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Screening for cervical cancer is not a component of health care in rural India. This article reports on a trial of cervical-cancer screening by human papillomavirus (HPV) testing, cytologic analysis, or visual inspection of the cervix with acetic acid in rural villages. The results, as compared with those in a group that received no screening, showed that a single round of HPV testing significantly reduced the incidence of invasive cervical cancer and mortality in rural Indian villages.
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In a multicenter, randomized trial, 2776 patients undergoing maintenance hemodialysis who were not currently taking a statin were randomly assigned to rosuvastatin or placebo. At a median of 3.8 years of follow-up, rates of the composite primary end point of death from cardiovascular causes, myocardial infarction, or stroke did not differ significantly between the two study groups.
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Previous trials have shown that the combination of fluorouracil-based chemotherapy and cetuximab is active when used as salvage treatment in patients with metastatic colorectal cancer; the present trial shows activity of this combination as first-line treatment as well. The trial also found that for cetuximab to be active, an unmutated KRAS gene in the tumor was required.
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In this analysis of 2003–2004 Medicare claims data, 20% of hospitalized patients were rehospitalized within 30 days after discharge. Fifty percent of patients who were rehospitalized after a medical discharge did not have an outpatient visit between discharge and readmission, raising the possibility that improved outpatient follow-up may reduce rehospitalizations.
The parents of an 8-year-old boy bring him to the pediatrician's office for evaluation of nightly bed-wetting. He often does not void during school hours, and when he returns home after school, he usually rushes to the bathroom. He arrives home thirsty after school, and most of his daily fluid intake is in the afternoon and evening. How should this boy be evaluated and treated?
In evaluating patients before electroconvulsive therapy (ECT), especially those with conditions such as hypertension, coronary artery disease, and congestive heart failure, the medical consultant should undertake risk stratification, assess management of coexisting conditions, and use strategies to reduce the risk of such post-ECT complications as prolonged blood-pressure elevation, myocardial ischemia, and headache.
A 51-year-old woman with a history of hypertension and depression reported progressively worsening pain in the left thigh over a period of several months, which had made her unable to walk for the past week. She also described generalized weakness and pains in her lower back, arms, and chest. She reported no weight loss, anorexia, trauma, or fever.
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