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October 14, 2010  Vol. 363 No. 16

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Perspective
1489-1491
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There have been ongoing concerns about the safety of the diabetes drugs containing rosiglitazone (Avandia, Avandaryl, and Avandamet) — a thiazolidinedione antidiabetic agent indicated as an adjunct to diet and exercise to improve glycemic control in ...

1492-1494
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Approaching the end of her first year as commissioner of the Food and Drug Administration (FDA), Dr. Margaret Hamburg remarked that, despite past experience with government bureaucracies, she is struck by how hard it is to make her agency act quickly. “...

1495-1497
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The Patient-Centered Outcomes Research Institute . . . shall not develop or employ a dollars per quality adjusted life year (or similar measure that discounts the value of a life because of an individual's disability) as a threshold to establish what type ...

Original Articles
1499-1509

A challenge associated with single-dose nevirapine to prevent mother-to-child transmission of HIV is the emergence of nevirapine-resistant HIV. In this study, women previously exposed to single-dose nevirapine received tenofovir–emtricitabine plus either nevirapine or ritonavir-boosted lopinavir.

1510-1520

In this randomized trial in children who had perinatal HIV infection despite peripartum single-dose nevirapine use and who required antiretroviral therapy between 6 and 36 months of age, a regimen based on ritonavir-boosted lopinavir was superior to a nevirapine-based regimen.

1521-1531

Modeling studies show that increased expression of nerve growth factor is associated with increased pain. This study tested the safety and efficacy of the monoclonal antibody tanezumab — which targets nerve growth factor — for the treatment of knee pain in patients with osteoarthritis.

1532-1543

In this study of ovarian clear-cell or endometrioid tumors, nearly half the samples had mutations in the ARID1A gene, which encodes a component of the SWI–SNF chromatin remodeling complex. Alterations in gene expression associated with abnormal chromatin remodeling may be linked with cancer.

Clinical Practice
1544-1550
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This article reviews the management of nausea and vomiting in pregnancy, with attention to pharmacologic and alternative management strategies and nutritional support.

Review Article
1551-1558

Genomic analyses indicate that although humans have a common origin and most genetic variation is shared, there are some differences among groups of humans. Those differences may be harnessed to clinical effect.

Images in Clinical Medicine
1559
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A 16-year-old boy with no medical or surgical history was hospitalized for evaluation of a congenital deformity of the anterior chest wall. The physical examination revealed substantial anterior sternal depression. The results of routine laboratory tests ...

e25

A 72-year-old man presented with a sudden onset of slurred speech. His medical history was unremarkable, and he was taking no medications and did not smoke. The physical examination revealed left-sided facial paralysis and dysarthrophonia. Diffusion-...

Interactive Medical Case
e26
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A 60-year-old man presented with fatigue, increasing frequency of urination, and increasing thirst. He reported no dysuria, urgency, incomplete bladder emptying, straining to initiate urination, fevers, chills, arthralgias, or rash. What diagnostic and management steps do you choose?

Case Records of the Massachusetts General Hospital
1560-1568

A 29-year-old woman was admitted to the hospital because of swelling, erythema, and pain of the hand at the site of a cat bite. Despite treatment with amoxicillin–clavulanic acid, her symptoms worsened and fever, chills, headache, and arthralgias developed.

Editorials
1570-1572

Approximately half of the 33.4 million persons living with the human immunodeficiency virus (HIV) worldwide are women of reproductive age, and among the 2.1 million HIV-infected children, virtually all were infected during pregnancy, delivery, or breast-...

1572-1573

Osteoarthritis, a common, painful condition, occurs at a rate of 1% per year and affects the majority of people who are over 55 years of age. In a proof-of-concept, phase 2 study in this issue of the Journal, Lane and colleagues1 report that blocking the ...

1574-1575

The association of endometriosis and ovarian cancer was first reported by Sampson in 1925.1 Transitional areas of endometriosis, ranging from benign to atypical, adjacent to ovarian cancer have been well documented.2 The risk of ovarian cancer among women ...

Correspondence
1576

To the Editor: Ang et al. (July 1 issue)1 developed a risk model for death from oropharyngeal squamous-cell carcinoma on the basis of human papillomavirus (HPV) status, pack-years of tobacco smoking, tumor stage, and nodal stage. Their results showed ...

1577-1578

To the Editor: Bardy et al. (July 1 issue)1 summarize the results of four pilot studies showing the feasibility of an entirely subcutaneous implantable cardioverter–defibrillator (ICD). The avoidance of the need for vascular access and its related ...

1578-1580

To the Editor: As reported by Maemondo et al. (June 24 issue),1 among patients receiving gefitinib for non–small-cell lung cancer with sensitive mutations of the epidermal growth factor receptor (EGFR), many clinicians pay particular attention to ...

1580-1583

To the Editor: Sacks and Campos (June 3 issue)1 review dietary therapy in hypertension and recommend the Dietary Approaches to Stop Hypertension (DASH) diet with low sodium intake (1.5 g per day) for all patients with hypertension. However, two ...

1583-1585

To the Editor: “Poppers” (slang for various forms of alkyl nitrite) are volatile nitric oxide donors that have been used for decades as recreational drugs. Both the popularity of and legal tolerance for poppers have led to the perception that these drugs ...

Corrections
1585

Dose Comparisons of Clopidogrel and Aspirin in Acute Coronary Syndromes Original Article, N Engl J Med 2010;363:930-942. In Figure 1B (page 935), the y axis of the inset graph should have read, “0.00, 0.01, 0.02, 0.03, 0.04, 0.05,” rather than “0.0, 0.1, ...

1585

Case 14-2010: A 54-Year-Old Woman with Dizziness and Falls Case Records of the Massachusetts General Hospital, N Engl J Med 2010;362:1815-1823. In the last sentence of the Cerebral Perfusion and Orthostatic Intolerance subsection of Differential Diagnosis ...

1585

Clostridium difficile — More Difficult Than Ever Review Article, N Engl J Med 2008;359:1932-1940. In reference 25 (page 1939), the second author's name should have been listed as “Gerson M,” rather than “Gerdsom M.” The article has been corrected at ...

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