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PERSPECTIVE: Shuffling toward Parity -- Bringing Mental Health Care under the Umbrella
Mercredi 09 Juillet 2008 - 06:55 - 6 mois depuis - Presse spécialisée - New England Journal of Medicin
For half a century, advocates and reformers have sought to ensure that mental illnesses are addressed in the same way as all other illnesses. Considerable progress has been made, and ...

PERSPECTIVE: The (Slowly) Vanishing Prescription Pad
Mercredi 09 Juillet 2008 - 06:55 - 6 mois depuis - Presse spécialisée - New England Journal of Medicin
The prescription pad, as familiar a medical emblem as the stethoscope or the white coat, is on its way to becoming a historical curiosity. Electronic prescribing -- narrowly speaking, the ...

ORIGINAL ARTICLE: Extended Antiretroviral Prophylaxis to Reduce Breast-Milk HIV-1 Transmission
Mercredi 09 Juillet 2008 - 06:55 - 6 mois depuis - Presse spécialisée - New England Journal of Medicin
The prevention of mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) during breast-feeding is a unique opportunity to curtail the AIDS epidemic. In this trial in Malawi, 3016 infants without HIV-1 infection who were born to infected mothers were randomly assigned to receive a single dose of nevirapine plus 1 week of zidovudine (control regimen) or the control regimen plus extended daily prophylaxis with nevirapine or with nevirapine plus zidovudine until the age of 14 weeks. Extended prophylaxis significantly decreased the rate of HIV-1 transmission (10.6%, 5.2%, and 6.4%, respectively) at 9 months.

ORIGINAL ARTICLE: Effects of Early, Abrupt Weaning on HIV-free Survival of Children in Zambia
Mercredi 09 Juillet 2008 - 06:55 - 6 mois depuis - Presse spécialisée - New England Journal of Medicin
Minimizing the risk of maternal-to-child transmission of the human immunodeficiency virus (HIV) is a high priority. In this trial in Zambia, 958 HIV-infected women were randomly assigned to breast-feeding according to the standard practice or to abrupt weaning at 4 months. There was no significant difference in HIV-free survival between the study groups at 24 months.

ORIGINAL ARTICLE: Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema
Mercredi 09 Juillet 2008 - 06:55 - 6 mois depuis - Presse spécialisée - New England Journal of Medicin
Noninvasive ventilation (either continuous positive airway pressure or noninvasive intermittent positive-pressure ventilation) had no effect on 7-day or 30-day mortality in patients with cardiogenic pulmonary edema, as compared with standard oxygen therapy. Noninvasive ventilation should be used only to relieve symptoms and correct metabolic disturbances.

ORIGINAL ARTICLE: Brief Report: Familial Myeloma
Mercredi 09 Juillet 2008 - 06:55 - 6 mois depuis - Presse spécialisée - New England Journal of Medicin
This report describes three generations of a family that included five cases of multiple myeloma, three cases of monoclonal gammopathy of undetermined significance (MGUS), and five cases of prostate cancer. The putative progenitor had progeny with prostate cancer, multiple myeloma, and MGUS with two female partners.

ORIGINAL ARTICLE: Brief Report: Atrial Natriuretic Peptide Frameshift Mutation in Familial Atrial Fibrillation
Mercredi 09 Juillet 2008 - 06:55 - 6 mois depuis - Presse spécialisée - New England Journal of Medicin
In a family with hereditary atrial fibrillation, linkage analysis and candidate-gene sequencing identified a frameshift mutation in the atrial natriuretic peptide gene. This mutation segregated with atrial fibrillation in the family and generated a fusion protein that was detected by radioimmunoassay in the plasma of affected family members. The mutant protein caused shortening of the atrial monophasic action potential and the effective refractory period in isolated perfused hearts.

CLINICAL PRACTICE: Initial Management of Epilepsy
Mercredi 09 Juillet 2008 - 06:55 - 6 mois depuis - Presse spécialisée - New England Journal of Medicin
A 29-year-old woman reports that the previous evening, her husband (who was in the next room) heard unusual sounds and found her lying on the bed looking dazed. She was confused for a few minutes but quickly returned to normal. She recalls an unwitnessed event about 1 month previously when she awoke feeling mildly confused and had sore muscles. How should she be evaluated and treated?

IMAGES IN CLINICAL MEDICINE: Digital Verrucae
Mercredi 09 Juillet 2008 - 06:55 - 6 mois depuis - Presse spécialisée - New England Journal of Medicin
A 34-year-old woman underwent renal transplantation for chronic idiopathic glomerulonephritis, and 4 years later small verrucae developed on her distal fingertips. Over the course of 11 years after transplantation, during ...

IMAGES IN CLINICAL MEDICINE: Bifid Uvula and Aortic Aneurysm
Mercredi 09 Juillet 2008 - 06:55 - 6 mois depuis - Presse spécialisée - New England Journal of Medicin
A 24-year-old man was hospitalized for evaluation of an aortic-root aneurysm. He had a family history of aortic disease. Physical examination revealed proptosis, retrognathia, bifid uvula (Panel A), and pectus ...

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