Influenza virus is the most frequently reported viral cause of rhabdomyolysis. A 7-year-old child is presented with rhabdomyolysis associated with parainfluenza type 2 virus. Nine cases of rhabdomyolysis associated with parainfluenza virus have been reported. Complications may include electrolyte disturbances, acute renal failure, and compartment syndrome.

BACKGROUND: It has been suggested by national data and popular media that prevalence of obesity and elevated Blood Pressure (BP) has increased in the United States over time. OBJECTIVE: To assess the trends in the prevalence of elevated BP and obesity in adult patients, and to quantify any correlation between them using national probability data sets. DESIGN/METHODS: An analysis of visit data for all patients 18 years and older included in the 2005-09 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey-Outpatient Department (OPD) was performed. BP data from 160,380 patient visits were analyzed, including adults seen in ambulatory or office-based settings (NAMCS, N=74,645) and hospital outpatient departments (OPD, N=85,735). Correlation between BP and BMI were calculated using the Pearson Correlation method. Results: Overall, the prevalence of hypertension decreased over time, while the prevalence of obesity increased. This data is represented in Table 1. Conclusions: This analysis suggests that while the prevalence of obesity may be increasing, the prevalence of elevated BP has actually decreased over time. This seemingly counter-intuitive finding may reflect improved BP control rates, despite obesity, which is suggested in contemporary NHANES data.

Background: The Heart Improvement Project (HIP) is a cardiovascular (CV) risk reduction clinic targeting high-risk, uninsured patients. Using coronary heart disease prediction models from the Framingham Heart Study, it is possible to project an individual’s 10-year CV disease risk based on status of the following risk factors: sex, age, LDL-Cholesterol (LDL-C), HDL-Cholesterol (HDL-C), blood pressure (BP), diabetes, and smoking status. Objective: To project the reduction in CV risk associated with two levels of intervention: first-line therapy (designed to decrease the systolic BP by 15 mm Hg and LDL-C by 30%) and maximal therapy to optimally control all modifiable risk factors. Methods: Data on 251 patients (52% male, mean age 51 yrs; 48% with Diabetes, 45% smokers) from HIP were analyzed. For each patient, their Framingham Risk Scores (FRS) and 10-year Coronary Heart Disease Risk (CHDR) were calculated in three different conditions: their actual risk assessment, and that projected under first-line, and maximal therapy. The three sets of FRS and CHDR were summarized using descriptive statistics. Pairwise differences between the three sets of FRS and CHDR were tested using two-sample t-test and 95% confidence intervals for the differences were computed. Results: Table 1 shows that the mean FRSs were 7.33, 4.90, and 3.51 (under initial, first-line, and maximal conditions, respectively). The corresponding CHDRs were 13%, 8%, and 6% respectively. All comparisons were statistically significant at the p<0.001 level. Conclusions: First-line interventions for BP and lipid management can yield significant improvement in CHD risk in a population of high-risk uninsured patients.

BACKGROUND: Blood pressure (BP) screening in adults has been identified by the US Preventive Services Task Force as a Grade A recommendation. OBJECTIVE: To compare BP screening rates in adult patients among payer sources and provider types in two national probability samples of outpatient office visits. DESIGN/METHODS: An analysis of visit data for all patients 18 years and older in the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey-Outpatient Department (OPD) during the years 2005-2009 was performed. Data on 279,510 patient visits were analyzed, including adults seen in ambulatory or office-based settings (NAMCS, N=147,675) and hospital outpatient departments (OPD, N=131,835). BP screening rates were compared based on provider type (Family Practice, Internal Medicine, Obstetrics-Gynecology, and Cardiovascular Specialist) and payer source (Private Insurance, Medicare, Medicaid, and Self Pay). Results: Overall, BP screening rates were higher in the OPD sample (65.70% vs, 55.83%, p < .001), despite a higher mean age and higher proportion of privately insured or Medicare patients in the NAMCS sample. The odds ratio for BP screening was 1.538 for insured patients compared to self-pay in the NAMCS sample (95% CI: 1.473-1.606); however, the disparity was not observed in the OPD data. Cardiovascular specialists demonstrated the most adherence to BP screening, regardless of payer source. Overall BP screening rates are shown in Table 1. Conclusions: Analysis of two national probability samples reflected marked disparity in BP screening in adult patients based on payer source and provider type.