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November 15, 2001 Vol. 345 No. 20
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Mechanical left ventricular assist devices have been used as a bridge to cardiac transplantation, but not as long-term therapy. In this study of patients with severe heart failure who were not candidates for transplantation, left ventricular assist was compared with optimal medical therapy. The one-year survival rate was 52 percent in the device group and 25 percent in the medical-therapy group. The device permitted patients to be ambulatory and improved the quality of life.
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Patients who have had an ischemic stroke are at risk of having another. Warfarin is the treatment of choice for the prevention of recurrent cardioembolic stroke. In this study, warfarin and aspirin were compared in the prevention of recurrent ischemic stroke due to causes other than cardioembolism. There was no significant difference between the warfarin and aspirin groups in either the rate of recurrence of ischemic stroke or the rate of hemorrhagic complications.
Chronic infection often develops in people who are infected with the hepatitis C virus (HCV). Such infection is difficult to eradicate and can eventually lead to end-stage liver disease. In this study, 44 patients with acute hepatitis C received 24 weeks of treatment with interferon alfa-2b in an attempt to prevent chronic infection. At the end of therapy, as well as 24 weeks later, 43 of the patients had undetectable levels of HCV RNA in serum.
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A 19-year-old woman with an aggressive lymphoma received a bone marrow transplant from her sister. Three and a half years later subcutaneous panniculitic T-cell lymphoma was diagnosed in the donor; the same rare tumor appeared in the recipient four and a half years after transplantation. The tumors had identical molecular features.
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