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Endoscopic vein-graft harvesting is often used in coronary-artery bypass grafting (CABG) to prevent postoperative wound complications. However, in this study, which had a 3-year follow-up, endoscopic harvesting was associated with a higher rate of graft failure and adverse clinical outcomes. Although this is not a randomized study, it calls into question the use of endoscopic vein-graft harvesting in CABG.
Adults who had a parent with Alzheimer's disease were randomly assigned either to a group that was informed about their own APOE genotype (a risk variant) or to a group that was not informed. There was no difference in clinically significant psychological distress between subjects who were informed about genotyping results and those who were not informed.
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This study assessed the ability of a capsule endoscope to detect the colorectal polyps and cancer seen with optical colonoscopy. The sensitivity and specificity of capsule endoscopy for the detection of advanced adenomas were 73% and 79%, respectively. These findings demonstrate the relatively low sensitivity of capsule endoscopy and do not support its use for colorectal-cancer screening at this time.
A sexually active 18-year-old woman presents to her internist for an annual examination and asks whether she should receive the human papillomavirus (HPV) vaccine. HPV causes cervical cancer. Currently available vaccines provide protection against some but not all oncogenic genotypes of the virus if the recipient has not previously been infected. Regular cervical-cancer screening is still required for vaccine recipients.
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A 59-year-old man was admitted to this hospital for induction chemotherapy for acute myeloid leukemia. On the seventh hospital day, neutropenia, fever, nausea, diarrhea, and abdominal pain developed. Despite the administration of broad-spectrum antimicrobial therapy, tender, erythematous skin lesions developed on the trunk, abdomen, and arms and legs, and bilateral pulmonary nodules were seen on computed tomographic scans of the chest. A diagnostic procedure was performed.
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