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The use of medical imaging procedures has been increasing, and this study estimated the exposure of U.S. patients to low-dose ionizing radiation from these procedures. The exposure was substantial, largely because of radiation from computed tomography and nuclear imaging. The highest average effective dose was attributable to myocardial perfusion imaging, and most imaging occurred in outpatient settings. These data indicate that the use of imaging can result in high radiation doses.
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In the 2009 Shattuck Lecture, Aram Chobanian describes the tremendous progress that has been made in the recognition and treatment of hypertension in the past 60 years. He lays out the basis of an apparent paradox: despite better recognition and treatment, the prevalence of untreated hypertension continues to increase.
Type 17 helper T cells (Th17) — a third class of T cells — and their major cytokine, interleukin-17, are essential for the defense against certain fungi, extracellular bacteria, and Mycobacterium tuberculosis. Defective control of Th17 cells and production of interleukin-17 are prominent in chronic inflammation and several immunoinflammatory disorders. Monoclonal antibodies against cytokines produced by Th17 cells are being investigated in clinical trials.
A 56-year-old woman was admitted to this hospital because of fever, rash, and lymphadenopathy. Eleven weeks earlier, fever and a rash had developed, shortly after an ant sting. Her symptoms responded to corticosteroids, but 6 weeks before admission, lymphadenopathy developed, followed by recurrent fever and rash. Evaluation disclosed no evidence of infection, and specimens from lymph-node biopsies did not yield a diagnosis. A diagnostic procedure was performed.
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The authors review the potential goals of disclosing investigators' financial relationships to research participants and discuss the limitations of disclosure in achieving these goals. They note that equity interests are especially problematic and should be limited or avoided rather than simply disclosed.
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