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January 15, 2004  Vol. 350 No. 3

Perspective
211-212

A second drug-eluting coronary stent. Another drug for erectile dysfunction. A sixth statin (or seventh, counting cerivastatin). Medical journals seem filled with research articles that induce a sense of déjà vu. Readers wonder, “Have I read this paper ...

213-215

    Fifty years ago, the idea that infectious agents caused lymphoma would have seemed heretical. Although viruses were known to cause tumors in animals, they were not considered a cause of disease in humans — that simply was not what infections did. Rather, ...

    215-217

    It may come as a surprise that a lowly tapeworm is responsible for as many as 10 percent of cases in which a patient presents with seizures to an emergency room in a large urban hospital in New Mexico or California. In fact, cysticercosis, infection with ...

    218-220

    The winter of 2003–2004 will be remembered as a year in which stories about influenza dominated the news and patients young and old clamored for influenza vaccination. This intense interest is the result of the confluence of multiple circumstances. The ...

    Original Articles
    221-231

    Coated-stent technology has emerged as an important advance in the prevention of restenosis after coronary stenting. This clinical trial shows that, as compared with a bare-metal stent, a polymer-based, paclitaxel-coated stent substantially reduces the rate of restenosis after stenting.

    232-238

    Antiplatelet therapy is used as an adjunct in patients undergoing coronary angioplasty and stenting in order to reduce the incidence of ischemic complications and improve the outcome. In this study of elective coronary stenting, patients were pretreated with aspirin and clopidogrel and then randomly assigned to receive the glycoprotein IIb/IIIa inhibitor abciximab or placebo. Abciximab added no benefit to the combination of aspirin and clopidogrel.

    239-248

    Immunoproliferative small intestinal disease is a type of gastrointestinal lymphoma that responds to antibiotics and may be triggered by a bacterial pathogen. The authors identified Campylobacter jejuni in gastrointestinal-tissue samples from a patient with immunoproliferative small intestinal disease. The pathogen was no longer detectable eight days after treatment with antibiotics. Campylobacter was also found in archival tissue samples from four of six additional patients with immunoproliferative small intestinal disease.

    249-258

    Neurocysticercosis is a major cause of seizures worldwide. This double-blind trial of a 10-day course of albendazole included 30 months of follow-up. With the antiparasitic treatment there was some reduction in the number of partial seizures and a significant reduction in the number of seizures with generalization.

    Clinical Practice
    259-265

    A 33-year-old woman presents with a seven-year history of hand washing for two to six hours a day, as well as urges to check doors and stoves extensively before leaving her home. Her life is restricted, and her family members are upset about her behavior. How should she be evaluated and treated?

    Images in Clinical Medicine
    266
    • Free Full Text

    A 15-year-old Peruvian girl who lived in the Andes mountains had a three-month history of headache, nausea, vomiting, and visual obscuration and a one-month history of incoherent speech, confusion, and visual and auditory hallucinations. On examination, ...

    e2
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    An 80-year-old woman with bright red blood from the rectum.

    Case Records of the Massachusetts General Hospital
    267-275

    Presentation of Case

    Dr. H. Daniel Clark (Oral and Maxillofacial Surgery): A 32-year-old man was admitted to the hospital because of a mandibular sarcoma. He had been well until two months before admission, when he had tenderness over the chin and saw a ...

    Editorials
    277-280

    Rupture or injury of an atherosclerotic coronary arterial plaque — as occurs spontaneously in patients with an acute coronary syndrome or as the result of a percutaneous coronary intervention — serves as a nidus for platelet aggregation and thrombus ...

    280-282

    Taenia solium causes two different diseases. When the adult cestode infests the human intestine, taeniasis develops; it is generally asymptomatic, but the host becomes a continuous source of taenia eggs, which are expelled every day in the feces, which ...

    Health Policy Report
    283-292

      This Health Policy Report describes the malpractice system in the United States, examines its shortcomings, and analyzes the forces that have led to past and current malpractice crises. The authors review options for reform of the U.S. malpractice system. Conventional tort reforms include caps on damages, limits on attorneys' fees, and shortening of the statute of limitations. Experts have also proposed major system reforms, such as enterprise liability or administrative compensation.

      Special Report
      293-301

      This Special Report discusses the implications of the 1998 Master Settlement Agreement between the states and the tobacco industry. In the context of current state budget crises, a decreasing proportion of the settlement dollars is being spent on programs to reduce smoking. This report presents an overview of local, state, and federal tobacco-control policies and reviews recent developments focused on taxation, smoking cessation, bans on smoking in public areas, and international trade policies.

      Correspondence
      302-303

      To the Editor: The article by Strom et al. (Oct. 23 issue)1 suffers from the classic shortcomings of retrospective studies of adverse drug reactions and particularly from the use of the term “allergic” to describe a myriad of outcomes grouped together as ...

      304

      To the Editor: The article by Sears et al. (Oct. 9 issue),1 as well as the accompanying editorial by Martinez,2 emphasizes the important contribution of early childhood experiences to the burden of asthma in adults in Dunedin, New Zealand, but fails to ...

      305

      To the Editor: The article by Arbuckle and colleagues (Oct. 16 issue)1 raises three points that need clarification. What percentage of the patients with systemic lupus erythematosus (SLE) had a positive test for antinuclear antibodies at a dilution of 1:...

      305-306

      To the Editor: Skinner et al. (Oct. 2 issue)1 report that the rates of total knee arthroplasty in Manhattan are significantly greater among Hispanic women than among non-Hispanic white women. These data corroborate those we have reported for New York ...

      307-308

      To the Editor: Petitti (Oct. 9 issue)1 offers recommendations regarding the use of estrogen–progestin oral contraceptives. Since third-generation compounds containing desogestrel or gestodene as progestin are associated with a higher risk of venous ...

      308-309

      To the Editor: Circulating ghrelin concentrations have been reported to be suppressed in morbidly obese patients after Roux-en-Y gastric bypass surgery,1 whereas no significant changes have been observed after adjustable gastric banding.2 The placement ...

      310-311

      To the Editor: The type B syndrome of severe insulin resistance is characterized by the presence of autoantibodies to the insulin receptor1 and frequently results in symptomatic hyperglycemia that is resistant to high doses of insulin.2 Available ...

      311-312

      To the Editor: Cysticercosis is a tissue infection with the larval stage (cysticercus) of the tapeworm Taenia solium. Neurocysticercosis is considered to be the most common parasitic disease of the central nervous system and the main cause of late-onset ...

      Book Reviews
      313-314

      In their engaging book, Lee and Tirnady do much more than discuss the effect of the use of DNA analysis on crime investigations. Of course, advances in DNA-based technology have changed the way the police can build a case against a suspect, solve old, ...

      314

      It has been over a decade since the American Medical Association's Council on Scientific Affairs stated that “the medical community — along with the criminal justice system — is the most likely to see women victims [of abuse] and as such constitutes a ...

      315-316

      Wondergenes is an engaging and readable overview of the potential benefits and harmful effects of genetic enhancement and of what might be done to limit the harm. Although the book raises no major new issues, it brings together, in a vivid and ...