New England Journal of Medicine

EARLY RELEASE: Contaminated Heparin Associated with Adverse Clinical Events and Activation of the Contact System

2008-04-24T11:16:16-07:00

Background There is an urgent need to determine whether oversulfated chondroitin sulfate (OSCS), a compound contaminating heparin supplies worldwide, is the cause of the severe anaphylactoid reactions that have occurred ...

EARLY RELEASE: Preliminary Results of Gene Therapy for Retinal Degeneration

Miller, J. W. — 2008-04-27T13:20:17-07:00

(No abstract is available for this citation)

EARLY RELEASE: Brief Report: Effect of Gene Therapy on Visual Function in Leber's Congenital Amaurosis

2008-04-27T13:20:41-07:00

Early-onset, severe retinal dystrophy caused by mutations in the gene encoding retinal pigment epithelium-specific 65-kDa protein (RPE65) is associated with poor vision at birth and complete loss of vision in ...

EARLY RELEASE: Brief Report: Safety and Efficacy of Gene Transfer for Leber's Congenital Amaurosis

2008-04-28T12:15:13-07:00

Leber's congenital amaurosis (LCA) is a group of inherited blinding diseases with onset during childhood. One form of the disease, LCA2, is caused by mutations in the retinal pigment epithelium-specific ...

EARLY RELEASE: Bona Fide Genetic Associations with Bone Mineral Density

Hirschhorn, J. N., Gennari, L. — 2008-04-29T10:28:55-07:00

(No abstract is available for this citation)

EARLY RELEASE: Multiple Genetic Loci for Bone Mineral Density and Fractures

2008-04-29T10:29:15-07:00

Background Bone mineral density influences the risk of osteoporosis later in life and is useful in the evaluation of the risk of fracture. We aimed to identify sequence variants associated ...

EARLY RELEASE: Neuroblastoma -- Linking a Common Allele to a Rare Disease

Kushner, B. H., Cheung, N.-K. V. — 2008-05-07T13:58:21-07:00

(No abstract is available for this citation)

EARLY RELEASE: Chromosome 6p22 Locus Associated with Clinically Aggressive Neuroblastoma

2008-05-12T10:31:08-07:00

Background Neuroblastoma is a malignant condition of the developing sympathetic nervous system that most commonly affects young children and is often lethal. Its cause is not known.

Methods We performed ...

EARLY RELEASE: The Aprotinin Story -- Is BART the Final Chapter?

Ray, W. A., Stein, C. M. — 2008-05-14T08:55:03-07:00

(No abstract is available for this citation)

EARLY RELEASE: DTCA for PTCA -- Crossing the Line in Consumer Health Education?

Boden, W. E., Diamond, G. A. — 2008-05-14T08:55:46-07:00

(No abstract is available for this citation)

EARLY RELEASE: A Comparison of Aprotinin and Lysine Analogues in High-Risk Cardiac Surgery

2008-05-14T08:55:24-07:00

Background Antifibrinolytic agents are commonly used during cardiac surgery to minimize bleeding and to reduce exposure to blood products. We sought to determine whether aprotinin was superior to either tranexamic ...

PERSPECTIVE: Vaccines and Autism Revisited -- The Hannah Poling Case

Offit, P. A. — 2008-05-14T13:55:25-07:00

On April 11, 2008, the National Vaccine Advisory Committee took an unusual step: in the name of transparency, trust, and collaboration, it asked members of the public to help set ...

PERSPECTIVE: Like Night and Day -- Shedding Light on Off-Hours Care

Shulkin, D. J. — 2008-05-14T13:55:25-07:00

Lately, I've been coming to work at midnight. You see, I've begun making late-night administrative rounds at the hospital where I am president and chief executive officer. No, I'm not ...

ORIGINAL ARTICLE: Class-Sparing Regimens for Initial Treatment of HIV-1 Infection

2008-05-14T13:55:25-07:00

Several regimens are used as initial antiretroviral therapy for HIV-1 infection, but few direct comparisons are available. In this randomized, open-label study, efavirenz plus two nucleoside reverse-transcriptase inhibitors (NRTIs), lopinavir-ritonavir plus two NRTIs, and lopinavir-ritonavir plus efavirenz were compared. Initial therapy with efavirenz plus two NRTIs was associated with less virologic failure than was lopinavir-ritonavir plus two NRTIs. The NRTI-sparing regimen of lopinavir-ritonavir plus efavirenz had virologic efficacy similar to that of efavirenz plus two NRTIs but was more likely to select for drug resistance.

