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In this trial, 17,802 healthy men and women with low-density lipoprotein cholesterol levels of less than 130 mg per deciliter and high-sensitivity C-reactive protein levels of 2.0 mg per liter or more were randomly assigned to rosuvastatin or placebo. At a median of 1.9 years, the incidence of major cardiovascular events was significantly lower in the rosuvastatin group.
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The authors of this study genotyped single-nucleotide polymorphisms (SNPs) at 18 diabetes-associated loci in participants of the Framingham Offspring Study. A genotype score based on these risk alleles predicted new cases of diabetes but resulted in only a slightly better prediction of risk than knowledge of common risk factors alone.
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Sixteen SNPs were determined and clinical factors examined in two Scandinavian cohorts that were followed for a median of 23.5 years. Type 2 diabetes developed in 11.7% of the subjects. The inclusion of common genetic risk factors, many of which impair the capacity of beta cells to increase insulin secretion, in risk models modestly improved the prediction of future type 2 diabetes.
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The timing of initiation of antiretroviral therapy in HIV-infected infants has been debated, in part because of the potential long-term toxicity of the medication, the risk of resistance, adherence challenges, and cost. In this randomized trial involving 377 HIV-infected infants in South Africa, early initiation of antiretroviral therapy reduced infant mortality by 76% and the rate of HIV progression by 75%.
Patients with a history of myocardial infarction and a reduced ejection fraction are at increased risk for life-threatening ventricular arrhythmias. Which of these patients are the most appropriate candidates for implantable cardioverter–defibrillator (ICD) therapy is unclear. Factors influencing the decision are discussed.
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This review presents evidence for two overlapping yet distinctive clinical types of sickle cell disease. The basis of one is the vaso-occlusive crisis; the other is the consequence of intravascular hemolysis. The authors focus on the acute vaso-occlusive crisis, the acute chest syndrome, and pulmonary hypertension, all common complications of sickle cell disease.
A 59-year-old man was admitted to this hospital with a 6-month history of chronic daily headache, fever, and myalgia. Dry mouth, polydipsia and polyuria, and pain in the jaws on chewing developed. Neuroimaging studies showed diffuse thickening and enhancement of the dura, extending to the pituitary stalk. Computed tomography revealed calcified nodules in the lungs and spleen. A diagnostic procedure was performed.
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