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PERSPECTIVE: Vaccines and Autism Revisited -- The Hannah Poling Case
Mercredi 14 Mai 2008 - 06:55 - 7 mois, 4 semaines depuis - Presse spécialisée - New England Journal of Medicin
On April 11, 2008, the National Vaccine Advisory Committee took an unusual step: in the name of transparency, trust, and collaboration, it asked members of the public to help set ...

PERSPECTIVE: Like Night and Day -- Shedding Light on Off-Hours Care
Mercredi 14 Mai 2008 - 06:55 - 7 mois, 4 semaines depuis - Presse spécialisée - New England Journal of Medicin
Lately, I've been coming to work at midnight. You see, I've begun making late-night administrative rounds at the hospital where I am president and chief executive officer. No, I'm not ...

ORIGINAL ARTICLE: Class-Sparing Regimens for Initial Treatment of HIV-1 Infection
Mercredi 14 Mai 2008 - 06:55 - 7 mois, 4 semaines depuis - Presse spécialisée - New England Journal of Medicin
Several regimens are used as initial antiretroviral therapy for HIV-1 infection, but few direct comparisons are available. In this randomized, open-label study, efavirenz plus two nucleoside reverse-transcriptase inhibitors (NRTIs), lopinavir-ritonavir plus two NRTIs, and lopinavir-ritonavir plus efavirenz were compared. Initial therapy with efavirenz plus two NRTIs was associated with less virologic failure than was lopinavir-ritonavir plus two NRTIs. The NRTI-sparing regimen of lopinavir-ritonavir plus efavirenz had virologic efficacy similar to that of efavirenz plus two NRTIs but was more likely to select for drug resistance.

ORIGINAL ARTICLE: Use of Multiple Biomarkers to Improve the Prediction of Death from Cardiovascular Causes
Mercredi 14 Mai 2008 - 06:55 - 7 mois, 4 semaines depuis - Presse spécialisée - New England Journal of Medicin
To predict the risk of death from cardiovascular causes in a community-based cohort of elderly men, the authors used a combination of biomarkers (troponin I, N-terminal pro-brain natriuretic peptide, cystatin C, and C-reactive protein). The addition of these markers to a model with traditional cardiovascular risk factors significantly improved risk stratification as compared with a model that used only the traditional risk factors.

ORIGINAL ARTICLE: Cardiac Troponin and Outcome in Acute Heart Failure
Mercredi 14 Mai 2008 - 06:55 - 7 mois, 4 semaines depuis - Presse spécialisée - New England Journal of Medicin
In this large, retrospective registry study, patients hospitalized with acute decompensated heart failure who had elevated cardiac troponin levels had higher mortality rates than those who were negative for troponin, even after correction for other predictive variables. Measurement of cardiac troponin, which may reflect myocyte injury, is useful for risk stratification of such patients.

ORIGINAL ARTICLE: Efficacy and Safety of Recombinant Activated Factor VII for Acute Intracerebral Hemorrhage
Mercredi 14 Mai 2008 - 06:55 - 7 mois, 4 semaines depuis - Presse spécialisée - New England Journal of Medicin
In a previous phase 2 placebo-controlled trial, recombinant activated factor VII (rFVIIa) reduced growth of the hematoma and improved survival and functional outcome in patients with intracerebral hemorrhage. Those findings were not reproduced in this phase 3 trial, in which rFVIIa reduced hematoma growth but did not improve clinical outcomes.

CLINICAL PRACTICE: Rotator-Cuff Failure
Mercredi 14 Mai 2008 - 06:55 - 7 mois, 4 semaines depuis - Presse spécialisée - New England Journal of Medicin
A 63-year-old woman presents with a 2-year history of progressive weakness and discomfort in her right shoulder, especially when she puts dishes on the top shelf in her kitchen. She is otherwise healthy and has had no injuries. Physical examination shows some atrophy of the muscles in the right shoulder and weakness when the right arm is elevated. Magnetic resonance imaging shows a large defect in the rotator cuff. How should her case be managed?

REVIEW ARTICLE: Medical Progress: Biomarkers in Heart Failure
Mercredi 14 Mai 2008 - 06:55 - 7 mois, 4 semaines depuis - Presse spécialisée - New England Journal of Medicin
Heart failure results not only from cardiac overload or injury but also from a complex interplay among genetic, neurohormonal, inflammatory, and biochemical changes acting on cardiac myocytes, the cardiac interstitium, or both. This review focuses on biomarkers for heart failure other than routinely determined laboratory values and discusses how these might be used in assessing and managing heart failure.

IMAGES IN CLINICAL MEDICINE: Keratoderma Blennorrhagica
Mercredi 14 Mai 2008 - 06:55 - 7 mois, 4 semaines depuis - Presse spécialisée - New England Journal of Medicin
A 55-year-old bisexual man presented with a few weeks' history of lethargy followed by the onset of a widespread nonpruritic rash that covered much of his body, including the palms ...

IMAGES IN CLINICAL MEDICINE: Giant Ovarian Cyst
Mercredi 14 Mai 2008 - 06:55 - 7 mois, 4 semaines depuis - Presse spécialisée - New England Journal of Medicin
A 24-year-old woman (gravida 0, para 0) presented with a history of progressive abdominal distention during the previous year, accompanied by early satiety and constipation. There was no history of ...

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