Medical Inspection – Health Blog

Primary renal lymphoma (PRL), describes non-Hodgkin’s lymphoma involving the kidney in the absence of any other organ or nodal disease focus. The majority of patients are older than 40 years and present with acute renal failure. Flank pain, hematuria, weight loss, and abdominal mass are other common manifestations, similar to renal cell carcinoma. PRL presenting with immune thrombocytopenia has also been reported. Lymphoid tissue is normally absent in renal histological architecture and consequently the existence of PRL has been questioned.

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A 79-year-old Caucasian male presented to our unit with symptoms of generalized body aches, weakness and decreased urine output. He is a known patient with chronic renal insufficiency, well-controlled type II diabetes, and myocardial infarction. Physical examination revealed a blood pressure of 154/65 mm Hg and pitting edema of the lower left lumbar region. There was no peripheral lymphadenopathy or pulmonary edema.

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Primary renal lymphoma usually occurs in middle-aged individuals and commonly presents with renal dysfunction. Acute renal failure is associated with a poor prognosis. We present a case of a 79-year-old man who presented with acute-on-chronic renal insufficiency and a unilateral renal mass with biopsy proven low grade В cell non-Hodgkins lymphoma. Non-Hodgkins Lymphoma involving the kidney was first described by Gison in 1948 and again by Davis and Olivelli in 1951Л. Read More…

In this population-based study, a number of recommended measures of quality diabetes care (e.g., monitoring of blood glucose and cholesterol concentrations and screening for foot, and eye disease) were positively associated with patient satisfaction. In this sample of African Americans with diabetes, reported satisfaction with care was generally excellent or good. The perception of not having difficulty getting care, having one physician for diabetes care, and receiving diabetes education were each positively and independently associated with patient satisfaction. As previously reported, levels of diabetes care in this population of African Americans seemed comparable to or better than US national averages.

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Among participants in the study: 13% were 18 to 44 years old, 50% were 45 to 64 years old, and 37% were older than 65 years; 65% were women; 42% were married or coupled; 61% had completed high school education or higher; 39% were employed; 33% had annual household incomes <$10,000 and 65% had incomes < $25,000; 16% had no health insurance coverage; 89% had at least with 17% receiving education within the previous year; and 10% perceived difficulty getting care in the past year.

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The methods used in Project DIRECT are described in detail elsewhere. Briefly, the survey was conducted in 1997, among civilian, non institutionalized adults, aged >18 years, by using a multistage, population-based probability sample from census files in predominantly African-American neighborhoods in Raleigh and Greensboro, NC. All data were collected at baseline, before interventions were commenced, from both the intervention and control communities. Field interviewers visited each sample housing unit and selected eligible persons according to a specified protocol. Those selected were asked for a personal interview. The overall interview response rate was 87%. Participants (n=591) who met the following criteria were included in the cross-sectional analyses reported here: self-report of diabetes; being African American; and seeing a physician, nurse, or other health professional for any reason during the last year.

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Patient satisfaction is increasingly recognized as an important aspect of the quality of medical care. It is accepted that patient satisfaction is determined by many factors of care delivery, including communication among the patient, the provider, and the health care system; accessibility; availability; and convenience. For these reasons, patient satisfaction has been recently proposed as an indicator of the quality of diabetes care in the United States by the National Committee of Quality Assurance for the Diabetes Quality Improvement Project (DQIP)A However, the relationship between the process measures of the quality of diabetes care and patient satisfaction has not been examined to date.

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