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December 20, 2001  Vol. 345 No. 25

Original Articles
1787-1793

Some studies have indicated that women who take oral contraceptives have an increased risk of myocardial infarction. This study focused specifically on second- and third-generation oral contraceptives. The risk of myocardial infarction was significantly increased by the use of second-generation pills; the findings regarding the use of third-generation pills were inconclusive but suggested that the risk was lower than that with second-generation pills.

1794-1800

Serotyping is typically used to define HLA class I antigens during the selection of donors for bone marrow transplantation. Some HLA variants, however, are identifiable only by DNA sequencing of the allele (allele typing). Among more than 450 patients who received marrow transplants from unrelated donors, antigen mismatches were more predictive of graft rejection than allele mismatches.

1801-1808
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Epidemiologic studies have linked the use of nonnarcotic analgesics with the development of chronic renal failure, yet whether this relation is causal has been unclear. This nationwide, population-based, case–control study of early-stage chronic renal insufficiency in Sweden found that the regular use of either aspirin or acetaminophen increases the risk of chronic renal failure by a factor of 2.5.

1809-1817

The antiplatelet effects of aspirin are caused by the irreversible inhibition of the activity of the enzyme cyclooxygenase. In contrast, nonsteroidal antiinflammatory drugs (NSAIDs) are reversible inhibitors of this activity and have only transient effects on platelet function. This study found that pretreatment with ibuprofen before the administration of aspirin blocked the antiplatelet effects of aspirin. Neither the cyclooxygenase-2 inhibitor rofecoxib nor acetaminophen had this blocking effect.

Images in Clinical Medicine
1818
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Figure 1. A 43-year-old man was admitted with a three-week history of general malaise, dysphagia, chronic cough, nausea, and a feeling of fullness after eating. He had undergone a Whipple procedure in the past because of a chronic inflammatory mass in the ...

Clinical Practice
1819-1824

    A healthy 54-year-old woman comes for a routine examination and asks whether she should be taking any vitamin supplements. What do you advise? This article reviews the evidence that supports or fails to support the use of any of several common vitamin supplements for the prevention of disease.

    Review Article
    1825-1832

    In the wake of traumatic events, subjective reports of sleep disturbance are common. This review article examines both subjectively identified and objectively confirmed sleep disorders after traumatic events. Recommendations with respect to diagnostic procedures and therapeutic options are also reviewed.

    Case Records of the Massachusetts General Hospital
    1833-1839

    Presentation of Case

    A two-day-old girl was admitted to the hospital because of persistent hypoglycemia.

    The infant had been born at 34 weeks' gestation to a 35-year-old mother after an uneventful pregnancy. The birth weight was 3510 g. The Apgar score ...

    Editorials
    1841-1842

    The use of oral contraceptives first became widespread some 40 years ago, and reports of an excess risk of cardiovascular disease among women who used these agents soon followed. Because the risks seemed to be dose related, manufacturers created new ...

    1842-1844

    Despite the very large number of volunteers willing to donate bone marrow for unrelated recipients (currently numbering over 7 million worldwide), many candidate recipients still cannot obtain marrow because no HLA-matched volunteer can be found. The ...

    1844-1846

    “Take two aspirin and call me in the morning”? Clinical decision making is no longer so straightforward. Millions of patients take analgesic and antiinflammatory medications regularly. The reasons are simple: these drugs are effective in relieving pain ...

    1846-1848

    In this issue of the Journal, Lavie points out the high frequency of sleep disturbances, primarily insomnia and nightmares, that occur after local or distant disasters.1 This observation is supported by the recent article on stress reactions after the ...

    Correspondence
    1850-1852

    To the Editor: Lieberman et al. (Aug. 23 issue)1 report that one-time screening with both a fecal occult-blood test and sigmoidoscopy failed to identify 24 percent of subjects with advanced neoplasia. They do not, however, comment on the incremental risk ...

    1852-1853

    To the Editor: Agnelli et al. (July 19 issue)1 report the results of one of the few large trials addressing the optimal duration of anticoagulant therapy after a first episode of idiopathic deep-vein thrombosis. They state that improving risk ...

    1853-1855

    To the Editor: For a study that was conducted at 22 centers in the United States and that involved patients with a disease that has a worldwide prevalence of 2 percent, the recruitment of only 229 patients with psoriasis, as reported by Ellis and Krueger ...

    1855-1856

    To the Editor: In his review of subclinical hypothyroidism, Cooper (July 26 issue)1 did not fully address the complex issue of prenatal screening. Since Haddow et al.2 reported that the offspring of women with elevated thyrotropin concentrations had ...

    1856

    To the Editor: Recent studies13 have suggested that cyclooxygenase-2 (COX-2) inhibitors can be safely used in patients with asthma who have documented intolerance to COX-1 inhibitors such as aspirin and nonsteroidal antiinflammatory drugs. On the basis ...

    Book Reviews
    1857-1858

    Counters and classifiers of deaths and diseases, including demographers and epidemiologists, have long been fascinated with the statistical regularities of social inequalities in morbidity and mortality. The earliest studies of social class and mortality ...

    1858

    Richard Rapport, a neurosurgeon, has written a fascinating and accurate account of the life of Paul Beeson, who rose to the highest levels of academic medicine not only because of his outstanding professional achievements but also because of his humility, ...

    Corrections
    1860

    A Comparison of Lorazepam, Diazepam, and Placebo for the Treatment of Out-of-Hospital Status EpilepticusOriginal Article, N Engl J Med 2001:345;631-637.. On page 637, the sentence that begins on line 14 of the left-hand column should have read, “We ...

    1860

    Severe Coagulopathy as a Consequence of Smoking Crack Cocaine Laced with RodenticideCorrespondence, N Engl J Med 2001:345;700-701.. On page 701, in Table 1, the first entry in the first column should be “coagulation factor II,” not “coagulation factor I,” ...

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