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February 27, 2003  Vol. 348 No. 9

Perspective
775-776

    Since the introduction of treadmill exercise testing by Robert Bruce five decades ago, graded exercise testing has been a cornerstone of diagnostic procedures for coronary artery disease. An article in this issue of the Journal from the Cleveland Clinic ...

    777-778

    Information about health is worthwhile only if it is accurate and fairly communicated. Recently, a number of advertisements on the Internet have contained statements about dietary supplements that could lead one to believe, erroneously, that information ...

    779-780

    Does growth hormone prevent aging? An article by Rudman et al. that appeared in the Journal in 19901 reported the effect on body composition of administering human growth hormone for six months to 12 older men. This article incited a proliferation of “...

    Original Articles
    781-790
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    Exercise-induced ventricular ectopy is known to be associated with an increased risk of death. In this study of more than 29,000 subjects, frequent ventricular ectopy that occurred during the recovery period after the cessation of exercise was a better predictor of the five-year risk of death than frequent ventricular ectopy during exercise.

    791-799

    This study explores the link between germ-line mutations in the DNA-repair gene MYH and recessive inheritance of multiple colorectal adenomas and classic adenomatous polyposis coli. Patients with biallelic mutations and multiple colorectal adenomas had more polyps and were more likely to have colon cancer than those without MYH mutations.

    800-807

    Hepatitis B e antigen (HBeAg)–negative chronic hepatitis B is associated with progressive liver injury and is likely to require long-term therapy. In this trial, histologic liver abnormalities improved after 48 weeks of therapy with adefovir dipivoxil, and no resistance mutations were found.

    808-816

    In this 48-week placebo-controlled, randomized trial, adefovir dipivoxil improved histologic liver abnormalities in patients with hepatitis B e antigen (HBeAg)–positive chronic hepatitis B and did not result in the development of mutations in the hepatitis B virus polymerase gene that are associated with resistance to the drug.

    Images in Clinical Medicine
    817
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    A 50-year-old woman suddenly became unconscious during her birthday celebration; there was no measurable pulse or blood pressure. Breathing and circulation returned spontaneously within a few minutes, but the exact time was unknown. On admission, she was ...

    Special Article
    818-825

    This study was based on a survey of 84 liver-transplantation centers, of which 42 reported that they performed 449 transplantations from living donors in adults in 1997 through 2000. The number of such transplantations increased markedly during that period, and the procedure now accounts for 5 percent of all liver transplantations in adults. The mortality rate among donors was very low, but the rate of complications was not inconsequential.

    Clinical Practice
    826-833

    While obtaining a peripheral venous blood sample from a patient with the acquired immunodeficiency syndrome, a 35-year-old phlebotomist is injured by a bloody 18-gauge needle attached to a syringe. The patient has been taking didanosine and stavudine for more than six months, but her quantitative plasma human immunodeficiency virus (HIV) RNA titer and CD4 T-lymphocyte count have not been measured for many weeks. What is the appropriate postexposure treatment for the phlebotomist?

    Case Records of the Massachusetts General Hospital
    834-843

    Presentation of Case

    A 43-year-old man was admitted to the hospital because of fever and rapid deterioration of vision in the left eye.

    The patient had been well until six weeks earlier, when fevers, sweats, myalgias, and right-sided pleuritic chest pain ...

    Editorials
    845-847

    In this issue of the Journal, Sieber et al.1 report that up to 30 percent of cases of multiple colorectal adenomas (15 to 100 adenomas) might be linked to biallelic mutations in the MYH gene. What are the implications of this finding for the diagnosis and ...

    848-850

    Clinicians caring for patients with chronic viral hepatitis face complex challenges. The ultimate goal of therapy for chronic hepatitis is to heal hepatic inflammation and necrosis, thereby halting progression to cirrhosis and hepatocellular carcinoma. ...

    Sounding Board
    851-855

    The authors propose several simple and inexpensive ways to reduce errors in teaching hospitals. Their suggestions include computerized procedures to sign out patients when residents go off duty, standardized placement and composition of medical charts and equipment, and the replacement of “see one, do one, teach one” with a rational system for training residents to perform procedures.

    Correspondence
    856-857

    To the Editor: In their randomized trial comparing total and subtotal hysterectomy, Thakar et al. (Oct. 24 issue)1 assessed sexual function with the use of questionnaires and concluded that neither type of surgery had an adverse effect. We believe that ...

    857-858

    To the Editor: The study by Sundar et al. (Nov. 28 issue)1 regarding oral miltefosine for the treatment of Indian visceral leishmaniasis is very promising. However, the reason for excluding from the study patients with a platelet count below 50,000 per ...

    858-860

    To the Editor: The study by Phu et al. (Sept. 19 issue)1 demonstrated that peritoneal dialysis is associated with a poorer outcome than hemofiltration in the treatment of infection-associated acute renal failure. We believe that certain factors in ...

    860-863
    • Free Full Text

    To the Editor: In their article on the dispute over the iron-chelating agent deferiprone (Oct. 24 issue),1 Nathan and Weatherall focus on the ethical implications for the relationships among scientists, their institutions, and industry. Their article ...

    863-864

    To the Editor: I was disappointed to note that, in their discussion of the issues surrounding relationships between academia and the biomedical science and pharmaceutical industries, Moses et al. (Oct. 24 issue)1 neglected to comment on one of the most ...

    864-865

    To the Editor: We are concerned by Annas's contention (Nov. 28 issue)1 that “the application of medical criteria to the possible end of removing someone from within the reach of the death penalty on the basis of mental retardation need not be classified ...

    865-867

    To the Editor: Autologous pericardium has been used for angioplasty in pediatric cardiovascular surgery with good results, except in the case of the pulmonary valve.1 However, we know of no report on the histology of implanted autologous pericardium. We ...

    867-868

    To the Editor: Immunocompromised patients can persistently shed influenza, increasing the potential for resistance to antiviral drugs and for nosocomial transmission.1,2 We report the case of a 23-year-old man with acute lymphocytic leukemia who ...

    Book Reviews
    869-870

    The idea that excessive exercise or undernutrition can postpone puberty, reduce fertility, or prevent menstruation is now so embedded in the body of medical knowledge that it is hard to believe that Frisch's pioneering studies, beginning in the late 1960s,...

    870-871

    In 1865, an 18-year-old woman named Mollie Fancher began her career as “the Brooklyn Enigma.” For more than a decade after a horsecar accident, Fancher exhibited symptoms that included blindness, trance, memory loss, paralysis, seizures, and clairvoyance —...

    871-873

    The permissiveness of the maternal immune system toward the fetus as an allogeneic “graft” is governed by complex immunologic interactions that ultimately allow successful pregnancy in most cases. Contributing to these processes are fetal and maternal ...

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