 |
 |
|
|
Articles 
Allison L. Naleway, Edward A. Belongia, Robert T. Greenlee, Burney A. Kieke, Jr, Robert T. Chen, and David K. Shay Relying only on a self-reported history of eczematous skin disease will miss a substantial proportion of individuals who should not receive smallpox vaccine in a preexposure vaccination campaign.
Catherine Cordonnier, Sylvie Chevret, Marc Legrand, Homa Rafi, Nathalie Dhédin, Blandine Lehmann, François Bassompierre, Eliane Gluckman for the GREFIG Study Group* This clinical trial showed that prophylactic immunoglobulin is not effective in patients undergoing allogeneic hematopoietic stem-cell transplantation.
Giancarlo Agnelli, Paolo Prandoni, Cecilia Becattini, Mauro Silingardi, Maria Rita Taliani, Maddalena Miccio, Davide Imberti, Renzo Poggio, Walter Ageno, Enrico Pogliani, Fernando Porro, Pietro Zonzin for the Warfarin Optimal Duration Italian Trial Investigators* Patients with pulmonary embolism have a substantial risk for recurrence after stopping oral anticoagulation, regardless of the length of treatment. Physicians should try to identify patients who may benefit from indefinite oral anticoagulation because of their high risk for recurrent venous thromboembolism.
Brief Communications
Giuseppe Nunnari, Luciano Nigro, Filippo Palermo, Massimo Attanasio, Annemarie Berger, Hans W. Doerr, Roger J. Pomerantz, and Bruno Cacopardo GB virus C may interfere with progression of HIV-1 infection by maintaining an intact T-helper 1 cytokine profile.
Improving Patient Care
Gilad J. Kuperman and Richard F. Gibson The authors examine the potential benefits and costs of computer physician order entry. They also describe issues to consider before implementation of this type of order entry system.
Academia and Clinic
Michelle M. Mello, David M. Studdert, and Troyen A. Brennan While litigation may serve a valuable compensation function for injured participants in human subjects research, it will also profoundly affect institutional review procedures. More mechanistic ethical review, a likely outcome, will not further the interests of human subjects or scientific progress.
Reviews
Samir Gupta, Stephen Bent, and Jeffrey Kohlwes According to the "best-case" estimates of
Clinical Guidelines
U.S. Preventive Services Task Force* According to the U.S. Preventive Services Task Force, the evidence is insufficient to recommend for or against the use of supplements of vitamins A, C, or E; multivitamins with folic acid; or antioxidant combinations to prevent cancer or cardiovascular disease. The Task Force recommends against the use of beta-carotene supplements, either alone or in combination, for preventing cancer or cardiovascular disease.
Cynthia D. Morris and Susan Carson This systematic review evaluates the evidence that routine vitamin supplementation reduces the risk for cancer and cardiovascular disease.
Editorials
Daniel D. Federman The paper by Mello and colleagues in this issue describes the growth of litigation about protection of participants in research trials, and a letter by Humphreys and associates reports on the costs of institutional review boards. Reconciling the pursuit of new knowledge with minimizing risk to patients and preserving their freedom to sue may prove impossible. In the event of an impasse, society should construct a procedure to compensate research subjects who come to harm.
On Being a Doctor
Keiki Hinami My grandfather, like many, endures the indignity of falling apart. I am powerless and cannot prevent him from falling further. I can only prevent him from falling alone.
Shyam K. Bhat It feels routine now, this mundane ordering of expensive tests with no questions asked about cost. No more do I feel the sense of wonder and amazement that suffused me when I first started working as a physician in the United States. But today, as I order the scan and look into the eyes of this 92-year-old lady with a dying body that all these thousands of dollars will not save, I think back to the boy.
Letters Routine Tandem Transplantation for Patients with Myeloma
Bent (Head-Down) Posture and Aberrant Internal Carotid Artery in the Mouth: A New Risk Factor for Stroke?
Improved Outcomes in a Voluntary Hospitalist Model
The Who, What, When, Where, Whom, and How of Hospitalist Care
The Cost of Institutional Review Board Procedures in Multicenter Observational Research
Developing and Implementing a Program of Grand Rounds for Internists That Is Free of Commercial Bias
A New Cutaneous Sign of Mercury Poisoning
| ||||||||||||||||||||||||||||||||||||||||||||||
In this Issue
Articles
Previous Issue
-fetoprotein sensitivity and specificity, this test is not effective for detecting hepatocellular carcinoma in hepatitis C virus–infected patients. 