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ORIGINAL ARTICLE: Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke
Mercredi 24 Septembre 2008 - 06:55 - 1 mois, 3 semaines depuis   -  Presse spécialisée  -  New England Journal of Medicin
Intravenous thrombolysis with alteplase improves the outcomes after acute stroke when alteplase is given within 3 hours after the onset of symptoms. In this randomized trial involving patients who presented between 3 and 4.5 hours after the onset of stroke, clinical outcomes were modestly better in patients treated with alteplase than in patients given placebo (favorable outcome in 52% vs. 45% of patients).
ORIGINAL ARTICLE: Drug-Eluting or Bare-Metal Stents for Acute Myocardial Infarction
Mercredi 24 Septembre 2008 - 06:55 - 1 mois, 3 semaines depuis   -  Presse spécialisée  -  New England Journal of Medicin
In an analysis of patients undergoing coronary-artery stenting for acute myocardial infarction in Massachusetts, recipients of drug-eluting stents were compared with recipients of bare-metal stents in propensity-matched cohorts. Mortality rates and repeat target-vessel revascularization rates at 2 years were significantly lower with drug-eluting stents. The rates of reinfarction were reduced in patients with myocardial infarction without ST-segment elevation who were treated with drug-eluting stents.
ORIGINAL ARTICLE: Intensive Lipid Lowering with Simvastatin and Ezetimibe in Aortic Stenosis
Mercredi 24 Septembre 2008 - 06:55 - 1 mois, 3 semaines depuis   -  Presse spécialisée  -  New England Journal of Medicin
In this randomized, placebo-controlled trial, the combination of simvastatin and ezetimibe had no effect on the progression of aortic stenosis, despite substantial lowering of low-density lipoprotein cholesterol. There was a reduction in the need for coronary bypass surgery in the simvastatin-ezetimibe group, but unexpectedly, active treatment was also associated with an increased incidence of cancer.
SPECIAL ARTICLE: Analyses of Cancer Data from Three Ezetimibe Trials
Mercredi 24 Septembre 2008 - 06:55 - 1 mois, 3 semaines depuis   -  Presse spécialisée  -  New England Journal of Medicin
The Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) trial involving the combination of ezetimibe and simvastatin in patients with aortic stenosis suggested an increased incidence of cancer associated with the use of active therapy. The current analysis of two other ongoing trials of ezetimibe and simvastatin does not support the suggestion of an increased incidence of cancer but does show increased cancer mortality.
REVIEW ARTICLE: Molecular Origins of Cancer: Lung Cancer
Mercredi 24 Septembre 2008 - 06:55 - 1 mois, 3 semaines depuis   -  Presse spécialisée  -  New England Journal of Medicin
The Molecular Origins of Cancer series continues with this review of molecular and genetic mechanisms of lung cancer. The authors review genetic susceptibility to lung cancer and four genes of importance in the evolution of the disease: EGFR, KRAS, the PI3K-Akt-mTOR complex, and TITF1. They also discuss gene profiling and protein profiling, with emphasis on the clinical value of these methods.
IMAGES IN CLINICAL MEDICINE: Periungual Fibromas
Mercredi 24 Septembre 2008 - 06:55 - 1 mois, 3 semaines depuis   -  Presse spécialisée  -  New England Journal of Medicin
A 36-year-old woman with mild mental retardation and facial angiofibromas presented for evaluation of recurrent seizures, which she reported having had since childhood. Periungual fibromas were seen in the feet. ...
IMAGES IN CLINICAL MEDICINE: New-Onset Clubbing Associated with Lung Cancer
Mercredi 24 Septembre 2008 - 06:55 - 1 mois, 3 semaines depuis   -  Presse spécialisée  -  New England Journal of Medicin
A 45-year-old woman with a 27-pack-year history of smoking presented for evaluation of progressive distal finger enlargement and polyarthralgias, which had developed over a period of 18 months. During the ...
CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 30-2008 -- A 47-Year-Old Woman with a Mass in the Breast and a Solitary Lesion in the Spine
Mercredi 24 Septembre 2008 - 06:55 - 1 mois, 3 semaines depuis   -  Presse spécialisée  -  New England Journal of Medicin
A 47-year-old premenopausal woman came to this hospital for treatment of breast cancer. A mass that measured 5 cm in diameter was present in the left breast; needle biopsies showed infiltrating ductal carcinoma that was grade 2 of 3, hormone receptor-positive, HER2/neu-negative. An evaluation of the staging disclosed a solitary lesion in the T6 vertebral body, which was asymptomatic. A management decision was made.
EDITORIAL: Thrombolytic Therapy for Acute Stroke -- Not a Moment to Lose
Mercredi 24 Septembre 2008 - 06:55 - 1 mois, 3 semaines depuis   -  Presse spécialisée  -  New England Journal of Medicin
Stroke, the most common cause of disability in the world among adults, remains the only neurologic disorder for which physicians are potentially able to completely reverse disabling deficits.1 Thrombolytic therapy, ...
EDITORIAL: Calcific Aortic Stenosis -- Time to Look More Closely at the Valve
Mercredi 24 Septembre 2008 - 06:55 - 1 mois, 3 semaines depuis   -  Presse spécialisée  -  New England Journal of Medicin
Calcific aortic stenosis is a progressive disease that results in stiff valve leaflets with eventual obstruction to left ventricular outflow. Once symptoms occur, valve replacement is the only effective treatment, ...

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