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December 6, 2007  Vol. 357 No. 23

Audio Summary of this Issue

Perspective
2321-2324

Dr. Joshua Sharfstein, Marisa North, and Dr. Janet Serwint write that, in October, an FDA advisory committee voted in favor of immediate action against the use of cough and cold medications in children under 6. After the meeting, the major manufacturers ...

2325-2327

Dr. David Ludwig writes that if we don't take steps to reverse the course of the obesity epidemic, the children of each successive generation seem destined to be fatter and sicker than their parents. Ludwig discusses four overlapping phases of the ...

Original Articles
2329-2337
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In this Danish study, body-mass index in childhood was associated with coronary heart disease (CHD) events in adulthood. The association was stronger in boys than in girls, and the risk of an event in adulthood increased in both sexes as the child's age increased from 7 to 13 years. These important data focus attention on the public health significance of the epidemic of childhood obesity.

2338-2347

This longitudinal observational study of people living in various regions of Switzerland relates the rate of loss of lung function to declines in exposure to inhaled particulates less than 10 μm in diameter. Persons living in regions where there were the greatest decreases in particulate exposure had the smallest declines in lung function. Cleaning up particulate pollutants has a health benefit.

2348-2358

Laboratory exposures of persons with asthma to diesel exhaust are associated with physiological and clinical changes that are consistent with diminished disease control. In this trial, which involved persons with mild or moderate asthma, exposure to diesel exhaust during a walk on a London street was associated with physiological changes in lung function as compared with a walk in a nearby park. Exposure to diesel exhaust can result in worsening of asthma.

2359-2370

This study assessed the effects of 26 weeks of therapy with tesamorelin, a growth hormone–releasing factor analogue, versus placebo on visceral adiposity in patients infected with the human immunodeficiency virus (HIV); 86% of the patients were men. Daily tesamorelin treatment decreased the amount of visceral fat and improved the lipid profile. Treatment with tesamorelin is a potential strategy for HIV-infected patients who have treatment-associated accumulation of central fat.

Special Article
2371-2379
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Obesity, which is increasingly common among adolescents, is a risk factor for coronary heart disease (CHD). In this report, modeling the effects of overweight and obesity in adolescents on the risk of future CHD projects a substantial increase in the number of cases in the future.

Clinical Therapeutics
2380-2387

Profound bilateral sensorineural hearing loss is diagnosed in a 4-month-old baby girl, and a cochlear implant is recommended. Unlike hearing aids, which amplify sound, cochlear implants stimulate the cochlear nerve directly. The benefit of this form of therapy depends on the patient's age at implantation, but it also requires participation by the patient and family in therapy for speech and oral language development.

Images in Clinical Medicine
2388
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A 24-year-old man presented with black discoloration and hairy appearance of his tongue, which he had had for 2 days, and a sore throat. He had been taking ciprofloxacin and doxycycline for the past week for an upper respiratory tract infection. He did ...

e25
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This 51-year-old man with non–small-cell lung cancer had aphonia and left vocal cord paresis. After radiation therapy, vocal cord mobility returned, and he could speak normally.

Clinical Problem-Solving
2389-2393

    A 23-year-old black woman presented to the emergency department with diffuse, colicky abdominal pain of 1 hour's duration. The pain was followed by nausea and episodes of bilious vomiting and did not radiate or change with the patient's position. The patient did not report fever, chills, diarrhea, hematochezia, or melena.

    Editorials
    2395-2397

    This issue of the Journal includes two multifaceted studies describing significant associations between exposures to particulate matter in ambient air and indexes of health-related responses.1,2 They are remarkable in their use of carefully selected ...

    2397-2399

    Patients with human immunodeficiency virus (HIV) infection often have a reduced mass of skeletal muscle and bone and a maldistribution of body fat. Loss of muscle mass, strength, and function are integral to the AIDS wasting syndrome and are associated ...

    Clinical Implications of Basic Research
    2400-2402

    A recent study underscores the importance of substance P and its upstream mediator, ΔFosB, in modifying learned helplessness — a model of depression — in mice.

    Correspondence
    2403-2405

    To the Editor: Singh et al. (Sept. 6 issue)1 conclude that dronedarone is significantly more effective than placebo in decreasing the rate of arrhythmic recurrences in atrial fibrillation. They do not comment on the high 1-year incidence of biological ...

    2405-2407

    To the Editor: In his Shattuck Lecture on improving American health, Schroeder (Sept. 20 issue)1 argues that the low U.S. international ranking in health can be attributed primarily to behaviors such as tobacco use and overeating. He suggests that ...

    2407-2408

    To the Editor: Hotez et al. (Sept. 6 issue)1 present an excellent review of current global approaches to neglected tropical diseases. However, vigilant ongoing (post-intervention) surveillance to ensure that these diseases do not rebound should not be ...

    2408-2410

    To the Editor: In the article by Yellon and Hausenloy (Sept. 13 issue)1 on myocardial perfusion injury, I would like to challenge the statement about therapeutic hypothermia, since this method is emerging as a novel way to reduce final myocardial infarct ...

    2410-2411

    To the Editor: In their review of anabolic therapies for osteoporosis, Canalis et al. (Aug. 30 issue)1 mention contraindications to teriparatide use, including skeletal malignant conditions. We wish to add an additional caution concerning the use of this ...

    2411-2412

    A 28-year-old male-to-female transsexual patient, who was taking hormone therapy, presented with severe headache and visual disturbances. MRI revealed a giant olfactory-groove meningioma.

    Book Reviews
    2413-2414

    Kids grow up too fast these days — many parents, grandparents, and educators have voiced this sentiment, but is it true? When Puberty Is Precocious cogently presents both facts and speculations about whether children today are entering puberty earlier ...

    2414-2415

    The first edition of Goodwin and Jamison's book on manic depressive illness, published in 1990, became a classic, and clinicians, researchers, and patients alike frequently referred to it as the bible of bipolar disorders. Producing the much-anticipated ...

    2415-2416

    Damage to only part of the brain has the potential to result in complex impairments that can disrupt life in innumerable ways. Neuroplasticity — the brain's capacity to repair itself — makes possible considerable recovery after a neurologic insult. The ...

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