Thanksgiving is almost here. We will gather with family and friends and share a tasty meal. For most people, it is a happy occasion. However, some people dread the festive feast. Many people who live with chronic kidney disease have dietary restrictions that don't coincide with the culinary delights of the holiday season. The dialysis diet can be difficult to adhere to during the holidays, so it is important to make sure your holiday meal is healthy. And remember many family members may be dealing with their own dietary restrictions.

Si tuvi?ramos cien mil d?lares para mejorar las condiciones del paciente renal, lo primero que har?amos ser?a asegurarnos de convertir esa cantidad en un fondo recurrente, protegido por un banco reconocido, fiable y notariado con el prop?sito de que gane intereses. Para asegurarnos de que se hiciera buen uso de ?l, seleccionar?amos un comit? compuesto de pacientes renales que representaran sus respectivos turnos. De esta manera, cualquier compañero que solicitara ayuda econ?mica, deber?a presentar su petici?n, debidamente justificada, a este comit?.

If we had one hundred thousand dollars to improve conditions for renal patients, the first thing we would do is to make that amount into a renewable fund, protected by a well-known, trustworthy bank, and notarized so that it earns interest. To make sure that it would be used appropriately, we would select a committee of renal patients to represent their different shifts. This way, any fellow patient who requested economic assistance, would present their request, rightfully justified, to this committee.

The portable artificial kidney, "Arty," would be similar to a pace maker. "Arty" would be to the kidney what the pace maker is to the heart. The artificial kidney would be a small machine about the size of a woman's fist. A patient would only need one artificial kidney that would be placed inside the patient's body through a small 2 inch incision in the area where one of the kidneys is located. The artificial kidney would consist of a soft pliable type material that has a lot of micro fibers similar to a natural kidney's nephrons. It would also take over the functions of a diseased kidney by filtering nitrogenous wastes and toxins from the blood and produce urine. The urine would then be stored in the urinary bladder until it is full. The urine would then exit the body through the urethra.

I'm going with the theory that you start at home, make changes in your own neighborhood, city, or county, then, like a pebble dropped in a still pond, you wait for the ripples to spread the message. That's how I am going to use these funds to try to move my state towards an opt-out program of organ donation. What's that, you ask? Well, instead of asking residents to sign a donor card on their driver's license saying they opt-in, they would be asked to sign a card saying that they DON'T want to be a donor and sign that. This then begins the process of re-educating the populace to believe they are considered an organ donor unless they say otherwise.

First, I would educate them. Once a person has been diagnosed with renal disease and will need to begin dialysis, I would have a fellow dialysis patient who has had the procedure--catheter, life-site or graph--assigned to the new patient. Let them share their personal story about the surgical process, the healing period, and what the incision will look like once it has healed. Although my brain knows this procedure will not only save my life but give me a better quality of life, as a woman, my heart tells me that I will have a scar that will be unattractive and might limit my wearing of certain clothing. To some this might seem superficial but to a female, especially a young female, this is a very real concern. It's important to have affirmation from someone who has already been where I still have to go.

Twenty six million Americans have signs of kidney damage based on urine or blood tests. People of all ages and races are at risk for kidney disease, but African Americans are much more likely than other groups to develop kidney failure, which is severe kidney damage requiring treatment with dialysis or kidney transplant. In fact, African Americans are four times more likely than Caucasians to be diagnosed with kidney failure.

We see our elected leaders on television, we read about them in the newspapers, and sometimes we even encounter them in person. Most of the time these elected officials are doing the talking-they tell us about themselves, their plans, their policies, and their problems. Election season turns things around. Now, it's our turn to speak, and our leaders must listen. They know that to get our votes they will need to understand our interests and concerns.

I started dialysis nine and a half years ago and at that time, as I lay in my hospital bed undergoing three days a week dialysis on an emergency basis, I wondered if I would ever return to my job.

At 4'11" and 98 pounds, I'm petite, and have been all my life. So, needless to say, when I tell people that I have four kidneys and two pancreases, they are shocked. But, really, I'm very fortunate. I'm alive today because of the support and love of my mother and father and the expertise of amazing medical professionals.

BERLIN (MedPage Today) -- The long-term prognosis for stroke patients is better at community hospitals equipped with monitoring technology, trained multidisciplinary teams, and teleconsultation capability, researchers found.

PARIS (MedPage Today) -- Patients with severe, refractory obsessive-compulsive disorder (OCD) found some relief of symptoms after stimulation of the brain's subthalamic nucleus, a small preliminary study showed.

ATLANTA (MedPage Today) -- Mild cognitive impairment can be determined in less than five minutes with a three-word memory test and a clock- drawing task, according to researchers here. The words are apple, penny, and table.

CHARLOTTESVILLE, Va. (MedPage Today) -- The popular plant supplement Ginkgo biloba does not prevent cognitive decline or halt progress to Alzheimer's disease, researchers here found.