ORIGINAL ARTICLE: Use of Multiple Biomarkers to Improve the Prediction of Death from Cardiovascular Causes

2008-05-14T13:55:25-07:00

To predict the risk of death from cardiovascular causes in a community-based cohort of elderly men, the authors used a combination of biomarkers (troponin I, N-terminal pro-brain natriuretic peptide, cystatin C, and C-reactive protein). The addition of these markers to a model with traditional cardiovascular risk factors significantly improved risk stratification as compared with a model that used only the traditional risk factors.

ORIGINAL ARTICLE: Cardiac Troponin and Outcome in Acute Heart Failure

2008-05-14T13:55:25-07:00

In this large, retrospective registry study, patients hospitalized with acute decompensated heart failure who had elevated cardiac troponin levels had higher mortality rates than those who were negative for troponin, even after correction for other predictive variables. Measurement of cardiac troponin, which may reflect myocyte injury, is useful for risk stratification of such patients.

ORIGINAL ARTICLE: Efficacy and Safety of Recombinant Activated Factor VII for Acute Intracerebral Hemorrhage

2008-05-14T13:55:25-07:00

In a previous phase 2 placebo-controlled trial, recombinant activated factor VII (rFVIIa) reduced growth of the hematoma and improved survival and functional outcome in patients with intracerebral hemorrhage. Those findings were not reproduced in this phase 3 trial, in which rFVIIa reduced hematoma growth but did not improve clinical outcomes.

CLINICAL PRACTICE: Rotator-Cuff Failure

Matsen, F. A. — 2008-05-14T13:55:25-07:00

A 63-year-old woman presents with a 2-year history of progressive weakness and discomfort in her right shoulder, especially when she puts dishes on the top shelf in her kitchen. She is otherwise healthy and has had no injuries. Physical examination shows some atrophy of the muscles in the right shoulder and weakness when the right arm is elevated. Magnetic resonance imaging shows a large defect in the rotator cuff. How should her case be managed?

REVIEW ARTICLE: Medical Progress: Biomarkers in Heart Failure

Braunwald, E. — 2008-05-14T13:55:25-07:00

Heart failure results not only from cardiac overload or injury but also from a complex interplay among genetic, neurohormonal, inflammatory, and biochemical changes acting on cardiac myocytes, the cardiac interstitium, or both. This review focuses on biomarkers for heart failure other than routinely determined laboratory values and discusses how these might be used in assessing and managing heart failure.

IMAGES IN CLINICAL MEDICINE: Keratoderma Blennorrhagica

Tonna, I., Laing, R. B.S. — 2008-05-14T13:55:25-07:00

A 55-year-old bisexual man presented with a few weeks' history of lethargy followed by the onset of a widespread nonpruritic rash that covered much of his body, including the palms ...

IMAGES IN CLINICAL MEDICINE: Giant Ovarian Cyst

Young, T.-H., Lee, H.-S. — 2008-05-14T13:55:25-07:00

A 24-year-old woman (gravida 0, para 0) presented with a history of progressive abdominal distention during the previous year, accompanied by early satiety and constipation. There was no history of ...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 15-2008 -- A 55-Year-Old Man with an Elevated Prostate-Specific Antigen Level and Early-Stage Prostate Cancer

Barry, M. J., Kaufman, D. S., Wu, C.-L. — 2008-05-14T13:55:25-07:00

A 55-year-old man was referred to this hospital for management of prostate cancer. An elevated serum prostate specific antigen (PSA) level was found during evaluation of urinary symptoms; core needle biopsies of the prostate disclosed adenocarcinoma, with a Gleason score of 6 out of 10. Examination and computed tomography showed a smoothly enlarged prostate and no lymphadenopathy. Options for management were discussed.

EDITORIAL: Initial Treatment for HIV Infection -- An Embarrassment of Riches

Hirschel, B., Calmy, A. — 2008-05-14T13:55:25-07:00

Drugs that are used to treat patients with human immunodeficiency virus (HIV) infection are classified according to their target. The first ones to be developed were nucleoside reverse-transcriptase inhibitors (NRTIs), ...

