Source: NEJM This Week - Audio Summaries

“…findings is almost definitive for a malignant process. The hedgehog pathway and pancreatic cancer. . A clinical implications of basic research article by among when he dongle. From the center announced -- on the investor got on its -- kernel the guts Madrid Spain. Aberrant activation. Of the hedgehog pathway has been observed in multiple human cancers including pancreatic cancer. . For this reason several small molecule inhibitors of the pathway. Have been advanced clinical trials to evaluate their efficacy in treating various solid cancers. A recent study suggests that pancreatic cancer is a particularly good candidate for experimental treatment with hedgehog inhibitors. Treatment of a mouse model of aggressive pancreatic cancer with an inhibitor of the hedgehog pathway in hence tumor sensitivity to genocide of the and resulted in the stabilization of disease. The hedgehog pathway is altered in three compartments of pancreatic cancer. . The differentiated cells of pancreatic cancer so called -- cancer cells. . The stem cells of the cancer and the stroman. Accretion of hedgehog lie against by pancreatic cancer cells activate the hedgehog pathway in the letter to compartments. Leading to the maintenance of cancer stem cells and the formation of five Broderick Roma. It is clear that clinical trials in which hedgehog inhibitors are used to treat persons with pancreatic cancer are warranted. …”

“…mutations. A novel protective prion protein variant and cool -- exposure. And pancreatic cancer and the hedgehog pathway. A review article on inflammatory bowel disease a case report of a man with cough coarseness and abnormalities …”

“…States April to June 2009. -- Jane from the Centers for Disease Control and Prevention Atlanta Georgia. Pandemic influenza a H1N1 virus has spread rapidly around the world during the past six months. Causing substantial illness and social disruption. In this report investigators from the Centers for Disease Control and Prevention. Describe the clinical characteristics of the earliest patients who were hospitalized with the virus in the United States. During a …”

“…2009 pandemic H1N1 influenza virus. By Kathy Hancock from the Centers for Disease Control and Prevention Atlanta. To assess the level of pre existing immunity in humans and to evaluate seasonal vaccine strategies. The investigators -- …”

“…multicenter trial. Patients with sub optimal like hated hemoglobin levels while receiving Matt Foreman and salt funnel -- therapy. Were randomly assigned to and by -- it -- Angel or basal insulin. During the first year …”

“…clinics Dusseldorf Germany. Writes that the treatment algorithms for adding insulin to Matt Foreman insult funnel -- seem relatively simple safe and convenient and applications. However this study used only insulin analogue X which were produced …”

“…defined by more than just the clearance of small -- utes. Strict blood pressure control and progression of renal failure in children by the escape trial group. This study assessed the long term -- protective effect of intensified blood pressure control among children receiving a fixed high dose of an anti -- in converting enzyme inhibitor. Patients were randomly assigned to intensified blood pressure control. With a target 24 hour mean arterial pressure below the fiftieth percentile or conventional blood pressure control. Mean arterial pressure in the fiftieth in 95 percentile. The -- by the addition of anti hypertensive therapy that does not target the reunion and -- attention system. The primary end point with the -- to a decline of 50% in the economy are you -- filtration rate or progression to end stage renal disease. A total of 29 point 9% of the patients in the group that received intensified blood pressure control reached the primary end point. As assessed by means of a Kaplan Meier analysis. As compared with 41 point 7%. In the group that received conventional blood pressure control. Hazard ratio zero point 65. Intensified blood pressure control confers a substantial benefit with respect to -- function among children with chronic kidney disease. However reappearance of protein area after initial successful -- a lot control was common. In an editorial Julie -- finger and editor for the journal. Writes that the results suggest that controlling blood pressure to reach a target of less than the fiftieth percentile strict blood pressure control. Improves outcome. One hopes that this study will set a precedent for long term randomized controlled treatment trials involve. In children with regional disease. Multi center analysis of glucose -- reverse today's mutations in Parkinson's disease. . By -- that grand scheme from the National Human Genome Research Institute Bethesda Maryland. Recent studies indicating increased frequency of mutations in the gene encoding glucose -- GB day. A deficiency of which causes -- disease among patients with Parkinson's disease. . In this international collaborative study mutations in the gene negotiate disease TBA. Were much more likely to be detected in patients with Parkinson's disease. . Than in controls. Confirming that there is a strong association between GPA mutations and Parkinson's disease. . The combined data show that this finding is not exclusive to a specific ethnic group or a specific TBA mutation. Although indications and GPA are most likely a susceptibility factor rather than them in dealing and cause of Parkinson's disease. . The high frequency of mutations among ethnically diverse heterogeneous cohorts of patients with Parkinson's disease makes the mutation in the Eckstein. The most common genetic risk factor for Parkinson's disease that has been identified to date. This Latin versus this platinum closed -- a group decision for standard risk capital blessed moment. …”

“…the intensity of continuous Reno replacement therapy in critically ill patients. Strict blood pressure control and progression of renal failure in children. Look -- for today's the occasions in Parkinson's disease says flattened versus its platinum plus stocks are Robison for standard risk capital blast on the X linked from the affiliate within …”

