Upstaging, not just a non-small matter

Insulin resistance compensation: not just a matter of β-Cells?

The global epidemic of type 2 diabetes is largely secondary to insulin resistance induced by obesity and sedentary lifestyles. Most insulin-resistant subjects are able to increase b-cell secretion to meet the increased insulin demand and do not develop diabetes. However, when b-cell compensation fails, type 2 diabetes develops (1,2). Understanding the mechanisms of this compensatory response is...

Mini-BAL: not a small matter

the study by Lacroix and colleagues [1] in the previous issue of Critical Care, we appreciate the early use of the mini-bronchoalveolar lavage (mini-BAL) to diagnose health care-associated pneumonia (HCAP). However, some limitations of the study create diffi culties in initiating this protocol in our institution. Hospitalized/intubated patients with HCAP were not studied. Th ese patients repres...

decreasing high failure rate of vaccinations in patients with chronic kidney disease; not just a matter of quantity

Not just a fracture.

To cite: Van de Vijver M. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2013-202432 DESCRIPTION An 8-month-old girl presented with a reluctance to weight bear on her left leg following a trivial, low impact fall. X-rays showed a fracture of the distal third of the left tibial shaft. The child’s general health and development were normal. There was no suspicion ...

Peritoneal dialysis adequacy: not just small-solute clearance.

Two indices of small-solute clearance, Kt/V urea and creatinine clearance, are widely used as markers of peritoneal dialysis (PD) adequacy. It has become clear, however, that increasing the small-solute clearance above a minimum level does not result in improved long-term PD outcomes. Several other factors may affect optimal dialysis outcome. These include, but are not limited to, ultrafiltrati...