Join the 200th Anniversary Celebration
Advanced Search

Issue IndexA searchable index of tables of contents

Find An Issue

By Volume and Issue
By Date
Current Issue
Recent Issues

Table of contents for

August 31, 2006  Vol. 355 No. 9

Audio Summary of this Issue

Perspective
861-864
Primary Care — Will It Survive?
T. Bodenheimer
  • Free Full Text

Dr. Thomas Bodenheimer writes that primary care is facing a confluence of factors that could spell disaster. Patients are increasingly dissatisfied, many primary care physicians are unhappy, and fewer and fewer U.S. medical students are choosing to enter ...

864-866
Becoming a Physician: Primary Care — The Best Job in Medicine?
B. Woo
  • Free Full Text
  • Audio

Changes in our health care system have made primary care medicine less satisfying for practitioners and less attractive to students and residents. But, Dr. Beverly Woo writes, with all the changes in our health care system, one thing remains constant: the ...

866-869
Focus on Research: Marburg Hemorrhagic Fever — The Forgotten Cousin Strikes
H. Feldmann

    The long forgotten pathogen has struck twice in the recent past, leaving no doubt about its survival in nature or its pathogenic potential. Dr. Heinz Feldmann explains that the fear of bioterrorism has greatly changed societal attitudes toward dangerous ...

    869-871
    Control of Japanese Encephalitis — Within Our Grasp?
    T. Solomon

      The second half of 2005 saw one of the largest outbreaks of Japanese encephalitis in northern India in recent years. Dr. Tom Solomon writes that the best hope for controlling Japanese encephalitis lies in vaccination.

      Original Articles
      873-884
      Celecoxib for the Prevention of Sporadic Colorectal Adenomas
      M.M. Bertagnolli and Others
      • Free Full Text

      In this placebo-controlled trial of patients who had had colonic adenomas removed before study entry, celecoxib reduced the risk of recurrence of adenomas after three years of treatment (risk ratio, 0.67 for 200 mg of celecoxib twice daily and 0.55 for 400 mg of celecoxib twice daily) and increased the risk of serious cardiovascular events (risk ratio, 2.6 and 3.4, respectively).

      885-895
      Celecoxib for the Prevention of Colorectal Adenomatous Polyps
      N. Arber and Others
      • Free Full Text

      Subjects who had a history of colonic adenomas were randomly assigned to three years of treatment with 400 mg of celecoxib or placebo once daily. Celecoxib significantly reduced the risk of adenomas (cumulative rate, 34 percent in the celecoxib group and 49 percent in the placebo group) and advanced adenomas (cumulative rate, 5 percent and 10 percent, respectively).

      896-908
      A Randomized Trial of Deep-Brain Stimulation for Parkinson's Disease
      G. Deuschl and Others
      • Free Full Text

      In this randomized trial comparing neurostimulation of the subthalamic nucleus with medical management alone in 156 patients with severe Parkinson's disease, neurostimulation improved the quality of life and motor symptoms. Severe adverse events included a fatal intracerebral hemorrhage resulting from surgical placement of the neurostimulator.

      909-919
      Marburg Hemorrhagic Fever Associated with Multiple Genetic Lineages of Virus
      D.G. Bausch and Others
      • Free Full Text

      An outbreak of 154 cases of Marburg hemorrhagic fever in the Democratic Republic of the Congo between 1998 and 2000 had a case fatality rate of 83 percent. Multiple insertions of the virus into the population were identified and were associated with independent chains of human transmission.

      Special Article
      920-927
      The Value of Medical Spending in the United States, 1960–2000
      D.M. Cutler, A.B. Rosen, and S. Vijan
      • Free Full Text

      This study compared the increases in spending on medical care and the gains in life expectancy from 1960 through 2000. The authors estimate that increased spending on health care resulted in a cost of about $20,000 per year of life gained and conclude that the additional spending has been worthwhile.

      Review Article
      928-939
      Medical Progress: Cerebral Aneurysms
      J.L. Brisman, J.K. Song, and D.W. Newell

        Saccular intracranial aneurysms cause substantial morbidity and mortality. Recently, major changes have occurred in the way we think about and treat this disease. This review discusses the percutaneous endovascular treatment of intracranial aneurysms as compared with surgical intervention. The technological advances and supporting research contributing to this important change in practice patterns are reviewed.

        Images in Clinical Medicine
        940
        Anthrax of the Cecum
        A. Ghossain
        • Free Full Text

        A 25-year-old man was admitted for pain and distention of the abdomen. He had a three-day history of dizziness, fatigue, myalgia, and mild fever. On physical examination, he was in shock, with ascites and oculofacial congestion. Bowel sounds were absent. ...

        e8
        Anomalous Origin of the Right Coronary Artery
        S. Wann and G. Schuchard
        • Free Full Text

        In this 49-year-old man, exercise testing was suggestive of inferior-wall myocardial ischemia. CT coronary angiography with contrast showed anomalous origin of the right coronary artery from the left coronary cusp.

        Case Records of the Massachusetts General Hospital
        941-948
        Case 27-2006 — A 17-Year-Old Boy with Fever and Lesions in the Liver and Spleen
        S.I. Pelton, J.Y. Kim, and R.L. Kradin

          A 17-year-old boy began to have daily fevers two weeks after moving to the Dominican Republic, which persisted for two months despite antibiotic therapy. Imaging studies disclosed nodules in the liver and spleen. Routine cultures were negative. A diagnostic procedure was performed.

