79 Learning Nephrology Through Mobile Devices: The Nephrology On-Demand Mobile Experience

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<ul><li><p>77COMPARISON OF HEPATITIS C SEROCONVERSION IN TWO CENTERS AND REUSE PRACTICES Maria de Jesus, Vivek Soi, Sancar Eke, Yahya Osman Malik, Jerry Yee, Roque Diaz. Henry Ford Hospital, Detroit, Michigan, USA. Several mechanisms could potentially contribute to nosocomial HCV transmission between hemodialysis patients. These include internal contamination of hemodialysis machines, contamination of the hands of staff members, item sharing and dialyzer reuse. The relationship between dialyzer reuse and anti-HCV positivity has been confirmed in some but not all studies. The purpose of this retrospective study was to compare the incidence of Hepatitis C seroconversion in two urban centers which differed with respect to dialyzer reuse. The incidence of Hepatitis C seroconversion was calculated for the two urban centers. Data between 2001 and 2006 from 339 patients from Center A and 356 from Center B was analyzed. During this time, dialyzer reuse occurred at Center B but did not occur at Center A. Because seroconversion was expected to occur at very low rates, a Poisson regression model was used to compare rates between centers as well as to estimate the relative risk of developing a seroconversion . Association between Dialyser Reuse (Center) and Seroconversion Rate Center Incidence Relative Risk (95% CI) P-value Center B (Reuse) 0.011 5.52 (1.93, 15.78) 0.002 Center A 0.062 The incidence of seroconversion was higher at Center A (0.062) where hemodialyzers were not reused than at Center B (0.011) where hemodialyzers were reused. The ratio of incidence of seroconversion for Center A relative to Center B was 5.52. There was between a 1.93 and 15.78 greater probability of seroconversion if a patient had hemodialysis at a center that did not reuse hemodialyzers relative to a center that did participate in reuse.This study illustrates that a non-reuse strategy does not significantly lower the risk of seroconversion when compared to the alternative. Other variables including the number of surgeries, transfusion load, race, and sex, were not significant predictors of seroconversion in the Poisson regression model. Intensification of other infection control procedures should be emphasized to prevent the spread of the Hepatitis C virus. </p><p>78BLOGGING HAS GLOBAL APPEAL AMONGST NEPHROLOGY ON-DEMAND USERS Tejas Desai, East Carolina University Brody School of Medicine, Greenville, North Carolina; Maria Ferris, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina An increasing number of health professionals author medical blogs. Although blogging is an alternave way of communicang, lile data exists on the popularity of medical blogs. We measured the usage of our medical blog, Nephrology On-Demand (ISSN 2155-9813) (hp://www.nephrologyondemand.org). Eight blogs from naonal (6) and regional (2) scienc meengs were published online, detailing the key learning points of selected seminars within a specic meeng. We used Google Analycs to measure usage data for each blog during the rst 90 days aer their publicaon. A total of 525 visitors and 871 page views were recorded during the study period (Figure 1). The average number of visitors and page views to blogs of local/regional meengs were 22 and 57, respecvely. These numbers increased to 80 and 121, respecvely, for the naonal/internaonal meeng blogs. Of the 2 local/regional scienc meengs, at least 30% of all visitors were from outside the United States, compared to at least 18% of visitors of the 6 naonal/internaonal meengs. The medical blogs published in Nephrology On-Demand have broadly aracted readers from around the world. These blogs provide a unique and popular method for sharing medical informaon. Further research is underway to determine if this new form of communicaon is also eecve in educang blog readers. </p><p>79LEARNING NEPHROLOGY THROUGH MOBILE DEVICES: THE NEPHROLOGY ON-DEMAND MOBILE EXPERIENCE Tejas Desai, East Carolina University Brody School of Medicine, Greenville, North Carolina; Maria Ferris, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina The frequency of medical educaon accessed via mobile devices is increasing. We examine how HCPs use mobile devices to access a medical educaon website. Nephrology-related informaon was made available to all mobile devices through the website Nephrology On-Demand.org (NOD) --maintained by the Division of Nephrology at East Carolina University. It contains evidence-based teaching material, categorized by topic, date, and target audience. Google Analycs code was included to track visits, pageviews, me on site, bounce rate, locaon, connecon speed, and device and browser types. </p><p>638 mobile visits were made from 2/10-10/20 (5.4% of visits). Visits came from 4 regions (USA 91%, Europe 3%, and Asia 4%, Central &amp; South America 2%). 441 (71%) were from Apple iPhones and 16% were from Adobe Flash-compable devices, and 55% were through a cellular connecon. Users spent the most me on the website (264 seconds/visit) when using these connecons. Faster connecon speeds resulted in less me on-site, but more resource views (97-158 seconds/visit for 2.14-2.65 resources/visit). </p><p>Data from NOD guides educators in developing user-friendly teaching tools. Further invesgaon on mobile user experiences is underway.</p><p>80OUTCOMES OF FIBRILLARY GLOMERULONEPHRITIS: A SINGLE CENTER EXPERIENCE Susmitha Dhanyamraju, Gene Falkowski, Taher Yahya Geisinger Medical Center, Danville, Pennsylvania Fibrillary glomerulonephritis (FGN) is a rare glomerulopathy associated with poor long-term outcome and characterized histopathologically by deposition of fibrillary structures within the glomeruli. Therapeutic options for FGN are currently limited. Angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), cytotoxic agents, and combination therapies thereof have been utilized with limited success. We have conducted a retrospective review of 458 native renal biopsies performed at Geisinger Medical Center from 1998 to 2009. 10/458 (2%) cases were identified as FGN and a retrospective chart review of these patients was completed. Progression to end stage renal disease and mortality were examined over a mean follow up period of 5.8 years. Mean age and eGFR at time of diagnosis was 49.7 years and 32ml/min/1.73m2 respectively. Greater than 60% of the patients exhibited nephrotic range proteinuria and hematuria upon diagnosis. </p><p> Patients with fibrillary glomerulonephritis usually present late in the course of their disease and have poor outcomes. In this retrospective chart review, outcomes of progression to ESRD and mortality varied in all ten patients. Treatment options to reduce progression to ESRD and mortality have yet to be established. </p><p>NKF 2011 Spring Clinical Meetings Abstracts</p><p>Am J Kidney Dis. 2011;57(4):A1-A108A36</p></li></ul>

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