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In this study involving 54 patients in a vegetative or minimally conscious state, the use of functional magnetic resonance imaging (MRI) to assess responses during mental-imagery tasks showed that 5 patients were able to willfully modulate their brain activation. These findings suggest that functional MRI can be used to demonstrate evidence of awareness and cognition that cannot be detected by means of clinical assessment.
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The salt intake of the U.S. population is rising. Using the Coronary Heart Disease Policy Model, these investigators found that a reduction in salt intake of 3 g per day would result in substantial reductions in the incidence of coronary heart disease, stroke, and death. A more modest reduction of 1 g per day would also have public health benefits. The reduction of salt intake is an important goal for the country.
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The use of platelet transfusions to prevent bleeding in patients with thrombocytopenia due to chemotherapy or other causes of marrow suppression is widespread, but the optimal number (dose) of platelets is unsettled. In this randomized trial, three doses of platelets were studied: the usual dose, half the usual dose, and twice the usual dose. No major differences in bleeding complications were found among the three groups, but more transfusions were given in the lowest-dose group to prevent bleeding.
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Training community-based birth attendants in rural communities in developing countries in the Essential Newborn Care program (routine care and resuscitation) was not associated with a reduction in the rate of neonatal death in the 7 days after birth, but the rate of stillbirth was significantly reduced. In a subsequent cluster-randomized trial, training in the Neonatal Resuscitation Program (more advanced resuscitation training) did not significantly reduce rates of neonatal death or stillbirth.
A 65-year-old man with a history of well-controlled hypertension presents for a follow-up visit after an incidental finding of a small mass in the right kidney on an abdominal computed tomographic scan (ordered to evaluate lower-quadrant pain, which has since resolved). The mass is 3.2 cm, anterior, heterogeneous, and solid, and is in the right renal hilum near the main renal artery, vein, and ureter; the left kidney appears normal. The patient feels well, his physical examination is unremarkable. His serum creatinine level is 1.2 mg per deciliter. How should this patient be further evaluated and treated?
A 51-year-old man with human immunodeficiency virus and hepatitis C virus infections presented with proteinuria, edema, and worsening hypertension. He had obesity, hyperlipidemia, obstructive sleep apnea, and a history of hypertension and coronary artery disease. He had recently taken nonsteroidal antiinflammatory drugs for joint pain. A diagnostic procedure was performed.
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Now that there are many disaster-relief organizations on the ground in Haiti, it is critical that we coordinate efforts, both during this acute phase of the response and as we move forward. There is still an overwhelming number of patients who require ...
