In this single-blind trial, 162 women with systemic lupus erythematosus were randomly assigned to combined oral contraceptives, a progestin-only pill, or a copper intrauterine device. There were no significant differences in global or maximum disease activity, incidence or probability of flares, or medication use, irrespective of the type of contraceptive used.

This double-blind, randomized, noninferiority trial prospectively evaluated the effect of oral contraceptives on lupus activity in premenopausal women with stable systemic lupus erythematosus. The results indicate that oral contraceptives do not increase the risk of a flare of disease among women with lupus whose condition is stable.

During the 2003–2004 influenza season in the United States, 153 influenza-associated deaths were reported in children (median age, three years). Fifty-three percent of the children had a condition conferring a high risk of influenza or had another chronic condition, and 47 percent were classified as "previously healthy." Infants younger than six months of age had the highest mortality rate. Improvements in vaccination, diagnosis, and treatment should be given high priority in the effort to reduce childhood mortality from influenza.

It has been suggested that rapid atrial pacing (AOP) may be beneficial in some patients with sleep apnea. However, in a study comparing AOP with nasal continuous positive airway pressure (n-CPAP) in a series of patients with moderate or severe obstructive sleep apnea, AOP had no significant effect, whereas n-CPAP was highly effective.

A 19-year-old woman seeks care for slowly progressive hair growth. Since high school, she has shaved her upper lip weekly and waxed her abdomen and thighs monthly. Her menstrual periods are regular. Physical examination is unremarkable except for a body-mass index of 31 and trace hair over the abdomen and thighs, with a moderate amount over her back. There is no clitorimegaly. How should this patient be evaluated and treated?

A 29-year-old woman with a history of lupus erythematosus and nephritis was admitted to the hospital because of edema, proteinuria, and rising blood pressure in the second trimester of pregnancy. During the next three weeks, proteinuria persisted, anemia and thrombocytopenia developed and worsened, and the blood pressure continued to rise. A procedure was performed.

Recent events — including the Terri Schiavo case —have involved public questioning of the commonly held belief that decisions about artificial nutrition and hydration should be made in the same way in which decisions about other treatments are made. This article reviews the principles that have guided decisions about the use of artificial nutrition and hydration over the past 20 years. The authors outline their own recommendations for improving decision making about artificial nutrition and hydration.