THE CONSEQUENCES of anabolic steroid use is a treatment reality for many clinicians, including urologists. Although anabolic steroid use among professional athletes gets the lion's share of attention in the media, many more casual competitors partake as well.

THE ABILITY to purchase organs from live donors could largely eliminate transplant waiting times and only modestly increase total transplantation costs, according to a newly published economic analysis.

SHOULD CHILDREN with disorders of sex development (DSD) —in which genitalia, chromosomes, or reproductive systems diverge from what is considered the norm for females or males—have reconstructive surgery before they are old enough to make their own decisions? Few questions in medicine evoke a more emotional and divided response. It is a question that may be asked more often than you might think.

Most physicians in this country provide patient care in busy private practice offices or non-teaching hospitals. Practicing physicians often try to adhere to relevant guidelines to optimize patient care and achieve better outcomes. The guidelines, however, are usually developed by certain groups of opinion leaders and experts who are mostly, if not exclusively, academicians from renowned universities or research centers.

Research developments that have implications for nephrology and urology certainly are not limited to the meetings and journals targeting these specialties. That is why our news coverage extends to meetings that nephrologists and urologists usually do not attend and journals they usually do not read.

Through millions of years of evolution, nature has created a fantastic array of plant and animal species, each with specific adaptations to survive. These adaptations have resulted in an incalculable number of organic compounds unique to each living thing.

Dr. U, 41, was a sole urologist in a small community in the Midwest. He'd been in private practice for only two years, but he felt quite positive about his professional prospects and his future—until he was sued.

When the emergency department nurses had difficulty passing a urethral catheter, Dr. S was the urologist on call. One such case led to a malpractice suit.

Dr. M, 56, was an old hand at the twists and turns of prostatic cancer. He'd been taught well by a urology professor who drawled, "It's just like huntin' swamp foxes. You never know what direction they're gonna turn next." Still, the professor's wisdom failed to shield Dr. M from a malpractice suit.

Laws that limit certain damage awards in malpractice cases are limiting insurance premiums, too.

A network of organizations that will collect and analyze data on medical errors and "near-misses" while protecting physician and patient confidentiality may be in place by the end of this year. Federal agencies are in the midst of finalizing regulations to create Patient Safety Organizations (PSOs), whose data would be protected from discovery by malpractice attorneys.

Current protocols can prevent many wrong-site surgeries if they are properly followed, a Pennsylvania watchdog agency reports.

The FDA has accepted a New Drug Application for silodosin, a novel alpha1-adrenoreceptor antagonist, from Watson Pharmaceuticals, Inc., of Corona, Calif. Watson is seeking approval of silodosin for the treatment of BPH symptoms.

The FDA announced that Baxter Healthcare Corporation, of Deerfield, Ill., has temporarily stopped manufacturing multiple-dose vials of heparin due to reports of severe allergic reactions and hypotension in patients who receive high "bolus" doses of the drug.

AMAG Pharmaceuticals, Inc., of Cambridge, Mass., has announced that the FDA has accepted for standard review its New Drug Application (NDA) for ferumoxytol as an IV treatment of iron deficiency anemia in CKD patients.

Renal transplant recipients have similar death-censored graft survival regardless of age, according to researchers in Norway.

Following an initial PSA test result of 3.0-19.99 ng/mL in men aged 50-70 years, a repeat PSA test within seven weeks allows for more accurate assessment as to whether a biopsy will reveal prostate cancer, a British team reports.

Ascorbate deficiency is common among peritoneal dialysis (PD) patients and can be identified readily with serum ascorbate measurements, researchers in Australia report.

AT PRESENT, almost one fourth of stage 5 CKD patients experience a life-threatening episode of hyperkalemia requiring emergency treatment, according to data cited in a recent article in Seminars in Dialysis (2007;20:431-439). The authors, Nirupama Putcha, MD, and Michael Allon, MD, note that although "many options have been proposed for the prevention of interdialytic hyperkalemia...prevention currently rests largely upon compliance with diet and a thoughtful use of medication regimens."

THE POSITIVE association between obesity and kidney disease (KD) is strongly supported by results of a recent meta-analysis by Wang et al (Kidney Int. 2008;73:19-33) that demonstrate a significantly increased risk for people with BMI greater than the normal range of 18.5-25 kg/m2. Along with CKD, the study also examined the occurrence of renal calculi and kidney cancer. According to the authors, 24.2% and 33.9% of KD cases among American men and women, respectively, could be prevented if overweight and obesity were eliminated.

RENAL HEALTH professionals recognize the detrimental effects of high sodium intake on BP control, congestive heart failure, and fluid balance in CKD patients.

It is a troubling time for investors, with both the economy and the stock market seemingly in a relentless decline. Many investors are fleeing the turmoil, moving to super-safe United States Treasury bonds. But Treasuries provide only modest returns. For better results, consider the following rock-solid investments that are suitable for even the most conservative investors.

WITH STOCKS tanking recently in places like India and Brazil, investors may be cautious about investing abroad. But many experts say that this is no time stay at home. In an era when markets are becoming increasingly global, investors should put at least 30% of their equity portfolios in foreign stocks.

AS MORTGAGE defaults increased last year, the markets took unnerving turns. Panicked investors raced to buy Treasuries and sell securities that seemed to present risks.

FOR NEPHROLOGY practices bringing a new physician on board and physicians searching for a practice, success ultimately is measured in terms of establishing a long-term relationship that meets the most critical needs of all involved and results in a seamless integration of new clinical staff.

When it comes to negotiating a physician agreement with a third-party payer, knowledge is power. There is a direct correlation between your level of success and how well-informed you are about payers' needs, their knowledge, and their bargaining strategies.

THE FIRST part of this article, which appeared in the August issue, discussed the benefits of the electronic health record, how to decide whether it is justified for a particular practice, and how to select and purchase a system. This second part provides guidance for installation and implementation.

ERECTILE dysfuction (ED), defined as the inability to reach or maintain an erection sufficient for satisfactory sexual performance, is age-related and an extremely prevalent medical condition. It is esti-mated to affect more than half of all men over the age of 60, and in the United States alone, ED will develop in more than 600,000 men aged 40-69 annually.1

PERITONITIS IS a frequent complication of continuous ambulatory peritoneal dialysis (CAPD) and the most common cause of CAPD failure. About 60% of patients receiving CAPD will have at least one episode of peritonitis during the first year of this mode of dialysis, according to Ram Gokal, MD, Consultant Nephrologist and Honorary Lecturer at the University of Manchester in the United Kingdom. CAPD peritonitis is associated with catheter loss, adhesions, increased protein loss, return to hemodialysis, and considerable morbidity.

MOST PATIENTS who have high BP have primary or essential hypertension, the cause of which is as yet unknown. About 5%-10% of adults with hypertension have an identifiable or "secondary" cause of their elevated BP. Although relatively rare, the diagnosis of secondary hypertension is important because, depending on the source, it may be possible to cure the underlying condition or tailor therapy as a means to achieving optimal BP control.