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July 4, 2002 Vol. 347 No. 1
Inflammation within a vulnerable coronary plaque may cause unstable angina by producing erosion or rupture. This study used measurements of neutrophil myeloperoxidase to assess neutrophil activation in blood from the aorta, femoral vein, and great cardiac vein. The data support the concept that in unstable angina there is widespread inflammation in the coronary bed, not just in a single vulnerable plaque.
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Insect-borne diseases are a major cause of illness and death worldwide. Insect repellents can reduce the risk of being bitten. In this study, volunteers inserted their arms into standardized mosquito-containing cages, and investigators calculated the elapsed time until the first bite in order to evaluate which repellent products available to consumers in the United States offered the most complete, reliable protection. Products containing high concentrations of N,N-diethyl-3-methylbenzamide (DEET) were most effective, with other products containing IR3535 or botanicals offering far less protection.
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It is uncertain whether thrombophilia polymorphisms in women are associated with an increased risk of intrauterine growth restriction in their offspring. In this large case–control study, the presence in the mother or newborn of polymorphisms for methylenetetrahydrofolate reductase (MTHFR) C677T or A1298C, factor V Leiden G1691A, or prothrombin G20210A was not associated with an increased risk of intrauterine growth restriction (defined as birth weight below the 10th percentile).
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The efficacy of a heat-inactivated varicella vaccine in recipients of hematopoietic-cell transplants was evaluated in a randomized trial in which vaccination was compared with no vaccination. Patients who received the vaccine had a significantly lower incidence of zoster than patients in the control group and recovered clinically significant T-cell immunity against varicella–zoster virus earlier than did the patients who received no vaccine.
A 35-year-old man who underwent allogeneic hematopoietic-cell transplantation two years earlier for acute myeloid leukemia has recently moved to a new town. He comes in for a general checkup because he tires easily and has frequent bouts of sinusitis. Physical examination reveals small central cataracts, some patches of vitiligo, and a dry mouth. What are the major issues in the long-term follow-up of patients after successful hematopoietic-cell transplantation?
Hypocapnia, defined as low partial pressure of arterial blood carbon dioxide, is usually well tolerated and often has no apparent effects. Although transient induction of hypocapnia can be lifesaving in patients with severe intracranial hypertension or neonatal pulmonary-artery hypertension, prolonged hypocapnia may adversely influence outcome. In this article, Laffey and Kavanagh review the prevalence and pathogenesis of hypocapnia, as well as the role of hypocapnia in clinical medicine.
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