Jennifer R. Guthrie, MPAS, PA-C

• Assistant Professor
• Director of Experiential Education, Physician Assistant Program
• College of Pharmacy and Health Sciences, Butler University, Indianapolis, Indiana

https://www.schneckmed.org/find-a-provider/providers/jennifer-r-guthrie,-pa/

The authors conclude that diabetic skin buy dapagliflozin with american express, at least in their aspects of the process of platelet-mediated throm model blood sugar with gymnema generic dapagliflozin 5 mg visa, fibrin mesh deposition contributed more bosis in vessels diabetes mellitus sweet urine cheap dapagliflozin american express. Platelets do not adhere to undam to the pathogenesis of thrombotic occlusion of trau aged diabetes 88 reverse buy discount dapagliflozin 5mg, healthy intimal surfaces, but when the intima matized arteries than platelet aggregation. The is injured in any fashion, exposed collagen triggers incidence of hematomas in the animals treated platelet adhesion to the vessel surfaces. The feel that heparin does not improve patency in activated platelets have stimulated receptor sites to uncomplicated repairs and that the risk of bleeding which fibrinogen adheres, and fibrinogen then forms outweighs its potential benefit as an anticoagu proteinaceous bridges between platelets. The fibrin in turn promotes flaps can result in large clots around the small ves red clot and further strengthens the growing clot. This action was believed to be medi ment of platelets, which eventually reach a critical ated by the endothelial cyclooxygenase pathway mass that can cause thrombus formation by either with subsequent blockage of thromboxane A. Heparin has been trary to previous expectations, Restifo and col used for years as an anticoagulant. Heparin acts leagues59 found a clear increase in prostacyclin primarily to increase the action of antithrombin-3, production at the anastomosis; they speculated which inactivates thrombin. Heparin has also been that perhaps the rising levels of prostacyclin shown to decrease platelet adhesion51,52 and to ham stemmed from smooth muscle or fibroblasts in the per the conversion of fibrinogen to fibrin. The authors conclude prevented anastomotic occlusion for 72h after sur that the thrombogenic tendency of the anasto gery in the arterial inversion model. Stassen and coworkers80 report successful dissolution of tion of von Willebrand factor, a major contributor to platelet aggregation and adhesion to vessel wall arterial thrombosis with selective infusion of collagen. Because of reports of allergic reactions to dext showed profound inhibition of platelet function in ran,50 a test dose should be administered first. Dex humans after administration of murine monoclonal tran can also cause bleeding and subsequent vessel antibodies directed against human platelet glyco occlusion problems, similar to heparin. Lan and associates83 suggest another strategy for Proteolytic enzymes such as streptokinase and urokinase are being evaluated as lytic agents in salvage of thrombosed microvascular anastomoses. In duced by group C beta-hemolytic streptococci and the rat femoral vein model there was a high rate of urokinase is produced by human kidney cells. Davies84 surveyed the practice of anticoagula can convert plasminogen into plasmin, a highly spe cific fibrinolytic enzyme. On the basis ates70 report salvage of 6/7 thrombosed free flap of responses he received from 73 centers in 22 countries, Davies84 was able to document equal vessels by infusion of streptokinase or urokinase. A subflap hematoma developed postoperatively in success rates (89%) for free flaps performed with only 1 case. For limb replantation the overall success by human vascular endothelium and is responsible rate was lower with anticoagulation (76%) than with for activating plasminogen, the inactive precursor out anticoagulation (89%). Anticoagulation or fibrinolytic therapy may be Walkinshaw102 showed that proximal bowel seg indicated in clinical situations where mechani ments are more resistant to warm ischemia than cal or metabolic factors are not favorable and distal small bowel segments and suggested using cannot be improved. From a review of the literature, we have com Tissue Response to Ischemia and Hypoxia piled the following estimates of tissue tolerance to ischemia (Table 2): the transfer of tissues by microvascular anasto moses requires a period of tolerance to ischemia by the donor tissue. Irreversible dam muscle <2h 8h age to the microcirculation of skeletal muscle in bone <3h 24h man begins at around 6 hours. In contrast, connective tissue rich in Reperfusion Injury and the No-Reflow Effect fibroblasts, chondroblasts, or osteoblasts is relatively Success in the clinical setting often depends on resistant to prolonged