          Editorial
          950-952
          Risks and Benefits of Celecoxib to Prevent Recurrent Adenomas
          B.M. Psaty and J.D. Potter

            In late September 2004, the cardiovascular risks identified in a placebo-controlled adenoma-prevention trial that was terminated early precipitated the voluntary withdrawal from the market of the cyclooxygenase-2 (COX-2) inhibitor rofecoxib.1 Later that ...

            Clinical Implications of Basic Research
            953-954
            RNA Interference as Potential Therapy — Not So Fast
            P.A. Marsden

              RNA interference has been successfully used to treat several animal models of human disease, giving hope that this approach may have therapeutic potential. A new study shows, however, that the approach interferes with an innate mechanism of gene silencing and that it is associated with toxic effects and death.

              Correspondence
              955-956
              Computed Tomography for Pulmonary Embolism
              • Free Full Text

              To the Editor: In an important recent study, the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) trial, Stein et al. (June 1 issue)1 found that multidetector computed tomographic angiography (CTA) had excellent specificity and ...

              956-958
              Catheters and the Treatment of Acute Lung Injury
              • Free Full Text

              To the Editor: The National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network reports an increased incidence of arrhythmias among patients who received a pulmonary-artery catheter (PAC), as compared with ...

              958-960
              Caffeine for Apnea of Prematurity
              • Free Full Text

              To the Editor: Schmidt et al. (May 18 issue)1 appear to misconstrue the effect of caffeine on growth. Figure 2 of the article identifies a difference in growth appearing at one week of age and reflecting a greater weight loss in babies treated with ...

              960
              Microarray Analysis and Tumor Classification
              • Free Full Text

              To the Editor: Quackenbush (June 8 issue)1 provides a comprehensive review of microarray technology within the framework of clinical application and also addresses some limitations of molecular analyses. A consideration not mentioned in the review is ...

              961
              Acute Pancreatitis
              • Free Full Text

              To the Editor: In his article on acute pancreatitis, Whitcomb (May 18 issue)1 does not mention the debate about the use of protease inhibitors, such as gabexate, as prophylaxis for pancreatitis induced by endoscopic retrograde cholangiopancreatography (...

              962-963
              Discovery of Monkeypox in Sudan
              • Free Full Text

              To the Editor: On November 4, 2005, the Poxvirus Program at the Centers for Disease Control and Prevention (CDC), a World Health Organization (WHO) Collaborating Center for Smallpox and other Poxvirus Infections, was contacted by a former volunteer with ...

              Book Reviews
              964-965
              Agricultural Medicine: A Practical Guide
              • Free Full Text

              In the early 18th century, Bernardino Ramazzini, an Italian physician now recognized as the father of occupational medicine, wrote that farmers “have to wrestle with unending toil and the direst poverty on another man's estate” and that the causes of ...

              965-966
              Handbook of Complex Occupational Disability Claims: Early Risk Identification, Intervention, and Prevention
              • Free Full Text

              It should come as no surprise that some of the most poorly understood medical conditions are also the most difficult to treat successfully. The causes of low back pain, whiplash, chronic headache, post-traumatic stress disorder, mild closed head injury, ...

              966-967
              Pain in Older Persons
              • Free Full Text

              Although few would now agree with the notion that children, medically speaking, are little more than small adults, the proposition that older adults are just older is still accepted. That this thinking continues to dominate clinical practice is supported ...

              Corrections
              967
              Spectrum of Disease and Relation to Place of Exposure among Ill Returned Travelers
              • Free Full Text

              Spectrum of Disease and Relation to Place of Exposure among Ill Returned Travelers Original Article, N Engl J Med 2006:354;119-130.. In Table 3 on page 127, the value for Sub-Saharan Africa for the “Swimmer's itch” row should have been <1 per 1000, not ...

              967
              Ascites and Renal Dysfunction in Liver Disease: Pathogenesis, Diagnosis, and Treatment
              • Free Full Text

              Ascites and Renal Dysfunction in Liver Disease: Pathogenesis, Diagnosis, and Treatment Book Review, N Engl J Med 2006:354;2733-2734.. On page 2733 of the book review by Bass, the figure legend should have read, “Photomicrograph of a Human Liver,” not “...

              967
              Taking Heart — Cardiac Transplantation Past, Present, and Future
              • Free Full Text

              Taking Heart — Cardiac Transplantation Past, Present, and Future Perspective, N Engl J Med 2006:355;231-235.. In the figure shown on page 233, the labels for the arteries at the top of Panels A and B should read from left to right “Brachiocephalic trunk,” ...

              My Account
              My Alerts
              My Saved Items
              My CME Exams
              Article Category
              Research
              Reviews
              Clinical Cases
              Perspective
              Commentary
              Other
              Browse all articles
              Multimedia
              Videos in Clinical Medicine
              Images in Clinical Medicine
              Interactive Medical Cases
              Weekly Audio Summaries
              Browse all multimedia
              This Week
              Last Week
              Browse full index
              Selected Specialties
              Cardiology
              Endocrinology
              Gastroenterology
              Genetics
              Hematology/Oncology
              Infectious Disease
              Nephrology
              Neurology/Neurosurgery
              Obstetrics/Gynecology
              Pediatrics
              Primary Care/Hospitalist
              Pulmonary/Critical Care
              Surgery
              Browse all Specialties & Topics
              Featured Topics
              Clinical Practice Center
              Health Policy and Reform
              Author Center
              Submit a Manuscript or Letter
              Track a Manuscript
              Help