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Money and the Changing Culture of Medicine
Drs. Pamela Hartzband and Jerome Groopman argue that assigning a monetary value to every aspect of a physician’s time and effort may actually reduce productivity, impair the quality of performance, and thereby even increase costs.
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The Neurontin Legacy — Marketing through Misinformation and Manipulation
Recently, lawsuits alleging damages from illegal marketing of gabapentin (Neurontin) have yielded remarkable discoveries about the structure and function of pharmaceutical marketing. Drs. Seth Landefeld and Michael Steinman write that Neurontin’s most important legacy may be promoting our discussion of these issues and pushing us beyond the tipping point to action.
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Toward the Elimination of Schistosomiasis
Schistosomiasis remains one of the world’s most prevalent diseases. Dr. Charles King discusses how we can break the cycle of transmission. (View an interactive graphic on schistosomiasis prevalence and the life cycle of the schistosome.)
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Vitiligo
Vitiligo is the most common depigmenting disorder. This article reviews the distinctive clinical features of nonsegmental and segmental vitiligo and discusses treatment and management strategies.
CME Exam
 Listen to the full text of this article.
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A Man with Progressive Cognitive Decline
A 57-year-old man had a generalized seizure, after which he was confused, incoherent, and intermittently agitated. He had had episodes of confusion for the past 5 years and worsening memory loss and performance problems. MRI of the brain revealed diffuse signal abnormalities in the white matter.
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Timing of Elective Repeat Cesarean Delivery and Neonatal Outcomes
As compared with deliveries at or after 39 weeks, cesarean deliveries before 39 weeks of gestation were associated with an increased risk of a composite primary outcome that included neonatal death, respiratory complications, need for mechanical ventilation, treated hypoglycemia, newborn sepsis, and admission to the neonatal intensive care unit.
CME Exam
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A Strategy to Control Transmission of Schistosoma japonicum in China
Schistosoma japonicum has been successfully controlled in villages along Poyang Lake, the largest freshwater lake in China. In addition to synchronous chemotherapy for humans and cattle, successful interventions have included the removal of cattle from snail-infested grasslands, improvements in sanitation, and intensive health education.
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Deletion of IKZF1 and Prognosis in Acute Lymphoblastic Leukemia
This study investigated genetic abnormalities in high-risk and low-risk acute lymphoblastic leukemia (ALL). The evidence suggests that a loss of function of IKZF1 has a role in resistance to chemotherapy in ALL.
 January 7, 2009 (DOI: 10.1056/NEJMoa0808253), in Print January 29, 2009
Related Editorial: Acute Lymphoblastic Leukemia — On the Wings of IKAROS
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Glucose Control and Vascular Complications in Diabetes
In this study, military veterans with poorly controlled type 2 diabetes were randomly assigned to receive either standard or intensive glucose control. There was no significant difference between the two groups in the rates of major cardiovascular events, death, or microvascular complications.
CME Exam
Published Online December 17, 2008 (DOI: 10.1056/NEJMoa0808431)
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Arterial Blood Gases and Oxygen Content in Climbers on Mount Everest
The authors measured arterial oxygen tension in climbers on their ascent to and descent from the peak of Mount Everest. The oxygen tensions recorded are quite low and indicate that humans can function, when acclimatized, in environments with very low ambient oxygen tension.
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Mortality Attributable to Smoking in China
In this large study of Chinese adults in 2005, tobacco smoking was associated with increased mortality. The authors estimate that 673,000 deaths in China in 2005 were caused by smoking.
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Making Small Risks Even Smaller
Tiotropium in Chronic Obstructive Pulmonary Disease
Defibrillators in Heart Failure and Quality of Life
Magnesium Sulfate for the Prevention of Cerebral Palsy
Continuous Glucose Monitoring and Type 1 Diabetes
Monoclonal Antibody Therapy and Non-Hodgkin’s Lymphoma
Elimination of Antibodies to Recombinant Enzyme in Pompe’s Disease
Glycemic Control in Patients with Insulinoma Treated with Everolimus
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