A new analysis of existing studies of gastroesophageal reflux disease (GERD) finds that the risk for GERD symptoms, erosive esophagitis and esophageal cancer increases 1.5- to 2.0-fold with overweight or obesity compared with normal weight (Article, p. 199). Researchers say that the link with obesity implies that losing excess weight may be important in the prevention and treatment of GERD and associated complications.
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Study Assesses Risk for Death Associated with Two Kinds of Kidney Dialysis
A study of 1,041 patients with end-stage renal disease (ESRD) receiving peritoneal dialysis or hemodialysis found that risk for death did not differ between the groups during the first year of the dialysis but was higher among those undergoing peritoneal dialysis in the second year (Article. p. 174). An editorial writer says that for many reasons the study cannot help the individual patient choose between the two forms of dialysis (Editorial, p. 229). The writer also discusses newer technologies for dialysis.
A National Health Information Infrastructure Will Cost Billions
Researchers estimate that achieving a workable national health information infrastructure within the next five years would cost at least $156 billion in capital investment and $48 billion in annual operating costs (Article, p. 165). At current rates of spending, U.S. hospitals, physician practices and nursing homes will invest only $24 billion in capital costs and $7 million in annual operating costs in functionalities alone. The interoperability system by which various providers enter data into a record and "talk" to each other would require an additional $53 billion in capital investment and $21 billion in ongoing annual operating costs. The bulk of this money will be needed by physician office practices. Researchers say that information technology is "an important tool to improve the safety and efficiency of U.S. health care, but its adoption remains limited largely because of a lack of aligned financial incentives and national standards."
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Journal
Annals of Internal Medicine