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April 1, 2004 Vol. 350 No. 14
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This large, prospective study calls into question the value of the C-reactive protein (CRP) concentration in the prediction of coronary events. In contrast to previous research, this study found that the strength of the CRP concentration as a predictor is relatively moderate and that it adds little to the predictive value of standard coronary risk factors, such as the cholesterol concentration, smoking status, and blood pressure.
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This case–control study of all children born in Denmark from 1990 through 2000 examined detailed information on vaccinations and the occurrence of type 1 diabetes. Using Poisson regression models, the investigators estimated rate ratios for diabetes among all children according to vaccination status. There appeared to be no association between any type of vaccination and diabetes mellitus.
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Governments and ethics boards increasingly require written informed consent from all subjects before enrollment in clinical registries. The authors of this article examine the effect of a comprehensive effort to obtain informed consent on the participation rate in the prospective Registry of the Canadian Stroke Network. The overall participation rate was 39.3 percent during phase 1 of the project and 50.6 percent during phase 2. Obtaining written consent was costly, leading to selection bias.
About half of all nosocomial infections are associated with indwelling devices. Infections associated with implanted surgical devices are particularly difficult to deal with because they can require prolonged antibiotic treatment and repeated surgical procedures. This review summarizes the diagnostic challenges and explains the approaches to managing infections that are associated with various devices, including prosthetic heart valves, vascular grafts, pacemakers and defibrillators, and joint prostheses.
Ductal carcinoma in situ of the breast (also called intraductal carcinoma), a clonal proliferation of malignant-appearing cells within the mammary duct lumens without evidence of invasion beyond the epithelial basement membrane, is the precursor lesion of invasive breast cancer. In the past 20 years, concomitant with the wide use of screening mammography, its detected incidence has risen dramatically. Data from large cohort studies and randomized trials have emerged to guide treatment. This review summarizes progress in the understanding, pathogenesis, and treatment of ductal carcinoma in situ.
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