EDITORIAL: Multiple Biomarker Panels for Cardiovascular Risk Assessment

de Lemos, J. A., Lloyd-Jones, D. M. — 2008-05-14T13:55:25-07:00

Guidelines for the assessment of cardiovascular risk remain focused squarely on established risk factors.1 Although it is known that tools based on these risk factors, such as the Framingham Risk ...

EDITORIAL: Intracerebral Hemorrhage -- Improving Outcome by Reducing Volume?

Tuhrim, S. — 2008-05-14T13:55:25-07:00

Intracerebral hemorrhage accounts for 10 to 15% of all strokes. It is the type of stroke with the highest mortality, with a 1-year survival rate of less than 50%.1 Most ...

CLINICAL DECISIONS: Management of Carotid Stenosis -- Polling Results

Klein, A., Solomon, C. G., Hamel, M. B. — 2008-05-14T13:55:25-07:00

CORRESPONDENCE: Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq

2008-05-14T13:55:25-07:00

To the Editor: We wish to express a number of concerns about the methods used in the study of mild ...

CORRESPONDENCE: Outcomes 18 Months after the First Human Partial Face Transplantation

Guntinas-Lichius, O., Dubernard, J.-M., Lengele, B., Devauchelle, B. — 2008-05-14T13:55:25-07:00

To the Editor: The acceptance of a partial face allograft as a promising procedure for patients with facial disfigurement will ...

CORRESPONDENCE: Selective Publication of Antidepressant Trials

2008-05-14T13:55:25-07:00

To the Editor: The importance of the study reported by Turner et al. (Jan. 17 issue),1 on selective publication of ...

CORRESPONDENCE: Physicians and Execution

Bizer, L. S., Weinblatt, M., Parke, R. M., Neelon, F. A. — 2008-05-14T13:55:25-07:00

To the Editor: In their editorial about physicians and executions, Curfman et al. (Jan. 24 issue)1 are correct that our ...

CORRESPONDENCE: Perspective Roundtable: Lethal Injection

Rosoff, P. M. — 2008-05-14T13:55:25-07:00

To the Editor: I was deeply disturbed by the discussion, led by Gawande, on physicians and executions (Jan. 31 issue).1 ...

CORRESPONDENCE: Letting the Genome Out of the Bottle

2008-05-14T13:55:25-07:00

To the Editor: The Perspective article by Hunter et al. (Jan. 10 issue)1 concludes that commercialization of personal genomics is ...

CORRESPONDENCE: Serotonin Syndrome Associated with Triptan Monotherapy

2008-05-14T13:55:25-07:00

To the Editor: Triptans are serotonin-receptor agonists used in the treatment of migraine headaches. When administered in combination with certain ...

BOOK REVIEW: The Longevity Revolution: The Benefits and Challenges of Living a Long Life

Gavrilov, L., Gavrilova, N. — 2008-05-14T13:55:25-07:00

This book about the ongoing revolution in human longevity and its implications for society was written by Robert Butler, a professor of geriatrics who is still working at the age ...

BOOK REVIEW: Fundamentals of the Stem Cell Debate: The Scientific, Religious, Ethical and Political Issues

Hearn, J. — 2008-05-14T13:55:25-07:00

Human embryonic stem cells were isolated 10 years ago with the use of knowledge that had been gained from more than 20 years of research in rodents and nonhuman primates. ...

BOOK REVIEW: Sex Differences in the Brain: From Genes to Behavior

Perrot-Sinal, T. — 2008-05-14T13:55:25-07:00

Like it or not, we are defined by being male or female. One of the first things children can tell you about themselves is their sex, and they are remarkably ...

CME: Class-Sparing Regimens for Initial Treatment of HIV-1 Infection

2008-05-14T13:55:25-07:00

(No abstract is available for this citation)

CME: Cardiac Troponin and Outcome in Acute Heart Failure

2008-05-14T13:55:25-07:00

(No abstract is available for this citation)

CME: Case 15-2008: A 55-Year-Old Man with an Elevated Prostate-Specific Antigen Level and Early-Stage Prostate Cancer

2008-05-14T13:55:25-07:00

(No abstract is available for this citation)