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A 6-year-old girl who was born with a plaque on her forehead presented to the clinic. The plaque was smooth, elevated, and arranged in a linear pattern on the forehead. It then gradually grew down along the facial midline, conforming to Blaschko's lines...
New England Journal of Medicine - Tue, 22 May 2012
http://www.nejm.org
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In a large observational study using detailed Australian databases with information on several potential confounders, results confirmed previous findings of an increased risk of birth defects among births conceived with assisted reproductive technology as compared with births from spontaneous conception. After multivariate adjustment, the association between IVF and the risk of any birth defect was no longer significant, whereas the increased risk of any birth defect associated with ICSI remained significant.
New England Journal of Medicine - Mon, 7 May 2012
http://www.nejm.org
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A randomized trial on 304 patients with advanced adrenocortical carcinoma showed that rates of response and progression-free survival were significantly better with EDP plus mitotane than with streptozocin plus mitotane as first-line therapy, with similar rates of toxic events, although there was no significant difference in overall survival.
New England Journal of Medicine - Mon, 7 May 2012
http://www.nejm.org
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A comparison of the efficacy of three treatment regimens to achieve durable glycemic control in children and adolescents with recent-onset type 2 diabetes shows that monotherapy with metformin appears to be associated with durable glycemic control in approximately half of children and adolescents with type 2 diabetes. The addition of rosiglitazone, but not an intensive lifestyle intervention, resulted superior to metformin alone.
New England Journal of Medicine - Wed, 2 May 2012
http://www.nejm.org
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Plain-film radiographic images of a chest can reveal evidence of pneumoperitoneum, with gas extending from the infradiaphragmatic region to the inferior margin of the liver, outlining the gallbladder. Moreover, gas outlined the spleen on the lateral view can be highly suggestive of bowel perforation.
New England Journal of Medicine - Wed, 2 May 2012
http://www.nejm.org
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A randomized, controlled, single-center study, called the Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently (STAMPEDE) trial, compares intensive medical therapy with surgical treatment (gastric bypass or sleeve gastrectomy) as a means of improving glycemic control in obese patients with type 2 diabetes.
New England Journal of Medicine - Tue, 27 March 2012
http://www.nejm.org
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A trial determines the safety and efficiency of a Coronary computed tomographic angiography (CCTA)-based strategy, as a noninvasive test with a negative predictive value of nearly 100% for the detection of coronary artery disease.
New England Journal of Medicine - Tue, 27 March 2012
http://www.nejm.org
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People have suffered from asthma for millennia. Although the clinical presentation of asthma has probably changed little, there are many more people who now bear its consequences than there were 200 years ago. As a result of an intense interest in the condition, understanding of its pathobiology, how to diagnose it, and — most important — how to treat it has evolved dramatically over the past two centuries. To illustrate this change, authors provide three fictional reports of consultations performed for essentially the same patient, who has what we in 2012 would refer to as asthma.
New England Journal of Medicine - Tue, 13 March 2012
http://www.nejm.org
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A 74-year-old woman was undergoing a screening colonoscopy when it became apparent that the rectosigmoid junction might have become perforated. The procedure was terminated, and radiographs were obtained. The abdominal radiograph (Panel A) revealed...
New England Journal of Medicine - Tue, 13 March 2012
http://www.nejm.org
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A 50-year-old woman presented with fatigue and shortness of breath. One week before presentation, she experienced the gradual onset of dyspnea after moderate exertion, profound malaise, and a non-productive cough. In the 48 hours before admission, her shortness of breath worsened, such that she was dyspneic while at rest...
New England Journal of Medicine - Tue, 10 January 2012
http://www.nejm.org