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June 17, 2004 Vol. 350 No. 25
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This study evaluated the effect of large-volume abdominal liposuction on metabolic risk factors for coronary heart disease in women with abdominal obesity. Liposuction altered neither insulin sensitivity nor the plasma concentrations of C-reactive protein, interleukin-6, tumor necrosis factor α, or adiponectin. There also was no significant effect on other risk factors for coronary heart disease.
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This investigation identified 14 patients who had major clostridium infections after undergoing tissue-allograft transplantation, including a 23-year-old man who died of sepsis after receiving cadaveric cartilage. These infections were transmitted through tendon or cartilage transplants from the same tissue bank.
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Rituximab is a monoclonal antibody that selectively depletes CD20+ B cells. In this randomized trial involving patients with poorly controlled rheumatoid arthritis despite methotrexate treatment, rituximab was found to be an intriguing new therapy for alleviating symptoms in rheumatoid arthritis. However, use of rituximab led to serious infections in some cases.
An 85-year-old man with New York Heart Association class IV heart failure, hypertension, and moderate Alzheimer's disease, who lives at home with his 84-year-old wife, is admitted to the hospital after a hip fracture. His postoperative course is complicated by pneumonia, delirium, pressure ulcers on his heels and sacrum, and weight loss. What might the patient's physician do to address his needs, alleviate his suffering, and facilitate his discharge from the hospital and his care at home?
A better understanding of the pathophysiology of rheumatoid arthritis, together with influential trials aimed at treating early stages of the disease, has altered therapy. This article considers approaches that have resulted in markedly better clinical outcomes, including early diagnosis and treatment; the advent of combinations of disease-modifying antirheumatic drugs and agents that target cytokines; and recognition and treatment of important coexisting conditions, particularly cardiovascular disease and osteoporosis.
A boy was seen by his physician because of a one-week history of profound fatigue. He had mild fever, muscle aches, and chest pain but no gastrointestinal or respiratory symptoms. He was taking no medications and had no known allergies. A complete blood count revealed marked eosinophilia but no other abnormalities.
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