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

December 18, 2003  Vol. 349 No. 25

Perspective
2379-2380

An association between accelerated atherosclerosis and systemic lupus erythematosus (SLE), typified by the occurrence of a myocardial infarction in a 30-year-old woman who had had the disease for more than 10 years, was suggested in 1976.1 The two studies ...

2381-2382

    It was just over a year ago, in November 2002, that the first case of what was to become known as the severe acute respiratory syndrome (SARS) was identified in Foshan, Guangdong Province, China. The dramatic spread of SARS in the late winter and spring ...

    2383-2386

    The puzzle was how the surgeons in India do it. Take a town like Nanded, 400 miles east of Mumbai (as Bombay is now called), in the center of India. The public hospital in Nanded serves a district of 1400 villages and 2.3 million people. It has 500 beds, ...

    Original Articles
    2387-2398

    In this long-term trial, the combination of an alpha-blocker (doxazosin) and a 5α-reductase inhibitor (finasteride) was superior to either drug alone in retarding the clinical progression of benign prostatic hyperplasia.

    2399-2406

    Patients with systemic lupus are at increased risk for myocardial infarction. In this study, the extent of carotid atherosclerosis was investigated by ultrasonography in patients with lupus and matched controls. Patients with lupus had premature atherosclerosis that was not related to traditional cardiovascular risk factors.

    2407-2415

    Coronary artery disease is an important cause of death in patients with systemic lupus. In this study, electron-beam computed tomography was used to assess coronary-artery calcification in patients with lupus and matched controls. Coronary calcification was more frequent and more extensive and occurred at a younger age in the patients than in the controls.

    2416-2422

    This careful study is based on interviews of passengers and crew members on three flights that carried patients with the severe acute respiratory syndrome (SARS). Twenty-two persons became ill a mean of four days after one of the flights. The risk was highest among the passengers seated within three rows in front of the symptomatic index patient (relative risk, 3.1).

    Images in Clinical Medicine
    2423
    • Free Full Text

    A 73-year-old man presented with acute lower gastrointestinal bleeding. He was hemodynamically stable, and nasogastric-tube lavage revealed bile with no blood, suggesting a lower gastrointestinal source for the bleeding. Urgent colonoscopy, performed ...

    e24
    • Free Full Text

    Echodensities on the cusp of the aortic valve in a woman with a stroke.

    Clinical Practice
    2424-2430

    A 19-year-old woman visits her primary care provider for counseling about contraception. She became sexually active one year earlier and has had a new sexual partner for the past three months. Her partner currently uses a condom intermittently. She reports no medical problems, and her physical examination is unremarkable. Is testing for Chlamydia trachomatis indicated?

    Review Article
    2431-2441

      A summary of information on this pandemic.

      Case Records of the Massachusetts General Hospital
      2442-2447

      Presentation of Case

      A 33-year-old woman was admitted to the hospital because of gross hematuria.

      The patient had been in stable health until four days earlier, when gross hematuria developed, with passage of clots and mild dysuria but without an increase ...

      Editorial
      2449-2451

      The prostate is a complex organ composed of epithelial cells and fibromuscular stroma. Benign prostatic hyperplasia is a true hyperplastic process, with an increase in the number of cells arising initially in the transition zone of the gland. Complex ...

      Health Policy Report
      2452-2459

      This Health Policy Report reviews the history of the relationships between academic institutions and industrial organizations in the United States and discusses recent developments in this area. Academic–industrial relationships have fostered the development and dissemination of valuable medical advances, but they have also resulted in financial conflicts of interest that have threatened both the welfare of subjects enrolled in clinical research trials and the integrity of the research process. The author outlines strategies for managing academic–industrial relationships so as to safeguard both human subjects and the integrity of research.

      Correspondence
      2460-2461

      To the Editor: Martínez et al. (Sept. 11 issue)1 report that among patients who switched to efavirenz from a protease inhibitor, 29 (18.6 percent) subsequently discontinued efavirenz without virologic failure. This proportion is considerably in excess of ...

      2461-2464

      To the Editor: There is little doubt that per capita health care administrative costs are lower in Canada than in the United States, as Woolhandler et al. report (Aug. 21 issue),1 even though the precise magnitude of the gap is open to debate, a point ...

      2464-2465

      To the Editor: In his article on sudden death in young athletes (Sept. 11 issue),1 Maron includes a discussion of commotio cordis, in which he illustrates and describes a blow directly over the heart as an initiator of ventricular tachyarrhythmias. ...

      2465

      To the Editor: Collard et al. describe the diagnosis and management of an aortopulmonary fistula in a patient with hemoptysis (Sept. 4 issue).1 The diagnosis was delayed for seven weeks while the patient underwent a battery of laboratory tests, multiple ...

      2466
      • Free Full Text

      To the Editor: The Images in Clinical Medicine in the September 11 issue,1 showing a contrast-enhanced electron-beam computed tomographic (EBCT) study of a heart with myocardial bridging of the left anterior descending coronary artery, contains an error. ...

      2467

      To the Editor: In Case 29-2003 (Sept. 18 issue),1 it was hypothesized that the Howell–Jolly bodies seen in the blood smear of a patient with babesiosis were actually intracellular parasites (Babesia microti). In a recent case of babesiosis in an asplenic ...

      2468-2469

      To the Editor: The identification and sequencing of a novel coronavirus1 associated with the recently described severe acute respiratory syndrome (SARS)2 have permitted the development of antibody-based and genome-based tests for the infection.3,4 ...

      2469-2470

      To the Editor: Using the viral sequences derived from clinical specimens collected in Hong Kong between February and April 2003 from 139 patients with the severe acute respiratory syndrome (SARS),1 we attempted to estimate the timing of the last common ...

      Book Reviews
      2471

      In The Act of Creation, which was written almost 40 years ago, Arthur Koestler argued convincingly that very few ideas in science ever prove to be truly original. When they are, the originators seem to be so far ahead of their time that their ...

      2472

      Neither the title nor the subtitle of this book adequately reflects its true aim. Michael Bishop (Figure), who with Harold Varmus received the Nobel prize in 1989 for their discovery of oncogenes, is convinced that current difficulties in relations ...

      2473-2474

      Mary Roach certainly has an eye for the offbeat (and a stomach for the grisly). In Stiff: The Curious Lives of Human Cadavers, Roach, a columnist for Reader's Digest and the online news magazine Salon, surveys the uses to which corpses have been put over ...