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In this cross-sectional study involving magnetic resonance imaging (MRI) of the right knee in middle-aged and older men and women, more than a third of the participants had a meniscal tear or meniscal destruction or resection; many of these persons reported having had no knee pain or stiffness in the previous month. Meniscal damage was particularly common in persons with radiographic evidence of osteoarthritis. Clinicians should take into consideration the high prevalence of incidental meniscal findings when ordering or interpreting this test in older patients with knee pain.
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This randomized trial of the treatment of advanced head and neck cancer tested the efficacy of adding cetuximab, an antibody against the epidermal growth factor receptor, to standard therapy (platinum-based chemotherapy). As compared with standard chemotherapy alone, cetuximab plus chemotherapy prolonged median overall survival by almost 3 months.
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Impaired reabsorption of phosphate by renal tubules increases the risks of nephrolithiasis and bone demineralization. On the basis of data from animals, the sodium–hydrogen exchanger regulatory factor 1 (NHERF1) appears to control renal phosphate transport. The authors sequenced NHERF1 in people with nephrolithiasis or bone demineralization and identified three mutations, suggesting a previously unrecognized cause of renal phosphate loss in humans.
A 36-year-old woman with a presumptive diagnosis of endometriosis presents with long-standing pelvic pain that is not relieved by means of oral contraceptives or medroxyprogesterone. Treatment with a gonadotropin-releasing hormone agonist is recommended. Gonadotropin-releasing hormone agonists profoundly suppress gonadotropin secretion and sex-steroid production. Side effects include loss of bone mineral density and memory impairment.
There are more than half a million incident cases of squamous-cell carcinoma of the head and neck worldwide each year, primarily affecting the oropharynx, oral cavity, hypopharynx, and larynx. This review considers the biologic features of these tumors, including the role of human papillomavirus as a risk factor for cancer of the oropharynx. New therapies are considered, along with management approaches.
An 8-day-old boy was admitted to this hospital because of weakness and lethargy. He had been hospitalized briefly after birth because of respiratory distress, and sensorineural deafness was noted, but his postnatal course had been otherwise normal. On the day before admission, he became lethargic and hypothermic, with grunting respirations; lumbar puncture at another facility disclosed blood in the cerebrospinal fluid, and he was transferred to this hospital. Imaging studies disclosed intracerebral hemorrhage and edema. Coma developed, and the infant died on the fifth hospital day. An autopsy was performed.
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