The New England journal of medicine
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Although effective treatments for hyperthyroidism are available, none is perfect. Particularly with respect to Graves' disease, what is needed is a therapy directed at modulating the disease process itself rather than merely reducing the synthesis and secretion of thyroid hormones in the hope that the underlying Graves' disease will remit. ⋯ Broad-spectrum immunosuppression, with all its side effects, is not the answer; more focused therapies to inhibit the immune response to specific thyroid antigens may represent the treatment of the future. Meanwhile, radioiodine therapy is the most effective and convenient method of achieving long-term control of hyperthyroidism, although at the cost of hypothyroidism in many patients.
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Previous studies have suggested that higher levels of regular physical activity and cardiorespiratory fitness are associated with a reduced risk of coronary heart disease. We investigated the independent associations of physical activity during leisure time and maximal oxygen uptake (a measure of cardiorespiratory fitness) with the risk of acute myocardial infarction. ⋯ Higher levels of both leisure-time physical activity and cardiorespiratory fitness had a strong, graded, inverse association with the risk of acute myocardial infarction, supporting the idea that lower levels of physical activity and cardiorespiratory fitness are independent risk factors for coronary heart disease.
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Comment Letter Case Reports
Clinical problem-solving: assembling a coherent story.