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August 19, 2004 Vol. 351 No. 8
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In this study, on the basis of data on 11,391 tissue donors, the probability of undetected viremia with the human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and human T-lymphotropic virus was estimated to be 1 in 55,000 donors, 1 in 34,000, 1 in 42,000, and 1 in 128,000, respectively.
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Since 1999, nucleic acid–amplification testing has been used in the United States to identify units of blood from donors with viremia in the window period before seroconversion. This approach identifies approximately 1 unit infected with human immunodeficiency virus type 1 (HIV-1) among 3.1 million units screened and 1 infected with hepatitis C virus (HCV) among 230,000 units screened.
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An automated device that separates, identifies, and enumerates epithelial cells in whole blood was used to measure levels of circulating tumor cells in women with metastatic breast cancer who were embarking on a new course of treatment. High levels were correlated with short survival, whereas low levels predicted a favorable prognosis.
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WNT4, a secreted protein that suppresses male sexual differentiation, is thought to suppress the synthesis of gonadal androgen in females. These investigators describe a woman with no müllerian-derived structures, unilateral renal agenesis, and clinical signs of androgen excess who had a loss-of-function mutation in the WNT4 gene.
In areas of rural poverty in the tropics and subtropics, more than 700 million persons are infected with the parasites Necator americanus and Ancylostoma duodenale. The adult parasites cause intestinal blood loss, which leads to chronic iron-deficiency anemia. Hookworm infection is a major cause of disability in vulnerable populations. This review summarizes the current understanding of the life cycle of this parasite, the pathophysiology of the disease, and the options for simple and effective treatment that can have important benefits.
A 56-year-old woman with a history of smoking began to have a cough that was productive of blood-tinged sputum. Radiography and computed tomographic scanning revealed a 2.5-cm nodule in the right upper lobe, with no mediastinal lymphadenopathy. Positron-emission tomographic scanning with fludeoxyglucose F 18 showed uptake in the nodule but not in the lymph nodes. A biopsy disclosed non–small-cell lung cancer. A multidisciplinary team discusses the approach to therapy.
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