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PERSPECTIVE: Election 2008: Slowing the Growth of Health Care Costs -- Learning from International Experience
Mercredi 22 Octobre 2008 - 06:55 - 1 mois, 1 semaine depuis - Presse spécialisée - New England Journal of Medicin
High health care expenditures and the growing number of people without health insurance set the United States apart from all other industrialized countries. The United States spends twice per capita ...

ORIGINAL ARTICLE: K-ras Mutations and Benefit from Cetuximab in Advanced Colorectal Cancer
Mercredi 22 Octobre 2008 - 06:55 - 1 mois, 1 semaine depuis - Presse spécialisée - New England Journal of Medicin
This study examined the mutation status of the K-ras gene in colorectal tumors from patients who were enrolled in a trial of cetuximab, a monoclonal antibody against the epidermal growth factor receptor (EGFR). A survival benefit was found among patients with tumors bearing wild-type K-ras but not among patients with tumors bearing mutated K-ras. Wild-type K-ras is essential in transmitting signals initiated by EGFR.

ORIGINAL ARTICLE: Toll-like Receptor 4 Polymorphisms and Aspergillosis in Stem-Cell Transplantation
Mercredi 22 Octobre 2008 - 06:55 - 1 mois, 1 semaine depuis - Presse spécialisée - New England Journal of Medicin
Toll-like receptors (TLRs) are a central aspect of the innate immune response. Different TLRs are associated with the immune response to different infectious pathogens. In this retrospective analysis, an increased susceptibility to invasive aspergillosis was associated with certain polymorphisms in donor TLR4 in patients who received an allogeneic hematopoietic stem-cell transplant from an unrelated donor.

ORIGINAL ARTICLE: Pulmonary-Vein Isolation for Atrial Fibrillation in Patients with Heart Failure
Mercredi 22 Octobre 2008 - 06:55 - 1 mois, 1 semaine depuis - Presse spécialisée - New England Journal of Medicin
In patients with symptomatic atrial fibrillation and heart failure, pulmonary-vein isolation was found to be superior to atrioventricular-node ablation with biventricular pacing. Isolation of the pulmonary veins by means of ablation is a viable option for patients with refractory atrial fibrillation and heart failure.

ORIGINAL ARTICLE: Alemtuzumab vs. Interferon Beta-1a in Early Multiple Sclerosis
Mercredi 22 Octobre 2008 - 06:55 - 1 mois, 1 semaine depuis - Presse spécialisée - New England Journal of Medicin
In this randomized, phase 2 trial involving previously untreated patients with early, relapsing-remitting multiple sclerosis, alemtuzumab, a monoclonal antibody targeting CD52 on lymphocytes and monocytes, was more effective than interferon beta-1a in reducing the progression of disability and relapse. Alemtuzumab caused autoimmune complications, including immune thrombocytopenic purpura (resulting in one death) and thyroid disorders.

SPECIAL ARTICLE: Cardiovascular Outcomes after a Change in Prescription Policy for Clopidogrel
Mercredi 22 Octobre 2008 - 06:55 - 1 mois, 1 semaine depuis - Presse spécialisée - New England Journal of Medicin
A program requiring prior authorization for the use of clopidogrel was in place in Canada in 2000. After the prior-authorization requirement was removed in September 2003, the use of clopidogrel in patients receiving coronary stents after myocardial infarction increased substantially and clinical outcomes improved.

REVIEW ARTICLE: Medical Progress: Uric Acid and Cardiovascular Risk
Mercredi 22 Octobre 2008 - 06:55 - 1 mois, 1 semaine depuis - Presse spécialisée - New England Journal of Medicin
This review summarizes relevant studies concerning uric acid and possible links to hypertension, renal disease, and cardiovascular disease. Whether uric acid is an independent risk factor for such diseases is still a point of debate. Current evidence is presented.

IMAGES IN CLINICAL MEDICINE: What Lies Beneath?
Mercredi 22 Octobre 2008 - 06:55 - 1 mois, 1 semaine depuis - Presse spécialisée - New England Journal of Medicin
A 74-year-old male smoker was hospitalized for a transurethral resection of the prostate. His medical history was notable for the insertion of a dual-chamber pacemaker to treat symptomatic bradycardia 10 ...

IMAGES IN CLINICAL MEDICINE: Corneal Dendritic Ulcer from Herpes Simplex Virus Infection
Mercredi 22 Octobre 2008 - 06:55 - 1 mois, 1 semaine depuis - Presse spécialisée - New England Journal of Medicin
A 24-year-old man presented with a 2-day history of redness, photophobia, and blurry vision in the right eye. He reported no medical problems, similar previous episodes, fever, recent illnesses, or ...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 33-2008 -- A 63-Year-Old Woman with Dyspnea on Exertion
Mercredi 22 Octobre 2008 - 06:55 - 1 mois, 1 semaine depuis - Presse spécialisée - New England Journal of Medicin
A 63-year-old woman was admitted to the hospital because of a 3-week history of dyspnea on exertion, associated left subscapular burning pain, and a mild dry cough. She had a history of ulcerative colitis, which was most recently treated with azathioprine and infliximab. On examination, there were inspiratory wheezes and rales, without expiratory wheezes. Chest imaging showed ground-glass opacities in both lower lobes. A diagnostic procedure was performed.

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