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Class-Sparing Regimens for Initial Treatment of HIV-1 Infection
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.
CME Exam
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Aprotinin versus Lysine Analogues in High-Risk Cardiac Surgery
In patients undergoing high-risk cardiac surgery, aprotinin was somewhat more effective than either aminocaproic acid or tranexamic acid in reducing massive perioperative bleeding but at the expense of a higher rate of death. Aprotinin cannot be recommended to control blood loss in this clinical setting.
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 May 14, 2008 (DOI: 10.1056/NEJMoa0802395), in Print May 29, 2008
 Related Editorial: The Aprotinin Story — Is BART the Final Chapter?
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Biomarkers to Predict Death from Cardiovascular Causes
To predict the risk of death from cardiovascular causes in 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.
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Cardiac Troponin in Acute Heart Failure
Patients hospitalized with acute decompensated heart failure who had elevated cardiac troponin levels had higher mortality rates than those who were negative for troponin. Measurement of cardiac troponin, which may reflect myocyte injury, is useful for risk stratification of such patients.
CME Exam
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Recombinant Factor VIIa for Intracerebral Hemorrhage
In this phase 3 trial, recombinant activated factor VII (rFVIIa) reduced hematoma growth but did not improve clinical outcomes in patients with intracerebral hemorrhage.
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Rotator-Cuff Failure
A 63-year-old woman presents with a 2-year history of progressive weakness and discomfort in her right shoulder. MRI shows a large defect in the rotator cuff. How should her case be managed?
 Listen to the full text of this article.
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Biomarkers in Heart Failure
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.
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A Man with an Elevated PSA Level and Early-Stage Prostate Cancer
A 55-year-old man was evaluated for management of prostate cancer. An elevated serum prostate-specific antigen level was found; core needle biopsies of the prostate disclosed adenocarcinoma, with a Gleason score of 6 out of 10. CT showed a smoothly enlarged prostate.
CME Exam
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Management of Carotid Stenosis — Polling Results
This interactive feature presented the case of a patient with carotid stenosis. Readers were invited to vote for one of three possible treatment options. Polling results are now available, including results by country (see interactive map) and over 250 comments from readers.
Free Full Text
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DTCA for PTCA — Crossing the Line in Consumer Health Education?
On November 22, 2007, television viewers witnessed the launch of the first direct-to-consumer advertising campaign for percutaneous transluminal coronary angioplasty with a drug-eluting coronary stent. Drs. William Boden and George Diamond ask, has industry crossed the line this time?
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| May 14, 2008 (DOI: 10.1056/NEJMp0801433), in Print May 22, 2008 |
Vaccines and Autism Revisited — The Hannah Poling Case
Hannah Poling was diagnosed with encephalopathy caused by a mitochondrial enzyme deficit. Her parents believed that vaccines had triggered her encephalopathy, and they sued the Department of Health and Human Services for compensation under the Vaccine Injury Compensation Program and won. Dr. Paul Offit writes that the Poling case is best understood in the context of the decision-making process of this unusual vaccine court.
Free Full Text
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Like Night and Day — Shedding Light on Off-Hours Care
Dr. David Shulkin has begun making late-night administrative rounds at the hospital where he is president and chief executive officer. These visits are part of an initiative intended to address the stark discrepancy in quality between daytime and nighttime inpatient services.
Free Full Text
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Initial Treatment for HIV Infection — An Embarrassment of Riches
Multiple Biomarker Panels for Cardiovascular Risk Assessment
Intracerebral Hemorrhage — Improving Outcome by Reducing Volume?
Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq Free Full Text
Outcomes 18 Months after the First Human Partial Face Transplantation
Free Full Text
Selective Publication of Antidepressant Trials
Physicians and Execution Free Full Text
Perspective Roundtable: Lethal Injection Free Full Text
Letting the Genome Out of the Bottle Free Full Text
Serotonin Syndrome and Triptan Monotherapy
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