The American journal of the medical sciences
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Although individuals with kidney disease, including those dependent on dialysis, often present clinically with signs and symptoms consistent with frailty, there is limited information about sociodemographic and clinical risk factors that may be associated. ⋯ In multivariable analyses, the risk for frailty in patients undergoing hemodialysis, as assessed by the presence of 3 or more criteria that comprise the Fried frailty index, was increased in association with peripheral vascular disease and cardiac conditions, such as dysrhythmia and atrial fibrillation, and was decreased for those with higher serum albumin concentration and for blacks compared with whites. Among patients who met the Fried definition of frailty, 78% scored as frail on walk speed and 56% scored as frail on grip strength, the 2 physical performance measures.
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Positive predictive value (PPV) of hemoglobin A1c (HbA1c) for diagnosis of prediabetes in clinical practice has not been well studied. ⋯ PPV of HbA1c for diagnosis of prediabetes in clinical setting is low. Patients with HbA1c of 5.7% to 6.4% should undergo OGTT to confirm diagnosis of dysglycemia.
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Hematologists/Oncologists spend years of training in a fellowship program. At academic centers, patients receiving treatment are often seen by fellows. It has not been established what patients understand about fellowship training, therefore the purpose of this study was to explore their understanding and whether they are content with fellows taking part in their care. ⋯ Patients at academic centers being seen by Hematology/Oncology fellows appear to have a lack of knowledge of a fellow's role and background but have a desire to be educated. Educational initiatives can be introduced to teaching institutions to help patients better understand the role of a fellow.
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Letter Case Reports
Acute myocardial infarction associated with painless thyroiditis.