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August 9, 2001  Vol. 345 No. 6

Original Articles
391-397
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This study surveyed 758 patients treated with antiarrhythmic drugs or implantable defibrillators.

398-407

Patients who received quadruple therapy had the highest rate of suppression of plasma HIV RNA.

408-416

An impairment of an endothelial anticoagulation pathway in severe meningococcal disease.

417-423
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Risk factors included hypoxic encephalopathy, head and neck infections, and prothrombotic disorders.

Images in Clinical Medicine
424
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Figure 1. Back pain developed in a 31-year-old man who had undergone total nodal irradiation and chemotherapy for Hodgkin's disease at the age of 15 years (when asymptomatic hilar adenopathy was found on a routine chest film) and who had received a second ...

Review Articles
425-432

    Leukoencephalopathy is a structural alteration of cerebral white matter in which myelin suffers the most damage. Toxic leukoencephalopathy may be caused by exposure to a wide variety of agents, including cranial irradiation, therapeutic agents, drugs of ...

    433-442

    Nonsteroidal antiinflammatory drugs (NSAIDs) are widely used to treat arthritis, menstrual pain, and headache. Although they are effective, their long-term use is limited by gastrointestinal effects such as dyspepsia and abdominal pain and, less often, ...

    Case Records of the Massachusetts General Hospital
    443-449

    Presentation of Case

    A 46-year-old woman was admitted to the hospital because of recurrent hemoptysis.

    Eight months earlier, a cough, nonpleuritic left-sided chest pain, and fatigue had developed, with minor episodes of hemoptysis. A tuberculin skin test ...

    Editorials
    451-452

    Many Americans consider driving a basic necessity for everyday life. Yet driving is an activity that is inherently dangerous both to the driver and to others. Society must therefore restrict driving privileges only to those who are able to drive without ...

    452-455

    Combination therapy with three antiretroviral drugs improves the outcome of patients infected with human immunodeficiency virus type 1 (HIV-1) and has led to sustained decreases in AIDS-related morbidity and mortality in North America and Europe.13 Long-...

    Sounding Board
    456-458

    Two years ago, I wrote about the National Bipartisan Commission on the Future of Medicare, of which I was a member.1 The commission went out of business in March 1999, having failed to adopt recommendations or issue a report. Since then, a fair amount of ...

    458-462

    Reforming Medicare, which serves persons who are 65 years of age or older and many persons with disabilities, is a popular topic whenever the program's solvency is perceived to be at stake. Given that the latest report of the Medicare trustees predicts ...

    Correspondence
    464-465

    To the Editor: The findings of Vázquez et al. (March 29 issue)1 on the effectiveness of the varicella vaccine were reassuring. However, we are concerned by the finding that only 74 percent of the suspected cases of chickenpox were confirmed by the ...

    465-466

    To the Editor: Clinicians pondering the negative results of Paradise et al. (April 19 issue)1 should note that 82 percent of the children had unilateral or discontinuous middle-ear effusions. Although the timing of insertion of tympanostomy tubes had no ...

    466-467

    To the Editor: It is with concern that I read the article by the Research Unit on Pediatric Psychopharmacology Anxiety Study Group (April 26 issue)1 promoting the treatment of young children with potent psychotropic drugs, adding to the several million ...

    467

    To the Editor: In the review article on spontaneous dissection of the carotid and vertebral arteries (March 22 issue),1 Dr. Schievink recommends therapeutic anticoagulation unless the dissection extends intracranially. Intraarterial angiography is often ...

    467-469
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    To the Editor: In their review article on epilepsy, Browne and Holmes (April 12 issue)1 state that electroencephalographic studies should be performed 48 hours or more after a suspected seizure. We disagree. Studies of chronic partial epilepsy show that ...

    469

    To the Editor: Many acute psychotic episodes encountered in emergency situations are related to addictive substances. Nalbuphine is a synthetic opiate agonist–antagonist, chemically related to both the opioid antagonist naloxone and the analgesic ...

    469-471

    To the Editor: As part of our research on the relation between the Internet and substance abuse, we have identified several Web sites that promulgate information about illicit drugs. These “partisan” Web sites are easily identified by common search ...

    Book Reviews
    472

    Set on a world stage, this book is about the “psychoactive revolution” of the past 500 years. Courtwright, well known for his work concerning the history of drug addiction and, more generally, social history, observes that in wealthy societies in the 20th ...

    472-473

    This book is a trove of valuable clinical information on 30 of the most common genetic syndromes. The editors state that the book is intended as a resource for primary care physicians, medical specialists, and other physicians, most of whom are not ...

    473-474
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    The second edition of the German textbook Dermatology is just that — a comprehensive reference on the specialty of dermatology. Appearing nine years after the first edition, the second edition is a practical necessity. Nondermatologists may not believe it,...