“…supplements a perspective article by Peter Cohen from the Cambridge health alliance Somerville Massachusetts. . In one of the most dangerous cities in the United States one portly police sergeant has more to worry about the crime. His doctor had been encouraging him for years to lose weight and like millions of other Americans he decided to try a weight loss supplement to help them shed this extra pounds. But instead of losing weight he lost his job. According to the label his …”

“…school of public health Houston. Food borne bacterial diarrhea is an emerging health threat. . Of the more than five point two million cases of bacterial diarrhea that occur each year in the United States. 80% are …”

“…liver cancer. By June -- G from the National Institutes of Health Bethesda Maryland. . The -- cellular carcinoma is a common and aggressive cancer that occurs mainly in men. These investigators examined micro RNA expression patterns …”

“…stands infection. Bye ya I got -- volley from the university of Bamako Mali. Manson -- stands infection is widely distributed across Central Africa and northern South America and the Caribbean islands. With prevalence is …”

“…features articles on cardiac -- synchronous nation therapy for the prevention of heart failure events. Treatment for mild gestation diabetes. Moderate hypothermia for Peri natal -- fix you'll encephalopathy. Recurrence of -- salt export deficiency after liver transplantation. Variation in hospital mortality associated with the inpatient surgery. And balancing no blame with -- accountability in patient safety. A review article on maternal and neonatal herpes simplex virus infections. A clinical problem solving article describing the writing on the wall. And perspective articles on opportunities and challenges for the NIH. …”

“…Cardiac precinct organization therapy for the prevention of heart failure advance. By Arthur moss from the University of Rochester medical center New York. Cardiac -- secret is stationed therapy is recommended for patients with advanced symptomatic heart failure. . This trial was designed to determine whether cardiac precinct organization therapy with by ventricular pacing. Would reduce the risk of death or heart failure events. In patients with mild cardiac symptoms a reduced ejection fraction and a wide QRS complex. The use of cardiac reaching organization therapy combined with an implantable Carty over defibrillator I seeding. Was associated with 834%. Reduction in the risk of death or heart failure events as compared with the use of and I CD alone. The benefit was driven by -- 41%. Reduction in the risk of heart failure events. A finding that was evident primarily. In a pre specified subgroup of patients. With a Q -- restoration of 115. Milliseconds …”

“…A double blind delayed start trial for a sad to clean and Parkinson's disease. . By C Warren Alando from Mount Sinai School of Medicine New York. This double blind trial was designed to determine whether it's -- to clean it slows the progression of Parkinson's disease. . Early start treatment with -- to clean added dose of one milligram per day met all and points in the primary analysis. A smaller mean increased rate of worsening in the unified Parkinson's disease rating scales -- between weeks twelve and 36. Zero point 09 points per week in the early start group versus zero point 14 points per week in the placebo group. Less worsening in this court between baseline and weeks 722. Point 82 point vs four point 52 points respectively. And non inferiority between the two groups with respect to their rate of change in the unified Parkinson's disease rating scale score. Between weeks 48 and 72. All three and points were not met with the stature lean at a dose of two milligrams per day. Since that change in the unified Parkinson's disease rating scale score between baseline and weeks 72. Was not significantly different in the two groups. As compared with delayed treatment early …”

“…attenuated influenza vaccines. A delayed start trial for sad to lean in Parkinson's disease the delayed start study design and interferon alpha and the treatment of leukemia. A review article -- failure in cirrhosis and cased …”

“…the FDA and drug regulation preemption. A review article on screening for colorectal cancer a case report of a man with weight loss again -- Asia and failure to thrive. And perspective articles on poverty wealth and access to pandemic influenza vaccines. I'm systemwide cost control the missing link in health care reform. On health insurers at the table industry proposals for regulation and reform. And on health insurance exchanges. Making the markets work. -- like Akron versus war for -- in patients with atrial fibrillation. By Stuart Connolly from McMaster …”

“…class of therapeutic agents with far reaching implications in oncology. Screening for colorectal cancer a clinical practice article by David Lieberman from the Oregon health and science university Portland. This year it is estimated that there will be 147000. Newly diagnosed cases of colorectal cancer. . And nearly 50000 deaths associated with this disease. There is considerable evidence that screening -- asymptomatic persons who -- at average risk can detect cancer at an early and curable stage. Resulting in a reduction in mortality. Furthermore some screening tests may also detect cancer precursor lesions which if removed. May result in reduced incidence of colorectal cancer. . There are several different screening tests each with advantages and limitations. Differences among strategies in terms of the sensitivity and specificity of the test their complexity. And the associated risk complicate the process of informed decision making. Patients should be informed that there is strong evidence that screening persons who were at average risk. It's effective in reducing the risk of death from colorectal cancer. . But that there is no perfect screening test and each program has advantages limitations and uncertainties. Patients also should be informed about …”

“…kept sent home and first met its -- clinic next he's our Munich Germany. . Writes that the whole truth concerning the adverse effects of type -- galore. May require -- valuation inning much larger number of patience something that may be beyond the capacity of …”

“…Stockholm Sweden. The authors describe PM now caused by infection with human polio virus JC virus. In a patient with multiple sclerosis who is treated with Natalie you meant. The first PM I'll symptoms appeared after …”