NEWS: Health and Medical

The Cost Implications of Health Care Reform

New England Journal of Medicine - Thu, 05/13/2010 - 12:31
(No abstract is available for this citation)

Tobacco Product Regulation -- A Public Health Approach

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

On June 22, 2009, President Barack Obama signed the Family Smoking Prevention and Tobacco Control Act. This historic legislation provides the Food and Drug Administration (FDA) with the authority to ...

Treatment Decisions after Brain Injury -- Tensions among Quality, Preference, and Cost

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

Many patients with sudden severe brain injury from stroke, trauma, or cardiac arrest die after family members and clinicians decide, given a poor prognosis, to withdraw treatment. Although it's difficult ...

Bisphosphonates and Fractures of the Subtrochanteric or Diaphyseal Femur

New England Journal of Medicine - Wed, 05/12/2010 - 15:55
Recent case reports and series have identified a subgroup of atypical femoral-shaft fractures associated with bisphosphonate use. This study analyzed data from three large, randomized bisphosphonate trials. Subtrochanteric or diaphyseal femur fractures were very rare, even among women who had been treated with bisphosphonates for as long as 10 years. In patients with osteoporosis, proven benefits for fracture reduction appear to outweigh the possible risk of femoral-shaft fractures.

Robot-Assisted Therapy for Long-Term Upper-Limb Impairment after Stroke

New England Journal of Medicine - Wed, 05/12/2010 - 15:55
In this randomized study evaluating rehabilitative therapies in patients with long-term upper-limb impairment after stroke, outcomes at 12 weeks were similar with robot-assisted therapy, intensive comparison therapy, and usual care. In secondary analyses, modest improvements were observed over 36 weeks in both intensive-therapy groups, as compared with the usual-care group.

Maternal Vitamin A Supplementation and Lung Function in Offspring

New England Journal of Medicine - Wed, 05/12/2010 - 15:55
In this article, the investigators examined a subgroup of children whose mothers had participated in a trial of prenatal vitamin A supplementation that was performed in an area of Nepal where traditionally there is suboptimal nutrition. The lung function of children whose mothers had received vitamin A supplementation during pregnancy was 2 to 3% better than that of children whose mothers had received placebo.

Quality Indicators for Colonoscopy and the Risk of Interval Cancer

New England Journal of Medicine - Wed, 05/12/2010 - 15:55
In this large study of colorectal-cancer screening, the endoscopist's rate of adenoma detection was associated with the risk of interval colorectal cancer after screening colonoscopy. Colorectal cancers were less likely to be diagnosed between screening examinations when colonoscopies were performed by endoscopists with an adenoma detection rate of 20% or more.

Current Concepts: Hospital-Acquired Infections Due to Gram-Negative Bacteria

New England Journal of Medicine - Wed, 05/12/2010 - 15:55
Hospital-acquired infections are most commonly associated with mechanical ventilation, invasive medical devices, or surgical procedures. Gram-negative bacteria are responsible for more than 30% of hospital-acquired infections and predominate in hospital-acquired pneumonia. They are highly efficient at up-regulating or acquiring mechanisms of antibiotic drug resistance, especially in the presence of antibiotic selection pressure. This review updates what clinicians should know about these often life-threatening infections.

Erythema Gyratum Repens

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

An 83-year-old man was evaluated for a 1-year history of a pruritic, progressively worsening migratory rash, with associated weakness and a 5-kg weight loss. He had a 30-pack-year history of ...

Morgagni's Hernia

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

A 41-year-old woman was evaluated for a 5-month history of dyspnea and cardiac arrhythmia. Chest radiography revealed an enlarged right mediastinum with air content on the right side (Panel A, ...

Case 14-2010 -- A 54-Year-Old Woman with Dizziness and Falls

New England Journal of Medicine - Wed, 05/12/2010 - 15:55
A 54-year-old woman was admitted to this hospital because of 2 months of episodes of dizziness resulting in falls, which occurred only when standing and were associated with diaphoresis, weakness in the legs, and palpitations. She had a history of borderline hypertension and atrial fibrillation. Physical and neurologic examinations were normal. Orthostatic vital signs showed decreased blood pressure and increased heart rate on standing. Symptoms persisted despite treatment with meclizine, metoprolol, fluid administration, and fludrocortisone. A diagnostic test result was received.

Evolving Data about Subtrochanteric Fractures and Bisphosphonates

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

Osteoporosis, a skeletal disorder characterized by reduced bone strength that predisposes to an increased risk of fracture, affects 10 to 12 million people in the United States. In 2000, there ...

Brain Repair after Stroke

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

Stroke is the second leading cause of death worldwide. A majority of patients survive stroke, however, making this disorder a major source of human disability. Although most patients have some ...

Lung Development, Lung Function, and Retinoids

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

In this issue of the Journal, Checkley et al. report that, in a region with endemic vitamin A (retinol) deficiency, children whose mothers had received vitamin A supplementation before, during, ...

Whistle-Blowers' Experiences in Fraud Litigation against Pharmaceutical Companies

New England Journal of Medicine - Wed, 05/12/2010 - 15:55
The authors interviewed 26 whistle-blowers who had initiated qui tam cases against pharmaceutical companies that were successfully prosecuted for health care fraud. The whistle-blowers reported undergoing substantial personal hardships during their legal cases, which lasted an average of 5 years. They were paid a median of $3 million.

Childhood Obesity, Other Cardiovascular Risk Factors, and Premature Death

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

To the Editor: Franks et al. (Feb. 11 issue)1 report that childhood obesity and glucose intolerance greatly increased the risk ...

Correction: Internal versus External Tocodynamometry in Labor

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

To the Editor: Bakker et al. (Jan. 28 issue)1 report the outcomes of internal and external tocodynamometry in a randomized, ...

Hypofractionated Radiotherapy for Breast Cancer

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

To the Editor: Whelan et al. (Feb. 11 issue)1 report 10-year results of hypofractionated radiotherapy, as compared with standard radiotherapy, ...

Alzheimer's Disease

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

To the Editor: In their article on Alzheimer's disease, Querfurth and LaFerla (Jan. 28 issue)1 stated that "the level of ...

Comparative Effectiveness and Health Care Spending

New England Journal of Medicine - Wed, 05/12/2010 - 15:55

To the Editor: Weinstein and Skinner (Feb. 4 issue)1 provide a helpful framework for visualizing the relationship of aggregate medical ...

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