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Rotavirus is the leading cause of gastroenteritis in children worldwide. In this report, the efficacy of the rotavirus vaccine among 4417 children in Malawi and South Africa was studied in a randomized trial. Severe rotavirus gastroenteritis occurred in 4.9% of the infants in the placebo group as compared with 1.9% of the infants in the pooled vaccine group; the vaccine efficacy was 61.2%.
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Rotavirus remains an important cause of diarrhea-related death and complications worldwide. Implementation of rotavirus vaccination in Mexico since late 2007 has been associated with a relative reduction of 35% in diarrhea-related mortality in children under 5 years of age, with the greatest decrease found in infants 11 months of age or younger, the age group that was eligible to receive vaccination.
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In this multicenter, randomized trial, internal tocodynamometry was compared with external monitoring of uterine activity in women with induced or augmented labor. The use of internal tocodynamometry did not reduce the rate of operative deliveries or improve other maternal or neonatal outcomes.
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The rotavirus vaccine is being widely implemented and must be given early in life to minimize the risk of intussusception. In this report, rotaviral infection with the vaccine strain was identified in three children who were vaccinated before they were found to have severe combined immunodeficiency, thus raising concern regarding the safety of this live attenuated vaccine in severely immunocompromised persons.
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In this comparison of Medicare plans that increased copayments for ambulatory care visits with plans that did not, higher copayments were associated with fewer outpatient visits and more hospitalizations. The higher copayments may have resulted in preventable hospital admissions and increased the overall cost of care.
This review of Alzheimer's disease assembles a variety of findings relevant to the mechanism of the disease and ties them together using the current understanding of the basis of the loss of cognition: the accumulation of misfolded proteins, which cause oxidative and inflammatory damage to the brain and, ultimately, synaptic dysfunction.
A 4.5-month-old boy was seen in the pediatric neurology clinic of this hospital because of developmental delay and irritability. He had been born at full term to a mother who had been addicted to drugs and had hepatitis C and herpes simplex virus infections during pregnancy. Development appeared normal for the first 3 months, but at 4 months he had feeding difficulties, growth retardation, and irritability. Examination disclosed signs of spasticity. A diagnostic procedure was performed.
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