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Total nephrectomy for renal cancer associated with late erectile dysfunction.
EurekAlert: The retrospective study evaluated two cohorts of men, totaling 432 patients, who underwent surgery for renal cell carcinoma. One group underwent complete removal of the kidney while the other had kidney-sparing surgery. Sexual function was accessed pre- and post-operatively with a sexual health questionnaire known as the International Index of Erectile Function. "What we are seeing is a dramatic yet delayed effect. Approximately six years after surgery, patients who had a total nephrectomy were 3.5 times more likely to develop erectile dysfunction compared to those who had kidney reconstruction," said Derweesh.

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SPECT/CT helps to diagnose difficult cases of infectious endocarditis.
SNM: Of the 131 patients, 97 were found to have uptake indicating infection.The 99mTc-HMPAO-WBC SPECT/CT scan was true-positive in 46 of 51 patients and false negative in 5 of 51 cases (90 percent sensitivity, 94 percent negative predictive value and 100 percent specificity and positive predictor value). In addition, septic embolism was detected in 41 percent of the patients.

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Higher serum bicarbonate associated with lower type 2 diabetes risk in Nurses Health Study.
CMAJ: Interpretation: Higher plasma bicarbonate levels were associated with lower odds of incident type 2 diabetes mellitus among women in the Nurses' Health Study. Further studies are needed to confirm this finding in different populations and to elucidate the mechanism for this relation.

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CMS announces initial group of practices participating in the ACO (Accountable Care Organization) model.
CMS: Overview The Advance Payment Model is designed for physician-based and rural providers who have come together voluntarily to give coordinated high quality care to the Medicare patients they serve. Through the Advance Payment ACO Model, selected participants will receive upfront and monthly payments, which they can use to make important investments in their care coordination infrastructure. The following Advance Payment ACOs were announced for the performance period that began on April 1, 2012:

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Patient weight gain after change of acid concentrate supplier with same nominal dialysate sodium level.
IJAO: Conclusions: Changing dialysate acid concentrates, both labeled 1:44 dilution, led to the delivery of a higher dialysate sodium, resulting in weight gains, increased pre-dialysis blood pressure, but less symptomatic intradialytic hypotension. Following readjustment of volumetric dialysate mixing, excess weight gains and increased blood pressure resolved over 4 weeks, highlighting the importance of checking the delivered dialysate sodium following a change in dialysate acid concentrate.

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