VOL. 26, No. 12, December  2009





Case in Point
Surgical Management of Spontaneous Rupture of Umbilical Hernia Using Biological Mesh
Jose Antonio Moreno, MD, Imtiaz A. Munshi, MD, MBA, and Virgilio George, MD
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Testing the BRIEF Health Literacy Screening Tool
Jolie Haun, PhD, Virginia Noland-Dodd, PhD, MPH, Jill Varnes, EdD, John Graham-Pole, MD, Barbara Rienzo, PhD, and Patricia Donaldson, RN
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Methicillin-Resistant Staphylococcus aureus: What’s the Big Deal?
Gio J. Baracco, MD, Robert Muder, MD, and Rajiv Jain, MD
More | CME Exam






Guest Editorial
Starving for Health Care: Ethical Issues Surrounding the Uninsured Population
Debra Shipman, MSN, MBA, RN, Tammy Vant Hul, MSN, ACNP, RN, and Jack Hooten, MSN, MHA, RN
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Practitioner Forum
Caring for Patients with Posttraumatic Stress Disorder During Gastrointestinal Procedures
Beverly Taylor, RN and Patricia Rushton, APRN, PhD
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Clinical Digest

• Acupuncture for Pregnancy Pain
• How Common is Klebsiella pneumoniae Bacteremia?
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Drug Monitor

• Eplerenone Decreases Hospitalization Time
• Antiosteoporotic Medication Adherence
More

Federal Health Matters

• Senate Committee Looks at VA-IHS Collaborations
• VA’s OIG Finds Ongoing Problems at Marion Facility
More






Managing Advanced Renal Cell Carcinoma
This supplement to Federal Practitioner on renal cell carcinoma (RCC), supported by Pfizer Inc, was developed with the aim of helping primary care providers in federal practice (especially those within the VA health care system) provide the highest quality care to their patients with RCC. It is our hope that, after reading this supplement, you will be better prepared to:

• Identify patients at risk for RCC and know when to consider screening measures.
• Recognize the signs and symptoms of RCC and refer the patient for appropriate imaging studies and other testing.
• Understand the systems used to stage and grade RCC.
• Discuss the options available for treating both early-stage and advanced RCC and their appropriate uses according to distinct patient and disease characteristics.
• Educate patients about the potential adverse effects of various treatments for advanced disease and apply appropriate monitoring.

The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Quadrant HealthCom Inc., the U.S. government, or any of its agencies. Pfizer Inc provided limited editorial input. Some of the drugs or classes of drugs discussed in this supplement may not be listed on the VA national formulary or the DoD basic core formulary or addressed in VHA or DoD treatment guidelines. Please review complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients. Pazopanib (Votrient; GlaxoSmithKline, London, United Kingdom), an oral tyrosine kinase inhibitor, received FDA approval during the development of this supplement. Therefore data for this product is not included in the overview of available treatments.

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