hypoxia. Muscle and fat cells show a marked after their blood supply had been reestablished, increase in histologic changes with duration of cold and called this the no-reflow phenomenon. This hypothesis correlates well with clinical 24h and reported complete flap survival; in the rat, observations of excellent blood flow immediately maximum ischemia time was 6h at normal body following anastomosis that decreases shortly after temperatures and 48h if cooled. Takayanagi and Tsukie100 report survival of at denervated free epigastric flaps in the rabbit, which least the skin portion of a latissimus dorsi musculo closely approximates the clinical situation. Thus in a replanted Zdeblick and others104 studied the no-reflow limb certain areas will suffer more than others, and effect in replanted rat hind limbs. Predictors of no surgeons may choose to be more liberal with anti reflow were (a) an increased number of red blood coagulants when ischemia is prolonged. In the short cell aggregates 5min after replantation and (b) term anticoagulants serve to decrease inflamma changes in tissue pH persisting for >1h post tion associated with the clotting cascade and replantation. Clearance of H+ and lactate is associ potentially help salvage these watershed areas of significant but reversible ischemia. Suval oxygenase and block the effects of thromboxane and others106,107 showed that changes in microvas A, such as vasoconstriction and microvascular 2 thrombus formation. Douglas and associates112 cular permeability occur during reperfusion after 30min or 2h of ischemia. The first manifestations showed that ibuprofen-treated flaps survive longer of tissue damage in reperfusion injury are due to periods of ischemia. No fluorescein uptake that suggested reversal of throm bosis and vasoconstriction. Feng and colleagues113 reflow occurred in 30% of the muscle tissue regardless of ischemia time. Schmid-Schonbein,114 on the duced injury to cells and the role of oxygen free radicals in the reperfusion of ischemic tissue. This effect makes fasciotomies pru dent in most cases and mandatory in all but those microanastomoses in splenectomized rats with with the shortest ischemia times. The swelling may thrombocytosis versus rats with normal platelet also be evident in buried muscle flaps. The inflammatory response parallels ischemia In summary, the common denominator in failure time up until cell death begins to occur. When cell of microvascular anastomoses is endothelial disrup death is diffuse, such as after very long ischemia tion with exposure of subendothelial collagen containing surfaces to which platelets adhere. Areas of platelet aggregation reaches a certain mass, it will muscle that have slight ischemic damage will there trigger fibrin deposition that leads to vasospasm, fore generate few inflammatory mediators upon stenosis, and eventual thrombosis of the vessel. For instance, muscle flaps that are the blood flow rate through the anastomosis falls appropriately cooled or flaps that were reperfused below a critical level, the flap fails. When this hap in under 1h will generate much less inflammation pens in enough of the watershed areas, it can propa than muscle which was not cooled or that was gate to other potentially salvageable but neverthe exposed to longer ischemia times. Digital replantation was less suc sionally free flaps experience a slow, progressive, cessful (79. Unlike the operating ence with 10 patients in whom free flap failure was microscope, loupes are cost effective, portable, and not an all-or-none phenomenon. This was a retrospective review with an flaps can often be salvaged without resorting to other inherent bias, since at the time of flap transfer the free tissue transfer. Despite the presence of bias, the findings tomosis and the technique of anastomosis. Other support the use of loupe magnification for selected miscellaneous considerations influencing the out microsurgical cases in the hands of experienced come of free tissue transfer are the choice of donor microsurgeons. One of the most important complications were recorded in the two groups prerequisites for success in microsurgery is organi and shorter operating times in the loupe group. The operating room, staff, and equipment Microsurgical instruments should be few in num must be well prepared for microsurgery. Postoperative care is as important as all the steps that come before the recovery room. Germann, Bruner, and Pelzer117 offer concise and Number of Sutures useful principles for organization of and prepara the number of sutures used in the anastomosis is tion for microsurgery. Shenaq, Klebuc, and Vargo123 recount an 8-year experience with loupe between the number of sutures and the strength of magnification for free tissue transfer.

