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May 6, 2004  Vol. 350 No. 19

Perspective
1927-1929

    Recent rounds on the infectious disease ward in Mir Wais Hospital, in Kandahar, Afghanistan, found a young farmhand recuperating from meningitis sitting with the two friends who had accompanied him to the hospital. He had survived the disease, but only ...

    1930-1931

    Heart failure is common and costly, and it primarily affects the elderly. As the elderly population expands, there will be marked increases in the number of persons with heart failure. Epidemiologic studies have established that 40 percent to 50 percent ...

    1932-1934

    The mucopolysaccharidoses are a group of lysosomal storage diseases caused by a deficiency of enzymes that degrade glycosaminoglycans.1 Mucopolysaccharidosis type I, an autosomal recessive disorder caused by a deficiency of the enzyme α-L-iduronidase, is ...

    1935-1936

    Eight years ago in the Journal, a colleague and I described a new breed of physician — the “hospitalist” — whose primary role was to care for hospitalized patients, returning them to the care of their regular physicians at hospital discharge.1 Since that ...

    Original Articles
    1937-1944

    In this randomized trial of the postoperative treatment of high-risk squamous-cell carcinoma of the head and neck, concurrent radiotherapy plus chemotherapy (cisplatin) reduced the incidence of local and regional recurrence and prolonged disease-free survival, as compared with radiotherapy alone. The combined treatment was substantially more toxic than radiotherapy alone.

    1945-1952

    This randomized trial of adjuvant treatment for locally advanced cancer of the head and neck compared radiotherapy alone with radiotherapy plus concomitant cisplatin after surgery with curative intent. Progression-free and overall survival were superior in the combined-therapy group.

    1953-1959

    This hemodynamic study provides convincing evidence that heart failure in patients with a normal left ventricular ejection fraction is due to abnormal diastolic function.

    1960-1969

    In patients with Hurler's syndrome, cord-blood transplantation before the age of two years halts disease progression and prolongs life, but many children lack donors. This study reports complete donor chimerism and normal leukocyte α-L-iduronidase levels in 17 of 20 children with Hurler's syndrome who received cord-blood transplants from unrelated donors. Their neurocognitive performance improved and somatic features decreased after transplantation.

    Clinical Practice
    1970-1977

      A 22-year-old woman presents to her gynecologist with genital lesions. Examination reveals bilateral labial ulcerations, cervical ulcerations, and mildly tender inguinal lymphadenopathy. To her knowledge, neither she nor any of the four sexual partners she has had, including her husband of two years, has ever had herpes. How should this patient's case be managed?

      Review Article
      1978-1988

        The most common cutaneous lymphoma is mycosis fungoides, a non-Hodgkin's, peripheral T-cell lymphoma. Recent advances in the understanding of the molecular and biologic behavior of T cells in this lymphoma — notably, their ability to home to the skin, function in an activated state, and achieve clonal dominance — have had a tremendous influence on current treatment. In this review, the expanding armamentarium of biologic agents, phototherapeutic and irradiation techniques, and combination regimens available to treat mycosis fungoides is discussed.

        Images in Clinical Medicine
        1989
        • Free Full Text

        A 29-year-old man presented with severe dyspnea and hemoptysis. He said he had always had a reduced capacity for exercise as compared with his peers. He had an elevated jugular venous pressure, a right ventricular heave, a loud pulmonic second sound, and ...

        e17
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        A 17-year-old was involved in a car accident. Before she was transported to a hospital, a central venous catheter was inserted.

        Clinical Problem-Solving
        1990-1995

          A 26-year-old woman with end-stage renal disease from primary membranoproliferative glomerulonephritis who had received her second cadaveric renal transplant 11 months previously presented with a 2-week history of intermittent fever, with temperatures as high as 39°C.

          Editorial
          1997-1999

          Squamous-cell cancer of the head and neck is the sixth most common cancer worldwide, with a lifetime risk of 2 percent for men and 0.6 percent for women. There are approximately 76,000 and 37,000 new cases of oral-cavity, pharyngeal, and laryngal cancer ...

          Correspondence
          2000-2001

          To the Editor: According to the report by Freedman et al. (Feb. 5 issue),1 the median ratio of arachidonic acid to docosahexaenoic acid in patients with cystic fibrosis was higher than that in healthy subjects. Because linoleic acid is metabolized to ...

          2001-2003

          To the Editor: Meunier et al. (Jan. 29 issue)1 studied the effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis in a placebo-controlled trial. We are surprised by their statement, “To date, no ...

          2003-2004

          To the Editor: Levine et al. (Feb. 12 issue)1 have shown that increased levels of soluble fms-like tyrosine 1 (sFlt-1) and reduced levels of placental growth factor (PlGF) predict the development of preeclampsia, a few weeks before the onset of clinical ...

          2004-2006

          To the Editor: Rhoden and Morgentaler1 and Snyder2 (Jan. 29 issue) assuage the anxiety of physicians who administer testosterone to older men because the men report andropause, a collection of ill-defined maladies related to male aging. Their position in ...

          2006-2007
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          To the Editor: We would like to add some information to Young and Brown's review (Feb. 5 issue)1 of parvovirus B19 infection and myocarditis. We studied myocardial tissue from five patients with fulminant parvovirus B19–associated myocarditis by in situ ...

          2008-2010

          To the Editor: In their review of lung-cancer management (Jan. 22 issue),1 Spira and Ettinger fail to mention the value of endoscopic ultrasonography with fine-needle aspiration in the staging of non–small-cell lung cancer. This method can identify lymph ...

          2010-2011

          To the Editor: Neuroblastoma is the most common form of malignant solid tumor during childhood. Japan is the only country in which mass screening for neuroblastoma has been adopted as a national policy, and the program has been conducted since 1984. In ...

          Book Reviews
          2012-2013

          Jonathan Weiner is a talented science writer. He won a Pulitzer Prize for his book on Darwin's finches and a National Book Critics Circle Award for one on the genetics of behavior in drosophila. Here he tells the poignant story of Stephen Heywood, a ...

          2013-2014

          The brief personal introduction that ends with “. . . and I'm an alcoholic” is often parodied in film and print, but it captures the central discovery that Bill Wilson stumbled on as he found the path to freedom from his own addiction to alcohol. It was ...

          2014-2015

          Frederick Holmes, physician and professor emeritus of medicine at the University of Kansas Medical Center, took a sabbatical leave in 1991 to study British history and became enamored with the Stuart family of 17th-century kings and queens (Figure). The ...