New England Journal of Medicine

The Constitutionality of the Individual Mandate for Health Insurance

Balkin, J. M. — 2010-01-13T13:57:34-08:00

(No abstract is available for this citation)

Compelling Evidence for Public Health Action to Reduce Salt Intake

Appel, L. J., Anderson, C. A.M. — 2010-01-20T13:48:09-08:00

(No abstract is available for this citation)

Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease

2010-01-20T13:51:00-08:00

Background The U.S. diet is high in salt, with the majority coming from processed foods. Reducing dietary salt is a potentially important target for the improvement of public health.

Methods ...

Brief Report: Lack of Cyclophilin B in Osteogenesis Imperfecta with Normal Collagen Folding

2010-01-20T13:49:46-08:00

Osteogenesis imperfecta is a heritable disorder that causes bone fragility. Mutations in type I collagen result in autosomal dominant osteogenesis imperfecta, whereas mutations in either of two components of the ...

Avoiding Side Effects in Implementing Health Insurance Reform

Pauly, M. V. — 2010-01-27T14:34:05-08:00

(No abstract is available for this citation)

Press Ahead or Scale Back? The Reform Effort after the GOP Victory in Massachusetts

Iglehart, J. K. — 2010-01-27T14:34:34-08:00

(No abstract is available for this citation)

The Earthquake in Haiti -- Dispatch from Port-au-Prince

Pape, J. W., Johnson, W. D., Fitzgerald, D. W. — 2010-01-27T14:35:01-08:00

(No abstract is available for this citation)

Cogito Ergo Sum by MRI

Ropper, A. H. — 2010-02-03T13:47:26-08:00

(No abstract is available for this citation)

Giving Teeth to Comparative-Effectiveness Research -- The Oregon Experience

Saha, S., Coffman, D. D., Smits, A. K. — 2010-02-03T13:48:17-08:00

(No abstract is available for this citation)

Surgeons' Dispatch from Cange, Haiti

Sullivan, S. R., Taylor, H. O.B., Pauyo, T., Steer, M. L. — 2010-02-03T13:48:40-08:00

(No abstract is available for this citation)

Risking Big Changes with Small Reforms

Butler, S. M. — 2010-02-03T13:49:05-08:00

(No abstract is available for this citation)

Willful Modulation of Brain Activity in Disorders of Consciousness

2010-02-03T13:47:53-08:00

Background The differential diagnosis of disorders of consciousness is challenging. The rate of misdiagnosis is approximately 40%, and new methods are required to complement bedside testing, particularly if the patient's ...

Coordinating and Prioritizing Aid in Haiti

Ivers, L. C., Cullen, K. — 2010-02-03T13:49:26-08:00

(No abstract is available for this citation)

Cottage Industry to Postindustrial Care -- The Revolution in Health Care Delivery

2010-02-03T13:55:29-08:00

U.S. health care is broken. Although other industries have transformed themselves using tools such as standardization of value-generating processes, performance measurement, and transparent reporting of quality, the application of these ...

Medicare and Medical Technology -- The Growing Demand for Relevant Outcomes

Neumann, P. J., Tunis, S. R. — 2010-02-03T13:55:29-08:00

In deciding whether to pay for new medical technologies, the Centers for Medicare and Medicaid Services (CMS) is becoming more specific about its requirements for evidence of improved health outcomes ...

Withholding Information from Patients -- When Less Is More

Epstein, R. M., Korones, D. N., Quill, T. E. — 2010-02-03T13:55:29-08:00

As clinicians who strongly value truth telling and active patient involvement in medical decision making,1 we have lately been reflecting on the circumstances in which physicians consciously (and sometimes unconsciously) ...

Launching HITECH

Blumenthal, D. — 2010-02-03T13:55:29-08:00

Information is the lifeblood of modern medicine. Health information technology (HIT) is destined to be its circulatory system. Without that system, neither individual physicians nor health care institutions can perform ...

A Placebo-Controlled Trial of Oral Fingolimod in Relapsing Multiple Sclerosis

2010-02-03T13:55:30-08:00

In this 24-month, randomized trial involving patients with relapsing-remitting multiple sclerosis, oral fingolimod reduced the rates of relapse and disability progression, as compared with placebo. Adverse events reported in patients treated with fingolimod included bradycardia, atrioventricular conduction block, macular edema, elevations in liver-enzyme levels, and mild hypertension.

Oral Fingolimod or Intramuscular Interferon for Relapsing Multiple Sclerosis

2010-02-03T13:55:30-08:00

In this 12-month trial involving patients with relapsing-remitting multiple sclerosis, oral fingolimod was more effective than intramuscular interferon beta-1a in reducing relapse rates. Adverse events associated with fingolimod included herpesvirus infections (two fatal infections), atrioventricular block, macular edema, skin cancer, and liver-enzyme elevation.

