(No abstract is available for this citation)

EARLY RELEASE: Managing and Reducing Uncertainty in an Emerging Influenza Pandemic

(No abstract is available for this citation)

EARLY RELEASE: A Strategy for Health Care Reform -- Toward a Value-Based System

(No abstract is available for this citation)

EARLY RELEASE: Finding Money for Health Care Reform -- Rooting Out Waste, Fraud, and Abuse

(No abstract is available for this citation)

EARLY RELEASE: Tobacco, Public Health, and the FDA

(No abstract is available for this citation)

EARLY RELEASE: Synthetic Lethality -- A New Direction in Cancer-Drug Development

(No abstract is available for this citation)

EARLY RELEASE: Inhibition of Poly(ADP-Ribose) Polymerase in Tumors from BRCA Mutation Carriers

Background The inhibition of poly(adenosine diphosphate [ADP]-ribose) polymerase (PARP) is a potential synthetic lethal therapeutic strategy for the treatment of cancers with specific DNA-repair defects, including those arising in carriers ...

EARLY RELEASE: Rapid-Test Sensitivity for Novel Swine-Origin Influenza A (H1N1) Virus in Humans

(No abstract is available for this citation)

EARLY RELEASE: Spread of a Novel Influenza A (H1N1) Virus via Global Airline Transportation

(No abstract is available for this citation)

EARLY RELEASE: The Persistent Legacy of the 1918 Influenza Virus

(No abstract is available for this citation)

EARLY RELEASE: Severe Respiratory Disease Concurrent with the Circulation of H1N1 Influenza

Background In the spring of 2009, an outbreak of severe pneumonia was reported in conjunction with the concurrent isolation of a novel swine-origin influenza A (H1N1) virus (S-OIV), widely known ...

EARLY RELEASE: Pneumonia and Respiratory Failure from Swine-Origin Influenza A (H1N1) in Mexico

Background In late March 2009, an outbreak of a respiratory illness later proved to be caused by novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. We describe ...

EARLY RELEASE: Current Concepts: Historical Perspective -- Emergence of Influenza A (H1N1) Viruses

(No abstract is available for this citation)

EARLY RELEASE: Prioritizing Comparative-Effectiveness Research -- IOM Recommendations

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EARLY RELEASE: Comparative-Effectiveness Research -- Implications of the Federal Coordinating Council's Report

(No abstract is available for this citation)

PERSPECTIVE: Health Care TWOTHOUSANDNINE: The Role of Medical Liability Reform in Federal Health Care Reform

Although enthusiasm for health care reform is resounding in Washington these days, the specific shape reform will take and the compromises that will have to be made along the way ...

PERSPECTIVE: Health Care TWOTHOUSANDNINE: A Win-Win Approach to Financing Health Care Reform

No hurdle facing health care reform in the United States today is more daunting than the problem of financing universal coverage. There is an inescapable logic of reform that lies ...

PERSPECTIVE: Health Care TWOTHOUSANDNINE: The Individual Mandate -- An Affordable and Fair Approach to Achieving Universal Coverage

Some of the most prominent shortcomings of the U.S. health insurance market are rooted in the fact that the system is a voluntary one. Outside the state of Massachusetts, which ...

PERSPECTIVE: A Higher Bar -- Vermont's New Law on Marketing Prescribed Products

As Congress continues to discuss the reform of physician-industry relations, individual states are enacting new laws. In July 2009, regulations on the conduct of pharmaceutical and medical-device manufacturers take effect ...

ORIGINAL ARTICLE: M-Type Phospholipase A2 Receptor as Target Antigen in Idiopathic Membranous Nephropathy

In this study of patients with membranous nephropathy, serum samples from 70% of patients with idiopathic, but not secondary, membranous nephropathy were found to have antibodies against a 185-kD glycoprotein in nonreduced glomerular extracts, identified as the M-type phospholipase A2 receptor (PLA2R). PLA2R is present in normal podocytes and in immune deposits in patients with idiopathic membranous nephropathy, indicating that PLA2R is a major antigen in this disease.

ORIGINAL ARTICLE: Epidemiologic Study of In-Hospital Cardiopulmonary Resuscitation in the Elderly

In this longitudinal study of hospitalized Medicare patients, there was no improvement in survival after cardiopulmonary resuscitation (CPR) during the period from 1992 through 2005. The overall rate of survival to discharge of patients who underwent in-hospital CPR was 18.3%. Survival after CPR was lower among black patients than among white patients.

ORIGINAL ARTICLE: Preoperative Staging of Lung Cancer with Combined PET-CT

Combined positron-emission tomography and computed tomography (PET-CT) plus conventional staging was compared with conventional staging alone for preoperative staging of non-small-cell lung cancer (NSCLC). The end point was the number of futile thoracotomies in each group (with futility defined as a result other than potentially curable NSCLC). Preoperative staging of NSCLC with PET-CT was found to reduce the total number of thoracotomies and the number of futile thoracotomies.

ORIGINAL ARTICLE: Renal and Retinal Effects of Enalapril and Losartan in Type 1 Diabetes

This study aimed to determine whether early administration of drugs that block the renin-angiotensin system slows the progression of change in glomerular mesangial fractional volume and retinopathy progression of two steps or more, according to the retinopathy severity scale. Early blockade of the renin-angiotensin system did not modify nephropathy progression in patients with type 1 diabetes but had important effects in slowing retinopathy.

