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In this study from a large Swedish registry, the long-term risk of death or myocardial infarction was similar among patients who received bare-metal coronary stents and those who received drug-eluting stents. The rate of restenosis was lower among patients who received drug-eluting stents, especially among those at increased risk for restenosis.
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Whole-genome linkage analysis in children with normotensive hypokalemic metabolic alkalosis, epilepsy, ataxia, sensorineural deafness, and tubulopathy identified a single relevant locus on chromosome 1q23.2 containing KCNJ10, which encodes a potassium channel expressed in the brain, inner ear, and kidney. The findings suggest that KCNJ10 plays an important role in renal salt handling and perhaps also in the maintenance and regulation of blood pressure.
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This report describes three siblings with susceptibility to bacterial and viral infections, autoimmune hemolytic anemia, immune thrombocytopenia, lymphadenopathy, hepatosplenomegaly, and other defects. DNA from one of the siblings showed a homozygous mutation in STIM1, a protein involved in store-operated Ca2+ entry into cells. Both parents were heterozygous for the mutation. These cases illustrate that Ca2+ entry is a requirement for lymphocyte activation.
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In the United States, the rate of exemption from immunization requirements has increased. The major reasons for vaccine refusal are parental concerns about vaccine safety and a low level of concern about the risk of the diseases that vaccines prevent. Clinicians are the main source of information about vaccines; they play a crucial role in parental decisions about immunization.
This account of the mechanisms of scleroderma highlights the genetic and molecular changes that cause the vascular changes and fibrosis in the disease. The role of autoantibodies, of which there are several in scleroderma, is unclear. The authors outline a stepwise process that begins with inflammation, reaches its zenith in fibrosis, and ends in atrophy.
A 64-year-old man was brought to the emergency department because of sudden-onset blurred vision in both eyes and diplopia, as well as a frontal headache that had begun earlier that day. On presentation, he was noted to have an altered mental status. There was no history of fevers, chills, or focal weakness.
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