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Why Doctors Should Worry about Preemption
A leading drug company may be poised to win a landmark legal victory next fall. Dr. Gregory Curfman, Stephen Morrissey, and Dr. Jeffrey Drazen write that if Wyeth prevails in a case soon to be argued before the U.S. Supreme Court (Wyeth v. Levine), drug companies could effectively be immunized against state-level tort litigation if their FDA-approved products are later found to be defective. (View interactive timeline.)
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Collective Accountability for Medical Care — Toward Bundled Medicare Payments
In their June report, the Medicare Payment Advisory Commission (MedPAC) made 3 recommendations intended to create collective accountability across providers for selected hospital episodes. Glenn Hackbarth, Robert Reischauer, and Anne Mutti hope that this set of policies will create an environment that encourages and enables providers to accept bundled payments while also testing the feasibility of this payment design.
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Effect of In Utero and Early-Life Conditions on Adult Health and Disease
This review synthesizes evidence from several disciplines to support the contention that environmental factors acting during development should be accorded greater weight in models of disease causation.
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Removing the Golden Coat of Staphylococcus aureus
Inhibiting the synthesis of the carotenoid pigment of a strain of Staphylococcus aureus counters the virulence of the bacterium in vitro and in vivo.
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A Gut Feeling
A 72-year-old man presented with a 3-month history of watery diarrhea. This condition was associated with intermittent fevers, abdominal pain, and weight loss of 15 lb.
CME Exam
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Intensity of Renal Support in Critically Ill Patients
Intensive renal support did not decrease mortality, improve recovery of kidney function, or reduce the rate of nonrenal organ failure as compared with thrice-weekly intermittent hemodialysis.
CME Exam
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| Published Online May 20, 2008 (DOI: 10.1056/NEJMoa0802639) |
Epinephrine with or without Vasopressin in Cardiopulmonary Resuscitation
A combination of epinephrine plus vasopressin was compared with epinephrine alone in out-of-hospital cardiopulmonary resuscitation. There was no benefit from the addition of vasopressin.
CME Exam
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Motesanib Diphosphate in Progressive Differentiated Thyroid Cancer
This trial investigated the efficacy of motesanib diphosphate in patients with advanced differentiated thyroid cancer. No patient had a complete response, but 14% had a partial response, with a median duration of 32 weeks.
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Detection of Mutations in EGFR in Circulating Lung-Cancer Cells
This study describes a method for capturing circulating tumor cells in patients with non–small-cell lung cancer with the use of antibody tethered to microposts. The isolated cells were of sufficient quantity and purity to genotype and thus could feasibly be used to guide genotype-specific treatment.
 Related Editorial: Noninvasive Monitoring of Tumors
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 July 2, 2008 (DOI: 10.1056/NEJMoa0800668), in Print July 24, 2008 |
Endomyocardial Fibrosis in Mozambique
This study used echocardiographic screening for endomyocardial fibrosis in Mozambique and found a prevalence of nearly 20%, much of which was mild to moderate in severity.
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Adoption of Electronic Health Records in Ambulatory Care
Only 4% of physicians use an extensive, fully functional system for electronic health records, and 13% use some form of basic electronic records. Those who use electronic records believe that they improve the quality of care that patients receive.
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| Published Online June 18, 2008 (DOI: 10.1056/NEJMsa0802005) |
Peculiar Morphology of Stones in Primary Hyperoxaluria
These authors analyzed calculi obtained from 74 patients with a diagnosis of primary hyperoxaluria type 1 and found that all showed very peculiar morphologic characteristics. This direct examination constitutes a simple, rapid, and cheap tool that might point toward the early diagnosis of primary hyperoxaluria type 1.
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Dialysis in Acute Kidney Injury — More Is Not Better
Published Online May 20, 2008 (DOI: 10.1056/NEJMe0803765)
Medical-Device Safety and the FDA Free Full Text
Mechanical Ventilation of the Diaphragm
Cholesterol Gene Polymorphisms and Cardiovascular Events
Imiquimod for Vulvar Intraepithelial Neoplasia
Drug-Review Deadlines and Safety Problems Free Full Text
Hydroxyurea for Sickle Cell Anemia
More on Melanoma with Transdifferentiation
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