Antithrombotic medications and recurrent miscarriage.

N Engl J Med. 2010 Aug 26;363(9):887-8; author reply 888

Authors: Visser J, Cohen D, Bloemenkamp KW

PMID: 20799392 [PubMed - in process]

Cost consciousness and medical education.

N Engl J Med. 2010 Aug 26;363(9):889-90; author reply 890-1

Authors: Robben SH, Melis RJ, Olde Rikkert MG

PMID: 20799393 [PubMed - in process]

Cost consciousness and medical education.

N Engl J Med. 2010 Aug 26;363(9):889; author reply 890-1

Authors: Dzik W

PMID: 20799394 [PubMed - in process]

Cost consciousness and medical education.

N Engl J Med. 2010 Aug 26;363(9):890; author reply 890-1

Authors: Azer SA

PMID: 20799395 [PubMed - in process]

Antithrombotic medications and recurrent miscarriage.

N Engl J Med. 2010 Aug 26;363(9):887; author reply 888

Authors: Pasquier E, de Saint Martin L

PMID: 20738192 [PubMed - in process]

Cost consciousness and medical education.

N Engl J Med. 2010 Aug 26;363(9):888-9; author reply 890-1

Authors: Rivas H, Morton JM, Krummel TM

PMID: 20738193 [PubMed - in process]

This week in the journal.

N Engl J Med. 2010 Aug 19;363(8):710

Authors:

PMID: 20718669 [PubMed - in process]

Effect of valsartan on the incidence of diabetes.

N Engl J Med. 2010 Aug 19;363(8):792-3

Authors:

To the Editor: In their article on the valsartan portion of the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial (April 22 issue),(1) McMurray et al. report a significant reduction of 14% in the relative hazard of diabetes among patients receiving valsartan, as compared with placebo. However, the investigators did not address the presence of two possibly confounding factors. First, there was a higher prevalence of the metabolic syndrome among patients assigned to placebo than among those assigned to valsartan, which could have predisposed those patients to diabetes.(2) It is unclear whether this difference was taken into . . .

PMID: 20718670 [PubMed - in process]

Dutasteride and prostate cancer.

N Engl J Med. 2010 Aug 19;363(8):793-6

Authors:

To the Editor: In the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial, Andriole et al. (April 1 issue)(1) found that there was a reduction in low-grade prostate cancer among high-risk men after dutasteride treatment - similar to the results with finasteride therapy among low-risk men in the Prostate Cancer Prevention Trial.(2) However, there was a slightly increased risk of high-grade tumors in the dutasteride group at the end of the study. The authors speculate that this was caused by the more frequent early detection of low-grade tumors in the placebo group. Some of these might have progressed to . . .

PMID: 20718671 [PubMed - in process]

Ultrasound-guided internal jugular vein cannulation.

N Engl J Med. 2010 Aug 19;363(8):796-7

Authors:

To the Editor: We wish that Ortega et al. (April 22 issue)(1) had demonstrated the use of the needle-guide technique in their video of internal jugular vein cannulation. As noted in the video, it can be difficult to determine the location of the tip of the needle, which may be either in front of or behind the narrow cross-sectional plane of the ultrasound image. With the use of a needle guide, the operator can direct the needle tip such that it intersects the middle of the image on the screen at the depth prescribed by the guide. This technique has . . .

PMID: 20718672 [PubMed - in process]

Maternal vitamin a supplementation and lung function in offspring.

N Engl J Med. 2010 Aug 19;363(8):798

Authors:

Maternal Vitamin A Supplementation and Lung Function in Offspring Original Article, N Engl J Med 2010:362;1784-1794. In Figure 4C (page 1791), the y axis should have been labeled "Postpartum Retinol Component of Estimated FVC (liters)," rather than ". . . of Estimated FEV(1) (liters)." We regret the error. The article has been corrected at NEJM.org.

PMID: 20718673 [PubMed - in process]

Rituximab in ANCA-Associated Disease.

N Engl J Med. 2010 Aug 19;363(8):798

Authors:

Rituximab in ANCA-Associated Disease Editorial, N Engl J Med 2010:363;285-286. In the penultimate paragraph (page 286), the fifth sentence should have read, "At this juncture, the 6-month follow-up of the RAVE trial does not provide an answer to the question of whether anti-B-cell therapy and glucocorticoids will result in a sustained remission," rather than ". . . whether anti-B-cell therapy, glucocorticoids, and azathioprine used to maintain remission will result in a sustained remission." The article has been corrected at NEJM.org.

PMID: 20718674 [PubMed - in process]

Don'T forget tobacco.

N Engl J Med. 2010 Aug 19;363(8):798

Authors:

Don't Forget Tobacco Perspective, N Engl J Med 2010:363;201-204. In the map (page 203), the prevalence of adult smokers for Rhode Island should have been 15.1-20.0%, rather than 20.1-25.0%. We regret the error. The article has been corrected at NEJM.org.

PMID: 20718675 [PubMed - in process]

This week in the journal.

N Engl J Med. 2010 Aug 12;363(7):608

Authors:

PMID: 20701532 [PubMed - in process]

Combination lipid therapy in type 2 diabetes.

N Engl J Med. 2010 Aug 12;363(7):692-5

Authors:

To the Editor: In the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial (ClinicalTrials.gov number, NCT00000620) reported on by Ginsberg et al. (April 29 issue),(1) the use of fenofibrate in patients with type 2 diabetes mellitus who were receiving simvastatin and who were at high risk for cardiovascular disease greatly reduced triglyceride levels but hardly increased levels of high-density lipoprotein (HDL) cholesterol and did not reduce cardiovascular risk. To put these findings into context, it is important to know which lipid variables most strongly predict risk among high-risk patients who receive statins. We therefore prospectively recorded vascular events among . . .

PMID: 20701533 [PubMed - in process]

Blood pressure control in type 2 diabetes.

N Engl J Med. 2010 Aug 12;363(7):695-7

Authors:

To the Editor: The members of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study group (April 29 issue)(1) report that targeting a systolic blood pressure of less than 120 mm Hg, as compared with less than 140 mm Hg, did not reduce the incidence of cardiovascular events in patients with type 2 diabetes. My colleagues and I caution against early conclusions. Nonfatal myocardial infarction and death from cardiovascular causes accounted for more than 85% of the composite outcome. Lowering blood pressure too aggressively can cause harm.(2),(3) A diastolic blood pressure of less than 60 mm Hg was . . .

