Issue IndexA searchable index of tables of contents
Find An Issue
- Free Full Text
- Video
- Free Full Text
There is substantial variation in the dose of warfarin required to achieve therapeutic anticoagulation. In this study, mathematical models for warfarin dosage were constructed that used either clinical factors alone or clinical and genetic factors. The model incorporating genetic factors, when tested retrospectively with data from an international cohort, provided better estimates than a model that included only clinical factors.
Isocitrate dehydrogenases, encoded by the IDH1 and IDH2 genes, catalyze the reduction of NADP+ to NADPH in the brain. One or the other of these two genes was found to be mutated in 70% of 445 gliomas of World Health Organization grade II or III. The mutations abolished the enzymatic activity of the IDH1 and IDH2 proteins. The evidence suggests that mutation of an IDH gene is an early event in the development of gliomas.
This substudy of the Occluded Artery Trial, in which high-risk patients with an occluded infarct-related artery who were in stable condition were randomly assigned to percutaneous coronary intervention (PCI) or medical therapy alone, showed a marginal advantage in cardiac physical functioning in the medical-therapy group at 4 months but not thereafter; costs were higher and quality-adjusted survival was marginally lower in the PCI group.
A 61-year-old man presents to the emergency room with left-sided epistaxis that has continued for 1 hour. He estimates having lost approximately 1/2 cup of blood and reports no history of nasal obstruction, epistaxis, trauma, bleeding diathesis, or easy bruising. He has a history of hypertension. Medications include atenolol and baby aspirin. How should this patient be evaluated and treated?
This review discusses the results of DNA microarray signatures in breast cancer. These signatures have been useful in the classification of breast cancers, and they have an association with clinical outcomes. Surprisingly, there is little overlap in the types of genes among several useful microarray signatures. The true value of these signatures will become apparent only when prospective trials, now in progress, have been completed.
A 37-year-old woman had a 4-month history of episodes of vertigo, followed by tinnitus, decreased hearing in her right ear, and right facial weakness; on the day of admission, she had a generalized seizure. On admission, she was confused and combative and had garbled speech, a right facial droop, and generalized hyperreflexia. Magnetic resonance imaging of the brain and spinal cord revealed multifocal linear and nodular enhancement of the leptomeninges. A diagnostic procedure was performed.
- Free Full Text
In recent years, the number of clinical trials conducted in the United States has declined, and the majority of study sites are now outside the United States, with marked growth of research in developing countries. The authors discuss the implications of the globalization of clinical research and make recommendations about how to address the challenges that have emerged.
In September 2007, President George W. Bush signed into law a bill requiring the registration of clinical trials in phase 2 or beyond and the public reporting of the results of those trials. This article reviews the initial implementation of the law and considers its strengths and weaknesses.
- Free Full Text
- Free Full Text
- Free Full Text
- Free Full Text