Contextualism about Race Contemporary race theory has endeavored to transcend the paradoxes of classical liberalism and to make explicit the implicit ideologies of race diabetic diet indian recipes purchase cheap dapagliflozin line. On the questions of 182 Racialized Identities and Racist Subjects the status of the category race and whether racial identity should be continued blood glucose for non diabetics buy dapagliflozin in united states online, this recent body of work falls roughly into three positions: (1) Nominalism (or eliminativism) diabetes insipidus in spanish purchase dapagliflozin 10 mg without a prescription. It is the bio logical meaning of racial concepts that have led to racism diabetes mellitus with ketoacidosis cheap generic dapagliflozin uk, but racial concepts are necessarily biological claims (as opposed to ethnic or cultural concepts, for ex ample). Therefore, the use of racial concepts should be avoided in order to be metaphysically accurate as well as to further an antiracist agenda. Members of racial groups share a set of characteristics, a set of political interests, and a historical destiny. The problem of racism has affected the content given to racial description rather than the method of racial description itself. Race is socially constructed, historically malleable, cul turally contextual, and reproduced through learned perceptual practices. Whether or not it is valid to use racial concepts and whether or not their use will have positive or negative political effects depends on the context. It also falsely assumes on the basis of a commitment to semantic realism and an over in ation of the importance of science that racial concepts can have no nonbio logical referent and thus no valid meaning. It naively assumes that an end to the use of racial concepts will solve (or contribute toward solving) the current enor mous sociological and economic determinism of racialized identities, and that this positive result can occur before we try to understand the ways in which beliefs and practices of racialization have informed every political theory, every conceptual framework, and every metanarrative, at least in the West. It wrongly assumes that racial identities are obvious and easily demarcated, that racialized groupings are homogeneous, and that ancestry is all-determining. It operates on a mistaken notion of what cultures are, as if they are merely the developing expression of an originary logic rather than the effect of negotiations from multiple sources. And it promotes the futile mission of opposing the tide of global hybridization and identity metamorphosis. It can acknowledge the current devastating reality of race while holding open the possibility that present-day racial formations may change signi cantly or perhaps wither away. It provides a better explanation for the variety of racial beliefs and practices across cultures, and thus acknowledges the contingency and uncertainty of racial identities and boundaries. One can hold without contradiction that racialized identities are produced, sus tained, and sometimes transformed through social beliefs and practices and yet that race is real, as real as anything else in lived experience, with operative effects in the social world. Ob jectivist approaches attempt a de nition of race general enough to be applicable the Phenomenology of Racial Embodiment 183 across a variety of contexts even while recognizing that context will determine the speci c content and political valence given to a racial concept. These approaches start with sociological facts, Census categories and their transformations, and the history of racializations to develop an account of how race organizes social relations. Most of the current debates over race concern only objective de nitions of race and racial identity. However, objectivist approaches to race that chart its effects in the public domain sometimes hinder an appreciation for the everydayness of racial experi ence. Objectivist approaches that de ne race by invoking metanarratives of his torical experience, cultural traditions, or processes of colonization and that take a third-person perspective can be inattentive to the microinteractions in which ra cialization operates, is reproduced, and is sometimes resigni ed. In contrast, subjectivist approaches that begin from the lived experience of racialization can reveal how race is constitutive of bodily experience, subjectivity, judgment, and epistemic relationships. During the building of the Panama Canal, workers were divided and identi ed by the U. In Canal Commission documents, gold workers were described as loyal, earnest, responsible, self-sacri cing, and en thusiastic. Here race explicitly determined economic and social status, but it also was understood by the dominant white authorities to be the de terminate constitutive factor of subjectivity, indicating personal character traits and internal constitution (for example, blacks were thought to be more resistant to yel low fever). Such publicly instituted and circulated