PMID: 20701534 [PubMed - in process]

Bar-code technology to reduce medication errors.

N Engl J Med. 2010 Aug 12;363(7):698

Authors:

To the Editor: Poon et al. (May 6 issue)(1) describe the successful use of bar codes to reduce the error rate in order transcription and medication administration. We observed similar results at our 653-bed facility, Baystate Medical Center, during a 6-month pilot evaluation of bar-code point of care in three nursing units from April 2008 through September 2008. Before hospital-wide implementation of the program, self-reported medication errors totaled 1.2 per 1000 patient days, according to the University HealthSystem Consortium's Patient Safety Net. During the pilot program, challenges in implementing the technology were identified, since rates of bar-code scanning reached only . . .

PMID: 20701535 [PubMed - in process]

Lenient versus strict rate control in atrial fibrillation.

N Engl J Med. 2010 Jul 22;363(4):392-3; author reply 393-4

Authors: Grimsley EW, Patel R, Persed P

PMID: 20677362 [PubMed - in process]

Lenient versus strict rate control in atrial fibrillation.

N Engl J Med. 2010 Jul 22;363(4):393; author reply 393-4

Authors: Bhaskar E

PMID: 20677363 [PubMed - in process]

Epidural analgesia for labor and delivery.

N Engl J Med. 2010 Jul 22;363(4):395

Authors: Young P, Emery NC, Reisin R

PMID: 20677364 [PubMed - in process]

Patient-Specific Induced Pluripotent Stem-Cell Models for Long-QT Syndrome.

N Engl J Med. 2010 Jul 21;

Authors: Moretti A, Bellin M, Welling A, Jung CB, Lam JT, Bott-Flügel L, Dorn T, Goedel A, Höhnke C, Hofmann F, Seyfarth M, Sinnecker D, Schömig A, Laugwitz KL

BACKGROUND: Long-QT syndromes are heritable diseases associated with prolongation of the QT interval on an electrocardiogram and a high risk of sudden cardiac death due to ventricular tachyarrhythmia. In long-QT syndrome type 1, mutations occur in the KCNQ1 gene, which encodes the repolarizing potassium channel mediating the delayed rectifier I(Ks) current. METHODS: We screened a family affected by long-QT syndrome type 1 and identified an autosomal dominant missense mutation (R190Q) in the KCNQ1 gene. We obtained dermal fibroblasts from two family members and two healthy controls and infected them with retroviral vectors encoding the human transcription factors OCT3/4, SOX2, KLF4, and c-MYC to generate pluripotent stem cells. With the use of a specific protocol, these cells were then directed to differentiate into cardiac myocytes. RESULTS: Induced pluripotent stem cells maintained the disease genotype of long-QT syndrome type 1 and generated functional myocytes. Individual cells showed a "ventricular," "atrial," or "nodal" phenotype, as evidenced by the expression of cell-type-specific markers and as seen in recordings of the action potentials in single cells. The duration of the action potential was markedly prolonged in "ventricular" and "atrial" cells derived from patients with long-QT syndrome type 1, as compared with cells from control subjects. Further characterization of the role of the R190Q-KCNQ1 mutation in the pathogenesis of long-QT syndrome type 1 revealed a dominant negative trafficking defect associated with a 70 to 80% reduction in I(Ks) current and altered channel activation and deactivation properties. Moreover, we showed that myocytes derived from patients with long-QT syndrome type 1 had an increased susceptibility to catecholamine-induced tachyarrhythmia and that beta-blockade attenuated this phenotype. CONCLUSIONS: We generated patient-specific pluripotent stem cells from members of a family affected by long-QT syndrome type 1 and induced them to differentiate into functional cardiac myocytes. The patient-derived cells recapitulated the electrophysiological features of the disorder. (Funded by the European Research Council and others.) Copyright 2010 Massachusetts Medical Society.

PMID: 20660394 [PubMed - as supplied by publisher]

Revisiting the Rosiglitazone Story -- Lessons Learned.

N Engl J Med. 2010 Jul 21;

Authors: Rosen CJ

PMID: 20660395 [PubMed - as supplied by publisher]

Walking the Tightrope of Health Insurance Reform between 2010 and 2014.

N Engl J Med. 2010 Jul 21;

Authors: Jennings CC, Hayes KJ

PMID: 20660396 [PubMed - as supplied by publisher]

Truth and Consequences -- Insurance-Premium Rate Regulation and the ACA.

N Engl J Med. 2010 Jul 21;

Authors: Mills A, Engelhard CL, Tereskerz PM

PMID: 20660397 [PubMed - as supplied by publisher]

Health Reform, Primary Care, and Graduate Medical Education.

N Engl J Med. 2010 Jul 21;

Authors: Iglehart JK

PMID: 20660398 [PubMed - as supplied by publisher]

Clinical evaluation of the knee.

N Engl J Med. 2010 Jul 22;363(4):e5

Authors: Schraeder TL, Terek RM, Smith CC

PMID: 20660399 [PubMed - in process]

Congenital cholesteatoma of the middle ear.

N Engl J Med. 2010 Jul 22;363(4):e6

Authors: Sergi B, Fetoni A

PMID: 20660400 [PubMed - in process]

A randomized trial of treatment for acute anterior cruciate ligament tears.