NORTH WALES, Pa. (MedPage Today) -- Stimulating growth hormone secretion in Alzheimer's patients did nothing to help clear beta-amyloid plaques or halt disease progression, researchers found.

WASHINGTON (MedPage Today) -- The brains of people whose cognition remained super-sharp in their 80s and beyond showed distinct features compared with those with age-normal functioning, a researcher said here.

NEW ORLEANS (MedPage Today) -- Finger-stick INR monitoring of warfarin (Coumadin) keeps blood levels within the target range when done by patients at home, according to a randomized trial.

MONTREAL (MedPage Today) -- Treating depression in patients with cardiovascular disease may not help improve cardiac outcomes, researchers reported here.

COPENHAGEN, Denmark (MedPage Today) -- Elevated nonfasting triglycerides, previously associated with an increased MI risk, also appear to be linked to risk of ischemic stroke, a population-based study found.

QUEBEC CITY (MedPage Today) -- Infants born to mothers with gestational diabetes are at increased risk of language impairment in early childhood, researchers here said.

Nephros: Nephros has launched two new products aimed at preventing the risk of water borne diseases at the point of use. The Nephros Protect! Kit, for showers and sinks, and the Nephros Prevent! Kit, for in-line applications such as ice machines and clinical equipment, provide immediate risk mitigation. There have been multiple reported outbreaks and deaths due to Legionnaire's disease this year in institutional facilities in the U.S. Legionnaire's disease is caused by a bacterium known as legionella pneumophila. Legionella can live in water and is often found in the plumbing systems of buildings such as hospitals, nursing and personal care facilities, ambulatory facilities and medical and dental practices. In cases where the levels of these pathogens may not pose much threat to healthy water users, immuno-compromised patients such as cancer, cystic fibrosis, HIV, organ transplant, and burn patients may have a substantial risk of infection. Nephros's DSU filtration products are an effective solution which can provide immediate safety from water borne pathogens including legionella.

Bill Peckham.com: In his 2008 book Critical Daschle mentions dialysis as an example of America's distorted use of medications - in this case EPO. A search of Thomas.gov shows that since 2000 while he was in the Senate, he never cosponsored the various Bills that were put forth to fix the dialysis reimbursement system or expand access to more frequent dialysis (though as Majority leader it would have been remarkable for him to cosponsor). That's not very much to go on. I guess we should all go out and buy the book.

New Scientist: Now William Fissell at the Cleveland Clinic in Ohio and colleagues at the University of Michigan have developed a filter made from a series of diamond layers drilled with successively smaller microscopic holes. Each layer only allows molecules below a certain size to pass through. And an electric field keeps away larger proteins that would otherwise clog its pores. This makes the filter more effective at removing toxic molecules from the blood stream than conventional membranes. What's more, Fissell says, the diamond device is small enough to be implanted into the body and works at ordinary blood pressures.

New Scientist: A Colombian woman has become the world's first recipient of windpipe tissue constructed from a combination of donated tissue and her own cells. Stem cells harvested from the woman's bone marrow were used to populate a stripped-down section of windpipe received from a donor, which was then transplanted into her body in June.

Kaiser: The 1st U.S. Circuit Court of Appeals in Boston on Tuesday upheld a New Hampshire law prohibiting the sale of information about physicians' prescribing practices for use in prescription drug marketing, the AP/Lexington Herald-Leader reports (Love, AP/Lexington Herald-Leader, 11/18). The New Hampshire law is intended to reduce state health care costs by removing the tools that pharmaceutical representatives use to target physicians to promote brand-name drugs (Saul, New York Times, 11/19). The law prohibits pharmacies, pharmacy benefit managers, insurance companies and data-mining companies that collect and analyze prescription information from selling or using that information for commercial purposes (AP/Lexington Herald-Leader, 11/18).

JASN early release: Abstract In uremic patients, hyperphosphatemia is associated with cardiovascular calcification and increased cardiovascular mortality. Despite the use of phosphate binders, only half of hemodialysis (HD) patients achieve recommended serum phosphate levels. A hyperphosphoric salivary content, which correlates linearly with serum phosphate, has been reported in HD patients. We hypothesized that binding salivary phosphate during periods of fasting in addition to using phosphate binders with meals could improve the treatment of hyperphosphatemia. We assessed the phosphate-binding capacity of the natural polymer chitosan by 31P nuclear magnetic resonance and established that 10 and 20% (wt/vol) middle viscosity chitosan solutions bind 30 and 50% of the phosphate contained in PBS, respectively. Thirteen HD patients with serum phosphate levels >6.0 mg/dl despite treatment with sevelamer hydrochloride chewed 20 mg of chitosan-loaded chewing gum twice daily for 2 wk at fast in addition to their prescribed phosphate-binding regimen. Salivary phosphate and serum phosphate significantly decreased during the first week of chewing; by the end of 2 wk, salivary phosphate decreased 55% from baseline (73.21 +/- 19.19 to 33.19 +/- 6.53; P < 0.00001), and serum phosphate decreased 31% from baseline (7.60 +/- 0.91 to 5.25 +/- 0.89 mg/dl; P < 0.00001). Salivary phosphate returned to baseline by day 15 after discontinuing the chewing gum, whereas serum phosphate levels took 30 d to return to baseline. Parathyroid hormone and serum calcium concentrations were not affected by the gum. In conclusion, adding salivary phosphate binding to traditional phosphate binders could be a useful approach for improving treatment of hyperphosphatemia in HD patients.

