The New England journal of medicine
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Reduced oxygen availability at high altitude is associated with increased neonatal and infant mortality. We hypothesized that native Tibetan infants, whose ancestors have inhabited the Himalayan Plateau for approximately 25,000 years, are better able to maintain adequate oxygenation at high altitude than Han infants, whose ancestors moved to Tibet from lowland areas of China after the Chinese military entered Tibet in 1951. ⋯ In Lhasa, Tibet, we found that Tibetan newborns had higher arterial oxygen saturation at birth and during the first four months of life than Han newborns. Genetic adaptations may permit adequate oxygenation and confer resistance to the syndrome of pulmonary hypertension and right-heart failure (subacute infantile mountain sickness).
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Randomized Controlled Trial Clinical Trial
A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure.
Congestive heart failure is the most common indication for admission to the hospital among older adults. Behavioral factors, such as poor compliance with treatment, frequently contribute to exacerbations of heart failure, a fact suggesting that many admissions could be prevented. ⋯ A nurse-directed, multidisciplinary intervention can improve quality of life and reduce hospital use and medical costs for elderly patients with congestive heart failure.
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Comparative Study
Survival after the age of 80 in the United States, Sweden, France, England, and Japan.
In many developed countries, life expectancy at birth is higher than in the United States. Newly available data permit, for the first time, reliable cross-national comparisons of mortality among persons 80 years of age or older. Such comparisons are important, because in many developed countries more than half of women and a third of men now die after the age of 80. ⋯ For people 80 years old or older, life expectancy is greater in the United States than it is in Sweden, France, England, and Japan. This finding suggests that elderly Americans are receiving better health care than the elderly citizens of other developed countries.
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People with Gilbert's syndrome have mild, chronic unconjugated hyperbilirubinemia in the absence of liver disease or overt hemolysis. Hepatic glucuronidating activity, essential for efficient biliary excretion of bilirubin, is reduced to about 30 percent of normal. ⋯ Reduced expression of bilirubin UDP-glucuronosyltransferase 1 due to an abnormality in the promoter region of the gene for this enzyme appears to be necessary for Gilbert's syndrome but not sufficient for the complete manifestation of the syndrome.