N Engl J Med. 2010 Jul 22;363(4):331-42

Authors: Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS

BACKGROUND: The optimal management of a torn anterior cruciate ligament (ACL) of the knee is unknown. METHODS: We conducted a randomized, controlled trial involving 121 young, active adults with acute ACL injury in which we compared two strategies: structured rehabilitation plus early ACL reconstruction and structured rehabilitation with the option of later ACL reconstruction if needed. The primary outcome was the change from baseline to 2 years in the average score on four subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS)--pain, symptoms, function in sports and recreation, and knee-related quality of life (KOOS(4); range of scores, 0 [worst] to 100 [best]). Secondary outcomes included results on all five KOOS subscales, the Medical Outcomes Study 36-Item Short-Form Health Survey, and the score on the Tegner Activity Scale. RESULTS: Of 62 subjects assigned to rehabilitation plus early ACL reconstruction, 1 did not undergo surgery. Of 59 assigned to rehabilitation plus optional delayed ACL reconstruction, 23 underwent delayed ACL reconstruction; the other 36 underwent rehabilitation alone. The absolute change in the mean KOOS(4) score from baseline to 2 years was 39.2 points for those assigned to rehabilitation plus early ACL reconstruction and 39.4 for those assigned to rehabilitation plus optional delayed reconstruction (absolute between-group difference, 0.2 points; 95% confidence interval, -6.5 to 6.8; P=0.96 after adjustment for the baseline score). There were no significant differences between the two treatment groups with respect to secondary outcomes. Adverse events were common in both groups. The results were similar when the data were analyzed according to the treatment actually received. CONCLUSIONS: In young, active adults with acute ACL tears, a strategy of rehabilitation plus early ACL reconstruction was not superior to a strategy of rehabilitation plus optional delayed ACL reconstruction. The latter strategy substantially reduced the frequency of surgical reconstructions. (Funded by the Swedish Research Council and the Medical Faculty of Lund University and others; Current Controlled Trials number, ISRCTN84752559.)

PMID: 20660401 [PubMed - in process]

Molecular architecture of the Goodpasture autoantigen in anti-GBM nephritis.

N Engl J Med. 2010 Jul 22;363(4):343-54

Authors: Pedchenko V, Bondar O, Fogo AB, Vanacore R, Voziyan P, Kitching AR, Wieslander J, Kashtan C, Borza DB, Neilson EG, Wilson CB, Hudson BG

BACKGROUND: In Goodpasture's disease, circulating autoantibodies bind to the noncollagenous-1 (NC1) domain of type IV collagen in the glomerular basement membrane (GBM). The specificity and molecular architecture of epitopes of tissue-bound autoantibodies are unknown. Alport's post-transplantation nephritis, which is mediated by alloantibodies against the GBM, occurs after kidney transplantation in some patients with Alport's syndrome. We compared the conformations of the antibody epitopes in Goodpasture's disease and Alport's post-transplantation nephritis with the intention of finding clues to the pathogenesis of anti-GBM glomerulonephritis. METHODS: We used an enzyme-linked immunosorbent assay to determine the specificity of circulating autoantibodies and kidney-bound antibodies to NC1 domains. Circulating antibodies were analyzed in 57 patients with Goodpasture's disease, and kidney-bound antibodies were analyzed in 14 patients with Goodpasture's disease and 2 patients with Alport's post-transplantation nephritis. The molecular architecture of key epitope regions was deduced with the use of chimeric molecules and a three-dimensional model of the alpha345NC1 hexamer. RESULTS: In patients with Goodpasture's disease, both autoantibodies to the alpha3NC1 monomer and antibodies to the alpha5NC1 monomer (and fewer to the alpha4NC1 monomer) were bound in the kidneys and lungs, indicating roles for the alpha3NC1 and alpha5NC1 monomers as autoantigens. High antibody titers at diagnosis of anti-GBM disease were associated with ultimate loss of renal function. The antibodies bound to distinct epitopes encompassing region E(A) in the alpha5NC1 monomer and regions E(A) and E(B) in the alpha3NC1 monomer, but they did not bind to the native cross-linked alpha345NC1 hexamer. In contrast, in patients with Alport's post-transplantation nephritis, alloantibodies bound to the E(A) region of the alpha5NC1 subunit in the intact hexamer, and binding decreased on dissociation. CONCLUSIONS: The development of Goodpasture's disease may be considered an autoimmune "conformeropathy" that involves perturbation of the quaternary structure of the alpha345NC1 hexamer, inducing a pathogenic conformational change in the alpha3NC1 and alpha5NC1 subunits, which in turn elicits an autoimmune response. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases.)

PMID: 20660402 [PubMed - in process]

Efficacy of gene therapy for X-linked severe combined immunodeficiency.

N Engl J Med. 2010 Jul 22;363(4):355-64

Authors: Hacein-Bey-Abina S, Hauer J, Lim A, Picard C, Wang GP, Berry CC, Martinache C, Rieux-Laucat F, Latour S, Belohradsky BH, Leiva L, Sorensen R, Debré M, Casanova JL, Blanche S, Durandy A, Bushman FD, Fischer A, Cavazzana-Calvo M

BACKGROUND: The outcomes of gene therapy to correct congenital immunodeficiencies are unknown. We reviewed long-term outcomes after gene therapy in nine patients with X-linked severe combined immunodeficiency (SCID-X1), which is characterized by the absence of the cytokine receptor common gamma chain. METHODS: The nine patients, who lacked an HLA-identical donor, underwent ex vivo retrovirus-mediated transfer of gamma chain to autologous CD34+ bone marrow cells between 1999 and 2002. We assessed clinical events and immune function on long-term follow-up. RESULTS: Eight patients were alive after a median follow-up period of 9 years (range, 8 to 11). Gene therapy was initially successful at correcting immune dysfunction in eight of the nine patients. However, acute leukemia developed in four patients, and one died. Transduced T cells were detected for up to 10.7 years after gene therapy. Seven patients, including the three survivors of leukemia, had sustained immune reconstitution; three patients required immunoglobulin-replacement therapy. Sustained thymopoiesis was established by the persistent presence of naive T cells, even after chemotherapy in three patients. The T-cell-receptor repertoire was diverse in all patients. Transduced B cells were not detected. Correction of the immunodeficiency improved the patients' health. CONCLUSIONS: After nearly 10 years of follow-up, gene therapy was shown to have corrected the immunodeficiency associated with SCID-X1. Gene therapy may be an option for patients who do not have an HLA-identical donor for hematopoietic stem-cell transplantation and for whom the risks are deemed acceptable. This treatment is associated with a risk of acute leukemia. (Funded by INSERM and others.)

PMID: 20660403 [PubMed - in process]

Functional hypothalamic amenorrhea.

N Engl J Med. 2010 Jul 22;363(4):365-71

Authors: Gordon CM

PMID: 20660404 [PubMed - in process]

Chloroquine-induced hair hypopigmentation.

N Engl J Med. 2010 Jul 22;363(4):372

Authors: Donovan JC, Price VH

PMID: 20660405 [PubMed - in process]

Case 22-2010 -- an 87-year-old woman with dementia and a seizure.

N Engl J Med. 2010 Jul 22;363(4):373-81

Authors: Greenberg SM, Rapalino O, Frosch MP

PMID: 20660406 [PubMed - in process]

Is early reconstruction necessary for all anterior cruciate ligament tears?

