Journal of general internal medicine
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Guidelines currently recommend annual screening for albuminuria only among persons with diabetes mellitus (DM). There is no guidance about albuminuria screening in those with other important risk factors for chronic kidney disease (CKD), such as hypertension and/or family history of kidney disease. We sought to create a risk score that predicts the likelihood of albuminuria in adults without diabetes to prompt earlier detection and management of CKD. ⋯ These results suggest that it may be helpful to use a risk score framework for albuminuria screening in people without DM to encourage earlier detection and management of CKD. Longitudinal studies are warranted to confirm this approach along with evaluation of its cost effectiveness.
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Rural America faces an alarming obesity crisis, with residents experiencing significantly higher rates of obesity due to socioeconomic disparities, limited access to healthcare, and structural challenges such as food deserts and insufficient healthcare infrastructure. This perspective addresses these pressing issues by proposing targeted, evidence-based interventions to reduce obesity in rural communities. ⋯ R. 1577, the Treat and Reduce Obesity Act, to alleviate financial barriers to treatment, including intensive behavioral therapy and pharmacotherapy; and (3) leveraging community-based programs, including the National Rural Obesity and Chronic Disease Initiative, the CDC's High Obesity Program, and the Delta Body and Soul initiative, to improve access to healthy foods and promote physical activity through local collaborations, education, and infrastructure enhancements. By implementing these comprehensive strategies, we aim to make obesity treatments and healthy lifestyle choices more accessible, ultimately reducing obesity rates, improving health outcomes, and enhancing the overall quality of life for rural residents across the USA.
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The University of Pittsburgh School of Medicine collaborated with The Addis Clinic to create a global telemedicine elective for fourth-year medical students during the COVID-19 pandemic. The elective aimed to promote cross-cultural understanding by providing unique, hands-on telemedicine experience. ⋯ Implementation of a unique global telemedicine elective was feasible and well received by both medical students and clinical officers in Kenya. The elective can be implemented at other institutions with faculty experienced in global health who would like to partner with The Addis Clinic.
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Multitarget stool DNA (mt-sDNA) is an increasingly utilized noninvasive option for colorectal cancer screening; however, its impact is limited by imperfect test adherence. Tailored patient navigation (TPN) improves adherence for other cancer screening tests, but its role in mt-sDNA is not known. ⋯ Tailored patient navigation was associated with improved rates of mt-sDNA completion and SCNBP results despite built-in navigation services provided by the manufacturer. TPN for mt-sDNA is a promising strategy for enhancing colorectal cancer screening uptake.