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Relapses
and Progression of Disability in Multiple Sclerosis
Multiple sclerosis is a progressive disease, although many patients have
superimposed relapses and remissions. This study examined the relation between
the type of multiple sclerosis and the occurrence of disability in 1844
patients. The median time from the onset of disease to the occurrence of
a slight limitation in the ability to walk was less than 1 year among patients
in whom the disease was progressive from the onset, as compared with 11
years among those in whom the onset was characterized by relapses and remissions.
Withholding
Heparin in Pregnant Women with a History of Venous Thromboembolism
Women who have had an episode of venous thromboembolism are thought to have
an increased risk of recurrent venous thromboembolism during pregnancy,
so therapy with heparin is often recommended. In this study, 125 women who
had had one previous episode of venous thromboembolism and who were less
than 20 weeks pregnant were followed during the rest of their pregnancies.
Only three women (2.4 percent) had recurrent venous thromboembolism, and
three other women had a recurrence during the first two months post partum;
most of these women were known to have thrombophilia.
Contrast-Enhanced Magnetic Resonance Imaging to Identify Reversible Myocardial
Dysfunction
In patients with coronary artery disease, the distinction between reversible
and irreversible myocardial damage has important therapeutic implications.
Gadolinium-enhanced magnetic resonance imaging (MRI) was used in this study
to identify areas of myocardium that were irreversibly damaged. Hyperenhanced
regions of myocardium detected by MRI were found to be nonviable and their
function did not improve after revascularization.
Atovaquone
and Azithromycin for Babesiosis
 Babesiosis
is a tick-borne, malaria-like infection that can cause severe illness. In
this randomized trial, which included 58 patients in southern New England,
treatment for seven days with a combination of atovaquone and azithromycin
was as effective as standard treatment with clindamycin and quinine. With
atovaquone and azithromycin, patients had far fewer side effects such as
tinnitus or diarrhea. |
