Whether live kidney donation is associated with an increased risk of end-stage renal disease (ESRD) is not clear. To explore this question, Muzaale and colleagues assessed risk of ESRD in a cohort of 96 217 kidney donors vs the risk in a cohort of 9364 healthy controls drawn from participants in The Third National Health and Nutrition Examination Survey. The authors report that compared with healthy nondonors, live kidney donors had an increased risk of ESRD; however, the magnitude of the absolute risk increase was small. In an Editorial, Gill and Tonelli highlight the importance of presenting both absolute and relative risks of ESRD when discussing live kidney donation with potential donors.
Preterm birth has been linked to insulin resistance in children and adults. In a prospective birth cohort of 1358 children who had random plasma insulin levels measured in cord blood and at median age 1.4 years (interquartile range, 0.8-3.3), Wang and colleagues found an inverse association between gestational age and elevated plasma insulin levels at birth and in early childhood. In an Editorial, Hanson discusses the early developmental environment and possible origins of type 2 diabetes.
The human papillomavirus (HPV) vaccine has a 3-dose schedule, which is associated with higher vaccination program costs and other feasibility issues. In a population-based cohort of more than 1 million Swedish girls and young women aged 10 to 24 years, Herweijer and colleagues assessed the association between number of doses of quadrivalent HPV vaccination received and incident condyloma—the first HPV-related disease end point that can be measured after vaccination. The authors found maximum reduction in condyloma risk after 3 vaccine doses; however, receipt of 2 doses was also associated with reduced risk of condyloma during a mean 3.8 years’ follow-up.
Author Video Interview
Hospital readmission within 30 days of discharge from inpatient rehabilitation facilities has been designated a quality indicator by the Centers for Medicare & Medicaid Services. To assess rates of 30-day readmission and associated factors, Ottenbacher and colleagues reviewed 2006-2011 Medicare data for 736 536 patients discharged to the community from 1365 inpatient rehabilitation facilities. The authors report that 30-day readmission rates ranged from 5.8% for lower extremity joint replacement to 18.8% for debility, and rates of readmission varied by patient sociodemographics, clinical characteristics, and functional status.
Continuing Medical Education
A 63-year-old man with a history of hepatocellular carcinoma and idiopathic pancreatitis is admitted for evaluation of recurrent abdominal pain and painful nodules on the extremities—appearing with or immediately after episodes of pancreatitis. One of the nodules has a yellow, oily discharge. Previous treatment included incision and drainage of a nodule and antibiotics for presumed cellulitis. The patient reports nausea, vomiting, and arthralgias. What would you do next?
A recent article in JAMA Neurology reported that 15 and 18 years after undergoing intrastriatal fetal cell transplantation, 2 patients with Parkinson disease had sustained motor improvements while remaining free of pharmacological dopaminergic therapy. In this From the JAMA Network article, Bega and Krainc discuss the discrepant data on outcomes of fetal cell transplants as reparative therapy in Parkinson disease and consider implications for future trials of fetal cell therapy.
Highlights. JAMA. 2014;311(6):545-547. doi:10.1001/jama.2013.279318