2009 Sep - Cross-Reactive Antibody Responses to the 2009 Pandemic H1N1 Influenza Virus
Background A new pandemic influenza A (H1N1) virus has emerged, causing illness globally, primarily in younger age groups. To assess the level of preexisting immunity in humans and to evaluate seasonal vaccine strategies, we measured the antibody response to the pandemic virus resulting from previous influenza infection or vaccination in different age groups.
2009 Sep - Trial of Influenza A (H1N1) 2009 Monovalent MF59-Adjuvanted Vaccine — Preliminary Report
Background The 2009 pandemic influenza A (H1N1) virus has emerged to cause the first pandemic of the 21st century. Development of effective vaccines is a public health priority.
2009 Sep - Response after One Dose of a Monovalent Influenza A (H1N1) 2009 Vaccine — Preliminary Report
Background A novel influenza A (H1N1) 2009 virus is responsible for the first influenza pandemic in 41 years. A safe and effective vaccine is urgently needed. A randomized, observer-blind, parallel-group trial evaluating two doses of an inactivated, split-virus 2009 H1N1 vaccine in healthy adults between the ages of 18 and 64 years is ongoing at a single site in Australia.
2009 Sep - Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes
Background Ticagrelor is an oral, reversible, direct-acting inhibitor of the adenosine diphosphate receptor P2Y12 that has a more rapid onset and more pronounced platelet inhibition than clopidogrel.
Methods In this multicenter, double-blind, randomized trial, we compared ticagrelor (180-mg loading dose, 90 mg twice daily thereafter) and clopidogrel (300-to-600-mg loading dose, 75 mg daily thereafter) for the prevention of cardiovascular events in 18,624 patients admitted to the hospital with an acute coronary syndrome, with or without ST-segment elevation.
2009 Sep - Clinical Implications of Basic Research: Understanding Abdominal Aortic Aneurysm
Abdominal aortic aneurysms occur in up to 9% of adults older than 65 years of age, and the rupture of these aneurysms accounts for about 15,000 deaths in the United States annually.1 Approximately 33,000 patients undergo repair of abdominal aortic aneurysms each year, with associated illness, death, and health care costs. Smoking is a major risk factor.
2009 Sep - Clinical Therapeutics: Parenteral Nutrition in the Critically Ill Patient
A 67-year-old woman with type 2 diabetes mellitus undergoes extensive resection of the small bowel and right colon with a jejunostomy and colostomy because of mesenteric ischemia. In the surgical intensive care unit, severe systemic inflammatory response syndrome with . . .
2009 Aug - NEJM Editorial: Clinical Application of Sensitive Troponin Assay
Despite the pervasive measurement of cardiac troponin for the diagnosis of myocardial infarction, the continued evolution of assays and guidelines for their application has created uncertainty among many practitioners regarding the use of cutoff values for clinical interpretation.
2009 Aug - Sensitive Troponin I Assay in Early Diagnosis of Acute Myocardial Infarction
Background Cardiac troponin testing is central to the diagnosis of acute myocardial infarction. We evaluated a sensitive troponin I assay for the early diagnosis and risk stratification of myocardial infarction.
Methods In a multicenter study, we determined levels of troponin I as assessed by a sensitive assay, troponin T, and traditional myocardial necrosis markers in 1818 consecutive patients with suspected acute myocardial infarction, on admission and 3 hours and 6 hours after admission.
2009 Aug - Early Diagnosis of Myocardial Infarction with Sensitive Cardiac Troponin Assays
Background The rapid and reliable diagnosis of acute myocardial infarction is a major unmet clinical need.
Methods We conducted a multicenter study to examine the diagnostic accuracy of new, sensitive cardiac troponin assays performed on blood samples obtained in the emergency department from 718 consecutive patients who presented with symptoms suggestive of acute myocardial infarction. Cardiac troponin levels were determined in a blinded fashion with the use of four sensitive assays (Abbott–Architect Troponin I, Roche High-Sensitive Troponin T, Roche Troponin I, and Siemens Troponin I Ultra) and a standard assay (Roche Troponin T). The final diagnosis was adjudicated by two independent cardiologists.
2009 Aug - Correspondence: Rapid-Test Sensitivity for Novel Swine-Origin Influenza A (H1N1) Virus in Humans
To the Editor: The Naval Health Research Center serves as the Navy hub for the Department of Defense's Global Emerging Infections Surveillance and Response System (GEIS), in which it monitors influenza-like illness among recruit trainees of all military services, military dependents, and crew members of large Navy ships (population, >1000).
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2009 Pneumonia and Respiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico
Background In late March 2009, an outbreak of a respiratory illness later proved to be caused by novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. We describe the clinical and epidemiologic characteristics of persons hospitalized for pneumonia at the national tertiary hospital for respiratory illnesses in Mexico City who had laboratory-confirmed S-OIV infection, also known as swine flu.
2009 Severe Respiratory Disease Concurrent with the Circulation of H1N1 Influenza
Background In the spring of 2009, an outbreak of severe pneumonia was reported in conjunction with the concurrent isolation of a novel swine-origin influenza A (H1N1) virus (S-OIV), widely known as swine flu, in Mexico. Influenza A (H1N1) subtype viruses have rarely predominated since the 1957 pandemic. The analysis of epidemic pneumonia in the absence of routine diagnostic tests can provide information about risk factors for severe disease from this virus and prospects for its control.
