diastolic BP was elevated among hemodialysis patients <50 yr of age and declined with advancing age. Mean arterial and pulse pressures were elevated among young hemodialysis patients and exhibited less age dependency than in the general population. Variability in BP within patients was similar to that between patients.

Conclusions: The relationship of BP to age differed from that in the general population. The variability in dialysis unit BP measurements may limit their use in managing hypertension and predicting outcomes. Nevertheless, dialysis unit BP measurements are necessary to minimize acute complications during the dialysis procedure.

Cortinarius mushroom induced kidney failure in the news - Horse Whisperer author Nicholas Evans being the latest victim

This is London: The best-selling author of The Horse Whisperer faces a 'long haul' of kidney dialysis after eating highly-toxic mushrooms. Nicholas Evans, whose book was turned into a film starring Robert Redford, picked them while walking in woodland with his family. The millionaire author was taken to hospital where he was given dialysis to combat the effects of the rare Cortinarius Speciosissimus mushrooms, which can cause kidney failure.