|
|
The Boundaries of Organ Donation after Circulatory Death
Before vital organs are procured, death statutes require the irreversible cessation of circulation and respiration or the irreversible cessation of brain functions. Dr. James Bernat asks, what duration of asystole proves irreversibility?
Free Full Text
A video roundtable discussion addresses key ethical aspects of organ donation after cardiac death. Moderator Atul Gawande is joined by George Annas, Arthur Caplan, and Robert Truog.
|
Donating Hearts after Cardiac Death — Reversing the Irreversible
Under current law, it is not possible to procure a transplantable heart after cardiac death. Robert Veatch discusses two possible ways out of
this dilemma.
Free Full Text
|
The Dead Donor Rule and Organ Transplantation
At the dawn of organ transplantation, the dead donor rule was accepted as an ethical premise that did not require reflection or justification. Dr. Robert Truog and Franklin Miller write that, in retrospect, it appears that reliance on the dead donor rule has greater potential to undermine trust in the transplantation enterprise than to preserve it.
Free Full Text
|
Naltrexone for the Management of Alcohol Dependence
A 44-year-old businessman presents with clinical evidence of alcohol dependence and acknowledges excessive drinking. The use of naltrexone is recommended. Naltrexone is an opioid-blocking agent that inhibits reward signaling in the brain and reduces alcohol craving.
CME Exam
|
Chromosomal Abnormalities in Cancer
This review gives an account of chromosomal aberrations in cancer cells. Such abnormalities have typically been associated with hematologic cancers, but recent work has shown a variety of chromosomal changes in solid tumors, including prostate cancer and non–small-cell lung cancer.
|
Harnessing the Power of Bacteria to Protect the Gut
A recombinant version of the bacterial protein flagellin protects the mouse gut and bone marrow against the effects of irradiation.
|
A Man with Fatigue and Lesions in the Pituitary and Cerebellum
A 43-year-old man was seen in the rheumatology clinic because of fatigue and lesions in the pituitary and cerebellum. Diabetes insipidus, hypogonadism, and hypothyroidism had developed beginning 9 years earlier. CT of the chest and abdomen disclosed abnormal soft tissue surrounding the aorta, renal arteries, and kidneys.
CME Exam
|
Effect of PCI on Quality of Life in Patients with Stable Coronary Disease
In the COURAGE trial, percutaneous coronary intervention (PCI), added to optimal medical therapy, did not reduce the subsequent rate of death or myocardial infarction among patients with chronic coronary disease. A quality-of-life analysis showed that measures of health status improved significantly with either strategy, but patients in the PCI group had greater initial improvements.
CME Exam
|
Bivalirudin vs. Unfractionated Heparin during PCI
Bivalirudin is a new direct thrombin inhibitor. In patients undergoing PCI for stable coronary disease, bivalirudin and unfractionated heparin resulted in similar overall outcomes, but there was less major bleeding with bivalirudin.
|
Effects of Tibolone in Older Postmenopausal Women
Tibolone has estrogenic, progestogenic, and androgenic effects. In this trial, tibolone was associated with a reduced risk of fracture, breast cancer, and possibly colon cancer. But the drug was associated with an increased risk of stroke.
|
Pediatric Heart Transplantation after Declaration of Cardiocirculatory Death
This report describes transplantation of hearts from three infant donors who had died from cardiocirculatory causes. The recipients all survived to 6 months with excellent left ventricular function. This controversial approach offers the prospect of expanding the donor pool.
Free Full Text
|
Glucagon-like Peptide 1–Receptor Scans to Localize Occult Insulinomas
The precise localization of some insulinomas with the use of conventional imaging techniques is a challenging clinical problem. These findings indicate that GLP-1–receptor scanning may offer a new diagnostic approach that permits the successful localization of small insulinomas.
Free Full Text
|
|
Cardiac Transplantation in Infants Free Full Text
Finding the Courage to Reconsider Medical Therapy for Stable Angina
Tibolone and the Promise of Ideal Hormone-Replacement Therapy
Multiple Biomarkers and Cardiovascular Risk
Sudden Cardiac Arrest and Early Repolarization
Tumor Angiogenesis
Pursuit of an Expanded Physician Supply Free Full Text
Anti–Glomerular Basement Membrane Disease after Alemtuzumab
|
|
|
|
|
NEJM Tools
