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The hypereosinophilic syndrome, although uncommon, is difficult to treat, and the treatment has substantial toxic effects. This proof-of concept trial shows that treatment of patients with the hypereosinophilic syndrome with an anti–interleukin-5 monoclonal antibody, mepolizumab, improves clinical and laboratory outcomes.
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Stored red cells undergo progressive structural and functional changes over time. In a study of 6002 patients undergoing cardiac surgery at a single institution, those who received blood stored for 14 days or less had lower rates of complications and death than those who received blood stored for more than 14 days.
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Several single-nucleotide polymorphisms (SNPs) associated with lipid levels have been identified. In a cohort of 5414 study subjects, 11 such SNPs were tested and their relationship with lipid levels confirmed. A genotype score comprising nine of these SNPs was independently associated with incident cardiovascular disease, even after adjustment for baseline lipid levels.
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Quality of life and satisfaction with outcome of treatment were ascertained by questionnaires in men with prostate cancer and their spouses or partners after prostatectomy, brachytherapy, or external-beam radiotherapy (with or without adjuvant hormonal treatment). Each treatment had it own pattern of effects on the quality of life, and in each case, residual effects of treatment caused distress in the patients' partners.
A healthy, lean 46-year-old woman who is a nonsmoker requests advice about contraception. She notes that her menstrual periods are less regular than previously, and she also reports intermittent bothersome hot flashes. She is in a new relationship after a divorce, and she is sexually active. She asks if she can begin to use an oral contraceptive. What would you advise?
The gram-negative coccobacillus acinetobacter, a pathogen once seen only in hot, humid climates, has become an increasingly common nosocomial problem even in temperate climates. For infections caused by multidrug-resistant isolates, antibiotic choices may be quite limited. This review summarizes the approaches to treatment and the current understanding of the ability of acinetobacter to accumulate diverse mechanisms of resistance, with the emergence of strains resistant to all commercially available antibiotics.
A 65-year-old woman was seen in the oral surgery clinic because of a nonhealing ulcer of the mandible at the site of a tooth that had been extracted 3 years earlier. The patient had multiple myeloma and had been treated with intravenous bisphosphonates for 6 years. Examination disclosed red, raised soft tissue in the right mandible, with mucosal ulceration and exposed bone. A diagnostic procedure was performed.
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