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Phospholipase A2 Receptor in Idiopathic Membranous Nephropathy
Phospholipase A2 receptor (PLA2R) is present in normal podocytes and in immune deposits in patients with idiopathic membranous nephropathy, indicating that it is a major antigen in this disease.
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Epidemiologic Study of In-Hospital CPR in the Elderly
In this study of hospitalized Medicare patients, there was no improvement in survival after cardiopulmonary resuscitation (CPR) during the period from 1992 through 2005. Survival after CPR was lower among black patients than among white patients.
CME Exam
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Preoperative Staging of Lung Cancer with Combined PET–CT
Preoperative staging of non–small-cell lung cancer with PET–CT was found to reduce the total number of thoracotomies and the number of futile thoracotomies.
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Effects of Enalapril and Losartan in Type 1 Diabetes
Early blockade of the renin–angiotensin system did not modify nephropathy progression in patients with type 1 diabetes but had important effects in slowing retinopathy.
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The Effect of Medicare Part D on Drug and Medical Spending
For patients who had no drug coverage before the implementation of Medicare Part D, the increase in drug spending after implementation was approximately offset by a decrease in other medical spending. Improved access to medications may achieve savings in nonpharmacy costs because of better control of chronic illness.
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Rhabdomyolysis and Acute Kidney Injury
Acute kidney injury is a dangerous complication of severe rhabdomyolysis. This review summarizes current views on the pathogenesis of myoglobin-induced kidney injury as well as on its prevention and treatment.
CME Exam
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A Fragile Balance
A 31-year-old man tripped over his backpack shoulder strap and noted immediate severe pain around his left shoulder. Shoulder x-rays revealed an impacted fracture of the left humerus and evidence of osteopenia.
CME Exam
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A Coup for the Cardiomyocyte
A recent study upends the hypothesis that cardiomyocytes are not renewed after the first weeks of life.
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Prioritizing Comparative-Effectiveness Research — IOM Recommendations
Directed by Congress to rapidly develop a list of priorities for comparative-effectiveness research (CER), the Institute of Medicine released a report recommending 100 study topics related to a range of diseases, research methods, and care models. John Iglehart reports.
Free Full Text
 June 30, 2009 (DOI: 10.1056/NEJMp0904133)
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Comparative-Effectiveness Research — Implications of the Federal Coordinating Council’s Report
The Council report, along with one from the Institute of Medicine, will inform the operational plan of the secretary of health and human services for $1.1 billion in CER funds. Drs. Patrick Conway and Carolyn Clancy write that the Council specifically identified high-priority research gaps and one-time investments in infrastructure that would accelerate the conduct of CER.
Free Full Text
June 30, 2009 (DOI: 10.1056/NEJMp0905631)
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The Role of Medical Liability Reform in Federal Health Care Reform
Should the health care reform package include reforms to the medical liability system, which is often blamed for contributing to rising health care costs? Michelle Mello and Dr. Troyen Brennan discuss the pros and cons.
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Published Online June 15, 2009 (DOI: 10.1056/NEJMp0903765)
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A Win–Win Approach to Financing Health Care Reform
How can the government finance such a sizeable new expenditure as universal coverage? Jonathan Gruber argues for the elimination or limiting of the income-tax exclusion for expenditures on employer-sponsored insurance.
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Published Online June 10, 2009 (DOI: 10.1056/NEJMp0904855)
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The Individual Mandate — An Affordable and Fair Approach to Achieving Universal Coverage
Some of the most prominent shortcomings of the U.S. health insurance market are rooted in the fact that the system is a voluntary one. Linda Blumberg and John Holahan argue for bringing all U.S. residents into our health insurance system through an individual mandate.
Free Full Text
Published Online June 17, 2009 (DOI: 10.1056/NEJMp0904729)
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A Higher Bar — Vermont’s New Law on Marketing Prescribed Products
A Vermont law signed on June 8 bans gifts to physicians from manufacturers of prescription drugs, medical devices, and biologic products, with few exceptions. Dr. Robert Steinbrook reports.
Published Online June 10, 2009 (DOI: 10.1056/NEJMp0904719)
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