Etanercept (Enbrel, Immunex, Seattle) is a soluble tumor necrosis factor (TNF) receptor fusion protein that binds and inactivates TNF, a proinflammatory cytokine that is overproduced in the joints of patients with rheumatoid arthritis.¹ Etanercept reduces ...

Tumor necrosis factor α (TNF-α) has a central role in the pathogenesis of rheumatoid arthritis,¹–³ as demonstrated by the clinical benefit of TNF-α–neutralizing therapy⁴–⁹ with either a TNF-α type II receptor–IgG1 fusion protein (etanercept) or a chimeric ...

Three randomized, controlled clinical trials have shown that both annual screening and biennial screening for occult blood in the stool significantly reduce the rate of death from colorectal cancer.¹–⁴ Several observational studies have had similar ...

It is widely accepted that the use of folic acid by pregnant women reduces their risk of having an infant with a neural-tube defect. Although observational studies had identified reductions in risk with the use of multivitamins that contain folic acid, it ...

Figure 1. A 78-year-old man with cardiac disease presented with pain in his left elbow of several hours' duration in the absence of trauma. Examination of the elbow disclosed no abnormalities, and he was admitted with a tentative diagnosis of atypical ...

Participants in clinical trials accept risks primarily to advance scientific knowledge. The recent death of a volunteer in a phase 1 trial of gene therapy has sparked concern that financial conflicts of interest on the part of investigators may compromise ...

Scientific misconduct involves inherently unacceptable behavior that directly threatens the integrity of research. Conflicts of interest may inappropriately influence the design, conduct, or reporting of research, thus threatening its scientific value and ...

Lung cancer is the leading cause of death from cancer among men and women in the United States. More people die each year of lung cancer than of colon, breast, and prostate cancer combined. Despite new diagnostic techniques, the overall five-year survival ...

Presentation of Case

An 11-day-old boy was admitted to the hospital because of an osteolytic lesion in the right tibia.

The infant was born at 39 1/2 weeks' gestation to a woman who had had one previous pregnancy, which had ended in a spontaneous ...

This year marks the 50th anniversary of the awarding of the Nobel Prize in Physiology and Medicine to Kendall, Hench, and Reichstein for the isolation and characterization of adrenocorticotrophic hormones.¹ Until now, nothing has even begun to approach ...

It is well established that screening for colorectal cancer with the fecal occult-blood test significantly lowers the rate of death from the disease.¹ The report by Mandel et al.² in this issue of the Journal suggests that it also prevents cancer, ...

Any clinical investigator will tell you that the success of a clinical trial is limited by the ability to recruit patients to become research subjects. Altruism aside, many patients who make this transition reach a conscious and informed decision to forgo ...

In 1799, Benjamin Waterhouse, one of the three full-time professors at Harvard Medical School, received a copy of Edward Jenner's Inquiry into the Causes and Effects of the Variolae Vaccinae. Armed with new knowledge of the efficacy of cowpox vaccination ...

To the Editor: The articles by Lieberman et al.¹ and Imperiale et al.² (July 20 issue) add greatly to our knowledge about screening for colorectal cancer. However, I disagree with Podolsky,³ who concludes in his editorial that the data in these articles ...

To the Editor: Vassallo et al. (June 29 issue)¹ depict a central role for the alveolar macrophage in the pathogenesis of pulmonary Langerhans'-cell histiocytosis. We made several observations in a series of five patients with biopsy-proved, CD1a+ ...

To the Editor: The study by Angelucci et al. (Aug. 3 issue)¹ provides useful evidence that the estimated hepatic iron concentration is an indirect measure of total mobilizable body iron stores, but the authors misinterpreted the results of our study.² ...

To the Editor: As the director of a large academic program in assisted reproduction with a particular emphasis on embryo cryopreservation, I wish to respond to the article by Annas (Aug. 3 issue)¹ on the fate and disposition of cryopreserved embryos. ...

To the Editor: In October 1998, the Centers for Disease Control and Prevention reported 20 endotoxin-like reactions to intravenous gentamicin¹ administered in a once-daily dosing regimen. We report on a completed investigation of a series of pyrogenic ...

This second edition of Hypertension in Pregnancy will inevitably be compared with the second edition of Chesley's Hypertensive Disorders in Pregnancy, which appeared last year (M.D. Lindheimer, J.M. Roberts, and F.G. Cunningham, eds. Stamford, Conn.: ...

This new textbook is intended to provide comprehensive information about respiratory medicine. One of the explicitly stated goals for the book is to reflect the worldwide perspective of the clinical and scientific community in respiratory medicine. This ...

In the past two decades, enormous advances in molecular biology and immunology have revolutionized our understanding of disease processes. One disease that is better understood as a result of these advances is asthma. Concepts of the physiological ...