N Engl J Med. 2010 Jul 22;363(4):386-8

Authors: Levy BA

PMID: 20660407 [PubMed - in process]

Goodpasture's disease--new secrets revealed.

N Engl J Med. 2010 Jul 22;363(4):388-91

Authors: Salant DJ

PMID: 20660408 [PubMed - in process]

Lenient versus strict rate control in atrial fibrillation.

N Engl J Med. 2010 Jul 22;363(4):392; author reply 393-4

Authors: Marine JE

PMID: 20660409 [PubMed - in process]

Epidural analgesia for labor and delivery.

N Engl J Med. 2010 Jul 22;363(4):394-5

Authors: Koppel BS, Chiechi M

PMID: 20660410 [PubMed - in process]

Case 10-2010: a woman with weakness and a mass in the brain.

N Engl J Med. 2010 Jul 22;363(4):395; author reply 395-6

Authors: Alangaden G, Chandrasekar PH

PMID: 20660411 [PubMed - in process]

JAK2 Mutations and Coronary Ischemia.

N Engl J Med. 2010 Jul 22;363(4):396-7

Authors: Lata K, Madiraju N, Levitt L

PMID: 20660412 [PubMed - in process]

Aprepitant for erlotinib-induced pruritus.

N Engl J Med. 2010 Jul 22;363(4):397-8

Authors: Vincenzi B, Tonini G, Santini D

PMID: 20660413 [PubMed - in process]

Trajectories of disability in the last year of life.

N Engl J Med. 2010 Jul 15;363(3):294; author reply 295

Authors: Kurrle S, Cameron ID, Maier AB

PMID: 20665928 [PubMed - indexed for MEDLINE]

Advance directives and surrogate decision making before death.

N Engl J Med. 2010 Jul 15;363(3):296; author reply 296

Authors: Henrikson CA

PMID: 20665929 [PubMed - indexed for MEDLINE]

This week in the journal.

N Engl J Med. 2010 Jul 29;363(5):410

Authors:

PMID: 20666627 [PubMed - in process]

Duration of clopidogrel therapy with drug-eluting stents.

N Engl J Med. 2010 Jul 29;363(5):488-90

Authors:

To the Editor: In their article about the duration of dual antiplatelet therapy after implantation of drug-eluting stents, Park and colleagues (April 15 issue)(1) report that the use of extended dual antiplatelet therapy in patients who had received drug-eluting stents was not significantly more effective than aspirin monotherapy in reducing the rate of myocardial infarction or death from cardiac causes. Yet the rate of a composite of myocardial infarction, stroke, or death from any cause was nearly significantly higher in patients receiving extended dual antiplatelet therapy than in those receiving aspirin alone. These results are unpredictable and thus are difficult . . .

PMID: 20666628 [PubMed - in process]

Physician cost profiling.

N Engl J Med. 2010 Jul 29;363(5):491-3

Authors:

To the Editor: Adams et al. (March 18 issue)(1) highlight problems in the use of claims data to profile physicians. We agree caution is necessary, but not all "profiling" is problematic. Three modifications can improve estimates: excluding infrequent and expensive items outside the physician's control, focusing on the primary care physician, and being condition-specific. For the profiling of resource use (i.e., cost) related to specific chronic illnesses, we recommend setting aside inpatient care. We evaluated data on 20,073 year-long episodes of care for patients with diabetes (excluding inpatient costs) in a large medical group in 2006, 2007, and 2008. Costs . . .

PMID: 20666629 [PubMed - in process]

Outpatient Management of Severe COPD.

N Engl J Med. 2010 Jul 29;363(5):493-5

Authors:

To the Editor: Niewoehner (April 15 issue)(1) reports that there are no serious safety problems associated with inhaled bronchodilators. We disagree. First, the Towards a Revolution in COPD Health trial (TORCH; ClinicalTrials.gov number, NCT00268216) showed a significantly increased risk of serious pneumonia with the use of long-acting beta-agonist combinations (relative risk with inhaled corticosteroids plus long-acting beta-agonists vs. long-acting beta-agonists, 1.58; 95% confidence interval [CI], 1.24 to 2.01).(2) Second, there was a significantly increased risk of intestinal obstruction (reported as adverse events) with the use of tiotropium (relative risk, 5.55; 95% CI, 1.24 to 24.8) in the Understanding Potential Long-Term . . .

PMID: 20666630 [PubMed - in process]

What's Keeping Us So Busy in Primary Care?

N Engl J Med. 2010 Jul 29;363(5):495-6

Authors:

To the Editor: The article by Baron (April 29 issue)(1) paints a fascinating picture of the reality of a five-member single-specialty primary care group practice. One interesting aspect of that practice is that although it employed four medical assistants, five front-desk staff, one business manager, and one billing manager, it did not have any nurse or midlevel practitioners on board at the time of the study. After the study, they hired a registered nurse (RN) to take on "information triage" to reduce some of the physicians' workload. This is a good example of the value of an electronic health record, . . .

PMID: 20666631 [PubMed - in process]

Low diagnostic yield of elective coronary angiography.

N Engl J Med. 2010 Jul 29;363(5):498

Authors:

Low Diagnostic Yield of Elective Coronary Angiography Original Article, N Engl J Med 2010:362;886-895. In Table 2 (page 892), the value of the Adjusted Odds Ratio in the "Not requiring dialysis" row under "Renal failure" should have been "1.15," rather than "1.45." The article has been corrected at NEJM.org.

PMID: 20666632 [PubMed - in process]

Pay-for-Performance System for English Physicians.

N Engl J Med. 2010 Jul 29;363(5):498

Authors:

Pay-for-Performance System for English Physicians Correspondence, N Engl J Med 2008:359;2176-2177. In Table 1 (page 2177), the Exception rate should have been equal to "n(2)/N(total), n(3)/N(total)," rather than "n(1)/N(total), n(3)/N(total)." We regret the error. The article has been corrected at NEJM.org.

PMID: 20666633 [PubMed - in process]

Stenting versus Endarterectomy for Treatment of Carotid-Artery Stenosis.

