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December 9, 2010  Vol. 363 No. 24

Audio Summary of this Issue

Perspective
2277-2279

After the 2010 elections, it is clear that the fight over health care reform is far from over. The reform law confronts burgeoning legislative, administrative, and legal challenges, and the partisan divide on health care is widening.

2279-2282

Cholera is a severe and often rapidly fatal diarrheal disease caused by the bacterium Vibrio cholerae. People die from cholera because the pathogen elicits the secretion of large quantities (up to 20 liters daily) of bacteria-laden fluid from the ...

2283-2285

Health literacy — commonly defined as the skills and abilities needed to gain access to, understand, and use health-related information — has emerged as an important priority for the United States. It has been linked to health outcomes and is considered ...

Original Articles
2287-2300

Frequent hemodialysis and conventional hemodialysis were compared for 12 months. Frequent hemodialysis was associated with improvement in primary outcomes (death or change in LV mass and death or change in physical health), but more interventions related to vascular access were required.

2301-2309
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Studies suggest that telemonitoring for outpatients with heart failure may improve outcomes. However, this trial indicates that neither death nor hospital readmission was affected by telemonitoring. The findings do not support its use in outpatients with heart failure.

2310-2319

Patients with coronary artery disease undergoing percutaneous coronary intervention were assigned to receive sirolimus-eluting, everolimus-eluting, or bare-metal stents. At 2 years, there was no significant between-group difference in the rate of death from cardiac causes or nonfatal myocardial infarction.

2320-2331

In this trial comparing methadone with buprenorphine in opioid-dependent pregnant women, neonates exposed to buprenorphine required less morphine to treat neonatal abstinence syndrome (NAS) and had a significantly shorter duration of hospitalization and of treatment for NAS.

Clinical Practice
2332-2338
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This article addresses the management of Tourette's, with attention to cognitive behavioral therapy and pharmacotherapy; the potential role of deep-brain stimulation in severe cases is also discussed. The importance of treating common coexisting conditions is emphasized.

Review Article
2339-2350
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The quickening pace of genetic discovery has resulted in the identification of more than 80 loci with proven roles in development of monogenic and multifactorial forms of nonautoimmune diabetes and obesity.

Images in Clinical Medicine
2351

A 55-year-old man with diabetic retinopathy and diabetic macular edema refractory to laser photocoagulation treatment underwent intravitreal injection of 4 mg (0.1 ml) of triamcinolone. On fundus photography performed after the procedure, the ...

e36
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A 39-year-old woman with a long-standing vascular malformation of the posterior tongue underwent intralesional sclerotherapy with a single dose of bleomycin. Within 1 week after treatment, painless, nonpruritic, flagellate hyperpigmentation developed on ...

Case Records of the Massachusetts General Hospital
2352-2361
  • CME

A 16-year-old girl with a history of lupus nephritis was seen in the emergency department because of altered mental status. She was somnolent and agitated and had no focal neurologic signs. Brain CT revealed no abnormalities. Laboratory studies revealed anemia and thrombocytopenia.

Editorials
2363-2364

The frequency of dialysis was established at three times a week in 1965,1 and this frequency has been used in most centers around the world. Soon after the establishment of this dialysis schedule, an analogue simulation concluded that daily (also known as ...

2364-2367

Rates of death and readmission after hospitalization for heart failure remain high despite considerable advances in evidence-based medical treatment.13 In 2009, the Centers for Medicare and Medicaid Services began public reporting of rates of readmission ...

Correspondence
2368-2370

To the Editor: In their report on the Initiating Dialysis Early and Late (IDEAL) study in patients with stage V chronic kidney disease, Cooper et al. (Aug. 12 issue)1 state that their results “tip the balance of evidence toward the view that no benefit ...

2370-2372

To the Editor: Vergote et al. (Sept. 2 issue)1 report on two treatment strategies, but they also describe an alarming variability in the rate of optimal and complete cytoreduction. The range for complete cytoreduction at primary debulking varied from 3.9%...

2372-2374

To the Editor: Health care entities compliant with the recent rules for “meaningful use” of electronic health records (EHRs) (Aug. 5 issue)1 will receive a share of billions in federal payments. EHRs can improve the quality of care, but the benefits ...

2374

To the Editor: In our Perspective article about market exclusivity for biologics (Nov. 12, 2009, issue),1 the table provided the cost to consumers for adalimumab for the treatment of Crohn's disease, for which the approved dose is an induction of 160 mg, ...