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June 2, 2005 Vol. 352 No. 22
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Herpes zoster and postherpetic neuralgia occur more often with increasing age. In this controlled trial among 38,546 adults 60 years of age or older, vaccination with a live attenuated varicella–zoster vaccine reduced the incidence of postherpetic neuralgia by 66.5 percent (as compared with placebo) and the incidence of herpes zoster by 51.3 percent.
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The gene encoding vitamin K epoxide reductase complex 1 (VKORC1) is the target of warfarin, and a variant of the gene may be associated with variations in dose requirements. This study reveals a strong association between VKORC1 haplotype and the warfarin dose among European Americans. It also suggests that VKORC1 variants may explain the variations in dose requirements among persons of different ancestries.
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This randomized trial included almost 1500 women with breast cancer and positive axillary nodes and compared treatment with doxorubicin and cyclophosphamide combined with either fluorouracil or docetaxel. The rates of disease-free and overall survival were significantly higher among women in the docetaxel group.
A 10-year-old girl with atopic dermatitis reports itching that has recently become relentless, resulting in sleep loss. Her mother has been reluctant to treat the girl with topical corticosteroids because she was told that they damage the skin, but she is exhausted and wants relief for her child. How should the problem be managed?
Brucellosis has been present for millennia and has managed to elude eradication, even in most developed countries. Brucellosis causes much clinical morbidity as well as an important loss of agricultural productivity in the developing world. In this era of international tourism, brucellosis has become a common imported disease in the developed world. This review article discusses the pathogenesis and treatment of the disease.
A 20-year-old man who had immigrated to the United States from Mexico three months earlier presented to the emergency department reporting weight loss and pain in his hip and the right side of his lower back. He had noted decreased appetite for several weeks and had unintentionally lost 16 kg.
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