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Up to 10% of women with a diagnosis of unilateral breast cancer have cancer in the contralateral breast, despite negative clinical and mammographic examinations. This study investigated the use of MRI examination of the contralateral breast in women with a diagnosis of unilateral breast cancer and negative clinical and mammographic examinations. MRI detected occult cancer in the contralateral breast in about 3% of these women. All of the cancers were early stage, without evidence of spread to the lymph nodes or beyond.
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In this 24-month clinical trial, torcetrapib, a cholesteryl ester transfer protein inhibitor, failed to cause regression of coronary atherosclerosis, as seen on intravascular ultrasonography, even though levels of high-density lipoprotein cholesterol were markedly elevated. The drug was also associated with an elevation in blood pressure, and the entire torcetrapib research program has been suspended.
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Mutations affecting both components of the telomerase enzyme, hTERT and hTR, are associated with familial idiopathic pulmonary fibrosis, and carriers of such mutations have shorter telomeres than do noncarrier family members. This finding suggests that the disease may be triggered by a loss of alveolar cells, the progenitors of which may be limited by short telomeres.
Asthmatic exacerbations result in part from constriction of airway smooth muscle. In this controlled trial, the use of bronchoscopically delivered thermoplasty to reduce the mass of airway smooth muscle resulted in fewer exacerbations among subjects with moderate or severe asthma. The incidence of adverse events was higher among subjects undergoing bronchial thermoplasty than among control subjects during the first 3 weeks after treatment.
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The Montreal Protocol requires limitation of the use of devices powered by chlorofluorocarbons (CFCs), which reduce stratospheric ozone levels. Albuterol, a medication commonly used for the treatment of asthma that is delivered by metered-dose inhalers with CFCs as propellants, will be withdrawn from the U.S. market by December 2008. This review article summarizes useful information about albuterol in metered-dose inhalers with non-CFC propellants and discusses associated economic issues.
A 55-year-old man was sculling when his boat collided with an eight-person shell; the prow of the larger boat entered his lower back and exited through his abdomen, throwing him into the water. He was taken to this hospital, where the trauma surgery team took over his care. Members of the team discuss the problems of traumatic abdominal and orthopedic injuries and the role of trauma systems.
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