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February 27, 2003 Vol. 348 No. 9
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Exercise-induced ventricular ectopy is known to be associated with an increased risk of death. In this study of more than 29,000 subjects, frequent ventricular ectopy that occurred during the recovery period after the cessation of exercise was a better predictor of the five-year risk of death than frequent ventricular ectopy during exercise.
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This study explores the link between germ-line mutations in the DNA-repair gene MYH and recessive inheritance of multiple colorectal adenomas and classic adenomatous polyposis coli. Patients with biallelic mutations and multiple colorectal adenomas had more polyps and were more likely to have colon cancer than those without MYH mutations.
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In this 48-week placebo-controlled, randomized trial, adefovir dipivoxil improved histologic liver abnormalities in patients with hepatitis B e antigen (HBeAg)–positive chronic hepatitis B and did not result in the development of mutations in the hepatitis B virus polymerase gene that are associated with resistance to the drug.
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This study was based on a survey of 84 liver-transplantation centers, of which 42 reported that they performed 449 transplantations from living donors in adults in 1997 through 2000. The number of such transplantations increased markedly during that period, and the procedure now accounts for 5 percent of all liver transplantations in adults. The mortality rate among donors was very low, but the rate of complications was not inconsequential.
While obtaining a peripheral venous blood sample from a patient with the acquired immunodeficiency syndrome, a 35-year-old phlebotomist is injured by a bloody 18-gauge needle attached to a syringe. The patient has been taking didanosine and stavudine for more than six months, but her quantitative plasma human immunodeficiency virus (HIV) RNA titer and CD4 T-lymphocyte count have not been measured for many weeks. What is the appropriate postexposure treatment for the phlebotomist?
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The authors propose several simple and inexpensive ways to reduce errors in teaching hospitals. Their suggestions include computerized procedures to sign out patients when residents go off duty, standardized placement and composition of medical charts and equipment, and the replacement of “see one, do one, teach one” with a rational system for training residents to perform procedures.
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