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May 11, 2006  Vol. 354 No. 19

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Perspective
1977-1981
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Dr. Susan Okie writes that Brazil's persistent and aggressive efforts to prevent new HIV infections have played a major role in slowing the spread of the virus and containing the country's epidemic.

1982-1983

Dr. John Hoey, former editor-in-chief of the CMAJ writes that there is a desperate need in medicine for open, plain-spoken discourse. Without it, the current erosion of public trust in science and medicine will continue and will ultimately translate into ...

Original Articles
1985-1997

Children whose parents have asthma and who begin to wheeze are at high risk for asthma. In this NIH-sponsored study, children who were two or three years old at enrollment were given either placebo or an inhaled corticosteroid for two years. Although they had better asthma control while using the corticosteroid, asthma control was not improved after the treatment was discontinued.

1998-2005
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Children at high risk for asthma were assigned to inhaled budesonide or placebo for two weeks after the first and subsequent episodes of wheezing illness after one month of age. At three years, there were no differences between groups in measures of asthma or lung function.

2006-2013

Hypophosphatemia, with associated changes in bone and mineral metabolism, developed in some patients with chronic myelogenous leukemia or gastrointestinal stromal tumors who were receiving imatinib, which inhibits several tyrosine kinases associated with these two diseases. The drug may thus inhibit bone remodeling in some patients.

2014-2023

The third component of complement, C3, exists as two main allotypes, F (fast) and S (slow), which affect the incidence of inflammatory disease. This study examined the association between the C3 allotypes of renal donors and recipients and graft function after transplantation and suggests that donor C3F and C3S alleles may confer functional differences.

Special Article
2024-2033

Frivolous lawsuits have been cited as a major contributor to the high costs of the malpractice system in the United States. In this national study of 1452 closed claims, physician reviewers found no evidence of medical errors in 37 percent. Most claims, however, did not result in payment to the plaintiffs. Claims not associated with errors accounted for only 13 to 16 percent of the total costs.

Review Article
2034-2045

This review surveys the mechanisms and clinical applications of three hematopoietic growth factors: erythropoietin, granulocyte colony-stimulating factor, and thrombopoietin.

Videos in Clinical Medicine
e19

    Arthrocentesis is used to establish the cause of an acute monoarthritis or polyarthritis. It is also used to drain large effusions or hemarthroses and to instill steroids or local anesthetic. This procedure video demonstrates how to perform arthrocentesis.

    Images in Clinical Medicine
    2046

    A 50-year-old smoker presented with acute-onset breathlessness and right-sided chest pain of four days' duration. There was no history of chest trauma. A posteroanterior chest radiograph (Panel A) demonstrated a right-sided pneumothorax. His symptoms ...

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    This 72-year-old man had been using crutches for more than 50 years. A painless shoulder mass had become progressively larger.

    Case Records of the Massachusetts General Hospital
    2047-2056

    A young woman was seen because of anemia and evidence of increased iron stores. She was of Italian descent. Her father, a paternal aunt, and one sister had Diamond–Blackfan anemia, and her mother had been told she had β-thalassemia trait.

    Editorials
    2058-2060

    In the Childhood Asthma Management Program study of school-aged children with established mild-to-moderate persistent asthma, twice-daily therapy with inhaled corticosteroids controlled symptoms of asthma but slightly reduced height growth and did not ...

    2060-2062

    The characteristics of renal allografts before transplantation present a multifaceted puzzle that in large part predetermines the outcome of kidney transplantation. Compatibility at the major-histocompatibility-complex (MHC) loci, the age of the donor, ...

    Sounding Board
    2063-2066

    Many experts believe that the threat of malpractice suits impedes the use of error-reporting systems to make hospitals safer. Annas argues that more lawsuits, not fewer, are needed. He believes that the courts should recognize a right to safety so that hospitals that fail to implement measures to improve safety could be sued when patients are injured owing to preventable errors.

    Clinical Implications of Basic Research
    2067-2068

    A study implicates a transcription factor as a key mediator of aortic aneurysm in two mouse models.

    Correspondence
    2069-2071

    To the Editor: According to the conclusions of Van den Berghe and colleagues (Feb. 2 issue),1 the mortality among patients staying three days or longer in a medical intensive care unit (ICU) was significantly decreased with the use intensive insulin ...

    2071-2074

    To the Editor: We have used an approach similar to that of Remuzzi et al. (Jan. 26 issue)1 in the assessment of kidneys from donors older than 60 years of age and the implantation of organs with minimal renal changes as assessed on biopsy before ...

    2074-2075

    To the Editor: In our opinion, the randomized clinical trial by Berry et al. (Feb. 16 issue)1 appears to mitigate the excitement that has been generated in recent years concerning the use of tumor necrosis factor α (TNF-α) inhibitors in the management of ...

    2075-2076

    To the Editor: In the article by Lees et al. (Feb. 9 issue)1 about the Stroke–Acute Ischemic NXY Treatment (SAINT I) trial, the abstract suggests significant reduction of hemorrhagic transformation after receipt of NXY-059, as determined by a post hoc ...

    2076-2078

    To the Editor: I am troubled by the universal enthusiasm displayed by interventional cardiologists for coronary-artery stenting — stent mania. As mentioned by Serruys et al. in their excellent review (Feb. 2 issue),1 “stenting [with bare metal stents] ...

    2078-2079

    To the Editor: In the Case Records, Walton at al. (Feb. 16 issue)1 elegantly discuss retinoblastoma, but their definition of leukokoria is inaccurate. Leukokoria is taken directly from the Greek and means simply “white pupil.” When the normal pupil is ...

    2079-2080

    To the Editor: Lenalidomide (Revlimid) is an analogue of thalidomide that has clinical activity in a variety of hematologic conditions.1 It has recently been approved by the Food and Drug Administration for certain myelodysplastic syndromes associated ...

    Book Reviews
    2081-2082

    Benjamin Franklin, the 10th of 12 children born to a candle and soap maker, left school at the age of 10 to work in the family business. At 17, he left his Boston home and moved to the bustling and prosperous city of Philadelphia, arriving with only a few ...

    2082-2083

    British pharmacy is the subject of this book, despite the comprehensive title. Although trends in the United States are occasionally held up for comparison, readers interested in American pharmacy should go elsewhere for that history.

    Still, there is much ...

    2083-2084

    This unusual book was written by a professor of business law at George Washington University Law School. Most other books on human longevity written for a general audience are focused almost exclusively on scientific ideas and breakthroughs in life-...

    2084-2085
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    Imagine falling mysteriously ill in a foreign country, in which the language, culture, and customs have no bearing on your own. Imagine trying to find medical help and evaluating your potential healers without understanding the territory, while the shadow ...

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