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Fractional Flow Reserve versus Angiography for Guiding PCI
The use of fractional flow reserve, as compared with coronary angiography alone, in guiding the placement of coronary stents resulted in the use of fewer stents and better clinical outcomes.
CME Exam
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Atypical Antipsychotic Drugs and the Risk of Sudden Cardiac Death
It is known that the use of typical antipsychotic agents is associated with an increased risk of sudden cardiac death. This study shows that the same association applies to the newer atypical antipsychotic agents and is dose-related.
CME Exam
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Cumulative Live-Birth Rates after IVF
Among couples undergoing up to six cycles of in vitro fertilization (IVF) at one large infertility center, the overall live-birth rate was 72% with an optimistic analysis and 51% with a conservative analysis.
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Effect of Pneumococcal Conjugate Vaccine on Pneumococcal Meningitis
Since the introduction of the heptavalent pneumococcal conjugate vaccine PCV7, rates of pneumococcal meningitis have decreased substantially in the United States, from 1.13 cases to 0.79 case per 100,000 persons between 1998–1999 and 2004–2005.
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Peginterferon Alfa-2a and Ribavirin in Latino and Non-Latino Whites with Hepatitis C
Latino and non-Latino white patients with chronic hepatitis C were treated with peginterferon alfa-2a and ribavirin for 48 weeks. The sustained virologic response rate was lower among Latino patients than among non-Latino patients (33% vs. 49%).
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A Surgical Safety Checklist in a Global Patient Population
In eight hospitals throughout the world, implementation of a 19-item surgical safety checklist was associated with improved outcomes. Use of the checklist may improve the safety of surgical procedures in hospitals representing various economic circumstances.
 January 14, 2009 (DOI: 10.1056/NEJMsa0810119), in Print January 29, 2009
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Endometriosis
This review emphasizes the participation of estrogen and inflammation in the development of endometriosis. A feedback cycle in which prostaglandins and aromatase activity are prominent allows for the persistence of endometriotic tissue. Knowledge of this cycle has important implications for the treatment of endometriosis.
CME Exam
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A Man with Pain and Swelling of the Right Hand and Hypotension
A 25-year-old man was transferred to the emergency department because of pain and swelling of the right hand and hypotension. His hand was mottled and swollen, with a black eschar on the dorsum, and soft-tissue swelling extended up the proximal forearm.
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Management of Prostate Cancer — Polling Results
This interactive feature presented the case a 63-year-old man with a normal digital rectal examination but a prostate-specific antigen level that has been increasing over a 3-year period. Readers were invited to vote for one of three possible treatment options. Polling results are now available, including results by country (see interactive graphic), and close to 200 comments from readers.
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Oncogenesis and Metastasis
Molecules that are involved in the epithelial-to-mesenchymal transition and that are known to promote metastasis also have a role in oncogenesis.
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Visions for Change in U.S. Health Care — The Players and the Possibilities
Recognizing the blunders that doomed the reform effort of President Bill Clinton 16 years ago, the new administration is working closely with Congress to craft a bill that will attract sufficient support to ensure enactment. John Iglehart reports. (View an interactive graphic on key players in health care reform.)
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Health Care Reform — Why So Much Talk and So Little Action?
Victor Fuchs writes that, in pursuing comprehensive health care reform, President-elect Obama should be aware of four major reasons why, in the past, we heard so much talk and saw so little action.
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The Fast-Food Fund
Dr. Perri Klass discusses the moments when doctors give — or think of giving — money to patients. Klass asks, if sending someone out of the office with a $20 bill will well and truly meet some small immediate need, what do you do?
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Long-QT Syndrome Induced by the Antiaddiction Drug Ibogaine
A 31-year-old woman was admitted to the emergency department because of a seizure-like attack after a single 3.5-g dose of ibogaine. ECG showed a severe prolonged-QT interval of 548 msec and ventricular tachyarrhythmias during prolonged monitoring.
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Refining the Art and Science of Coronary Stenting
Antipsychotic Agents and Sudden Cardiac Death — How Should We
Manage the Risk?
Stents in Acute Myocardial Infarction
Telmisartan for Prevention of Cardiovascular Events
SLCO1B1 Variants and Statin-Induced Myopathy
Hepatitis B Virus Infection Free Full Text
An α-Melanocyte–Stimulating Hormone Analogue
in Erythropoietic Protoporphyria
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