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April 12, 2001  Vol. 344 No. 15

Original Articles
1111-1116

Dementia shortens life expectancy: estimates of median survival from the onset of symptoms vary from 5 years (range, 1 to 13)1 to 9.3 years (range, 1.8 to 16 or more).2 These estimates are based on the follow-up of persons who had dementia at the time of ...

1117-1124

The latest worldwide survey of coronary revascularization shows that 583,000 coronary-artery bypass operations were performed in 1995.1 According to European statistics, the annual rate of use of balloon angioplasty is approximately 739 procedures per ...

1125-1131

Oncogenic human papillomaviruses (HPVs) are a major cause of anogenital cancers.1 HPV has also been implicated in head and neck cancer, because viral DNA, mostly of HPV type 16 (HPV-16), has been found in tumor tissue.1,2 However, the results of case ...

1132-1138
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Anticonvulsant drugs1 taken by pregnant women to prevent seizures are among the most common causes of potential harm to the fetus. In the 1970s and 1980s, the anticonvulsant drugs used most frequently to prevent seizures — phenobarbital, phenytoin, and ...

Images in Clinical Medicine
1139
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Figure 1. A 75-year-old man who was taking 8 mg of prednisone per day for systemic lupus erythematosus was admitted for the evaluation of an enlarging chest mass. Seventeen years earlier he had undergone aortocoronary saphenous-vein grafting. Two years ...

Review Articles
1140-1144

Complement at the Interface between Innate and Adaptive Immunity

The formation of an antibody–antigen complex (immune complex) is the principal way of activating the classical pathway of the complement system. C1q, an integral part of the first component ...

1145-1151

    Approximately 2 million persons in the United States have epilepsy,1,2 making the prevalence of this disorder similar to that of type 1 diabetes mellitus.3 Each year, 100,000 new cases of epilepsy are diagnosed in the United States.1,4 Both the prevalence ...

    Case Records of the Massachusetts General Hospital
    1152-1158

    Presentation of Case

    A 35-year-old woman was admitted to the hospital because of rapidly worsening renal failure.

    Twelve years before admission, she had received a diagnosis of systemic lupus erythematosus, manifested by Raynaud's syndrome, thoracic and ...

    Editorial
    1160-1161

    Dementia, and Alzheimer's disease in particular, is one of the principal causes of disability and decreased quality of life among the elderly and a leading obstacle to successful aging.1,2 In the next 50 years, the prevalence of Alzheimer's disease in the ...

    Sounding Board
    1162-1164

      In response to an article on grief, one of us received the following letter (the names have been changed):

      Dear Doctor,

      On August 3, my mother, Jean Smith, died. She had been a patient at the Medical Center with Dr. Roberts. Until her death, at 90, she ...

      Correspondence
      1166-1168

      To the Editor: Rai et al. (Dec. 14 issue)1 report the results of a long-term, multicenter, randomized trial comparing fludarabine with chlorambucil in previously untreated patients with advanced chronic lymphocytic leukemia (CLL). In their study the ...

      1168

      To the Editor: The observations in the report by Sveinbjörnsdóttir et al. (Dec. 14 issue)1 are important, but we believe they support a predominantly environmental cause rather than a major genetic contribution to the etiology of Parkinson's disease.

      ...

      1168-1170

      To the Editor: I am writing in response to the article by Petersen et al. (Dec. 28 issue)1 on the Veterans Health Administration (VHA). For the sake of VHA patients, I hope the VHA system does measure up. But the very idea of continuing the system in ...

      1170

      To the Editor: In the text accompanying their clinical image of Schistosoma haematobium, Kaplan and Meyers (Oct. 12 issue)1 state that “schistosomiasis is not thought to occur in Somalia.” We disagree. Schistosomiasis needs to be considered in the ...

      1170-1171

      To the Editor: Daniel Fox's review of my book PC, M.D.: How Political Correctness Is Corrupting Medicine (Feb. 8 issue)1 contains many misleading statements. Fox faults me for “exaggerating the influence” of the purveyors of political correctness (PC). ...

      1171-1172

      To the Editor: A 31-year-old woman (gravida 3, para 1) was hospitalized at 26 weeks of gestation with fever and vaginal bleeding from placenta previa. She was taking prednisone for an exacerbation of ulcerative colitis that had occurred on a recent ...

      1172-1173

      To the Editor: Methylenetetrahydrofolate reductase (MTHFR) catalyzes the reduction of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate. The C677T in the gene that encodes MTHFR decreases the activity of the enzyme by 35 percent in persons who ...

      Book Reviews
      1174

      Because they frequently go undiagnosed or untreated, sexually transmitted infections remain a major public health problem, in spite of the existence of tools to control them. Now, with the increasing resistance to antibiotics of some of the sexually ...

      1174-1175

      The extraordinary possibilities suggested by the discovery of the relation of the organism Helicobacter pylori to peptic ulcer disease have now been realized in the clinical management of the disorder. The implications of the various associations of H. ...

      1175-1176

      Plague Time is about the likelihood that infections cause atherosclerosis, some cancers, and other chronic diseases. This is certainly a current theory, and the book could be useful to readers who have not followed the literature in support of this ...

      Correction
      1176

      Efficacy of Mycophenolate Mofetil in Patients with Diffuse Proliferative Lupus Nephritis Correspondence, N Engl J Med 2001:344;382-383.. On page 383, the authors should have been listed as Fotini B. Karassa, M.D., followed by David A. Isenberg, M.D.