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  • 《新英格兰医学杂志》(The New England Journal of Medicine)2018年06月7日目次选登

    作者:the NEJM    来源:The NEW ENGLAND JOURNAL of MEDICINE    浏览量:    上传时间:2018-06-13 10:34:38

     
    Integrating Medical and Nonmedical Services — The Promise and Pitfalls of the CHRONIC Care Act
    A. Willink and E.H. DuGoff
    The CHRONIC Care Act boosts efforts to provide more integrated care for Medicare beneficiaries to better address needs that are not strictly medical, but it may also substantially affect risk selection in Medicare Advantage plans, which would be counterproductive.
    2153-2155
     
    Assessing Drug Safety in Children — The Role of Real-World Data
    A.W. McMahon and G. Dal Pan
    There are substantial gaps in evidence regarding the safety of many drugs in children. Increasingly, studies assessing drug safety can incorporate data obtained in the course of clinical care to generate real-world evidence and help fill these gaps.
    2155-2157
     
    The Scarlet Virus
    I. Mulasi
    Confident that she could manage her HIV, Ms. M. required little intervention; appointments seemed more like visits with an old friend. She counseled other patients in the waiting room, comforting peers who remained closeted and defamed even in the 21st century.
    2157-2159
     
    Original Articles
    Mifepristone Pretreatment for the Medical Management of Early Pregnancy Loss
    C.A. Schreiber and Others
    In this randomized trial, treatment with mifepristone before the use of misoprostol resulted in a higher rate of successful management of first-trimester pregnancy loss than treatment with misoprostol alone.
    2161-2170
     
    A Placebo-Controlled Trial of Bezafibrate in Primary Biliary Cholangitis
    C. Corpechot and Others
    In a randomized trial of patients with primary biliary cholangitis, bezafibrate and ursodeoxycholic acid resulted in a higher rate of complete biochemical response than ursodeoxycholic acid alone. Bezafibrate was associated with increases in creatinine and myalgias.
    2171-2181
     
    Five-Year Risk of Stroke after TIA or Minor Ischemic Stroke
    P. Amarenco and Others
    In a follow-up to a 1-year study involving patients who had a TIA or minor stroke, the rate of cardiovascular events including stroke was 6.4% in the first year and 6.4% in the second through fifth years.
    2182-2190
            
    Rivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source
    R.G. Hart and Others
    In a randomized trial involving patients who had a first stroke from an embolus of unknown source, rivaroxaban at a daily dose of 15 mg did not result in a lower incidence of recurrent stroke than aspirin at a dose of 100 mg. Bleeding rates were higher with rivaroxaban.
    2191-2201
     
    Special Article
    Clinical Trial Participants’ Views of the Risks and Benefits of Data Sharing
    M.M. Mello, V. Lieou, and S.N. Goodman
    In a survey of participants in clinical trials, the majority believed that the potential benefits of data sharing outweighed the potential negative consequences and were willing to share their data with both scientists in universities and scientists in for-profit companies.
    2202-2211
     
    Review Article
    Dry Eye
    J.A. Clayton
    Dry eye is a common, painful ocular disturbance that can result from systemic inflammatory diseases, localized eye problems, or commonly used medications. Current treatments address symptoms, but advances in understanding tear-film function may lead to new approaches.
    2212-2223
     
    Images in Clinical Medicine
    Lymphangioleiomyomatosis
    A. Sclafani and P. VanderLaan
    A 44-year-old woman presented with chest pain. She was found to have a large pneumothorax and diffuse intraparenchymal pulmonary cysts that were consistent with lymphangioleiomyomatosis.
    2224
     
    Left Main Coronary Artery Aneurysm
    L. Arboine and J.M. Palacios
    A 49-year-old man with hypertension was referred for evaluation of recurrent angina. Coronary angiography revealed a large aneurysm (shown in a video) in the left main coronary artery.
    e32
     
    Clinical Problem-Solving
    A Shocking Turn of Events
    E.M. DeFilippis, P. Sobieszczyk, N.K. Lakdawala, A.L. Miller, and J. Loscalzo
    A 38-year old woman presented to her physician’s office with shortness of breath, nonproductive cough, palpitations, and chest tightness. She had no lightheadedness or syncope.
    2225-2230
     
    Editorials
    A Better Medical Regimen for the Management of Miscarriage
    C.L. Westhoff
    Data from the National Survey of Family Growth suggest that at least 600,000 cases of early pregnancy loss, often called miscarriage, occur before 12 weeks of gestation each year in the United States.1 The treatment options for a woman with a miscarriage ...
    2232-2233
     
    Progress in Primary Biliary Cholangitis
    E.J. Carey
    Primary biliary cholangitis remains an incurable disease. The first medical treatment for this disease was ursodeoxycholic acid, which was approved in 1997 after it was shown to delay the progression of liver disease and improve transplantation-free ...
    2234-2235
     
    Clinical Implications of Basic Research
    The Microbiome and Systemic Lupus Erythematosus
    J.T. Rosenbaum and G.J. Silverman
    A mouse model of systemic lupus erythematosus implicates the translocation of the bacterium E. gallinarum from the small intestine to the liver as a risk factor for the disease.
    2236-2237
     
    Correspondence
    Infantile Pulmonary Teratoid Tumor
    Pleuropulmonary blastoma is a childhood tumor related to DICER mutations. The authors identify a new cancer, infantile pulmonary teratoid tumor, that has some histologic features of pleuropulmonary blastoma but is characterized by SMARCA4 biallelic lesions.
    2238-2240
     
    Complete Responses in the TEMPI Syndrome after Treatment with Daratumumab
    Patients with the TEMPI syndrome often have a response to bortezomib or autologous hematopoietic stem-cell transplantation. In two patients with disease that relapsed after standard treatment, the anti-CD38 antibody daratumumab produced durable responses.
    2240-2242
     
    Encouraging Trends in Modern Phase 1 Oncology Trials
    Historically, phase 1 trials have been aimed at defining the toxic effects of an agent. With the advent of targeted therapies and immunotherapies, response rates in 224 phase 1 trials reported from January 1, 2014, through June 30, 2015, were nearly 20%.
    2242-2243
     
    Helicobacter pylori and Prevention of Gastric Cancer
    To the Editor: In a prospective trial conducted in South Korea, Choi et al. (March 22 issue)1 found that during a median follow-up of 5.9 years, patients with early gastric cancer who had treatment to eradicate Helicobacter pylori had a lower rate of ...
    2244-2245
     
    Myth and Measurement — The Case of Medical Bankruptcies
    To the Editor: Dobkin et al.1 have made an important contribution in clarifying the relationship between health shocks and economic risk; like us, they have shown that health crises have major economic consequences for families and that even the insured ...
    2245-2247
     
    More on Acute Amnestic Syndrome Associated with Fentanyl Overdose
    To the Editor: Barash and colleagues (March 22 issue)1 describe an acute amnestic syndrome associated with fentanyl overdose. Millions of surgical patients each year receive fentanyl therapeutically as part of a general anesthetic regimen, often in doses ...
    2247-2248
     
    Correction
    4-Year Follow-up in a Child with a Total Autologous Tracheal Replacement
    4-Year Follow-up in a Child with a Total Autologous Tracheal Replacement (N Engl J Med 2018;378:1355-1357). In the full list of authors online, Nicolas Leboulanger, M.D., Ph.D., should have been listed between Drs. Coste and Denoyelle. In the online PDF ...
    2248
     
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