This randomized trial of adjuvant chemotherapy in women with axillary lymph node–positive or high-risk, lymph node–negative breast cancer showed that weekly paclitaxel improved disease-free and overall survival as compared with docetaxel, when either was given after standard adjuvant chemotherapy.

The decision to give intensive care to very preterm infants is often guided by gestational age alone. In this multicenter, prospective study of infants who received such care, female sex, singleton birth, higher birth weight, and antenatal corticosteroids were associated with reduced risks similar in magnitude to those associated with a 1-week increase in gestational age.

The chitinase-like protein YKL-40 is known to be involved in inflammation and tissue remodeling and is a biomarker of asthma severity and pulmonary function. This study shows an association between markers in the gene encoding YKL-40 and asthma, indicating that YKL-40 levels not only serve as a biomarker but also contribute to disease susceptibility.

A 28-year-old woman presents with a 7-month history of recurrent, crampy pain in the left lower quadrant, bloating with abdominal distention, and frequent, loose stools. She reports having had similar but milder symptoms since childhood. Physical examination is unremarkable except for tenderness over the left lower quadrant. How should her case be evaluated and treated?

With increasing numbers of extremely premature infants surviving, the outcome for these infants has generated much interest and controversy. This article reviews recent progress in the management and outcomes of some of the most common conditions affecting infants with very low birth weight (1500 g or less) and extremely low birth weight (1000 g or less).

A 1-day-old female infant was admitted to the neonatal intensive care unit because of intermittent apnea and cyanosis. She was delivered by cesarean section after a 44-hour labor, 17 hours after rupture of membranes. On the second day of life, multiple episodes of apnea occurred. A 24-hour electroencephalogram showed evidence of seizure activity.

Legal restrictions on off-label promotion of drugs are being challenged in the courts as a violation of First Amendment protection of "commercial speech." The authors argue that public health concerns make pharmaceutical promotion different from other commercial speech and that more stringent regulation should be permitted.

As patients store their personal health information in online repositories, the entities holding this information may be able to use it for a variety of purposes. This article explains the challenges and problems associated with a small number of companies holding large numbers of individual health records.

As medical records and research data are increasingly stored electronically, data standards permitting the integration and analysis of such information have become necessary. Progress is being made in developing and disseminating a common data format.

In this Health Policy Report, the author discusses the supply of physicians in the United States and the growing consensus that there will be a shortage of physicians in the future. Medical and osteopathic schools are expanding, and the Association of American Medical Colleges believes graduate medical education (residency) positions also should be increased.