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Table of contents for

November 25, 2010  Vol. 363 No. 22

Audio Summary of this Issue

Perspective
2081-2084
Responding to an FDA Warning — Geographic Variation in the Use of Rosiglitazone
N.D. Shah and Others
  • Free Full Text

After the diabetes drug rosiglitazone was linked to an increased risk of MI, the FDA issued a boxed warning for the drug. The warning led to decreases in the rate of rosiglitazone use, but some use persisted, and the level of use varied by location.

2085-2087
Medicaid Expansion — The Soft Underbelly of Health Care Reform?
B.D. Sommers and A.M. Epstein
  • Free Full Text

The Affordable Care Act will expand Medicaid to cover all adults with family incomes below 133% of the federal poverty level. But insurance eligibility doesn't always translate into enrollment, and heterogeneity among state Medicaid programs makes the outcome uncertain.

2087-2089
Pharmaceutical Marketing and the New Social Media
J.A. Greene and A.S. Kesselheim
  • Free Full Text

Facebook and Twitter, the largest social media Web sites, have more than 350 million users worldwide, and surveys indicate that 60% of Americans turn first to the Internet when seeking health-related information.1 It is therefore surprising that the ...

Original Articles
2091-2101
Reduced Mortality after Allogeneic Hematopoietic-Cell Transplantation
T.A. Gooley and Others
  • Free Full Text
  • CME

This comparison of outcomes of allogeneic hematopoietic stem-cell transplantation in 1993–1997 and 2003–2007 shows that although patients had a somewhat poorer overall prognosis in the more recent period, the rate of death not preceded by relapse, the risk of relapse, and overall mortality decreased.

2102-2113
Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance
T.M. Larsen and Others
  • Free Full Text
  • CME

Overweight adults who had lost weight on a low-calorie diet were randomly assigned to a maintenance diet and followed for 26 weeks. Diets with a higher protein content, a lower glycemic index, or both appeared to improve the diet-completion rate and weight-loss maintenance.

2114-2123
Use of Proton-Pump Inhibitors in Early Pregnancy and the Risk of Birth Defects
B. Pasternak and A. Hviid
  • Free Full Text

In this nationwide cohort study conducted in Denmark, there was no significant increase in the risk of birth defects associated with exposure to proton-pump inhibitors in the first trimester of pregnancy.

Special Article
2124-2134
Temporal Trends in Rates of Patient Harm Resulting from Medical Care
C.P. Landrigan and Others
  • Free Full Text

In this retrospective study of 10 hospitals, harms to patients resulting from medical care were common (25 per 100 admissions) and did not decline significantly between 2002 and 2007.

Clinical Practice
2135-2144
Retinal-Vein Occlusion
T.Y. Wong and I.U. Scott
  • CME
  • Full Text Audio

This article reviews the typical presentations of branch and central retinal-vein occlusion and the strategies for their management, with particular attention to the roles of laser therapy, ophthalmic glucocorticoids, and anti-VEGF therapies.

Images in Clinical Medicine
2145
Neonatal Pneumomediastinum and the Spinnaker-Sail Sign
J. Correia-Pinto and T. Henriques-Coelho
  • Free Full Text

A male infant was born at 40 weeks of gestation by vacuum-assisted vaginal delivery. Mild respiratory distress with expiratory grunting and subcostal retraction was noted 1 hour after birth. Arterial oxygen saturation remained at more than 95% without the ...

e33
Plasmacytoma of the Skull
M.-L. Nguyen and A.S. Patel
  • Free Full Text

A 42-year-old woman presented with a painless, nickel-sized lump on her scalp that was first noticed by her hairdresser 4 months earlier. Physical examination revealed a firm, nontender, subcutaneous nodule, 6 cm in diameter, and no neurologic deficits. A ...

Case Records of the Massachusetts General Hospital
2146-2156
Case 36-2010 — A 50-Year-Old Woman with Pain and Loss of Hearing in the Left Ear
K.M. Stankovic, A.F. Juliano, and R.P. Hasserjian

    A 50-year-old woman had pain and hearing loss in the left ear. Examination revealed erythema, white debris, and a serous effusion. Treatment led to transient improvement in pain, but hearing loss persisted. Three months after the onset of symptoms, a mass was noted in the ear canal.