associations between race and subjectivity must naturally have an effect on the self-perceptions of those persons so described. Omi and Winant offer an account of race that attempts to include both the macrolevel and the microlevel, or objective and subjective levels, of social rela tions. Greetings, handshakes, proximity, tone of voice, all reveal the effects of racial awareness, the presumption of superiority vis-a-vis` the other, or the protective defenses against the possibility of racism and misrecogni 6 tion. This idea could be useful here to understand how individuals fall into race-conscious habitual 7 postures in cross-racial encounters. Merleau-Ponty is mainly discussing motor habits of perception and movement used in performing various operations such as driving or typing, but the concept can easily be applied to postural attitudes and modes of perception taken in interactions with others whose identities are marked by gender, race, age, and so on. Following Fanon, Gordon, and Weiss, I will also argue that racialization structures the visual sphere and the imaginary self, and can block the development of coherent body images (Fanon 1967; Gordon 1995; Weiss 8 1998, esp. I agree with Omi and Winant that any adequate account of race would need to encompass both. But it seems to me that although subjectivist approaches have important advantages in accounting for how race works, they have been underdeveloped in the recent theoretical literature, even while there are many rst-person memoirs and rich descriptions of racial experience that might be tapped for theoretical analysis. A possible reason for the hesitancy one might have in going in this direction is a fear that phenomenological description will naturalize or fetishize racial expe riences. This can happen when descriptions of felt experience begin to operate as explanations of felt experience, as if the experience itself is fully self-presenting and explanatory. In other words, the claim here would be that one need go no further than accessible experience to explain the experience. For example, if one believes that human beings group perceptual objects under concepts as the natural result of our need to cope with the blooming, buzzing variety of perceptual experience, then one might be led to think that racial categories are the understandable result of the need to group and categorize. In other words, racism is the unfortunate but inevitable result of human cognitive processes. Phenomenological descriptions that detail the overwhelming salience of racializations for given individuals might then be used as support for such a belief. Against this, I will argue that although racial classi cation does operate on the basis of perceptual difference, it is also the case that, as Merleau-Ponty argues, perception represents sedimented contextual knowledges. However, I would not want to say, as some nominalists seem almost to say, that racialization has only an arbitrary connection to the realm of the visible.

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Scoliosis can result from congenital treatment diabetes gestational order dapagliflozin cheap, irritative diabetes medications webmd order dapagliflozin 5mg otc, neuromuscular diabetes insipidus gestational cheapest dapagliflozin, degenerative type 1 diabetes and zumba purchase 5mg dapagliflozin amex, and traumatic causes. Congenital scoliosis is the product of the failure of formation or segmentation of spinal elements in prenatal life. Neuromuscular curves develop due to muscle imbalance in children with encephalopathy, spina bifida, or myopathies. Degenerative curves are seen in adulthood and result from biomechanical failure of the arthritic spine. Trauma can result in scoliosis if the injury weakens the integrity of the spine by fracture or dislocation. Accurate knowledge of the natural history of a disease is mandatory for determining appropriate management of patients. The natural history of spinal curvature in the skeletally immature is different from expectations for curves presenting after spinal growth ceases. The probability of curve progression is the primary consideration when planning treatment (5,6). Therefore, determination of skeletal maturity is often helpful in predicting risk of progression. The onset of puberty is associated with a rapid increase in spinal growth velocity. The risk of curve progression is higher for a child in Risser stage 0 2 compared to a child in Risser stage 3 5. The probability of progression greater than 10 degrees by Cobb angle is 67% for curves 40 -50 degrees. Thus, for young patients with scoliosis, the major factors determining risk of progression are skeletal maturity, curve magnitude, and curve type. Optimal interval of follow-up is determined by the ability to detect a real difference in the curve magnitude by Cobb angles. A widely accepted estimate of error in measurements of Cobb angles is approximately 5 degrees (9). During the peak velocity of spinal growth, the curvature may progress by 1 to 2 degrees per