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KIDNEY DISEASE

Who's at risk? Who knows?

Most Americans have no idea whether they're at risk for chronic kidney disease, according to a report of the National Kidney Foundation's Kidney Early Evaluation Program (KEEP). The report summarized health information for more than 37,000 people at risk for developing chronic kidney disease. Although half of the participants in the report had chronic kidney disease, only 2% were aware of it.

 

Why the huge gap? Part of the problem, says Allan Collins, MD, director of the KEEP Data Coordinating Center, is lack of information from patients' health care providers. Even though 90% of participants had visited their health care provider in the previous year for problems like diabetes and high blood pressure, these problems were not treated by the providers as risk factors for chronic kidney disease.

 

The good news is that many of the participants who were told they have kidney disease then followed up with their health care provider regarding high blood pressure checks, blood tests for anemia, urine tests, and other screening and monitoring methods.

 

CARDIAC ARREST

Kids may fare better than adults

Children are more likely than adults to survive in-hospital cardiac arrests, according to a recent study in the Journal of the American Medical Association.

 

Earlier studies showed that cardiac arrests from ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT) have better outcomes in all patients than those resulting from asystole or pulseless electrical activity. However, because VF and VT cardiac arrests were thought to be less common in children than in adults, it was believed that children had lower cardiac arrest survival rates in general.

 

The new study, which evaluated almost 37,000 cardiac arrests (900 in children) in 253 U.S. and Canadian hospitals between January 1, 2000, and March 30, 2004, shows that VF and VT cardiac arrests are more common in children than previously thought. The study also found that even though these "better prognosis" arrests are still not as common in children as in adults, children have improved survival rates overall because they're more likely than adults to survive asystole and pulseless electrical activity-type arrests as well.

 

NEWS FLASH

Are your salary and benefits in line with those of your colleagues? How much impact does your experience or specialty certification have on your earnings? Let us know in the 7th annual Nursing salary survey. Go to http://www.Nursing2006.com and scroll down to Nursing2006 Salary and Benefits Survey. Click on the link to be taken to the survey. Hurry-the deadline for responses is March 31, 2006!!

 

OVARIAN CANCER

A promising chemo combo

Intraperitoneal (I.P.) chemotherapy, a treatment in which chemotherapy drugs are administered directly into the abdominal cavity, may add up to 16 months to the lives of women with advanced cases of ovarian cancer when combined with traditional I.V. therapy, according to results of eight Phase III clinical trials. The results are so promising that the National Cancer Institute (NCI) has taken the extraordinary step of issuing a clinical announcement encouraging health care practitioners to follow ovarian cancer surgery with the combination chemotherapy treatment.

  
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I.P. chemotherapy is not new, but it has rarely been used as a first-line treatment for ovarian cancer. Although the combination chemotherapy approach has a higher level of toxicity, the results of eight clinical trials conducted over the past 20 years associate this technique with a 12-month increase in median overall survival, compared with that of I.V. therapy alone. (In all of the studies, chemotherapy was administered after primary surgery.) Results of the most recent study, published in the January 6, 2006, issue of the New England Journal of Medicine, were even more remarkable: The improvement in median overall survival was 15.9 months.

 

More information on combined I.V. and I.P. chemotherapy for ovarian cancer is available on the NCI Web site, http://ctep.cancer.gov/highlights/ovarian.html.