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1004. Genomewide association studies of stroke.
作者: M Arfan Ikram.;Sudha Seshadri.;Joshua C Bis.;Myriam Fornage.;Anita L DeStefano.;Yurii S Aulchenko.;Stephanie Debette.;Thomas Lumley.;Aaron R Folsom.;Evita G van den Herik.;Michiel J Bos.;Alexa Beiser.;Mary Cushman.;Lenore J Launer.;Eyal Shahar.;Maksim Struchalin.;Yangchun Du.;Nicole L Glazer.;Wayne D Rosamond.;Fernando Rivadeneira.;Margaret Kelly-Hayes.;Oscar L Lopez.;Josef Coresh.;Albert Hofman.;Charles DeCarli.;Susan R Heckbert.;Peter J Koudstaal.;Qiong Yang.;Nicholas L Smith.;Carlos S Kase.;Kenneth Rice.;Talin Haritunians.;Gerwin Roks.;Paul L M de Kort.;Kent D Taylor.;Lonneke M de Lau.;Ben A Oostra.;Andre G Uitterlinden.;Jerome I Rotter.;Eric Boerwinkle.;Bruce M Psaty.;Thomas H Mosley.;Cornelia M van Duijn.;Monique M B Breteler.;W T Longstreth.;Philip A Wolf.
来源: N Engl J Med. 2009年360卷17期1718-28页
The genes underlying the risk of stroke in the general population remain undetermined.
1005. Myocarditis.
Myocarditis may present with a wide range of symptoms, ranging from mild dyspnea or chest pain that resolves without specific therapy to cardiogenic shock and death. Dilated cardiomyopathy with chronic heart failure is the major long-term sequela of myocarditis. Most often, myocarditis results from common viral infections; less commonly, specific forms of myocarditis may result from other pathogens, toxic or hypersensitivity drug reactions, giant-cell myocarditis, or sarcoidosis. The prognosis and treatment of myocarditis vary according to the cause, and clinical and hemodynamic data usually provide guidance to decide when to refer a patient to a specialist for endomyocardial biopsy. The aim of this review is to provide a practical and current approach to the evaluation and treatment of suspected myocarditis.
1018. Clinical practice. Primary ovarian insufficiency.
A 30-year-old woman presents with a history of no menses since she stopped taking oral contraceptives 6 months ago in order to conceive. She had undergone puberty that was normal in both timing and development, with menarche at 12 years of age. At 18 years of age, she started taking oral contraceptives for irregular menses. She reports stress at work. Her weight is 59 kg, and her height 1.66 m; her body-mass index (the weight in kilograms divided by the square of the height in meters) is 21.3. There is no galactorrhea, hirsutism, or acne. The pelvic examination is normal, a pregnancy test is negative, the prolactin level is normal, and the follicle-stimulating hormone (FSH) level is in the menopausal range. How should she be evaluated and treated?
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