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Extensively Drug-Resistant Tuberculosis
In 48 patients in Peru who had extensively drug-resistant tuberculosis, treatment with a structured, comprehensive, community-based approach and aggressive antituberculosis medications achieved a cure in 29 patients (60%).
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Monoclonal B-Cell Lymphocytosis and CLL
Small numbers of monoclonal B cells with the phenotype of chronic lymphocytic leukemia (CLL) were detected by means of high-sensitivity flow cytometry in about 5% of adults with a normal blood count and about 14% of subjects with lymphocytosis. In the latter group, frank CLL ultimately developed in 15%.
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Fibroblast Growth Factor 23 and Mortality among Patients Undergoing Hemodialysis
This study involving patients in whom hemodialysis was being initiated shows that increased levels of fibroblast growth factor 23 (FGF-23) appear to be independently associated with mortality.
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HHV-6A in Syncytial Giant-Cell Hepatitis
Human herpesvirus 6A (HHV-6A) from a liver donor was found to be the cause of syncytial giant-cell hepatitis in the organ recipient.
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Malaria Prevention during Short-Term Travel
A family is planning a safari in South Africa and Zambia. The husband recently discontinued fluoxetine for depression. His wife is 15 weeks pregnant. Their 7-year-old child is in good health. How should the risk and prevention of malaria be managed in this family?
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CME Exam
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Monoclonal Antibody Therapy for B-Cell Non-Hodgkin’s Lymphoma
Treatment of B-cell non-Hodgkin’s lymphoma has become more successful, largely owing to the availability of therapeutic monoclonal antibodies. This article reviews the current uses of monoclonal antibodies in B-cell non-Hodgkin’s lymphoma.
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Beware of First Impressions
A 64-year-old Filipino man presented to a Baltimore hospital with a 4-month history of worsening midback pain, progressive leg weakness, and intermittent bladder and bowel incontinence.
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Medicare, Graduate Medical Education, and New Policy Directions
In the context of the concerns of many experts about a looming shortage of physicians, the author discusses policy proposals to increase federal support for graduate medical education and to expand the supply of primary care physicians.
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The President’s Emergency Plan for AIDS Relief
On July 16, the Senate approved legislation that would increase the funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) to $48 billion for the next 5 years. Drs. Wafaa El-Sadr and David Hoos examine PEPFAR’s achievements, limitations, and lessons for the future.
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Dr. Wafaa El-Sadr discusses PEPFAR’s successes in addressing the HIV epidemic in the developing world, its broader effect on health care systems, and common criticisms of the program. Dr. El-Sadr is the director of the International Center for AIDS Care and Treatment Programs and a professor of clinical medicine and epidemiology at Columbia University, New York.
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| Published Online July 30, 2008 (DOI: 10.1056/NEJMp0803762) |
Medicare Showdown
In a stunning rebuke of President George W. Bush, the House and Senate voted July 15 in a strong bipartisan fashion to override his veto, erasing a scheduled reduction of 10.6% in the fees that Medicare pays physicians. John Iglehart reports.
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| Published Online July 16, 2008 (DOI: 10.1056/NEJMp0805760) |
Disclosure of Industry Payments to Physicians
Within the next several years, the manufacturers of drugs, medical devices, and medical supplies that are paid for by Medicare, Medicaid, or the State Children’s Health Insurance Program may be required to report publicly many of these gifts and payments; the information would be made available on a searchable government Web site. Dr. Robert Steinbrook discusses the Physician Payments Sunshine Act, which is pending in Congress.
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Treatment Outcomes in Extensively Resistant Tuberculosis
The authors retrospectively analyzed 205 cases of multidrug-resistant tuberculosis to determine what percentage met the definition of extensively drug-resistant tuberculosis and compared the treatment outcomes. Odds ratios for treatment success in the group of patients who had multidrug-resistant tuberculosis, as compared with those who had extensively drug-resistant tuberculosis, were 23.4 for the initial outcome and 21.1 for the long-term outcome.
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Facing Extensively Drug-Resistant Tuberculosis — A Hope
and a Challenge Free Full Text
Monoclonal B-Cell Lymphocytosis — A Frequent Premalignant Condition
FGF-23 and Outcomes Research — When Physiology Meets Epidemiology
Cytogenetically Normal Acute Myeloid Leukemia
MicroRNA in Acute Myeloid Leukemia
Mumps in the United States
Vaccines and Autism Revisited Free Full Text
More on Microembolism and Foam Sclerotherapy Free Full Text
Retraction: Gong Z et al. Injuries after a Typhoon in China. N Engl J Med 2007;356:196-7. Free Full Text
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