The New England journal of medicine
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Letter Case Reports
Treatment of brain metastases of malignant melanoma with temozolomide.
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The independent prognostic value of elevated jugular venous pressure or a third heart sound in patients with heart failure is not well established. ⋯ In patients with heart failure, elevated jugular venous pressure and a third heart sound are each independently associated with adverse outcomes, including progression of heart failure. Clinical assessment for these findings is currently feasible and clinically meaningful.
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Multicenter Study Clinical Trial
One-time screening for colorectal cancer with combined fecal occult-blood testing and examination of the distal colon.
Fecal occult-blood testing and sigmoidoscopy have been recommended for screening for colorectal cancer, but the sensitivity of such combined testing for detecting neoplasia is uncertain. At 13 Veterans Affairs medical centers, we performed colonoscopy to determine the prevalence of neoplasia and the sensitivity of one-time screening with a fecal occult-blood test plus sigmoidoscopy. ⋯ One-time screening with both a fecal occult-blood test with rehydration and sigmoidoscopy fails to detect advanced colonic neoplasia in 24 percent of subjects with the condition.