As the population ages and incidence of basal cell carcinoma continues to increase, we will be faced more frequently with difficult treatment decisions for basal cell carcinoma in the elderly. Different treatment options, including surgical excision, electrodessication and curettage, cryosurgery, imiquimod, photodynamic therapy, 5-fluorouracil, radiation therapy, vismodegib, combination therapy, and observation, may be considered on the basis of tumor characteristics. Given the wide range of therapeutic options, treatments can be tailored to achieve patients' goals of care within their anticipated life expectancy.

Methanol intoxication is an uncommon but serious poisoning that can cause severe cellular dysfunction and death, and delayed treatment can increase mortality to as high as 44%. Definitive diagnosis requires measurement with gas or liquid chromatography, which are difficult and costly tests, and clinical abnormalities can take 96 hours to appear, further complicating diagnosis. In this month's AJKD, Kraut presents a case involving a 22-year-old woman with acute methanol intoxication to investigate the value and limitations of new diagnostic approaches and treatments.

In this population-based cohort study, the authors examined whether postnatal growth in the first 6 months of life was associated with motor, cognitive, and behavioral outcomes in very preterm infants and whether this association varied by prenatal growth profile. Small-for-gestational-age (SGA) status, regardless of velocity of postnatal growth, was associated with behavioral problems and cognitive deficiency compared with appropriate-for-gestational-age (AGA) status. Deficient postnatal growth was associated with poor neurologic outcomes for both AGA and SGA preterm infants, and catch-up growth was not associated with better outcomes. Growth velocity within the first 15 days of life was highly associated with growth profile at 6 months of age. This study highlights the importance of early neonatal weight gain and early provision of nutrients.

Non-specific chronic spinal pain (NSCSP) is highly disabling. Current conservative rehabilitation commonly includes physical and behavioural interventions or a combination of these approaches. Since it remains unclear whether any of these approaches is superior, this systematic review aimed to assess the comparative effectiveness of physical, behavioral, and/or psychologically informed and combined interventions on pain and disability in patients with NSCSP. The authors report that only small differences in pain or disability were observed between physical, behavioral, and/or psychologically informed and combined interventions.

Skin cancer is the most common cancer, and its incidence is increasing. This study tested the efficacy of an Internet intervention in decreasing UV exposure and increasing skin protection behavior among young adults. Participants were randomized to one of three conditions: assessment only, referral to the website of a skin cancer organization, or a tailored interactive multimedia Internet intervention program (UV4.me). Individuals in all three conditions exhibited decreased exposure and increased protection at both follow-ups, but those in the intervention group had significant decreases in UV exposure and increases in skin protection at both follow-up time points.

Within the CHOICE project, women initially choosing injectable contraception had pregnancy rates similar to those choosing oral contraception and had significantly worse rates than those choosing intrauterine or implantable contraception.

Can Skilled Nursing Facility (SNF) staff tell you afterward whether a hospitalization could have been avoided? Root cause analyses (RCAs) were conducted by trained staff from 64 SNFs from across the U.S. Out of 4,527 RCAs, 23% could have been avoided or prevented, according to staff. The hope is that SNFs can use RCAs to educate and improve care processes to reduce avoidable hospitalizations in the future.

Swedish researchers combined information on genetic and nongenetic markers for the All New Diabetics in Scania project, a database that contains patient records from 10,785 newly diagnosed diabetes patients ages 0 to 97, and were able to identify five subgroups of diabetes. The findings, presented at the American Diabetes Association's 76th Scientific Sessions, showed that the new subgroups were classified according to the type of diabetes, beta-cell function impairment of non-autoimmune background, insulin resistance with the highest risk for kidney disease, obesity and age at onset.

A study found about 1 in 9 men will experience cardiac arrest before they reach 70 years of age, compared with 1 in 30 women, researchers reported in the Journal of the American Heart Association. The data found men who had two or more cardiovascular risk factors had a 12% risk of sudden cardiac death.

A South African study in JAMA Pediatrics found that efficacy of maternal flu vaccines in infants dropped from 85.6% during the first 8 weeks of life to about 25% to 30% at ages 8 to 16 weeks and 16 to 24 weeks. The findings were based on more than 1,000 babies whose mothers received flu shots during gestation.

Greater integration of medical and social services may decrease health care costs and improve patient outcomes, according to a study supported by the Blue Cross Blue Shield of Massachusetts Foundation. Targeting elderly, disabled and low-income populations with nutritional services, housing support and case management yields the greatest benefit, according to the findings, and The Commonwealth Fund is working to determine the best approaches for health care payers and providers to coordinate medical and nonmedical interventions, write the fund's Melinda Abrams and Donald Moulds.

A study in the journal Cancer Epidemiology, Biomarkers and Prevention found that almost 62% of US cancer survivors are at least 65 years old, and 73% of an estimated 26 million survivors will be at least 65 in 2040. The growing number of senior cancer survivors, many of whom develop chronic medical problems such as heart disease and diabetes, combined with a decreasing number of oncologists may further financially strain the US health care system, notes Kim Miller, an epidemiologist at the American Cancer Society.

Children with stable families and positive relationships with their parents were more likely to have healthy habits and less likely to be overweight than youths who didn't have high family functioning and positive parental relationships. The findings in the International Journal of Behavioral Nutrition and Physical Activity also showed that father-son relationships had a stronger influence in developing healthy behaviors, compared with mother-daughter relationships.