NEJM Audio Summary - Sep 15, 2011

TIME TABLE

00:43 | Apixaban versus Warfarin in Patients with Atrial Fibrillation
02:26 | A New Era for Anticoagulation in Atrial Fibrillation
03:24 | Stenting versus Aggressive Medical Therapy for Intracranial Arterial Stenosis
05:20 | The Challenges of Intracranial Revascularization for Stroke Prevention
06:25 | A Field Trial to Assess a Blood-Stage Malaria Vaccine
07:50 | Response-Guided Telaprevir Combination Treatment for Hepatitis C Virus Infection
09:42 | Breast-Cancer Screening
11:35 | Genomic Medicine: Genomics, Health Care, and Society
13:24 | Case 28-2011 — A 74-Year-Old Man with Pemphigus Vulgaris and Lung Nodules
15:03 | Moving beyond Parity — Mental Health and Addiction Care under the ACA
16:53 | Medical Devices — Balancing Regulation and Innovation
18:48 | Medical Devices and Health — Creating a New Regulatory Framework for Moderate-Risk Devices
20:35 | Splenic Calcification
21:14 | Gout Nodulosis

NEJM BLOGGERS

呼吸器内科医「AMA1組換え蛋白マラリアワクチンの有用性について」

ABRIDGED SCRIPT

"Breast-cancer screening",
a Clinical Practice article by Ellen Warner from University of Toronto, Canada.
Mortality from breast cancer in industrialized countries has been decreasing at the rate of approximately 2.2% per year. In the United States, this decline has been attributed both to advances in adjuvant therapy and to increasing use of screening mammography. Nevertheless, the 2009 recommendations of the U.S. Preventive Services Task Force support a reduction in the use of screening mammography. This revision resulted in considerable confusion and controversy. The two most disputed changes were the reclassification of screening for women between the ages of 40 and 49 years from a B recommendation (based on moderately strong evidence) to a C recommendation (“the decision should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms”), and the recommendation that the frequency of screening be reduced from every 1 to 2 years to every 2 years. This article focuses on the updated evidence and recommendations for screening women who are at average risk for breast cancer. The most important benefits of screening are a reduction in the risk of death and the number of life-years gained. Costs include the financial costs and other costs of the screening regimen itself (radiation risk, pain, inconvenience, and anxiety), the ensuing diagnostic workup in the case of false positive results, and overdiagnosis. The ratio of benefit to cost varies significantly with the patient's age. An audio version of this article is available at NEJM.org.

COMMONLY MISPRONOUNCED WORDS

gout [ɡaʊt]
malaria[məˈleriə]