N Engl J Med. 2010 Jul 29;363(5):498

Authors:

Stenting versus Endarterectomy for Treatment of Carotid-Artery Stenosis Original Article, N Engl J Med 2010:363;11-23. In the third paragraph of the Discussion section (page 21), the third sentence should have ended ". . . in ICSS, the protocol did not require formal examination until 30 days after the procedure," rather than ". . . in ICSS, patients were not formally examined per protocol before or after the procedure or at 30 days." The article has been corrected at NEJM.org.

PMID: 20666634 [PubMed - in process]

Cisplatin plus gemcitabine for biliary tract cancer.

N Engl J Med. 2010 Jul 8;363(2):192; author reply 192-3

Authors: Hall FM

PMID: 20653076 [PubMed - in process]

Apolipoprotein C3 gene variants in nonalcoholic fatty liver disease.

N Engl J Med. 2010 Jul 8;363(2):194; author reply 195

Authors: Valenti L, Nobili V, Fargion S

PMID: 20653077 [PubMed - in process]

Apolipoprotein C3 gene variants in nonalcoholic fatty liver disease.

N Engl J Med. 2010 Jul 8;363(2):194-5; author reply 195

Authors: Salamone F, Galvano F, Li Volti G

PMID: 20653078 [PubMed - in process]

Modernizing device regulation.

N Engl J Med. 2010 Jul 8;363(2):196-7; author reply 197

Authors: Kretzer RM, Foreman CL, Shuren J

PMID: 20653080 [PubMed - in process]

Finding My Way to Electronic Health Records.

N Engl J Med. 2010 Jul 13;

Authors: Benjamin R

PMID: 20647182 [PubMed - as supplied by publisher]

The "Meaningful Use" Regulation for Electronic Health Records.

N Engl J Med. 2010 Jul 13;

Authors: Blumenthal D, Tavenner M

PMID: 20647183 [PubMed - as supplied by publisher]

Facing the Wild West of Health Care Reform -- Donald Berwick, Pioneer.

N Engl J Med. 2010 Jul 14;

Authors: Iglehart JK

PMID: 20647184 [PubMed - as supplied by publisher]

Disclosing Industry Relationships -- Toward an Improved Federal Research Policy.

N Engl J Med. 2010 Jul 14;

Authors: Campbell EG, Zinner DE

PMID: 20647185 [PubMed - as supplied by publisher]

The Renaissance in HIV Vaccine Development -- Future Directions.

N Engl J Med. 2010 Jul 15;

Authors: Koff WC, Berkley SF

PMID: 20647186 [PubMed - as supplied by publisher]

The SGR for Physician Payment -- An Indispensable Abomination.

N Engl J Med. 2010 Jul 7;

Authors: Aaron HJ

PMID: 20647187 [PubMed - as supplied by publisher]

Don't Mess with the DSMB.

N Engl J Med. 2010 Jul 7;

Authors: Drazen JM, Wood AJ

PMID: 20647188 [PubMed - as supplied by publisher]

"Race Correction" in Pulmonary-Function Testing.

N Engl J Med. 2010 Jul 7;

Authors: Scanlon PD, Shriver MD

PMID: 20647189 [PubMed - as supplied by publisher]

Genetic Ancestry in Lung-Function Predictions.

N Engl J Med. 2010 Jul 7;

Authors: Kumar R, Seibold MA, Aldrich MC, Williams LK, Reiner AP, Colangelo L, Galanter J, Gignoux C, Hu D, Sen S, Choudhry S, Peterson EL, Rodriguez-Santana J, Rodriguez-Cintron W, Nalls MA, Leak TS, O'Meara E, Meibohm B, Kritchevsky SB, Li R, Harris TB, Nickerson DA, Fornage M, Enright P, Ziv E, Smith LJ, Liu K, Burchard EG

BACKGROUND: Self-identified race or ethnic group is used to determine normal reference standards in the prediction of pulmonary function. We conducted a study to determine whether the genetically determined percentage of African ancestry is associated with lung function and whether its use could improve predictions of lung function among persons who identified themselves as African American. METHODS: We assessed the ancestry of 777 participants self-identified as African American in the Coronary Artery Risk Development in Young Adults (CARDIA) study and evaluated the relation between pulmonary function and ancestry by means of linear regression. We performed similar analyses of data for two independent cohorts of subjects identifying themselves as African American: 813 participants in the Health, Aging, and Body Composition (HABC) study and 579 participants in the Cardiovascular Health Study (CHS). We compared the fit of two types of models to lung-function measurements: models based on the covariates used in standard prediction equations and models incorporating ancestry. We also evaluated the effect of the ancestry-based models on the classification of disease severity in two asthma-study populations. RESULTS: African ancestry was inversely related to forced expiratory volume in 1 second (FEV(1)) and forced vital capacity in the CARDIA cohort. These relations were also seen in the HABC and CHS cohorts. In predicting lung function, the ancestry-based model fit the data better than standard models. Ancestry-based models resulted in the reclassification of asthma severity (based on the percentage of the predicted FEV(1)) in 4 to 5% of participants. CONCLUSIONS: Current predictive equations, which rely on self-identified race alone, may misestimate lung function among subjects who identify themselves as African American. Incorporating ancestry into normative equations may improve lung-function estimates and more accurately categorize disease severity. (Funded by the National Institutes of Health and others.) Copyright 2010 Massachusetts Medical Society.

PMID: 20647190 [PubMed - as supplied by publisher]

Paget-schroetter syndrome.

N Engl J Med. 2010 Jul 15;363(3):e4

Authors: Seeger M, Bewig B

PMID: 20647195 [PubMed - in process]

Don'T forget tobacco.

N Engl J Med. 2010 Jul 15;363(3):201-4

Authors: Schroeder SA, Warner KE

PMID: 20647196 [PubMed - in process]

The Case for Primary Care -- A Medical Student's Perspective.

N Engl J Med. 2010 Jul 15;363(3):207-9

Authors: Ganguli I

PMID: 20647197 [PubMed - in process]

Rituximab versus Cyclophosphamide in ANCA-Associated Renal Vasculitis.

