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

June 3, 2004  Vol. 350 No. 23

Perspective
2327-2329

Dr. Robert Steinbrook analyzes the FDA's rejection of the application for nonprescription sales of Plan B.

2329-2332

    Dr. Bruce Levy and Dr. James O'Connell describe the challenges and hidden rewards that clinicians encounter when they provide health care to homeless people.

    2332-2334

    In terms of sheer drama, the emergence of the severe acute respiratory syndrome (SARS) rivaled the most exotic Michael Crichton thriller. A novel viral strain spread in “wet markets” from an obscure animal to food handlers; through a rural province in ...

    Original Articles
    2335-2342

    Combination chemotherapy plus bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor (VEGF), was superior to combination chemotherapy alone in the treatment of metastatic colorectal cancer.

    2343-2351

    In this large, multicenter trial of the adjuvant (postoperative) treatment of stage II and stage III colon cancer, a combination of oxaliplatin, fluorouracil, and leucovorin was superior to fluorouracil and leucovorin.

    2352-2361

    In 2003, the largest outbreak of the severe acute respiratory syndrome (SARS) outside Asia occurred in Toronto. This report summarizes data from a comprehensive investigation by Toronto Public Health of 2132 persons who were potentially infected and 23,103 contacts requiring quarantine. The 225 confirmed cases of SARS in this outbreak were limited primarily to hospitals and related households.

    2362-2374

    The prevalence and magnitude of childhood obesity are increasing dramatically. These investigators examined the effect of the degree of obesity on the prevalence of the metabolic syndrome and the relation of the syndrome to insulin resistance and C-reactive protein and adiponectin levels in a large multiracial, multiethnic cohort of children and adolescents.

    Clinical Practice
    2375-2382

      A 63-year-old man underwent complete resection of a T3N0M0, stage II adenocarcinoma of the ascending colon. No adjuvant therapy is planned. There is no family history of colorectal cancer. How should he be followed?

      Review Article
      2383-2397

      For many years, hereditary hemochromatosis was regarded as a clinically and genetically unique entity marked by a classic presentation consisting of diabetes, bronze skin pigmentation, and cirrhosis. In 1996, identification of “the hemochromatosis gene,” HFE, was reported; since then, several other iron-metabolism genes have also been identified. This article reviews the current understanding and management of hereditary iron-overload disorders.

      Images in Clinical Medicine
      2398
      • Free Full Text

      A 34-year-old woman with a nine-month history of postprandial dyspnea and substernal fullness had severe pain in her epigastrium, without emesis, shortly after the ingestion of an evening meal. On examination, she had audible bowel sounds, mild epigastric ...

      e21
      • Free Full Text

      In an 88-year-old woman, a painless, nonpulsating mass was palpable in the suprapubic region.

      Clinical Problem-Solving
      2399-2404

        A 74-year-old man was brought to the emergency department after being found confused and incapacitated at home. The patient lived in a residential hotel and had previously been healthy and socially active. Having not seen him for three days, his friends entered his room and found him on the floor, covered in stool. The patient was conversant but confused.

        Editorial
        2406-2408

        Until recently, fluorouracil was the only effective systemic treatment for colorectal cancer. It acts primarily by inhibiting thymidylate synthase, a key enzyme in DNA synthesis, and because leucovorin (folinic acid) enhances this effect, fluorouracil and ...

        Sounding Board
        2409-2412

          This Sounding Board article describes the debate over public “report cards” on doctors and hospitals. Providers argue that ratings according to quality are often based on inaccurate and misleading data. Payers argue that any information, even if imperfect, about the performance of physicians and hospitals is helpful to patients. The authors believe that providers and payers should work together to develop better systems for measuring and reporting the quality of care.

          Correspondence
          2413-2414

          To the Editor: In response to the editorial by Drazen and colleagues (April 8 issue)1: It is a terrible message that the findings of scientists can be subject to the pressure of politicians, especially when the goal is the same — to prevent undesired ...

          2414-2416

          To the Editor: Bhargava et al. (Feb. 26 issue)1 report that in their study in India, low birth size (expressed as the ponderal index) was associated with early adiposity rebound and impaired glucose tolerance. We have described type 2 diabetes in Asian ...

          2416-2417

          To the Editor: Mueller et al. (Feb. 12 issue)1 conclude that rapid measurement of B-type natriuretic peptide in the emergency department improved the evaluation and treatment of patients with acute dyspnea. The authors state that echocardiography was “...

          2417-2419

          To the Editor: Chlebowski and colleagues (March 4 issue)1 claim that “short-term use” of progestin and estrogen reduces the risk of invasive colorectal cancer. For a valid conclusion regarding prevention, we need to know how many of the 115 women with ...

          2419-2421

          To the Editor: Petersen et al. (Feb. 12 issue)1 provide further evidence that insulin resistance is associated with a reduction in mitochondrial function in muscle2 and an increase in lipid content.3 They propose that mitochondrial dysfunction causes ...

          2422-2423
          • Free Full Text

          To the Editor: Although generally comprehensive, Teichman's review of acute renal colic due to ureteral calculus (Feb. 12 issue)1 failed to mention the calcium-channel blocker nifedipine in the medical treatment of patients with ureteral colic. Three ...

          2423

          To the Editor: The original purpose of the data safety and monitoring board, as reported by Slutsky and Lavery (March 11 issue),1 was to protect subjects from the poor judgment of investigators who may have been so committed to advancing science for the ...

          2424-2425

          To the Editor: Ischemic mitral regurgitation is defined as mitral insufficiency that occurs as a result of coronary artery disease in the absence of intrinsic structural abnormalities of the mitral valve. Ischemic mitral regurgitation develops in ...

          Book Reviews
          2426-2427

          John Kastor's first book traced the history and fate of recent hospital mergers in Boston, New York City, and San Francisco. This book tells of crises in the academic medical centers of Johns Hopkins and the University of Pennsylvania in the 1990s. The ...

          2427

          Throughout history, pregnant women have been advised and admonished. The 18th-century handbook Rules and Cautions for the Conduct of Pregnant Women counseled pregnant women to avoid “agitation of the body from violent or improper exercise, as jolting in a ...

          2428

          What started off as a project under the auspices of the Tri-State Chapter of the American Academy of Psychiatry and the Law, in the mid-1970s, has blossomed into Principles and Practice of Forensic Psychiatry. Now in its second edition, and still under ...