2009 Neurologic prognosis after cardiac arrest [Review]
An excellent and clear-cut discussion about neurological prognostication for post cardiac arrest patients.
2009 Thrombomodulin Mutations in Atypical Hemolytic–Uremic Syndrome
Background: The hemolytic–uremic syndrome consists of the triad of microangiopathic hemolytic anemia, thrombocytopenia, and renal failure. The common form of the syndrome is triggered by infection with Shiga toxin–producing bacteria and has a favorable outcome. The less common form of the syndrome, called atypical hemolytic–uremic syndrome, accounts for about 10% of cases, and patients with this form of the syndrome have a poor prognosis. Approximately half of the patients with atypical hemolytic–uremic syndrome have mutations in genes that regulate the complement system. Genetic factors in the remaining cases are unknown. We studied the role of thrombomodulin, an endothelial glycoprotein with anticoagulant, antiinflammatory, and cytoprotective properties, in atypical hemolytic–uremic syndrome.
2009 Perspective: The Persistent Legacy of the 1918 Influenza Virus
David M. Morens, M.D., Jeffery K. Taubenberger, M.D., Ph.D., and Anthony S. Fauci, M.D. Volume 361:225-229 July 16, 2009 Number 3
It is not generally appreciated that descendents of the H1N1 influenza A virus that caused the catastrophic and historic pandemic of 1918–1919 have persisted in humans for more than 90 years and have continued to contribute their genes to new viruses, causing new pandemics, epidemics, and epizootics (see table). The current international pandemic caused by a novel influenza A (H1N1) virus derived from two unrelated swine viruses, one of them a derivative of the 1918 human virus,3 adds to the complexity surrounding this persistent progenitor virus, its descendants, and its several lineages (see diagram).
2009 Review Article, Current Concepts - Historical Perspective — Emergence of Influenza A (H1N1) Viruses
Shanta M. Zimmer, M.D., and Donald S. Burke, M.D.Volume 361:279-285 July 16, 2009 Number 3
On April 17, 2009, officials at the Centers for Disease Control and Prevention (CDC) confirmed two cases of swine influenza in children living in neighboring counties in California.1
2009 Raxibacumab for the Treatment of Inhalational Anthrax
Thi-Sau Migone, Ph.D., G. Mani Subramanian, M.D., Ph.D., John Zhong, Ph.D., Letha M. Healey, M.D., Al Corey, B.S., Matt Devalaraja, Ph.D., Larry Lo, Ph.D., Stephen Ullrich, Ph.D., Janelle Zimmerman, B.S., Andrew Chen, Ph.D., Maggie Lewis, M.S., Gabriel Meister, Ph.D., Karen Gillum, D.V.M., Daniel Sanford, Ph.D., Jason Mott, D.V.M., Ph.D., and Sally D. Bolmer, Ph.D. Volume 361:135-144 July 9, 2009 Number 2
Background Inhalational anthrax caused by Bacillus anthracis is associated with high mortality primarily due to toxin-mediated injury. Raxibacumab is a human IgG1 monoclonal antibody directed against protective antigen, a component of the anthrax toxin.
2009 Correspondence: Glucose Control in Critically Ill Patients
Greet Van den Berghe, M.D., Ph.D., Roger Bouillon, M.D., Ph.D., Dieter Mesotten, M.D., Ph.D., Catholic University of Leuven, B-3000 Leuven, Belgium. Volume 361:89-92 July 2, 2009 Number 1
To the Editor: In the Normoglycemia in Intensive Care Evaluation–Survival Using Glucose Algorithm Regulation (NICE-SUGAR) study (ClinicalTrials.gov number, NCT00220987 [ClinicalTrials.gov] ), reported by Finfer et al. (March 26 issue),1 intensive glucose control increased mortality. ....
2009 NEJM H1N1 Influenza Center
ORIGINAL ARTICLES
Severe Respiratory Disease Concurrent with the Circulation of H1N1 Influenza
G. Chowell and Others
Pneumonia and Respiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico
R. Perez-Padilla and Others
CURRENT CONCEPTS
Historical Perspective — Emergence of Influenza A (H1N1) Viruses
S.M. Zimmer and D.S. Burke
2009 Epidemiologic Study of In-Hospital Cardiopulmonary Resuscitation in the Elderly
William J. Ehlenbach, M.D., M.Sc., Amber E. Barnato, M.D., M.P.H., J. Randall Curtis, M.D., M.P.H., William Kreuter, M.P.A., Thomas D. Koepsell, M.D., M.P.H., Richard A. Deyo, M.D., M.P.H., and Renee D. Stapleton, M.D., M.Sc. NEJM. Volume 361:22-31 July 2, 2009 Number 1
Background It is unknown whether the rate of survival after in-hospital cardiopulmonary resuscitation (CPR) is improving and which characteristics of patients and hospitals predict survival.
Methods We examined fee-for-service Medicare data from 1992 through 2005 to identify beneficiaries 65 years of age or older who underwent CPR in U.S. hospitals. We examined temporal trends in the incidence of CPR and the rate of survival after CPR, as well as patient- and hospital-level predictors of survival to discharge.