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The recent epidemic of melamine-contaminated formula in China has been associated with urinary tract stones. The authors of this study screened 589 consecutively enrolled children; 421 had received formula contaminated by melamine. In all, 50 had urinary stones, 112 were suspected to have stones, and 427 did not have stones. Affected children lacked typical signs and symptoms of urolithiasis. Exposure to melamine-contaminated formula and prematurity were associated with the presence of stones.
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Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a serious disorder associated with ventricular arrhythmias and sudden death. Mutations in desmosomal proteins may be the cause in some cases. This study found reduced levels of immunostaining for the desmosomal protein plakoglobin in a high percentage of subjects, suggesting that immunostaining for this protein may be a useful diagnostic test.
The effect of long-term exposure to tropospheric ozone on air pollution–related mortality was examined in an analysis of data from almost 500,000 subjects over a period of 18 years. Ozone concentrations were not associated with the rate of death from any cause or, when concentrations of fine particulate matter were taken into account, with the rate of death from cardiopulmonary causes. However, ozone concentrations were significantly correlated with the rate of death from respiratory causes.
The authors report a nonsimultaneous chain of 10 kidney transplantations, which was initiated in July 2007 by a single altruistic donor and involved six transplantation centers in five states. This strategy, coordinated by two large, paired-donation registries with the use of powerful computer programs, can potentially result in more kidney transplantations.
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In this analysis of Medicare data, the number of physicians in general internal medicine who were working as hospitalists (defined as general internists who derived 90% or more of their evaluation-and-management claims from the care of hospitalized patients) increased from 6% in 1995 to 19% in 2006. During this period, the percentage of hospitals with at least three hospitalists increased from 12% to 47%.
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Severe headaches associated with hypertension developed in a 36-year-old woman 10 days after delivery of twins by cesarean section; initial brain magnetic resonance imaging (MRI) and computed tomographic examinations were normal. Headaches persisted despite antihypertensive medications; a seizure and an episode of aphasia and hemiparesis occurred. Repeated MRI and magnetic resonance angiography showed posterior white-matter changes on T2-weighted sequences and multifocal narrowing and dilatation of intracranial arteries. A diagnostic procedure was performed.
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