Science Daily: A newly developed equation produces more accurate estimates of the glomerular filtration rate (GFR)—a key indicator of kidney function in patients with chronic kidney disease (CKD), according to research being presented at the American Society of Nephrology's 41st Annual Meeting and Scientific Exposition in Philadelphia, Pennsylvania.

Wall Street Journal: A federal advisory panel backed a proposed Theravance Inc. antibiotic designed to treat serious skin infections, including some caused by a type of staph bacterium known as MRSA that is resistant to many antibiotics. The drug, telavancin, was considered Wednesday by a Food and Drug Administration panel of outside medical experts that was called to make recommendations to the agency about whether it thinks the drug should be approved.

HDCN: We have now upgraded all of the Renal Week registrants in our database or have sent them emails with instructions on how to upgrade. This week is the last of the RW2007 talks. This is part of a nephrology quiz by Drs. Emmett and Radhakrishnan focusing on fluids and electrolytes and glomerulonephritis. We are posting a conference held last month in Chicago sponsored by The Renal Network, Inc. and RPA on Preparing for the New Medical Director Responsibilities. Also we have begun posting ADC 2008 audiofiles. Please sign up for the 2009 meeting in Houston! Featured articles include a discussion of acid-base effects of GI disorders and an updated view of hypertensive renal disease.

New Scientist: The new drug targets a micro RNA - a molecule that inhibits the expression of a network of genes. Researchers recently discovered that a micro RNA called miR-208 is implicated in heart failure and that mice engineered to lack the gene for miR-208 are protected against heart failure (Science, DOI: 10.1126/science.1139089). So William Marshall at Miragen Therapeutics in Boulder, Colorado, and his colleagues developed an injectable "antagomir" - a string of nucleic acids designed to bind to miR-208 and block its action.

(St. Joseph's Hospital and Medical Center) Neuroscientists at Barrow Neurological Institute at St. Joseph's Hospital and Medical Center have discovered a direct link between eye motions and the perception of illusory motion that solves a 200-year-old debate.

(Johns Hopkins University Bloomberg School of Public Health) On Dec. 5, the Johns Hopkins Bloomberg School of Public Health and the New York Academy of Sciences will host a half-day symposium to mark the 60th Anniversary of the Universal Declaration of Human Rights. The event, "Public Health and Human Rights: The Work Ahead of Us," will evaluate progress in public health and human rights over the last 60 years.

(University of Texas Health Science Center at Houston) NanoMedical Systems Inc., an Austin-based startup cofounded by Mauro Ferrari, Ph.D., of the University of Texas Health Science Center at Houston, to improve the effectiveness of anti-cancer agents and other medications, has received a record $3.5 million Commercialization Award through the Texas Emerging Technology Fund.

(American Society for Therapeutic Radiology and Oncology) For breast cancer patients who underwent a mastectomy and who undergo radiation therapy after immediate breast reconstruction, autologous tissue reconstruction provides fewer long-term complications and better cosmetic results than tissue expander and implant reconstruction, according to a study in the Nov. issue of the International Journal of Radiation Oncology, Biology, Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.

(University of California - San Diego) University of California, San Diego Health Sciences leaders have announced that they have executed a formal Memorandum of Understanding with Johnson & Johnson Pharmaceutical Research & Development, L.L.C., with the objective of developing future collaborations in biomedical research and education to advance human health.

(University of Arizona) Evolutionary theory points to a new approach to combat drug resistance in disease-causing organisms and in cancer, according to new research. Keeping germs from cooperating can delay the evolution of drug resistance more effectively than killing germs one by one with traditional drugs such as antibiotics.

(American Friends of Tel Aviv University) A new early-warning test from Tel Aviv University detects polyps before cancer sets in.

(Agency for Science, Technology and Research (A*STAR), Singapore) Singapore researchers have developed an unlimited number of pure insulin-producing cells from mouse embryonic stem cells.

(Emory University) Cells can turn on tumor-promoting growth circuits by falsely reporting critical genetic information during the process of transcription: making RNA from DNA.Damage to the DNA making up a gene can lead to a misreading of the gene as it is made into RNA, a process called transcriptional mutagenesis.Transcriptional mutagenesis could represent an additional way DNA damage contributes to tumor formation.

(BMJ-British Medical Journal) Screening for colorectal cancer detects four out of ten cancers and should be carefully designed to be more effective, according to a study published today on bmj.com.