N Engl J Med. 2010 Jul 15;363(3):211-220

Authors: Jones RB, Cohen Tervaert JW, Hauser T, Luqmani R, Morgan MD, Peh CA, Savage CO, Segelmark M, Tesar V, van Paassen P, Walsh D, Walsh M, Westman K, Jayne DR,

BACKGROUND: Cyclophosphamide induction regimens for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis are effective in 70 to 90% of patients, but they are associated with high rates of death and adverse events. Treatment with rituximab has led to remission rates of 80 to 90% among patients with refractory ANCA-associated vasculitis and may be safer than cyclophosphamide regimens. METHODS: We compared rituximab with cyclophosphamide as induction therapy in ANCA-associated vasculitis. We randomly assigned, in a 3:1 ratio, 44 patients with newly diagnosed ANCA-associated vasculitis and renal involvement to a standard glucocorticoid regimen plus either rituximab at a dose of 375 mg per square meter of body-surface area per week for 4 weeks, with two intravenous cyclophosphamide pulses (33 patients, the rituximab group), or intravenous cyclophosphamide for 3 to 6 months followed by azathioprine (11 patients, the control group). Primary end points were sustained remission rates at 12 months and severe adverse events. RESULTS: The median age was 68 years, and the glomerular filtration rate (GFR) was 18 ml per minute per 1.73 m(2) of body-surface area. A total of 25 patients in the rituximab group (76%) and 9 patients in the control group (82%) had a sustained remission (P=0.68). Severe adverse events occurred in 14 patients in the rituximab group (42%) and 4 patients in the control group (36%) (P=0.77). Six of the 33 patients in the rituximab group (18%) and 2 of the 11 patients in the control group (18%) died (P=1.00). The median increase in the GFR between 0 and 12 months was 19 ml per minute in the rituximab group and 15 ml per minute in the control group (P=0.14). CONCLUSIONS: A rituximab-based regimen was not superior to standard intravenous cyclophosphamide for severe ANCA-associated vasculitis. Sustained-remission rates were high in both groups, and the rituximab-based regimen was not associated with reductions in early severe adverse events. (Funded by Cambridge University Hospitals National Health Service Foundation Trust and F. Hoffmann-La Roche; Current Controlled Trials number, ISRCTN28528813.) Copyright 2010 Massachusetts Medical Society.

PMID: 20647198 [PubMed - as supplied by publisher]

Rituximab versus Cyclophosphamide for ANCA-Associated Vasculitis.

N Engl J Med. 2010 Jul 15;363(3):221-232

Authors: Stone JH, Merkel PA, Spiera R, Seo P, Langford CA, Hoffman GS, Kallenberg CG, St Clair EW, Turkiewicz A, Tchao NK, Webber L, Ding L, Sejismundo LP, Mieras K, Weitzenkamp D, Ikle D, Seyfert-Margolis V, Mueller M, Brunetta P, Allen NB, Fervenza FC, Geetha D, Keogh KA, Kissin EY, Monach PA, Peikert T, Stegeman C, Ytterberg SR, Specks U,

BACKGROUND: Cyclophosphamide and glucocorticoids have been the cornerstone of remission-induction therapy for severe antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis for 40 years. Uncontrolled studies suggest that rituximab is effective and may be safer than a cyclophosphamide-based regimen. METHODS: We conducted a multicenter, randomized, double-blind, double-dummy, noninferiority trial of rituximab (375 mg per square meter of body-surface area per week for 4 weeks) as compared with cyclophosphamide (2 mg per kilogram of body weight per day) for remission induction. Glucocorticoids were tapered off; the primary end point was remission of disease without the use of prednisone at 6 months. RESULTS: Nine centers enrolled 197 ANCA-positive patients with either Wegener's granulomatosis or microscopic polyangiitis. Baseline disease activity, organ involvement, and the proportion of patients with relapsing disease were similar in the two treatment groups. Sixty-three patients in the rituximab group (64%) reached the primary end point, as compared with 52 patients in the control group (53%), a result that met the criterion for noninferiority (P<0.001). The rituximab-based regimen was more efficacious than the cyclophosphamide-based regimen for inducing remission of relapsing disease; 34 of 51 patients in the rituximab group (67%) as compared with 21 of 50 patients in the control group (42%) reached the primary end point (P=0.01). Rituximab was also as effective as cyclophosphamide in the treatment of patients with major renal disease or alveolar hemorrhage. There were no significant differences between the treatment groups with respect to rates of adverse events. CONCLUSIONS: Rituximab therapy was not inferior to daily cyclophosphamide treatment for induction of remission in severe ANCA-associated vasculitis and may be superior in relapsing disease. (Funded by the National Institutes of Allergy and Infectious Diseases, Genentech, and Biogen; ClinicalTrials.gov number, NCT00104299.) Copyright 2010 Massachusetts Medical Society.

PMID: 20647199 [PubMed - as supplied by publisher]

Multicenter, Placebo-Controlled Trial of Lorcaserin for Weight Management.

N Engl J Med. 2010 Jul 15;363(3):245-256

Authors: Smith SR, Weissman NJ, Anderson CM, Sanchez M, Chuang E, Stubbe S, Bays H, Shanahan WR,

BACKGROUND: Lorcaserin is a selective serotonin 2C receptor agonist that could be useful in reducing body weight. METHODS: In this double-blind clinical trial, we randomly assigned 3182 obese or overweight adults (mean body-mass index [the weight in kilograms divided by the square of the height in meters] of 36.2) to receive lorcaserin at a dose of 10 mg, or placebo, twice daily for 52 weeks. All patients also underwent diet and exercise counseling. At week 52, patients in the placebo group continued to receive placebo but patients in the lorcaserin group were randomly reassigned to receive either placebo or lorcaserin. Primary outcomes were weight loss at 1 year and maintenance of weight loss at 2 years. Serial echocardiography was used to identify patients in whom valvulopathy (as defined by the Food and Drug Administration) developed. RESULTS: At 1 year, 55.4% of patients (883 of 1595) receiving lorcaserin and 45.1% of patients (716 of 1587) receiving placebo remained in the trial; 1553 patients continued into year 2. At 1 year, 47.5% of patients in the lorcaserin group and 20.3% in the placebo group had lost 5% or more of their body weight (P<0.001), corresponding to an average loss of 5.8+/-0.2 kg with lorcaserin and 2.2+/-0.1 kg with placebo during year 1 (P<0.001). Among the patients who received lorcaserin during year 1 and who had lost 5% or more of their baseline weight at 1 year, the loss was maintained in more patients who continued to receive lorcaserin during year 2 (67.9%) than in patients who received placebo during year 2 (50.3%, P<0.001). Among 2472 patients evaluated at 1 year and 1127 evaluated at 2 years, the rate of cardiac valvulopathy was not increased with the use of lorcaserin. Among the most frequent adverse events reported with lorcaserin were headache, dizziness, and nausea. The rates of serious adverse events in the two groups were similar. CONCLUSIONS: In conjunction with behavioral modification, lorcaserin was associated with significant weight loss and improved maintenance of weight loss, as compared with placebo. (Funded by Arena Pharmaceuticals; ClinicalTrials.gov number, NCT00395135.) Copyright 2010 Massachusetts Medical Society.

