Medicine

Dermoscopy of Phthiriasis

A 50-year-old man presented with a 1-month history of mild, generalized pruritus. A total-body examination of the patient's skin revealed small, yellowish-brown flecks in the hair of the upper arm (Panel A), chest, and axilla . . .

Categories: Medicine

How to Think about Future Health Care Spending

New England Journal of Medicine - Wed, 03/10/2010 - 17:56
(No abstract is available for this citation)
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Whole-Genome Sequencing in a Patient with Charcot-Marie-Tooth Neuropathy

New England Journal of Medicine - Wed, 03/10/2010 - 17:56

Background Whole-genome sequencing may revolutionize medical diagnostics through rapid identification of alleles that cause disease. However, even in cases with simple patterns of inheritance and unambiguous diagnoses, the relationship between ...

Categories: Medicine

Individual Genomes on the Horizon

New England Journal of Medicine - Wed, 03/10/2010 - 17:55
(No abstract is available for this citation)
Categories: Medicine

Can States Pick Up the Health Reform Torch?

New England Journal of Medicine - Wed, 03/10/2010 - 17:55

It is impossible to recall another time when a single incident -- in this case, the off-cycle election of a U.S. senator -- so thoroughly implicated the long-term direction of ...

Categories: Medicine

Be Not Afraid

New England Journal of Medicine - Wed, 03/10/2010 - 17:55

Voters are angry and distrustful of Washington. Democrats have lost their nerve. Republicans, sensing weakness, are closing in for the kill. We have seen this health care reform horror movie ...

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Rapid Medical Relief -- Project Medishare and the Haitian Earthquake

New England Journal of Medicine - Wed, 03/10/2010 - 17:55

On the evening of January 12, 2010, a few hours after the Haitian earthquake, the leaders of Project Medishare in Miami began contacting Haitian associates, faculty and staff of the ...

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Civil-Military Collaboration in the Initial Medical Response to the Earthquake in Haiti

New England Journal of Medicine - Wed, 03/10/2010 - 17:55

Two days after Haiti's devastating earthquake, a medical relief team made up in part of four emergency physicians and four emergency nurses from Stanford University Hospital and three emergency physicians ...

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The Missing Voice of Patients in Drug-Safety Reporting

New England Journal of Medicine - Wed, 03/10/2010 - 17:55

A patient wants to know about symptoms she may have from a prescription drug she is taking. Consulting the label's "Adverse Reactions" section, she finds a wealth of data. Little ...

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Can the States Nullify Health Care Reform?

New England Journal of Medicine - Wed, 03/10/2010 - 17:55

On February 1, the Virginia Senate passed a bill stating that "No resident of this Commonwealth . . . shall be required to obtain or maintain a policy of individual insurance coverage." ...

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Health Care Volunteers and Disaster Response -- First, Be Prepared

New England Journal of Medicine - Wed, 03/10/2010 - 17:55

The human suffering that followed the devastating earthquake in Haiti, and the many survivors in urgent need of lifesaving care, brought an outpouring of support from the U.S. health care ...

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Tumor-Associated Macrophages and Survival in Classic Hodgkin's Lymphoma

New England Journal of Medicine - Wed, 03/10/2010 - 17:55
Clinically relevant biomarkers for predicting the outcome of treatment in patients with Hodgkin's disease have not been established. In this study, gene profiling and immunohistochemical analysis were used to find such a marker. A strong association was found between a poor outcome of treatment and an increased number of CD68+ cells in the microenvironment of Reed-Sternberg cells. CD68, a marker of macrophages, outperformed the conventional International Prognostic Score and is available for immunohistochemical staining of diagnostic samples of Hodgkin's lymphoma.

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Low Diagnostic Yield of Elective Coronary Angiography

New England Journal of Medicine - Wed, 03/10/2010 - 17:55
In this national registry of data on cardiac catheterization, only 38% of elective, diagnostic coronary angiograms showed obstructive lesions, and 39% of angiograms were interpreted as showing no disease. The findings indicate a relatively low diagnostic yield of elective coronary angiography, a procedure that exposes patients to substantial radiation.

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Oral Ivermectin versus Malathion Lotion for Difficult-to-Treat Head Lice

New England Journal of Medicine - Wed, 03/10/2010 - 17:55
There are limited treatments for head lice. In this multicenter, cluster-randomized trial of 812 patients in 376 households, oral ivermectin was found to be superior to topical malathion lotion in eradicating head-lice infestation.

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Use of the Thyroid Hormone Analogue Eprotirome in Statin-Treated Dyslipidemia

New England Journal of Medicine - Wed, 03/10/2010 - 17:55
This randomized, placebo-controlled, double-blind, multicenter trial assessed the safety and efficacy of the thyromimetic compound eprotirome in lowering the serum low-density lipoprotein cholesterol level in patients with hypercholesterolemia who were already receiving simvastatin or atorvastatin. Eprotirome was associated with decreased LDL levels in patients treated with statins.

Categories: Medicine

Medical Progress: Commotio Cordis

New England Journal of Medicine - Wed, 03/10/2010 - 17:55
Ventricular fibrillation and sudden death triggered by a blunt, nonpenetrating, and often innocent-appearing unintentional blow to the chest without damage to the ribs, sternum, or heart (in the absence of underlying cardiovascular disease) constitute an event known as commotio cordis. This review provides information on the clinical profile of this event, the physiological mechanisms underlying it, and steps that can be taken to prevent the event and to resuscitate the victim, should it occur.

Categories: Medicine

Red Puffy Ears

New England Journal of Medicine - Wed, 03/10/2010 - 17:55

A 63-year-old man with a history of recurrent aseptic meningitis presented with fever and headache. The physical examination showed scleral injection and mild nuchal rigidity. Analysis of the cerebrospinal fluid ...

Categories: Medicine

Dermoscopy of Phthiriasis

New England Journal of Medicine - Wed, 03/10/2010 - 17:55

A 50-year-old man presented with a 1-month history of mild, generalized pruritus. A total-body examination of the patient's skin revealed small, yellowish-brown flecks in the hair of the upper arm ...

Categories: Medicine

Case 7-2010 -- A 49-Year-Old Man with Peripheral Neuropathy and Ascites

New England Journal of Medicine - Wed, 03/10/2010 - 17:55
A 49-year-old man was admitted to this hospital because of ascites. During the past 4 years, paresthesias and weakness of the lower legs and hands had developed, followed by difficulty breathing, peripheral edema, and during the past year, blurred vision, optic-disk edema, and ascites. Imaging studies subsequently revealed retroperitoneal lymphadenopathy and lytic lesions in the tibia and sacrum. A diagnostic procedure was performed.

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Toward a Personalized Treatment of Hodgkin's Disease

New England Journal of Medicine - Wed, 03/10/2010 - 17:55

In this issue of the Journal, Steidl et al.1 provide a technically sound and important model for using molecular tools to better predict how various cancers will respond to currently ...

Categories: Medicine
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