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Articles
Miia Kivipelto, Eeva-Liisa Helkala, Mikko P. Laakso, Tuomo Hänninen, Merja Hallikainen, Kari Alhainen, Susan Iivonen, Arto Mannermaa, Jaakko Tuomilehto, Aulikki Nissinen, and Hilkka Soininen The association between the apolipoprotein E (apoE)
Jeffrey J. Molldrem, Eric Leifer, Erkut Bahceci, Yogen Saunthararajah, Mary Rivera, Cynthia Dunbar, Johnson Liu, Riotoro Nakamura, Neal S. Young, and A. John Barrett Almost half of the deaths that result from myelodysplastic syndromes are due to cytopenia associated with bone marrow failure. Treatment is mostly supportive care. In this nonrandomized, single-treatment study, 34% of patients with myelodysplastic syndromes who were treated with antithymocyte globulin became transfusion independent. Response was associated with a statistically significant longer survival and an almost significantly decreased time to disease progression.
André Tichelli, Gérard Socié, Judith Marsh, Renée Barge, Norbert Frickhofen, Shaun McCann, Andrea Bacigalupo, Jill Hows, Pedro Marin, David Nachbaur, Argiris Symeonidis, Jakob Passweg, Hubert Schrezenmeier for the European Group for Blood and Marrow Transplantation Severe Aplastic Anaemia Working Party* Successful pregnancy with normal outcome is possible in women with aplastic anemia previously treated with immunosuppression. Complications appear to be more likely in patients with low platelet counts and paroxysmal nocturnal hemoglobinuriaassociated aplastic anemia.
Reviews
Lyle R. Petersen and Anthony A. Marfin This paper provides the clinician with an understanding of the epidemiologic and biological characteristics of West Nile virus in North America, as well as useful information on the diagnosis, reporting, and management of patients with suspected West Nile virus infection and on advising patients about prevention.
David A. Grimes and Elizabeth G. Raymond This case-based review defines and discusses various aspects of emergency contraception, including available methods, efficacy, safety, side effects, prescribing guidelines, and follow-up.
In the Balance
William L. Isley Although human growth hormone is now readily available and approved for treatment of the growth hormone deficiency syndrome in adults, skepticism exists about its use. The author discusses questions surrounding this therapy and concludes that it should not be routinely used for most patients.
David M. Cook The author addresses common concerns about growth hormone therapy and encourages reluctant practitioners to at least consider it in patients with definite growth hormone deficiency.
Clinical Guidelines
U.S. Preventive Services Task Force* The U.S. Preventive Services Task Force concludes that the evidence is insufficient to recommend for or against behavioral counseling in primary care settings to promote physical activity.
Karen B. Eden, C. Tracy Orleans, Cynthia D. Mulrow, Nola J. Pender, and Steven M. Teutsch This systematic review supports the U.S. Preventive Services Task Force's position on behavioral counseling to promote physical activity.
Editorials
Lawrence A. Frohman In this issue, Isley and Cook provide strong arguments for diametrically opposed positions concerning growth hormone treatment for adult growth hormone deficiency. For those searching for a position between the two extremes, this editorial attempts to offer a rationale for a "middle ground."
Letters Medical Care of Premenopausal Women with Coronary Artery Disease
Physician-Assisted Suicide
Varieties of Healing
Tetany Secondary to the Use of a Proton-Pump Inhibitor
Donald W. Brady, Giselle Corbie-Smith, and William T. Branch, Jr. Too often housestaff speak of residency training as a "test of survival." However, faculty physicians know that these years of training are not lived in a vacuum but are inextricably interwoven into the fabric of residents' personal and professional lives. This paper describes the stories written by primary care housestaff during their 3 years of training.
Jonathan B. Perlin
Jules Cohen
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