In patients with chronic kidney disease, early complete correction of anemia does not reduce the risk of cardiovascular events.

In this trial of just over six hundred patients with estimated Glomerular Filtration Rates of 15 to 35 mls/minute, it didn't help at all. The end-point of eight mixed cardiovascular events stayed negative whether you used erythropoeitin to increase haemoglobin to a normal value or to something just below it. And if you're wondering why there seems to be a rash of kidney-related papers in the journals this week, it’s obviously because you haven't been in San Diego. If you had, you'd have immediately noticed that the streets were thronged with conferring nephrologists - always a striking sight.

http://content.nejm.org/cgi/content/abstract/355/20/2071

Autonomic Dysreflexia, also known as Hyperreflexia, is a condition where the blood pressure in a person with a spinal cord injury (SCI) above T5-6 becomes excessivly high due to the over activity of the Autonomic Nervous System

Autonomic Dysreflexia is usually caused when a painful stimulus occures below the level of.spinal cord injury. The stimulus is then mediated through the Central Nervous System (CNS) and the Peripheral Nervous System (PNS).

The CNS is made up of the spinal cord and brain, which control voluntary acts and end organs via their respective nerves. The PNS is made up from 12 pairs of crainial nerves, spinal nerves and peripheral nerves. The PNS also is divided into the somatic nervous system and the autonomic nervous system. The autonomic nervous system is responsible for the signs and symptoms of autonomic dysreflexia. The autonomic nervous system normally maintains body homeostasis via its two branches, the parasympathetic autonomic nervous system (PANS) and the sympathetic autonomic nervous system (SANS). These branches have complementary roles through a negative-feedback system; that is, when one branch is stimulated, the other branch is suppressed.

In a single-center study with 15 patients, it is found that sustained reversal of severe heart failure secondary to nonischemic cardiomyopathy could be achieved in selected patients with the use of a left ventricular assist device and a specific pharmacologic regimen.more::

Patients with an abnormal D-dimer level 1 month after the discontinuation of anticoagulation have a significant incidence of recurrent venous thromboembolism, which is reduced by the resumption of anticoagulation. The optimal course of anticoagulation in patients with a normal D-dimer level has not been clearly established. More:

This provocatively daft study suggests we should be instituting them. Over thirty thousand smokers were screened over roughly a ten year period and a little under five hundred cancers were discovered. Ten year survival rates in those operated on were 92% compared with an estimated 88% if the cancer had come to light without screening. You’ll look in vain for any discussion of the vast costs of a screening programme based on this, of the potential for damage both from radiation and over-diagnosis, and for any suggestion that the improved ten year survival rate was simply because cancers whose natural history were not being changed at all by treatment were being detected earlier . The conclusion is a masterpiece of pithy misdirection: “Annual spiral CT scanning can detect lung cancer that is curable.”

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