President's Message

This article derives statistical models relating adolescents’ universal human values with their problem and pathological gambling. An adolescent's values are measured by the priority accorded to each value using the Schwartz Values Inventory, whereas problem or pathological gambling, if any, is indicated by his or her answers to the South Oaks Gambling Screen. Among other complex results, statistical analysis suggests that the value subtypes of “non-faith tradition,” “faith tradition,” and “macro-universalism” and the value type “stimulation” are associated with less problem and pathological gambling. Among other uses, such findings help identify high-risk adolescents.     

Dysglycemia Predicts Cardiovascular and Kidney Disease in the Kidney Early Evaluation Program

J Clin Hypertens (Greenwich). 2010;12:51–58. ^© 2009 Wiley Periodicals, Inc.
The cardiometabolic syndrome has been associated with both chronic kidney disease (CKD) and cardiovascular disease (CVD). Using data from the National Kidney Foundation-Kidney Early Evaluation Program, the authors sought to investigate this association in a targeted CKD cohort. A total of 26,992 patients met eligibility criteria including age 18 years and older, diabetes, hypertension, or family history of CKD, diabetes, or hypertension and excluded those taking renal replacement therapy. Individuals were identified by Third Report of the National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III) criteria (dysglycemia, hypertension, and dyslipidemia) and World Health Organization criteria (obesity and proteinuria). Univariate and multivariate analyses were used to evaluate increasing components of the cardiometabolic syndrome, CKD, and CVD. On multivariate analysis there was a graded relationship between increasing components with an increased prevalence of CKD and CVD. Additionally, there was a graded trend with the stage of dysglycemia (eg, normoglycemia, prediabetes, and overt diabetes) and increasing CKD. However, there was only an increased prevalence of CVD observed in the clinically diabetic group. This trend was also observed with increasing serum glucose levels and an increasing percent of CVD and CKD up to 160 mg/dL. However, prevalent CVD increased at >140 mg/dL and prevalent CKD at >180 mg/dL. Therefore, data support that increasing metabolic components and dysglycemia are strongly associated with an increased prevalence of CKD and CVD.     

Biomarkers as surrogates for cancer development

Biomarkers are routinely applied in the management of chronic diseases to reduce morbidity and mortality through early diagnosis, as well as to assess the necessity for, and responsiveness to, applied interventions. Biomarkers yield mechanistic insights into layers of biologic organization from molecule to organelle, to cell, and finally to cellular organization and tissue. A step-wise approach to the development of tissue-based biomarkers is presented. These biomarkers may serve as molecular targets for scientific inquiry and intervention, as well as approvable endpoints for clinical trials.     

Authorship: "Law" and Order

Publication is a marker of academic success. In academia, appointments and promotions are in many cases strongly linked to the candidate's bibliography. The "publish or perish" mindset has placed extraordinary pressures on scientists and academic physicians alike. Authorship controversies have received considerable attention in the medical literature. Although guidelines are available to help determine how attribution should be acknowledged, anecdotal experiences with disputes associated with authorship continue to exist. This paper addresses several key problems facing authorship. A discussion of who should be given authorship, the responsibilities of an author, and a method for assigning authorship in a multiauthored publication is provided.     

Laparoscopic Roux-en-Y Gastric Bypass in Patients with Congenital Malrotation

Bariatric surgery is the only solution for morbidly obese individuals who desire to lose weight and maintain it and have failed to do so by non-surgical means. As the incidence of morbid obesity rises, laparoscopic Roux-en-Y gastric bypass (LRYGBP) is increasingly performed. With the increase in bariatrics, the chances of discovering aberrant anatomy at the operating-table also increase. We present two cases of LRYGBP in patients with intestinal malrotation, which is a congenital anomaly caused by failure of the intestines to rotate and fixate at 270° during embryonic development. It occurs in one out of every 500 births in the United States, accounting for 5% of all intestinal obstructions. To this date, only three reports have been published describing the incidental finding of congenital malrotation during the initial laparoscopic exploration for gastric bypass. We found that the operation can still be performed laparoscopically in such patients, with some modifications to the standard technique.