month. Therefore, rechecks should be scheduled every six months to allow sufficient time for a true change in the curvature to be detectable (greater than 5 degree error). Most patients with an established diagnosis of idiopathic scoliosis do not require treatment. For minor curves (less than 25 degrees) or the mature patient, examination and radiographs are repeated twice a year to monitor the curve. If the risk of progression is high due to curve magnitude and skeletal maturity, a brace is often recommended. In fact, the brace does not attempt to correct or to improve the magnitude of the curvature with any lasting effect. Bracing is used in a carefully selected patient to achieve a curvature under 30 degrees at skeletal maturity. Therefore, the current recommendation is for the brace to be worn 23 hours a day for optimal results. Physical therapy regimens and electrical stimulation have not been shown to affect the natural history of adolescent idiopathic scoliosis (12). Surgical indications are based on many factors including the curve type, skeletal maturity, and curve magnitude. Documented progression on radiographs or parameters that suggest a high risk of progression must also be noted. In general terms, the immature patient who presents with a curve beyond the limits of effective bracing (greater than 40 50 degrees) or who has demonstrated significant progression despite effective bracing is a candidate for fusion. Instrumentation uses a combination of rods, hooks, and screws to correct the spine over individual segments. The ability to straighten the spine and maintain that correction until effective fusion occurs is tremendous. Depending on the specific characteristics of the patient, different approaches can be used. Anterior approaches allow a shorter construct and maintenance of flexibility by saving spinal segments. Thorascopic and laparoscopic techniques are being developed to allow microinvasive approaches to instrument and fuse the scoliotic spine (13). For curves between 50 and 75 degrees, the curves will progress by 1 degree per year. Therefore, surgical stabilization of the spine is recommended for curves greater than 50 degrees at skeletal maturity (5,6). Mild to moderate idiopathic scoliosis in adulthood has no negative effect on pregnancy or delivery method. Restrictive pulmonary function does not occur until the curve reaches 100 degrees (16). No increased risk of mortality is found for adults with adolescent-onset idiopathic scoliosis (17). In most studies, the incidence of back pain does not differ significantly from the general population (4). Complex balance reactions in different sensory conditions: adolescents with and without idiopathic scoliosis. The prediction of curve progression in untreated idiopathic scoliosis during growth. Measurement of the Cobb angle on radiographs of patients who have scoliosis: Evaluation of intrinsic error. Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. A meta-analysis of the efficacy of non-operative treatments for idiopathic scoliosis [see comments]. Surgical treatment of adolescent idiopathic scoliosis: the basics and the controversies. Natural history of adolescent thoracolumbar and lumbar idiopathic scoliosis into adulthood. Long term followup of patients with idiopathic scoliosis: A study of mortality, causes of death, and symptoms. Radiographic curvature of the spine whose curvature is greater than or equal to 10 degrees. Congenital, neuromuscular, traumatic, infectious, neoplastic, inflammatory, syndromic and degenerative causes. Side-to-side curvature of the spine, rib hump, shoulder elevation, chest wall deformity, prominence of the scapula on one side. He complains of pain in his right leg and he has been having an increasingly difficult time walking over the last 2 days. Examination of his extremities reveals swelling, warmth and tenderness to his right proximal tibia. An orthopedic consultation is obtained, and a closed needle drainage of the area is done. The annual incidence of acute osteomyelitis is about 1/5000 children under 13 years old (1). This disease appears to affect males more often than females, and the majority of the cases occur in patients less than 20 years old. The most common cause of osteomyelitis is bacterial; however, fungal and viral causes are also possible. Acute bacterial osteomyelitis can be thought of in three different categories: 1) hematogenous seeding, 2) contiguous spread, and 3) direct inoculation of the bone either from surgery or trauma. Of the three categories, acute hematogenous osteomyelitis is the most common presentation in children. Acute hematogenous osteomyelitis has a predilection for the long bones of the body. The diaphysis or shaft is made of a dense lamellar bone, which is relatively acellular and slow growing. The ends of the bone near the growth plate (the metaphysis) is made of a maze like bone called cancellous bone. This maze like structure allows for spreading of the infection via small channels in the bone that leads into the subperiosteal space.

