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November 22, 2001 Vol. 345 No. 21
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In this prospective cohort study of 6989 subjects 55 years old or older, the risk of Alzheimer's disease was reduced significantly among those who were long-term users of nonsteroidal antiinflammatory drugs. There was no significant reduction in risk among those with less than 24 months' cumulative use of these medications, and there was no evidence of a protective effect against the development of vascular dementia.
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In a cohort of 1028 children and adolescents infected with human immunodeficiency virus type 1 (HIV-1), the use of combination therapy including protease inhibitors increased from 7 percent in 1996 to 73 percent in 1999. Over the four-year period, mortality declined from 5.3 percent to 0.7 percent. This analysis was adjusted for multiple potentially confounding variables; the authors estimate that the use of combination therapy including protease inhibitors in HIV-1–infected children reduces the risk of death by 67 percent.
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This double-blind, placebo-controlled trial involved 2032 patients with asthma. The participants received the inactivated influenza vaccine and placebo in random order, with a mean of 22 days between injections. The frequency of exacerbations of asthma was similar in the two weeks after influenza vaccination (28.8 percent) and after the placebo injection (27.7 percent).
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Embryos that are transferred after in vitro fertilization frequently fail to implant in the uterus; in many cases, this failure is due to chromosomal abnormalities in the embryo. The current methods of diagnosis of aneuploidy cannot detect many chromosomal abnormalities. This report on the case of a 38-year-old woman with a long history of infertility describes the use of comparative genomic hybridization to determine that all the chromosomes of a single embryo were free of aneuploidy, resulting in the birth of a healthy infant.
Fenoldopam is a peripherally acting dopamine-receptor agonist that has vasodilator and diuretic actions. Given intravenously, it is an effective treatment for patients with severe hypertension, including those with hypertensive encephalopathy and perioperative hypertension. This review summarizes the pharmacologic characteristics of fenoldopam and its efficacy as a treatment for patients with severe hypertension.
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