Join the 200th Anniversary Celebration

Issue IndexA searchable index of tables of contents

Find An Issue

By Volume and Issue
By Date

Table of contents for

October 2, 2003  Vol. 349 No. 14

Perspective
1307-1309

Sirolimus (rapamycin), an inhibitor of in-stent restenosis in the coronary arteries, is having a substantial effect on the care of patients with coronary artery disease, was discovered in a soil sample from Easter Island (known locally as Rapa Nui). A ...

1309-1311

The persistence of the eponyms “Hodgkin” and “Reed–Sternberg” and the noncommittal descriptor “disease” underscores the uncertainties long associated with the multinucleated giant cells that Sternberg believed to be a manifestation of infection and Reed ...

1311-1312

Invasive cardiovascular procedures offer many patients substantial diagnostic and therapeutic benefits. Vascular angioplasty, electrophysiological ablation procedures, and transjugular intrahepatic portosystemic shunt procedures are among the important ...

1312-1314

    Despite the fact that a licensed pneumococcal capsular polysaccharide vaccine has been available for more than 30 years, Streptococcus pneumoniae continues to sicken and kill children and adults throughout the world each day. Pneumococcus-related ...

    Original Articles
    1315-1323

    The sirolimus-eluting stent has shown promise in the prevention of restenosis after balloon dilation of simple coronary lesions. This clinical trial compared the sirolimus-eluting stent with a standard stent in patients with complex coronary lesions. The sirolimus-eluting stent proved to be superior in the prevention of restenosis and neointimal hyperplasia.

    1324-1332

    In a study of more than 60,000 young adults, a history of infectious mononucleosis significantly increased the risk of Hodgkin's disease, but only disease in which the tumor tissue contained evidence of the Epstein–Barr virus (EBV).

    1333-1340

    Preexisting renal failure confers a risk of radiocontrast-agent–induced nephropathy after percutaneous coronary interventions. This study compared preemptive hemofiltration administered in an intensive care unit (ICU) with isotonic intravenous hydration given in a step-down unit for the prevention of contrast-agent–induced nephropathy in high-risk patients. A decrease in renal function occurred less frequently with hemofiltration (in 5 percent vs. 50 percent of patients; P<0.001). In-hospital and cumulative one-year mortality was lower in the hemofiltration group.

    1341-1348

    This controlled trial involving 39,836 children evaluated the efficacy of a 9-valent pneumococcal conjugate vaccine in South Africa. Vaccination decreased the frequency of invasive pneumococcal disease among both HIV-negative and HIV-positive children and reduced the number of first episodes of radiologically confirmed pneumonia.

    Images in Clinical Medicine
    1349
    • Free Full Text

    A 60-year-old woman with a family history of colon cancer and a history of adenomatous colorectal polyps underwent surveillance colonoscopy. Her last endoscopy, three years previously, had revealed two polyps and normal colonic mucosa (Panel A). Since ...

    e13
    • Free Full Text

    U.S. soldier with fever and weight loss after travel to southern Italy.

    Special Article
    1350-1359
    • Free Full Text

    This study of the entire Medicare fee-for-service population documented substantial racial and geographic variation in the use of knee arthroplasty in the United States. Geographic variation explained part of the racial variation in national arthroplasty rates. However, geographic variation did not explain the significantly lower arthroplasty rates among black men than among non-Hispanic white men in nearly all geographic regions.

    Review Article
    1360-1368

    Chronic constipation is a common condition that can be debilitating and difficult to treat. This review explains the physiologic processes involved in colonic transit and defecation. The evaluation of patients is summarized along with current strategies for clinical management.

    Case Records of the Massachusetts General Hospital
    1369-1377
    • Video

    Presentation of Case

    A 44-year-old man was seen in the clinic because of a right atrial mass.

    Six years earlier, the patient had been found to have Pneumocystis carinii pneumonia and human immunodeficiency virus (HIV) infection. He had returned to a ...

    Editorial
    1379-1380

    The Healthy People 2010 initiative has made the reduction of racial disparities a central national health priority,1 but the achievement of this objective requires evidence-based action. The article by Skinner and colleagues in this issue of the Journal 2 ...

    Occasional Notes
    1381-1383

    On October 3, 1953 — almost exactly half a century ago — Rupert E. Billingham, Peter B. Medawar, and I published a paper in Nature titled “‘Actively Acquired Tolerance' of Foreign Cells.”1 Medawar was the senior author, Billingham was his research fellow, ...

    Correspondence
    1384-1385

    To the Editor: More than 20 years have elapsed since Wohl and Chernick speculated about the possible clinical efficacy of inhaled epinephrine in the treatment of infants with acute bronchiolitis.1 It turns out, according to the study reported by ...

    1385-1387

    To the Editor: Lee and colleagues (July 10 issue)1 provide strong and pertinent data indicating the benefit of prolonged treatment with low-molecular-weight heparin for the prevention of recurrent venous thromboembolism in patients with cancer. ...

    1387

    To the Editor: In their review of valvular heart disease in pregnancy, Reimold and Rutherford (July 3 issue)1 do not address the early puerperium. In our opinion, this period may be crucial. Many clinicians tend to believe that pregnancy in a patient at ...

    1387-1388

    To the Editor: I believe that Table 2 of the article by Nabel (July 3 issue)1 gives misleading information concerning apparent mineralocorticoid excess: this disease is said to be due to mutations in the gene encoding 11β-hydroxylase, but in fact, ...

    1388-1389

    To the Editor: Calabrese et al. (June 5 issue)1 describe cardiac transplantation in a patient with a 15-year history of human immunodeficiency virus type 1 (HIV-1) infection and multiple opportunistic infections who had dilated cardiomyopathy due to ...

    1389-1390

    To the Editor: The “compound” umbilical-cord knot reported by Camann and Marquardt (July 10 issue)1 is topologically two distinct knots that were probably “tied” at separate times. First, an overhand knot probably formed as the fetus passed through a ...

    1390-1391

    To the Editor: The limitations of the three licensed typhoid vaccines that precluded their use in children younger than five years old have been overcome by a Vi conjugate vaccine (Vi-rEPA, a conjugate of the capsular polysaccharide of Salmonella typhi, ...

    Book Reviews
    1392

    Modern scholarship about the relation between law and medicine is replete with impressive research and brilliant analyses, but wisdom, reflecting experience and compassion, is less common. In Refusing Care: Forced Treatment and the Rights of the Mentally ...

    1393

    During the past two decades, the diagnosis of Alzheimer's disease and the characterization of patients with this disease have progressed to the point where we now feel capable of identifying and describing the presymptomatic stage of the disease and ...

    1393-1394
    • Free Full Text

    Demographic changes in industrialized countries grow more compelling with each census. In many of these countries, 15 percent of the population or more is older than 65 years of age. In the United States, people in this age group make up 13 percent of the ...