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July 4, 2002  Vol. 347 No. 1

Perspective
2-3
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Concern about mosquitoes, ticks, and the pathogens that they transmit grows annually in temperate parts of the world with the leafing of the trees. The arrival of West Nile virus in North America in 1999 has added to anxieties about arthropods (see Figure)...

Original Articles
5-12
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Inflammation within a vulnerable coronary plaque may cause unstable angina by producing erosion or rupture. This study used measurements of neutrophil myeloperoxidase to assess neutrophil activation in blood from the aorta, femoral vein, and great cardiac vein. The data support the concept that in unstable angina there is widespread inflammation in the coronary bed, not just in a single vulnerable plaque.

13-18

Insect-borne diseases are a major cause of illness and death worldwide. Insect repellents can reduce the risk of being bitten. In this study, volunteers inserted their arms into standardized mosquito-containing cages, and investigators calculated the elapsed time until the first bite in order to evaluate which repellent products available to consumers in the United States offered the most complete, reliable protection. Products containing high concentrations of N,N-diethyl-3-methylbenzamide (DEET) were most effective, with other products containing IR3535 or botanicals offering far less protection.

19-25

It is uncertain whether thrombophilia polymorphisms in women are associated with an increased risk of intrauterine growth restriction in their offspring. In this large case–control study, the presence in the mother or newborn of polymorphisms for methylenetetrahydrofolate reductase (MTHFR) C677T or A1298C, factor V Leiden G1691A, or prothrombin G20210A was not associated with an increased risk of intrauterine growth restriction (defined as birth weight below the 10th percentile).

26-34

The efficacy of a heat-inactivated varicella vaccine in recipients of hematopoietic-cell transplants was evaluated in a randomized trial in which vaccination was compared with no vaccination. Patients who received the vaccine had a significantly lower incidence of zoster than patients in the control group and recovered clinically significant T-cell immunity against varicella–zoster virus earlier than did the patients who received no vaccine.

Images in Clinical Medicine
35
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Figure 1. Poison ivy (Rhus radicans) is a woody shrub or vine found throughout the United States. Red-tinged leaves grow in groups of three and have smooth, fine-toothed, or lobed margins, and small, yellow-green flowers form cream-colored fruit. The ...

e1
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Although hemoglobin S is considered to be protective against P. falciparum, this is not always the case.

Clinical Practice
36-42

A 35-year-old man who underwent allogeneic hematopoietic-cell transplantation two years earlier for acute myeloid leukemia has recently moved to a new town. He comes in for a general checkup because he tires easily and has frequent bouts of sinusitis. Physical examination reveals small central cataracts, some patches of vitiligo, and a dry mouth. What are the major issues in the long-term follow-up of patients after successful hematopoietic-cell transplantation?

Review Article
43-53

    Hypocapnia, defined as low partial pressure of arterial blood carbon dioxide, is usually well tolerated and often has no apparent effects. Although transient induction of hypocapnia can be lifesaving in patients with severe intracranial hypertension or neonatal pulmonary-artery hypertension, prolonged hypocapnia may adversely influence outcome. In this article, Laffey and Kavanagh review the prevalence and pathogenesis of hypocapnia, as well as the role of hypocapnia in clinical medicine.

    Editorials
    55
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    It is the responsibility of every person listed as the author of an article published in the Journal to have contributed in a meaningful and identifiable way to the design, performance, analysis, and reporting of the work. The specific requirements for ...

    55-57

    The realization that atherosclerosis is, morphologically, an inflammatory disease was originally derived from studies of animal models. Early after the initiation of an atherogenic diet in animals, monocytes adhere to the vascular endothelium and ...

    57-59

    Increased susceptibility to deep-vein thrombosis is a well-known facet of pregnancy and the puerperium, with the greatest risk occurring during the puerperium. It remains unclear, however, whether a genetically determined tendency toward clot formation in ...

    Correspondence
    63-65

    To the Editor: The results of two studies reported in the Journal (Feb. 21 issue)1,2 suggest that therapeutic hypothermia has a beneficial effect on neurologic outcome in survivors of out-of-hospital cardiac arrest. The authors of the accompanying ...

    65-67

    To the Editor: Davidson et al. (March 7 issue)1 describe four patients with pneumococcal pneumonia in whom therapy with oral levofloxacin failed. We report on a patient with pneumococcal pneumonia and bacteremia in whom meningitis and sepsis developed ...

    67-68

    To the Editor: Savage and Antman (Feb. 28 issue)1 summarize the pathogenesis of BCR-ABL–positive chronic-phase leukemias that are responsive to imatinib mesylate therapy. The authors point out that the mechanism of the antiproliferative action of ...

    68-69
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    To the Editor: Dr. Schmidt (Feb. 21 issue)1 appears not to appreciate the powerful need people have to give blood when a tragedy strikes or the potent symbolism involved. When America's Blood Centers, whose community-based network provides nearly half of ...

    69-70

    To the Editor: Pulmonary alveolar microlithiasis is a rare disease of unknown pathogenesis, characterized by widespread laminated calcispherites in alveolar spaces in the absence of any known disorder of calcium metabolism.1 It usually occurs in a ...

    Book Reviews
    71

    It is an exciting time to be a practitioner in the field of colon and rectal neoplasia. The past decade has brought great progress in our understanding of the environmental and genetic basis of this disease and in our ability to treat it successfully. ...

    71-72

    In a 1987 editorial accompanying two reports on the use of interleukin-2 for treating advanced cancer, John Durant, after several calls for caution, concluded that perhaps we were at the end of the beginning of the search for successful immunotherapy for ...

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