Expertise: no longer a sine qua non for guideline authors?

: Several sets of guidelines have been published recently and more are in the works. The very recent American College of Physicians/American Academy of Family Practitioners guidelines were put together by a set of authors and consultants without any expertise in the topic under discussion, that is, hypertension. Although we are not maintaining that all guidelines should be written exclusively by experts, complete lack of expertise among guideline authors is not acceptable.

Volatility of elevated serum ferritin in anemic hemodialysis patients.

BACKGROUND: Value of serum ferritin (SF) as an iron store index in hemodialysis (HD) patients has been questioned, especially at ranges >or=200. The objective of this study was to determine the variability of SF in patients with high SF (500-1,200.) and low TSAT (or=18 years, HD >or=90 days, SF 500-1,200., TSAT or=22,500 IU/week or >or=225 IU/kg/week and or=100., >or=200. and >or=300. were 61.0%, 29.3% and 12.2%, respectively, and 27% exhibited positive changes in SF. CONCLUSIONS: SF is a volatile and imprecise indicator of tissue iron stores in anemic HD patients with high SF and low TSAT. This volatility limits clinical utility of SF in this population.

Roundtable discussion: hypertension in children and adolescents.

Following a hypertension symposium held in Philadelphia, PA, on June 8, 2004, a roundtable discussion was held to discuss the treatment of hypertension in adolescents and children. The participants included Thomas D. Giles, MD, of Louisiana State College of Medicine, New Orleans, LA; Bonita Falkner, MD, of the Department of Medicine and Pediatrics, Thomas Jefferson University, Philadelphia, PA; Allan B. Schwartz, MD, of the Division of Nephrology and Hypertension, Drexel University College of Medicine, Philadelphia, PA; Raymond R. Townsend, MD, of the Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA; and Marvin Moser, MD, of the Department of Medicine/Cardiology, Yale University School of Medicine, New Haven, CT.