PMID: 20647200 [PubMed - as supplied by publisher]

Early versus Standard Antiretroviral Therapy for HIV-Infected Adults in Haiti.

N Engl J Med. 2010 Jul 15;363(3):257-65

Authors: Severe P, Jean Juste MA, Ambroise A, Eliacin L, Marchand C, Apollon S, Edwards A, Bang H, Nicotera J, Godfrey C, Gulick RM, Johnson WD, Pape JW, Fitzgerald DW

BACKGROUND: For adults with human immunodeficiency virus (HIV) infection who have CD4+ T-cell counts that are greater than 200 and less than 350 per cubic millimeter and who live in areas with limited resources, the optimal time to initiate antiretroviral therapy remains uncertain. METHODS: We conducted a randomized, open-label trial of early initiation of antiretroviral therapy, as compared with the standard timing for initiation of therapy, among HIV-infected adults in Haiti who had a confirmed CD4+ T-cell count that was greater than 200 and less than 350 per cubic millimeter at baseline and no history of an acquired immunodeficiency syndrome (AIDS) illness. The primary study end point was survival. The early-treatment group began taking zidovudine, lamivudine, and efavirenz therapy within 2 weeks after enrollment. The standard-treatment group started the same regimen of antiretroviral therapy when their CD4+ T-cell count fell to 200 per cubic millimeter or less or when clinical AIDS developed. Participants in both groups underwent monthly follow-up assessments and received isoniazid and trimethoprim-sulfamethoxazole prophylaxis with nutritional support. RESULTS: Between 2005 and 2008, a total of 816 participants - 408 per group - were enrolled and were followed for a median of 21 months. The CD4+ T-cell count at enrollment was approximately 280 per cubic millimeter in both groups. There were 23 deaths in the standard-treatment group, as compared with 6 in the early-treatment group (hazard ratio with standard treatment, 4.0; 95% confidence interval [CI], 1.6 to 9.8; P=0.001). There were 36 incident cases of tuberculosis in the standard-treatment group, as compared with 18 in the early-treatment group (hazard ratio, 2.0; 95% CI, 1.2 to 3.6; P=0.01). CONCLUSIONS: Early initiation of antiretroviral therapy decreased the rates of death and incident tuberculosis. Access to antiretroviral therapy should be expanded to include all HIV-infected adults who have CD4+ T-cell counts of less than 350 per cubic millimeter, including those who live in areas with limited resources. (ClinicalTrials.gov number, NCT00120510.) Copyright 2010 Massachusetts Medical Society.

PMID: 20647201 [PubMed - in process]

Schnyder's Crystalline Corneal Dystrophy.

N Engl J Med. 2010 Jul 15;363(3):275

Authors: Ahmad H, Heur M

PMID: 20647202 [PubMed - in process]

Case 21-2010 -- a request for retrieval of oocytes from a 36-year-old woman with anoxic brain injury.

N Engl J Med. 2010 Jul 15;363(3):276-83

Authors: Greer DM, Styer AK, Toth TL, Kindregan CP, Romero JM

PMID: 20647203 [PubMed - in process]

Rituximab in ANCA-Associated Disease.

N Engl J Med. 2010 Jul 15;363(3):285-6

Authors: Falk RJ, Jennette JC

PMID: 20647204 [PubMed - in process]

Drug Management of Obesity -- Efficacy versus Safety.

N Engl J Med. 2010 Jul 15;363(3):288-90

Authors: Astrup A

PMID: 20647205 [PubMed - in process]

Metabolism and vascular Fatty Acid transport.

N Engl J Med. 2010 Jul 15;363(3):291-3

Authors: Muoio DM

PMID: 20647206 [PubMed - in process]

Trajectories of disability in the last year of life.

N Engl J Med. 2010 Jul 15;363(3):294-5

Authors: Lunney JR, Lynn J, Kurrle S, Cameron ID, Maier AB, Allore HG, Han L, Gill TM

PMID: 20647207 [PubMed - in process]

Advance Directives and Surrogate Decision Making before Death.

N Engl J Med. 2010 Jul 15;363(3):295-6

Authors: Kierzek G, Rac V, Pourriat JL, Henrikson CA, Silveira MJ, Gillick MR

PMID: 20647208 [PubMed - in process]

Are all readmissions bad readmissions?

N Engl J Med. 2010 Jul 15;363(3):297-8

Authors: Gorodeski EZ, Starling RC, Blackstone EH

PMID: 20647209 [PubMed - in process]

Peripheral Ulcerative Keratitis in Wegener's Granulomatosis.

N Engl J Med. 2010 Jul 8;363(2):e2

Authors: Hood CT, Lowder CY

PMID: 20647210 [PubMed - as supplied by publisher]

Mitral Regurgitation Due to Degenerative Mitral-Valve Disease.

N Engl J Med. 2010 Jul 8;363(2):156-165

Authors: Foster E

PMID: 20647211 [PubMed - as supplied by publisher]

Genomewide Association Studies and Assessment of the Risk of Disease.

N Engl J Med. 2010 Jul 8;363(2):166-176

Authors: Manolio TA

PMID: 20647212 [PubMed - as supplied by publisher]

Large Prolactinoma.

N Engl J Med. 2010 Jul 8;363(2):177

Authors: Ahmed M, Al-Nozha O

PMID: 20647213 [PubMed - as supplied by publisher]

Case 20-2010 -- A 32-Year-Old Woman with Oligomenorrhea and Infertility.

N Engl J Med. 2010 Jul 8;363(2):178-186

Authors: Utz AL, Schaefer PW, Snuderl M

PMID: 20647214 [PubMed - as supplied by publisher]

Testosterone Deficiency and Replacement in Older Men.

N Engl J Med. 2010 Jul 8;363(2):189-191

Authors: Bremner WJ

PMID: 20647215 [PubMed - as supplied by publisher]

Cisplatin plus Gemcitabine for Biliary Tract Cancer.