A Placebo-Controlled Trial of Oral Cladribine for Relapsing Multiple Sclerosis

2010-02-03T13:55:30-08:00

In this 96-week, placebo-controlled trial, oral cladribine reduced relapse rates and lowered the risk of sustained disability in patients with relapsing-remitting multiple sclerosis. Patients who were treated with cladribine had large reductions in lymphocyte counts and more infections, including herpes zoster and one death from reactivation of tuberculosis.

Acyclovir and Transmission of HIV-1 from Persons Infected with HIV-1 and HSV-2

2010-02-03T13:55:30-08:00

Suppressive therapy for herpes simplex virus 2 (HSV-2) has also been shown to reduce the levels of human immunodeficiency virus type 1 (HIV-1). However, in this placebo-controlled trial involving 3408 African couples who were discordant in serologic status for these two viruses, daily treatment with acyclovir did not reduce the frequency of HIV-1 transmission, despite a reduction in HIV-1 RNA levels and a 73% reduction in the occurrence of HSV-2-positive genital ulcers.

Jet Lag

Sack, R. L. — 2010-02-03T13:55:30-08:00

A 55-year-old physician is planning a trip from Los Angeles to London to attend a scientific conference. His previous trip to Europe was complicated by sleepiness during meetings and difficulty falling asleep and remaining asleep at night. He wants to know what he can do to avoid jet lag. What would you advise?

Kinked Carotids

Rosenthal, R. L., Grimsley, B. R. — 2010-02-03T13:55:30-08:00

An 80-year-old woman presented with congestive heart failure due to aortic insufficiency associated with a markedly dilated ascending aorta. On physical examination, she was noted to have a pulsatile mass ...

Bleeding Esophageal Varices

Torrazza-Perez, E., Carreno, N. — 2010-02-03T13:55:30-08:00

A 52-year-old man with cirrhosis associated with alcohol abuse presented to the emergency department with hematemesis and lightheadedness, which had developed 3 hours earlier, after binge drinking. He had no ...

Under Pressure

Detsky, M. E., Balter, M. S., Sridhar, S. K., Granton, J. — 2010-02-03T13:55:30-08:00

A 25-year-old woman presented to her local hospital with dyspnea. She described a 2-year history of progressive shortness of breath on exertion. Within the previous 3 days, her condition had deteriorated to the point that she was unable to leave her bedroom without having dyspnea.

Oral Therapy for Multiple Sclerosis -- Sea Change or Incremental Step?

Carroll, W. M. — 2010-02-03T13:55:30-08:00

The long-awaited arrival of oral formulations for the treatment of relapsing-remitting multiple sclerosis is welcome news for the estimated 2.5 million people worldwide who have this chronic, disabling disease. Since ...

Reviewers for the Journal, July-December 2009

2010-02-03T13:55:30-08:00

Each year thousands of reviewers contribute their expertise to peer review, a process that contributes critically to the quality of the Journal. The editors and the authors of the papers ...

Comparative Effectiveness and Health Care Spending -- Implications for Reform

Weinstein, M. C., Skinner, J. A. — 2010-02-03T13:55:30-08:00

In this Sounding Board article, the authors argue that health care costs can be reduced without a negative effect on quality by reducing spending on interventions that are not cost-effective.

Intensity of Continuous Renal-Replacement Therapy

2010-02-03T13:55:30-08:00

To the Editor: In the Randomized Evaluation of Normal versus Augmented Level (RENAL) Replacement Therapy Study (Oct. 22 issue),1 investigators ...

Functional Status of Elderly Adults Receiving Dialysis

2010-02-03T13:55:30-08:00

To the Editor: Frail elderly patients with end-stage renal disease (ESRD) entering dialysis programs have a substantial and sustained decline ...

Accuracy of Financial Disclosures Reported by Physicians

Zuckerman, J. D., Okike, K., Kocher, M. S. — 2010-02-03T13:55:30-08:00

To the Editor: Okike et al. (Oct. 8 issue)1 found that the rate of conflict-of-interest disclosure reported by physicians who ...

Ankle-Brachial Index and Peripheral Arterial Disease

2010-02-03T13:55:30-08:00

To the Editor: Grenon et al. (Nov. 5 issue) have presented a validated method of calculating the ankle-brachial index that ...

Transfusion of RhD-Positive Blood in "Asia Type" DEL Recipients

Shao, C.-P. — 2010-02-03T13:55:30-08:00

To the Editor: The RhD status of transfusion recipients and donors is routinely matched for red-cell transfusion. This worldwide practice ...

A Wii Fracture

Eley, K. A. — 2010-02-03T13:55:30-08:00

To the Editor: In 1990, Brasington described "Nintendinitis"1 in a patient with pain over the extensor tendon of her thumb ...

CME: A Placebo-Controlled Trial of Oral Fingolimod in Relapsing Multiple Sclerosis

2010-02-03T13:55:30-08:00

(No abstract is available for this citation)

CME: Jet Lag

2010-02-03T13:55:30-08:00

(No abstract is available for this citation)

CME: Under Pressure

2010-02-03T13:55:30-08:00

(No abstract is available for this citation)