TheCox proportionalhazardmodelfortimetoall-causerecipientdeathincludedacuterejectionwithinthefirstyearof transplant metabolic syndrome kidney disease buy dapagliflozin 5 mg with mastercard,history ofpretransplantD M diabetes mellitus type 2 nih order 10 mg dapagliflozin visa,ageover60years diabetes type 1 eating plan buy dapagliflozin with visa,serum Ca> 2 blood sugar levels diabetes purchase cheap dapagliflozin line. Sum m ary Table ofR C Ts exam ining th e treatm entofC K D-M B Dwith sevelam er-H C lvs. Arm 2 Quality Modality (P-value) Overallnoclinically important BoneOverallSummary by W G m differencesbetweenthetwo A treatments. AnOpenL abel,D ose-Ranging Study toE stablishtheTolerability ofAlphareninHaemodialysisSubjectswithHyperphosphataemia. Atyeartworesults Boneoverallsummary by W G B favorlanthanum withbetter 211 turnover. BoneVolume Casupplementationallowed Year1 Same forhypocalcemicpatientsin Year2 Slightly better(+1. Arm 2 Quality Year Modality (P-value) Thedatainthispaper primarily showedthatbone 24 Boneoverallsummary by W G d formationdidnotsignificantly B L anthanum carbonate Cacarbonate Spasovski, VitaminD deterioratewithlanthanum 113 upto3000mg/d,adjustedto upto4000mg/d,adjustedto 2006 Protocol:nd (unlikealuminum) P 1. Using the Cognitive Drug Research tool, lanthanum arm was similar to standard therapy arm in deterioration of cognitive function as assessed by the Cognitive Drug Research tool. Case-mix adjustedmodelsincludedadditionalcovariates:age,gender,raceandethnicity,diabetesmellitus,vintage,primary insurance,marriagestatus,andstandardizedmortality ratioof thedialysisclinicduring entry quarter, continuousvaluesofK t/V,dialysatecalcium concentration,andadministereddosesofeachofvitaminD analogswithineachcalendarquarter. Thereferencegroupsweresubjectsreceiving therapy inthehighestvitaminD groups(25D > 30ng/mL;1,25D > 13pg/mL. Sum m ary Table ofth e treatm entofC K D-M B Dwith calcitriolorvitam inDanalogs vs. BoneTurnover(N = 134) Better(+30) Alfacalcidol Casupplements BoneMineralization nd Hamdy,199540 24mo Initialdose0. ComparisonofCholecalciferolVersusD oxercalciferolintheTreatmentofSecondary Hyperparathyroidism inChronicK idney D iseaseStageThreeandFour. E ffectsofOralCholecalciferol(VitaminD 3)onBoneHealth,NeuromuscularFunction,andQuality ofL ifeinAdultsW ithChronicK idney D isease. AnOpenL abel,Multi-CenterStudy oftheE ffectofParicalcitolonMarkersofInflammationinPatientsW ithStage5ChronicK idney D iseaseonHemodialysis. A Randomized,OpenL abelStudy E valuating theE ffectonRenalFunctionofIntravenousBonvivaG ivenby InjectionorInfusion,ComparedW ithOralAlendronate,inPostmenopausalW omenW ithOsteoporosisatHighRiskfor RenalD isease. Including thrombophlebitis, venous thromboembolism, clotting problems with the vascular accesses or increased vasomotor symptoms. Hematuria, hydronephrosis, abnormal kidney function, uremia, polyuria, glomerulitis, kidney failure, acute kidney failure, oliguria, and nephritis. Arm 2 Quality F ollow-up Regimen (P-value) Prevention Calcitrioloralphacalcidolvs. The mineralizationwasmuchbetter becausemorecalcitrioltreated patientsimprovedthemixedlesion whereasmoreplacebopatients Boneoverallsummary by W G m developedmixedlesion. The C Cuento Calcitriol CsA monotherapy or actualmeasurementof Mltwas Manzano, 0. One subject had and episode of irreversible rejection in the placebo arm and consequently lost their graft. Sum m ary Table ofR C Ts exam ining treatm entofC K D-M B Dwith bisph osph onates vs. Arm 3 Quality F ollow-up ImmunosuppressiveRegimen