N Engl J Med. 2010 Jul 8;363(2):192-193

Authors: Cariati A, Hall FM, Bridgewater J, Wasan H, Valle J

PMID: 20647216 [PubMed - as supplied by publisher]

Apolipoprotein C3 Gene Variants in Nonalcoholic Fatty Liver Disease.

N Engl J Med. 2010 Jul 8;363(2):193-195

Authors: Richart C, Auguet T, Terra X, Valenti L, Nobili V, Fargion S, Salamone F, Galvano F, Volti GL, Petersen KF, Shulman GI

PMID: 20647217 [PubMed - as supplied by publisher]

Individual Genomes on the Horizon.

N Engl J Med. 2010 Jul 8;363(2):195-196

Authors: Watkins D, Gallant C

PMID: 20647218 [PubMed - as supplied by publisher]

Modernizing Device Regulation.

N Engl J Med. 2010 Jul 8;363(2):196-197

Authors: Samp RA, Kretzer RM, Foreman CL, Shuren J, Garber AM

PMID: 20647219 [PubMed - as supplied by publisher]

Toward More Uniform Conflict Disclosures -- The Updated ICMJE Conflict of Interest Reporting Form.

N Engl J Med. 2010 Jul 8;363(2):188-9

Authors: Drazen JM, de Leeuw PW, Laine C, Mulrow C, Deangelis CD, Frizelle FA, Godlee F, Haug C, Hébert PC, James A, Kotzin S, Marusic A, Reyes H, Rosenberg J, Sahni P, Weyden MB, Zhaori G

PMID: 20627859 [PubMed - in process]

Step-up therapy for children with uncontrolled asthma.

N Engl J Med. 2010 Jul 1;363(1):90-1; author reply 91-2

Authors: O'Brien F, Aziz I

PMID: 20597147 [PubMed - in process]

Step-up therapy for children with uncontrolled asthma.

N Engl J Med. 2010 Jul 1;363(1):91; author reply 91-2

Authors: Lipworth B, Mukhopadhyay S, Palmer C

PMID: 20597148 [PubMed - in process]

Low diagnostic yield of elective coronary angiography.

N Engl J Med. 2010 Jul 1;363(1):93; author reply 94-5

Authors: Diamond GA, Kaul S

PMID: 20597149 [PubMed - in process]

Low diagnostic yield of elective coronary angiography.

N Engl J Med. 2010 Jul 1;363(1):93-4; author reply 94-5

Authors: Cuculi F, Kharbanda R, Prendergast B

PMID: 20597150 [PubMed - in process]

Low diagnostic yield of elective coronary angiography.

N Engl J Med. 2010 Jul 1;363(1):94; author reply 94-5

Authors: Bucciarelli-Ducci C, Pennell DJ

PMID: 20597151 [PubMed - in process]

Collection of data on race and ethnic group by physician practices.

N Engl J Med. 2010 Jul 1;363(1):96-7; author reply 97

Authors: Hull S, Dreyer G, Yaqoob M

PMID: 20597152 [PubMed - in process]

Private-Party Gun Sales, Regulation, and Public Safety.

N Engl J Med. 2010 Jun 30;

Authors: Wintemute GJ, Braga AA, Kennedy DM

PMID: 20592291 [PubMed - as supplied by publisher]

Bracing for the Impact of Expanded Second Amendment Rights.

N Engl J Med. 2010 Jun 30;

Authors: Cantor JD

PMID: 20592292 [PubMed - as supplied by publisher]

Adverse Events Associated with Testosterone Administration.

N Engl J Med. 2010 Jun 30;

Authors: Basaria S, Coviello AD, Travison TG, Storer TW, Farwell WR, Jette AM, Eder R, Tennstedt S, Ulloor J, Zhang A, Choong K, Lakshman KM, Mazer NA, Miciek R, Krasnoff J, Elmi A, Knapp PE, Brooks B, Appleman E, Aggarwal S, Bhasin G, Hede-Brierley L, Bhatia A, Collins L, Lebrasseur N, Fiore LD, Bhasin S

BACKGROUND: Testosterone supplementation has been shown to increase muscle mass and strength in healthy older men. The safety and efficacy of testosterone treatment in older men who have limitations in mobility have not been studied. METHODS: Community-dwelling men, 65 years of age or older, with limitations in mobility and a total serum testosterone level of 100 to 350 ng per deciliter (3.5 to 12.1 nmol per liter) or a free serum testosterone level of less than 50 pg per milliliter (173 pmol per liter) were randomly assigned to receive placebo gel or testosterone gel, to be applied daily for 6 months. Adverse events were categorized with the use of the Medical Dictionary for Regulatory Activities classification. The data and safety monitoring board recommended that the trial be discontinued early because there was a significantly higher rate of adverse cardiovascular events in the testosterone group than in the placebo group. RESULTS: A total of 209 men (mean age, 74 years) were enrolled at the time the trial was terminated. At baseline, there was a high prevalence of hypertension, diabetes, hyperlipidemia, and obesity among the participants. During the course of the study, the testosterone group had higher rates of cardiac, respiratory, and dermatologic events than did the placebo group. A total of 23 subjects in the testosterone group, as compared with 5 in the placebo group, had cardiovascular-related adverse events. The relative risk of a cardiovascular-related adverse event remained constant throughout the 6-month treatment period. As compared with the placebo group, the testosterone group had significantly greater improvements in leg-press and chest-press strength and in stair climbing while carrying a load. CONCLUSIONS: In this population of older men with limitations in mobility and a high prevalence of chronic disease, the application of a testosterone gel was associated with an increased risk of cardiovascular adverse events. The small size of the trial and the unique population prevent broader inferences from being made about the safety of testosterone therapy. (ClinicalTrials.gov number, NCT00240981.) Copyright 2010 Massachusetts Medical Society.

PMID: 20592293 [PubMed - as supplied by publisher]

Acute Pulmonary Embolism.

N Engl J Med. 2010 Jun 30;

Authors: Agnelli G, Becattini C

PMID: 20592294 [PubMed - as supplied by publisher]

Images in clinical medicine. Not all that wheezes is bronchial asthma.

N Engl J Med. 2010 Jul 1;363(1):e1

Authors: Randhawa I, Nussbaum E

PMID: 20592296 [PubMed - in process]