DURING THE past five years, the da Vinci robot has increasingly been used to perform radical prostatectomies. This robotic technology has revolutionized prostate cancer surgery. Among other benefits, the robot enables the surgeon to perform the operation in three dimensions (3D). Assisting surgeons, however, have had to view the procedure in two dimensions (2D).

AS PATIENTS, physicians, dialysis providers, and payers search for more favorable outcomes in patients with end-stage renal disease (ESRD), alternative dialysis regimens have gained popularity. Among these therapies are dialysis treatments that are performed more frequently, for longer periods of time, and/or at the patient's home.

On September 11, 2007, an FDA panel of health experts declined to recommend the quasi-expected restrictions on the use of the erythropoietin stimulating agents (ESA) in CKD patients. For years, the three FDA-approved ESAs (Aranesp, Epogen, and Procrit) have been heavily prescribed for anemia without much concern about serious adverse effects.

While comparing summer "must read" lists, a friend suggested I pick up a copy of "Good to Great" (Jim Collins, Harper Collins 2001). My friend argued the premise of this book (that companies and indivi-duals who leap from "good to great" follow a consistent formula) has important implications in medicine.

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.