UROLITHIASIS afflicts 7%-13% of the population and has a recurrence rate of up to 50% at five years. In the United States, the economic burden of treatment and lost productivity was estimated at $2.1 billion in 2001. Stone size and location determined from non-contrast CT and plain radiographs have long been used to triage patients for either shock wave lithotripsy (SWL) or endoscopic management.

Nephrologists and dietitians spend a significant amount of their time managing hyperphosphatemia. Phosphorus retention, which occurs in moderate to advanced CKD, is thought to contribute to secondary hyperparathyroidism and excessive vascular calcification. Diet counseling to reduce phosphorus intake is usually the first step in management. In most cases, however, the physician feels compelled to prescribe a so-called “phosphorus binder” to reduce GI absorption of phosphorus in the food.

Clinicians in virtually every medical and surgical specialty would have little trouble citing services for which they considered third-party reimbursement woefully inadequate for the time involved. Medicare reductions in payments for commonly performed procedures have forced physicians to change their practices so that they can pay for ever-increasing office expenses and still make a decent living.

The placebo is an integral part of clinical research, helping investigators arrive at the true effect of an experimental treatment. The mechanisms underlying the placebo effect are not fully understood, but it is clear that if subjects believe they are taking something that could help them, they can experience improvement in signs and symptoms, even by objective measures.

The term “targeted therapy” has entered the oncologic lexicon over the past five years, with primary applications in medical and radiation oncology.

The characteristicsof hypertension in hemodialysis patients differ from those in the general population. In dialysis patients, accelerated age-related changes in vascular stiffness, combined with factors peculiar to uremia, contribute to a loss of large and small vessel distensibility.

THE PAST two decades have witnessed the introduction a dizzying array of minimally-invasive surgical alternatives to the gold standard treatments for BPH—transurethral resection of the prostate (TURP) and the open simple prostatectomy.

Go to a grand rounds or medical conference and listen. What do you hear? In most discussions of patient care, clinicians relate compelling anecdotes typically beginning with “I once had a patient who…” Fill in the blank.

The recent publication of the CHOIR and CREATE studies in the New England Journal of Medicine questioning hemoglobin targets in dialysis patients (see article on page 19) have resulted in intense scrutiny of the relationship between Amgen, dialysis organizations, and physicians in the management of anemia. Last month, the U.S. House Ways and Means Committee held hearings on the matter. What is all the fuss about?