Issue IndexA searchable index of tables of contents
Find An Issue
Table of contents for
November 4, 2004 Vol. 351 No. 19
In a multicenter, double-blind, placebo-controlled, randomized study, subjects with type 2 diabetes mellitus and hypertension but normal urinary albumin levels were treated with an angiotensin-converting–enzyme (ACE) inhibitor (trandolapril) and a non-dihydropyridine calcium-channel blocker (verapamil) alone or in combination to investigate whether treatment could forestall the development of microalbuminuria, which heralds diabetic nephropathy. The use of trandolapril alone or with verapamil appeared to be effective, whereas verapamil alone was no better than placebo.
- Free Full Text
Both angiotensin II–receptor blockers and angiotensin-converting–enzyme (ACE) inhibitors are renoprotective, but direct, long-term comparisons of their use in patients with diabetes have not been conducted. This prospective, multicenter, double-blind comparison of telmisartan (an angiotensin II–receptor blocker) and enalapril (an ACE inhibitor) in 250 subjects with type 2 diabetes and early nephropathy found that the two agents were associated with similar decrements in the glomerular filtration rate.
- Free Full Text
An association between parkinsonism and type 1 Gaucher's disease has been described. The present study examined the relevance of mutations in the glucocerebrosidase gene (GBA), which cause Gaucher's disease, to idiopathic Parkinson's disease. A clinic-based series of 99 Ashkenazi patients with idiopathic Parkinson's disease were screened for six GBA mutations. Thirty-one patients (31.3 percent) carried one or two mutant GBA alleles.
A 29-year-old man reports that he has been stung by a bee or wasp outside his door, where he had previously noted a nest. Skin itching, diffuse hives, swelling of his arms and legs, tightness in his throat, dizziness, and difficulty talking developed immediately, and he was taken to a local clinic where he received epinephrine and antihistamines. He was observed for two hours, and all symptoms resolved. How should his case be managed subsequently?
More than 95 percent of infants who have neonatal stroke survive to adulthood, and many have residual motor or cognitive disabilities. This article makes the point that recognition of at-risk newborns by means of advanced methods of neuroimaging, combined with a plan for rational intervention, may result in the prevention or the reduction in the incidence of lifelong disabilities such as cerebral palsy, epilepsy, and behavioral and learning disorders.
A 42-year-old white man presented with a history of eight months of pain in his low back, hips, ankles, and feet. He had begun experiencing progressively severe pain during a 16-month period of incarceration, to the extent that he was having difficulty walking. He had also lost weight (from 76.2 to 67.6 kg) without a change in diet.
Several reports have detailed cases in which pharmacists have refused to fill prescriptions for emergency contraception. Should pharmacists have the right to refuse access to these medications? This Sounding Board article discusses arguments for and against the right to refuse and proposes a balanced solution to the problem.
- Free Full Text
- Free Full Text
- Free Full Text
- Free Full Text
- Free Full Text
- Free Full Text
- Free Full Text
- Free Full Text
- Free Full Text
