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Current IssueOctober 16, 2008
FULL TABLE OF CONTENTS | THIS WEEK IN THE JOURNAL | Audio Icon AUDIO SUMMARY
Original Article
graphic Monovalent Type 1 Oral Poliovirus Vaccine in Newborns
In infants in Egypt who were given either monovalent type 1 or trivalent vaccine at birth, significantly more infants given the monovalent vaccine underwent seroconversion to type 1 poliovirus (55%, vs. 32% of those given trivalent vaccine). In addition, the monovalent vaccine more effectively reduced shedding of type 1 poliovirus after challenge.   Free Full Text
Original Article
graphic Effectiveness of Immunization against Polio in Nigeria
In this study of poliomyelitis in Nigeria, the estimated per-dose efficacies of monovalent and trivalent vaccine for serotype 1 were 67% and 16%, respectively. The estimated efficacy of trivalent vaccine for serotype 3 was 18%.
Free Full Text
Original Article
graphic Effect of 17q21 Variants and Smoking Exposure in Early-Onset Asthma
A locus on chromosome 17 has previously been shown to be associated with susceptibility to asthma. This study shows that the association is specific to early-onset asthma (occurring at the age of 4 years or younger) in those exposed to environmental tobacco smoke in early life.
Online FirstOctober 15, 2008 (DOI: 10.1056/NEJMoa0806604), in Print November 6, 2008

Related Editorial: 17q21 Variants and Asthma — Questions and Answers

Original Article
graphic Gene Expression in Fixed Tissues and Outcome in Hepatocellular Carcinoma
The authors have established a method for the analysis of gene expression in tissue specimens preserved in formaldehyde. The expression profile of tissue adjacent to primary hepatocellular carcinoma, rather than the cancer itself, is associated with late recurrence.
Online FirstOctober 15, 2008 (DOI: 10.1056/NEJMoa0804525), in Print November 6, 2008

Related Editorial: Recurrence of Hepatocellular Carcinoma

Original Article
Computer-Aided Detection for Screening Mammography
This trial of methods used for the evaluation of screening mammograms compared the rate of detection of breast cancer achieved by the use of two readers for each mammogram with that of a single reader using computer-aided detection.   CME Exam
Published Online October 1, 2008 (DOI: 10.1056/NEJMoa0803545)
Original Article
graphic Recurrent Rearrangements of Chromosome 1q21.1 and Variable Pediatric Phenotypes
This study shows an association between a broad range of phenotypes and either deletion or duplication of a genomic segment at chromosome 1q21.1, suggesting a fundamental role of the deletion or duplication in early development.
Published Online September 10, 2008 (DOI: 10.1056/NEJMoa0805384)
Clinical Practice
graphic Gastroesophageal Reflux Disease
A 53-year-old man reports having had worsening heartburn for the past 12 months, with daily symptoms that disturb his sleep. What would you advise regarding his evaluation and treatment?   CME Exam
Current Concepts
graphic Blunt Aortic Injury
Blunt aortic injury occurs after sudden deceleration, and it is second only to head injury as the leading cause of death after automobile crashes. Helical CT of the thorax is more sensitive than angiography for detection. Although immediate operative repair was once the rule, endovascular repair is now an alternative for many patients.   CME Exam
Case Records of the Massachusetts General Hospital
graphic A Girl with Recurrent Oral Lesions and Cutaneous Bullae
A 10-year-old girl had recurrent oral ulcers and cutaneous bullae since 2 years of age. White lesions in the mouth and vesicles and bullae on the dorsal and plantar surfaces of the feet, the knees, and the hands that ulcerated and became painful occurred at intervals of 3 to 4 months.
Perspective
graphic Primum Non Nocere — The McCain Plan for Health Insecurity
Dr. David Blumenthal argues that the central purpose of John McCain’s health policy is to reduce the role of insurance and make Americans pay a larger part of their health care bills out of pocket. This plan would risk the viability of employer-sponsored insurance and the welfare of chronically ill Americans in pursuit of a radical vision of consumer-driven health care.   Free Full Text
Published Online September 24, 2008 (DOI: 10.1056/NEJMp0806563)
Perspective
graphic Symptomatic Relief, but No Cure — The Obama Health Care Reform
Barack Obama has laid out a vision for reform that promises health insurance for (nearly) everyone, with coverage as good as that enjoyed by members of Congress. Joseph Antos argues that the Obama plan offers a host of policy proposals that address the symptoms but not the underlying disease that afflicts the health care system.   Free Full Text
Published Online September 24, 2008 (DOI: 10.1056/NEJMp0806561)
Perspective
graphic Living Unlabeled — Diagnosis and Disorder
Dr. Lisa Rosenbaum writes that there is little room for diagnostic uncertainty in the hospital systems where physicians train. But diagnosis for the sake of diagnosis can be an ill in its own right.

Editorials
Monovalent Oral Poliovirus Vaccines — A Good Tool but Not
a Total Solution
  Free Full Text

Cytogenetic Technology — Genotype and Phenotype
Published Online September 10, 2008 (DOI: 10.1056/NEJMe0806570)

Correspondence
Desensitization during Renal Transplantation

Angiotensin II Blockade in Marfan’s Syndrome

Familial Myeloma

Age-Related Macular Degeneration  Free Full Text

Long-Term Results of Rabbit Antithymocyte Globulin and Basiliximab Induction

Problems Associated with the Use of Thyrogen in Patients with a Thyroid Gland
Published Online September 19, 2008 (DOI: 10.1056/NEJMc0807896)

Upcoming in Print
Published Online October 8, 2008
-GAD Treatment and Insulin Secretion in Recent-Onset Type 1 Diabetes
FULL TABLE OF CONTENTS | THIS WEEK IN THE JOURNAL | Audio Icon AUDIO SUMMARY

ELECTION 2008

Perspective Roundtable

graphic

Health Care in the Next Administration

Senior health policy advisors to the presidential candidates discuss health care reform in a symposium sponsored by the Journal and the Harvard School of Public Health.

-More Election Coverage

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Image of the Week

graphic

Gingival Hypertrophy

An otherwise healthy 46-year-old woman who was not taking any medications presented with anemia and gingival hypertrophy. The white-cell count was 10,300 per cubic millimeter, the hematocrit was 26%, and the platelet count was 81,000 per cubic millimeter.

-More Featured Images

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The New England Journal of Medicine (NEJM) is a weekly general medical journal that publishes new medical research findings, review articles, and editorial opinion on a wide variety of topics of importance to biomedical science and clinical practice. Material is published with an emphasis on internal medicine and specialty areas including allergy/immunology, cardiology, endocrinology, gastroenterology, hematology, kidney disease, oncology, pulmonary disease, rheumatology, HIV, and infectious diseases.

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