Medicine

Protecting the Children of Haiti

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

Haiti has long had difficulty in protecting its children from harm. The earthquake that struck the country on January 12 destroyed much of the capital, Port-au-Prince, as it killed many ...

Categories: Medicine

Recovering from Disaster -- Partners in Health and the Haitian Earthquake

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

The earthquake of January 12 killed many of Haiti's doctors and nurses and destroyed a large part of the country's medical infrastructure. But Zanmi Lasante (ZL), the Haitian branch of ...

Categories: Medicine

Medicare's Opportunity to Encourage Innovation in Health Care Delivery

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

The Democrats' loss of their 60-vote Senate majority after Massachusetts' January 19 special election creates major challenges for passage of comprehensive national health care reform. Critics of the Democrats' proposals ...

Categories: Medicine

Weighing Risks and Benefits of Liraglutide -- The FDA's Review of a New Antidiabetic Therapy

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

Type 2 diabetes mellitus affects approximately 24 million people in the United States, is the leading cause of kidney failure and blindness, and is associated with a doubling to quadrupling ...

Categories: Medicine

Comparison of Dopamine and Norepinephrine in the Treatment of Shock

New England Journal of Medicine - Wed, 03/03/2010 - 18:25
In this comparative-effectiveness trial, there was no significant difference in the overall survival rate between patients with shock who were treated with dopamine and those who were treated with norepinephrine. However, dopamine was associated with more cardiac arrhythmias and with a higher mortality rate among patients with cardiogenic shock.

Categories: Medicine

Ethosuximide, Valproic Acid, and Lamotrigine in Childhood Absence Epilepsy

New England Journal of Medicine - Wed, 03/03/2010 - 18:25
In this randomized trial of three common treatments for childhood absence epilepsy, ethosuximide and valproic acid were more effective than lamotrigine, and adverse effects on attention were less frequent with ethosuximide than with valproic acid. These findings suggest that ethosuximide has the best efficacy and safety profile.

Categories: Medicine

Glycated Hemoglobin, Diabetes, and Cardiovascular Risk in Nondiabetic Adults

New England Journal of Medicine - Wed, 03/03/2010 - 18:25
This community-based study of nondiabetic adults compared the prognostic value of glycated hemoglobin and fasting glucose for identifying persons at risk for clinical outcomes such as diabetes. As compared with fasting glucose, glycated hemoglobin was similarly associated with the risk of diabetes and more strongly associated with the risks of cardiovascular disease and death from any cause, adding to data about the use of glycated hemoglobin as a diagnostic measure.

Categories: Medicine

A Trial of a 7-Valent Pneumococcal Conjugate Vaccine in HIV-Infected Adults

New England Journal of Medicine - Wed, 03/03/2010 - 18:25
Pneumococcal infection is an important cause of death and complications in adults with human immunodeficiency virus (HIV) infection, particularly in Africa. In this placebo-controlled, randomized trial involving 496 predominantly HIV-infected Malawian adults who had recently had an invasive pneumococcal infection, the 7-valent conjugated pneumococcal vaccine was found to have 74% efficacy in preventing subsequent invasive pneumococcal infection with a vaccine-associated serotype.

Categories: Medicine

Current Concepts: Management of Varices and Variceal Hemorrhage in Cirrhosis

New England Journal of Medicine - Wed, 03/03/2010 - 18:25
Gastroesophageal varices are present at diagnosis in almost half of patients with cirrhosis, and variceal hemorrhage continues to be a lethal complication of cirrhosis. This review explains the three main challenges in clinical management: primary prophylaxis to prevent a first episode of hemorrhage, the treatment of acute bleeding episodes, and secondary prophylaxis to prevent recurrence of variceal hemorrhage.

Categories: Medicine

Congenital Cytomegalovirus Infection

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

A baby girl was delivered prematurely, at 30 weeks' gestation, by emergency cesarean section owing to deceleration and no acceleration on fetal heart-rate monitoring. In addition, she had severe intrauterine ...

Categories: Medicine

Neuropathic Ulceration

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

A 61-year-old man with a 15-year history of diabetes and resulting foot neuropathy presented with an ulcer of 3 months' duration overlying the first metatarsal head (Panel A). He was ...

Categories: Medicine

Stalking the Diagnosis

New England Journal of Medicine - Wed, 03/03/2010 - 18:25
A 58-year-old woman presented to her primary care physician after several days of dizziness, anorexia, dry mouth, increased thirst, and frequent urination. She had also had a fever and reported that food would "get stuck" when she was swallowing. She reported no pain in her abdomen, back, or flank and no cough, shortness of breath, diarrhea, or dysuria.

Categories: Medicine

Treating Shock -- Old Drugs, New Ideas

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

Circulatory shock is a medical emergency that is characterized by hypotension and decreased tissue perfusion; if left untreated, it can lead to irreversible cellular injury and death. Hypotension associated with ...

Categories: Medicine

Ethosuximide in Childhood Absence Epilepsy -- Older and Better

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

Where did our wisdom about treating epilepsy originate? The ketogenic diet came from ancient teachings. The mistaken belief that seizures were caused by sexual excess led to bromides. Modern medications ...

Categories: Medicine

Collection of Data on Patients' Race and Ethnic Group by Physician Practices

New England Journal of Medicine - Wed, 03/03/2010 - 18:25
The authors argue that physician practices should routinely collect data on the race and ethnic group of their patients. They caution against the use of these data to infer information about health-related values or beliefs, and they discuss the benefit of using these data at the population level to detect disparities in care and to improve the quality of care.

Categories: Medicine

On-Pump versus Off-Pump CABG

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

To the Editor: In the Veterans Affairs Randomized On/Off Bypass (ROOBY) trial, Shroyer et al. (Nov. 5 issue)1 assigned 2203 ...

Categories: Medicine

A Controlled Trial of Initial Antiviral Regimens for HIV-1 Infection

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

To the Editor: Sax et al. (Dec. 3 issue)1 found that abacavir-lamivudine was less potent than tenofovir disoproxil fumarate (DF)-emtricitabine ...

Categories: Medicine

Effects of Obesity and Smoking on U.S. Life Expectancy

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

To the Editor: Mortality from adult obesity and from persistent smoking have already been reliably assessed in studies of tens ...

Categories: Medicine

Repair of Mitral-Valve Prolapse

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

To the Editor: In the review article by Verma and Mesana (Dec. 3 issue),1 mitral-valve prolapse is defined as the ...

Categories: Medicine

A Crisis in Late Pregnancy

New England Journal of Medicine - Wed, 03/03/2010 - 18:25

To the Editor: In the article by Desai et al. (Dec. 3 issue),1 the electrocardiogram has the characteristics of one ...

Categories: Medicine
Syndicate content