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* This Week in the Journal
 May 11, 2006
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*
Correspondence
* Intensive Insulin Therapy in the Medical ICU
* Long-Term Outcome of Renal Transplantation from Older Donors
* Tumor Necrosis Factor {alpha} in Refractory Asthma
* NXY-059 for Acute Ischemic Stroke
* Coronary-Artery Stents
* Case 5-2006: Loss of Vision in the Right Eye
* Lenalidomide and Venous Thrombosis in Multiple Myeloma
*
Book Reviews
* Doctor Franklin's Medicine
* Making Medicines: A Brief History of Pharmacy and Pharmaceuticals
* The Quest for Human Longevity: Science, Business, and Public Policy
* Talking with Doctors
Original Articles
Inhaled Corticosteroids and Asthma in Preschool Children

Children whose parents have asthma and who begin to wheeze are at high risk for asthma. In this NIH-sponsored study, children who were two or three years old at enrollment were given either placebo or an inhaled corticosteroid for two years. Although they had better asthma control while using the corticosteroid, asthma control was not improved after the treatment was discontinued.

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Original Articles
Inhaled Corticosteroids in Infants with Wheezing

Children at high risk for asthma were assigned to inhaled budesonide or placebo for two weeks after the first and subsequent episodes of wheezing illness after one month of age. At three years, there were no differences between groups in measures of asthma or lung function.

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Original Articles
Altered Bone and Mineral Metabolism in Patients Receiving Imatinib

Hypophosphatemia, with associated changes in bone and mineral metabolism, developed in some patients with chronic myelogenous leukemia or gastrointestinal stromal tumors who were receiving imatinib, which inhibits several tyrosine kinases associated with these two diseases. The drug may thus inhibit bone remodeling in some patients.


Original Articles
Influence of Donor C3 Allotype on Late Renal-Transplantation Outcome

The third component of complement, C3, exists as two main allotypes, F (fast) and S (slow), which affect the incidence of inflammatory disease. This study examined the association between the C3 allotypes of renal donors and recipients and graft function after transplantation and suggests that donor C3F and C3S alleles may confer functional differences.

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Special Article
Claims, Errors, and Compensation in Medical Malpractice Litigation

Frivolous lawsuits have been cited as a major contributor to the high costs of the malpractice system in the United States. In this national study of 1452 closed claims, physician reviewers found no evidence of medical errors in 37 percent. Most claims, however, did not result in payment to the plaintiffs. Claims not associated with errors accounted for only 13 to 16 percent of the total costs.


Review Article
Mechanisms of Disease: Lineage-Specific Hematopoietic Growth Factors

This review surveys the mechanisms and clinical applications of three hematopoietic growth factors: erythropoietin, granulocyte colony-stimulating factor, and thrombopoietin.


Case Records of the Massachusetts General Hospital
A Woman with Anemia and Iron Overload

A young woman was seen because of anemia and evidence of increased iron stores. She was of Italian descent. Her father, a paternal aunt, and one sister had Diamond–Blackfan anemia, and her mother had been told she had beta-thalassemia trait.


Sounding Board
The Patient's Right to Safety — Improving the Quality of Care through Litigation against Hospitals

Many experts believe that the threat of malpractice suits impedes the use of error-reporting systems to make hospitals safer. Annas argues that more lawsuits, not fewer, are needed. He believes that the courts should recognize a right to safety so that hospitals that fail to implement measures to improve safety could be sued when patients are injured owing to preventable errors.


Clinical Implications of Basic Research
A Mediator of Aortic Aneurysm?

A study implicates a transcription factor as a key mediator of aortic aneurysm in two mouse models.


Videos in Clinical Medicine
Arthrocentesis

Figure

Arthrocentesis is used to establish the cause of an acute monoarthritis or polyarthritis. It is also used to drain large effusions or hemarthroses and to instill steroids or local anesthetic. This procedure video demonstrates how to perform arthrocentesis.


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