SPECIAL ARTICLE: The Effect of Medicare Part D on Drug and Medical Spending

This study examined expenditures on drugs and other medical services before and after the implementation of Medicare Part D. For patients who had no drug coverage before Part D, the increase in drug spending after the implementation of Part D was approximately offset by a decrease in other medical spending. Improved access to medications may achieve savings in nonpharmacy costs because of better control of chronic illness.

REVIEW ARTICLE: Current Concepts: Rhabdomyolysis and Acute Kidney Injury

The causes of acute rhabdomyolysis include trauma, drugs, toxins, and certain infections. Acute kidney injury is a dangerous complication of severe rhabdomyolysis. This review summarizes current views on the pathogenesis of myoglobin-induced kidney injury as well as on its prevention and treatment.

IMAGES IN CLINICAL MEDICINE: Telltale Triangle of Pneumoperitoneum

A 56-year-old man presented to the emergency department with a 3-day history of diarrhea and dull epigastric pain. The diarrhea had responded to antidiarrheal agents. However, the epigastric pain had ...

IMAGES IN CLINICAL MEDICINE: Tattoo Allergy

A 40-year-old man presented with intractable pruritus within portions of a tattoo imprinted with red ink on the left leg (Panel A). The intense localized itching had begun approximately 4 ...

CLINICAL PROBLEM-SOLVING: A Fragile Balance

A 31-year-old man presented to the emergency department with pain in the left shoulder. He had tripped over his backpack shoulder strap earlier in the day and noted immediate severe pain around his left shoulder. Physical examination revealed bony point tenderness over the humeral head and limited range of motion due to pain; crepitus was present. Shoulder radiographs revealed an impacted fracture of the left humerus and evidence of osteopenia.

EDITORIAL: Human Idiopathic Membranous Nephropathy -- A Mystery Solved?

Just over 50 years ago, the late David Jones1 identified (using the periodic acid-Schiff and methenamine silver stains) the unique glomerular pathologic features of membranous nephropathy, thus distinguishing it from ...

EDITORIAL: Diabetes Complications and the Renin-Angiotensin System

The hypothesis that inhibition of the renin-angiotensin system may be effective in preventing diabetic nephropathy was based on a large body of evidence.1 Positive findings from studies in animal models ...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Cardiomyocyte Renewal

A recent study upends the hypothesis that cardiomyocytes are not renewed after the first weeks of life.

CORRESPONDENCE: Glucose Control in Critically Ill Patients

To the Editor: In the Normoglycemia in Intensive Care Evaluation-Survival Using Glucose Algorithm Regulation (NICE-SUGAR) study (ClinicalTrials.gov number, NCT00220987), reported ...

CORRESPONDENCE: Racial Differences in Heart Failure

To the Editor: It is not known whether concentric hypertrophy is a common precursor to systolic dysfunction in human hypertensive ...

CORRESPONDENCE: Rosuvastatin in Patients Undergoing Hemodialysis

To the Editor: In their article on A Study to Evaluate the Use of Rosuvastatin in Subjects on Regular Hemodialysis: ...

CORRESPONDENCE: Cetuximab for Metastatic Colorectal Cancer

To the Editor: As a gastroenterologist who claims to have been the first physician in Connecticut to give fluorouracil to ...

CORRESPONDENCE: Moyamoya Disease and Moyamoya Syndrome

To the Editor: As the principal investigator of a National Institutes of Health (NIH)-funded natural-history study involving North American adults ...

CORRESPONDENCE: BRAF Mutation in Metastatic Colorectal Cancer

To the Editor: We recently found that progression-free survival was shorter among patients with metastatic colorectal cancer treated with chemotherapy, ...

BOOK REVIEW: Fixing My Gaze: A Scientist's Journey into Seeing in Three Dimensions

Seeing the three-dimensional world with two-dimensional retinas presents the brain with two problems. To locate an object in space requires depth perception, which can be acquired from one eye alone ...

BOOK REVIEW: Diagnostic Microbiology of the Immunocompromised Host

Laboratory medicine has no more urgent role than in the diagnosis and management of infections in immunocompromised patients. For this vulnerable population, clinical algorithms are logically rooted in the need ...

CORRECTIONS: Triple-Reassortant Swine Influenza A (H1) in Humans in the United States, 2005-2009

Triple-Reassortant Swine Influenza A (H1) in Humans in the United States, 2005-2009 (10.1056/NEJMoa9093812; published on May 7, 2009, at NEJM.org). In the list of authors, the name Susan Vagasky, D.V.M., ...

CORRECTIONS: Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans

Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans (10.1056/NEJMoa0903810; published on May 7, 2009, at NEJM.org). In the second paragraph of the Demographic and Clinical Features subsection ...

CME: Epidemiologic Study of In-Hospital Cardiopulmonary Resuscitation in the Elderly

(No abstract is available for this citation)

CME: Rhabdomyolysis and Acute Kidney Injury

(No abstract is available for this citation)

CME: A Fragile Balance

(No abstract is available for this citation)