Arm 3 (P-value) Prevention Bisphosphonatesvs. Arm 3 Quality F ollow-up ImmunosuppressiveRegimen Arm 3 (P-value) MeanCa(mmol/L) 2. Sum m ary Table ofR C Ts exam ining th e treatm entofC K D-M B Dwith bisph osph onates vs. Calcimimetics for secondary hyperparathyroidism in chronic kidney disease patients. Systematic review of the clinical efficacy and safety of sevelamer in dialysis patients. Standardized reporting of clinical practice guidelines: a proposal from the Conference on Guideline Standardization. Renal osteodystrophy; some therapeutic consideration relative to long-term dialysis and transplantation. Fractures and vertebral bone mineral density in patients with renal osteodystrophy. Retrospective study on the usefulness of radius and lumbar bone density in the separation of hemodialysis patients with fractures from those without fractures. Correlation of bone mineral density with the histological findings of renal osteodystrophy in patients on hemodialysis. Increased incidence of hip fractures in dialysis patients with low serum parathyroid hormone. Bone density and heel ultrasound testing do not identify patients with dialysis-dependent renal failure who have had fractures. Bone mineral density, biochemical markers and skeletal fractures in haemodialysis patients. Increased incidence of vertebral fracture in older female hemodialyzed patients with type 2 diabetes mellitus. Bone mineral density and its correlation with clinical and laboratory factors in chronic peritoneal dialysis patients. Incidence and risk factors for hip or other bone fractures among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study. Age and sex are sufficient for predicting fractures occurring within 1 year of hemodialysis treatment. Relationship between moderate to severe kidney disease and hip fracture in the United States. In elderly men and women treated for osteoporosis a low creatinine clearance of <65 ml/min is a risk factor for falls and fractures. Effect of alfacalcidol on natural course of renal bone disease in mild to moderate renal failure. Safety and efficacy of risedronate in patients with age-related reduced renal function as estimated by the Cockcroft and Gault method: a pooled analysis of nine clinical trials. Histologic evolution of bone disease 6 months after successful kidney transplantation. Bone loss after kidney transplantation: a longitudinal study in 115 graft recipients. Long-term bone loss in kidney transplant recipients: a cross-sectional and longitudinal study. Early rapid loss followed by long-term consolidation characterizes the development of lumbar bone mineral density after kidney transplantation. Parameters of high bone-turnover predict bone loss in renal transplant patients: a longitudinal study. Increased risk of mortality associated with hip fracture in the dialysis population. Vascular calcifications, vertebral fractures and mortality in haemodialysis patients. Correlation of simple imaging tests and coronary artery calcium measured by computed tomography in hemodialysis patients. Association of pulse wave velocity with vascular and valvular calcification in hemodialysis patients. Coronary artery calcification, common carotid artery intima-media thickness and aortic pulse wave velocity in patients on peritoneal dialysis. Coronary artery calcification and aortic pulse wave velocity in chronic kidney disease patients. Clinical impact of preexisting vascular calcifications on mortality after renal transplantation.

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