    Editorials
    2158-2159
    The Role of Allogeneic-Cell Transplantation in Leukemia
    J.H. Kersey

      In the early 1970s, patients with high-risk hematologic cancers had a small chance of long-term survival. This chance began to increase with allogeneic blood or bone marrow transplantation, which combines high-dose chemotherapy, total-body irradiation, ...

      2159-2161
      Weight-Loss Maintenance — Mind over Matter?
      D.S. Ludwig and C.B. Ebbeling

        Many people can lose weight in the short term by reducing their intake of calories with the use of a variety of diets, ranging from low-fat to very-low-carbohydrate. However, few people successfully maintain their weight loss.1 One explanation for the ...

        2161-2163
        Proton-Pump Inhibitors and Birth Defects — Some Reassurance, but More Needed
        A.A. Mitchell

          Limited data on safety are usually available when new medications are first marketed, but for appropriate ethical reasons, safety studies of the use of medications during pregnancy are rarely conducted before marketing. Because we must await postmarketing ...

          Occasional Notes
          2164-2168
          Name That Murmur — Eponyms for the Astute Auscultician
          I. Ma and L.M. Tierney, Jr.,
          • Video

          After the introduction of the stethoscope by René Laennec in 1819, the art of auscultation gained traction as a group of early adopters described the heart murmurs they were now able to hear. A race to discover and define ensued. Leading physicians ...

          Correspondence
          2169-2171
          Sildenafil in Idiopathic Pulmonary Fibrosis
          • Free Full Text

          To the Editor: Pulmonary hypertension develops in 37 to 59% of patients with end-stage idiopathic pulmonary fibrosis.1,2 Although it is not explicitly stated, the Sildenafil Trial of Exercise Performance in Idiopathic Pulmonary Fibrosis (STEP-IPF) (Aug. ...

          2171-2174
          Retinopathy Progression in Type 2 Diabetes
          • Free Full Text

          To the Editor: In the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye study, Chew et al. (July 15 issue)1 report that intensive glycemic control and intensive combination treatment of dyslipidemia were shown to reduce the rate of ...

          2174-2176
          Robot-Assisted Surgery and Health Care Costs
          • Free Full Text

          To the Editor: In their Perspective article, Barbash and Glied (Aug. 19 issue)1 focus primarily on the additional costs associated with robot-assisted surgery. They do not discuss key attributes of robot-assisted surgery such as increased precision, ...

          2176-2177
          Health Reform, Primary Care, and Graduate Medical Education
          • Free Full Text

          To the Editor: We take exception to a statement in the article by Iglehart (Aug. 5 issue)1 about health reform, primary care, and graduate medical education: “In the face of this decline in funding, the completion of a GME [graduate medical education] ...

          Corrections
          2178
          Case 31-2010: A 29-Year-Old Woman with Fever after a Cat Bite
          • Free Full Text

          Case 31-2010: A 29-Year-Old Woman with Fever after a Cat Bite Case Records of the Massachusetts General Hospital, N Engl J Med 2010;363:1560-1568. In the second paragraph of the Cellulitis subsection of Differential Diagnosis (page 1564), the sixth ...

          2178
          Epidural Analgesia for Labor and Delivery
          • Free Full Text

          Epidural Analgesia for Labor and Delivery Correspondence, N Engl J Med 2010;363:394-395. In the first letter (page 394), the magnetic resonance image shown in Figure 1A should have been described in the legend as a T2-weighted image, rather than a T1-...

          2178
          Large Islets, Beta-Cell Proliferation, and a Glucokinase Mutation
          • Free Full Text

          Large Islets, Beta-Cell Proliferation, and a Glucokinase Mutation Correspondence, N Engl J Med 2010;362:1348-1350. The authors (page 1350) should have been listed in the following order: Kassem, Bhandari, Rodríguez-Bada, Motaghedi, Heyman, García-Gimeno, ...

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