NEJM â Collection Updates for Diet/Nutrition

OTHER POINTS OF VIEW: Taxing âSin Foodsâ â Obesity Prevention and Public Health Policy

Thu, 10Â DecÂ 2009 00:00:00 -05:00

As the United States struggles to combat obesity, some health policy experts have asserted that a tax on sugar-sweetened beverages such as soda would lead to reduced consumption of sodas...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: A Look at the Low-Carbohydrate Diet

Steven R. Smith, M.D. — Thu, 03Â DecÂ 2009 00:00:00 -05:00

Most fad diets are just that â a bright flash that quickly fades, only to be followed by another best-seller and a new face on the talk-show circuit. The high-fat,...

HEALTH POLICY REPORT: The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages

Thu, 15Â OctÂ 2009 00:00:00 -05:00

The consumption of sugar-sweetened beverages has been linked to risks for obesity, diabetes, and heart disease123; therefore, a compelling case can be made for the need for reduced consumption of...

PERSPECTIVE: American Roulette â Contaminated Dietary Supplements

Thu, 15Â OctÂ 2009 00:00:00 -05:00

In one of the most dangerous cities in the United States, one portly police sergeant has more to worry about than crime. His doctor had been encouraging him for years...

CLINICAL THERAPEUTICS: Parenteral Nutrition in the Critically Ill Patient

Thomas R. Ziegler, M.D. — Thu, 10Â SepÂ 2009 00:00:00 -05:00

A 67-year-old woman with type 2 diabetes mellitus undergoes extensive resection of the small bowel and right colon with a jejunostomy and colostomy because of mesenteric ischemia. In the surgical...

CORRESPONDENCE: What Went In When Trans Went Out?

Steen Stender, M.D., Arne Astrup, M.D., and JÃ¸rn Dyerberg, M.D. — Thu, 16Â JulÂ 2009 00:00:00 -05:00

To the Editor: Industrially produced trans fatty acids in popular foods such as fast foods, cookies, cakes, and snacks1 are gradually being replaced in the United States and Western Europe...

HEALTH LAW, ETHICS, AND HUMAN RIGHTS: New York City's War on Fat

Michelle M. Mello, J.D., Ph.D. — Thu, 07Â MayÂ 2009 00:00:00 -05:00

In February, a federal appeals court handed public health officials in New York City an important victory in their ongoing war on obesity and chronic disease.1 In the past 3...

CORRESPONDENCE: Vitamin D Deficiency in Critically Ill Patients

Thu, 30Â AprÂ 2009 00:00:00 -05:00

To the Editor: Vitamin D deficiency is rarely considered or treated in critically ill patients. However, we recently reported three cases of life-threatening hypocalcemia secondary to vitamin D deficiency,12 highlighting...

PERSPECTIVE: Ounces of Prevention â The Public Policy Case for Taxes on Sugared Beverages

Thu, 30Â AprÂ 2009 00:00:00 -05:00

The obesity epidemic has inspired calls for public health measures to prevent diet-related diseases. One controversial idea is now the subject of public debate: food taxes.

Forty states already have small...

CORRESPONDENCE: Melamine and Nephrolithiasis in Children in Taiwan

Thu, 12Â MarÂ 2009 00:00:00 -05:00

To the Editor: The adverse renal effects of melamine-tainted formula have raised international concern. To address public concerns about melamine, the department of health in Taiwan initiated services to screen...

CORRESPONDENCE: Ultrasonographic Evaluation of Melamine-Exposed Children in Hong Kong

Thu, 12Â MarÂ 2009 00:00:00 -05:00

To the Editor: The recent melamine contamination of infant formula and milk products in China placed thousands of children in China and neighboring regions at risk for renal-stone formation and...

EDITORIAL: Melamine, Powdered Milk, and Nephrolithiasis in Chinese Infants

Craig B. Langman, M.D. — Thu, 12Â MarÂ 2009 00:00:00 -05:00

Melamine, a synthetic nitrogenous product found in many industrial goods and even in fertilizer destined for use in growing crops for human consumption, was recently found to have been added...

ORIGINAL ARTICLE: Melamine-Contaminated Powdered Formula and Urolithiasis in Young Children

Thu, 12Â MarÂ 2009 00:00:00 -05:00

Background: A recent epidemic of melamine contamination of baby formula in China has been associated with the development of urinary tract stones, though the clinical manifestations and predisposing factors are...

PERSPECTIVE: Coming to Grips with Foodborne Infection â Peanut Butter, Peppers, and Nationwide Salmonella Outbreaks

Thu, 05Â MarÂ 2009 00:00:00 -05:00

Two years ago, a nationwide outbreak of Shiga toxinâproducing Escherichia coli O157:H7 enteritis linked to consumption of contaminated spinach from one California supplier captured the attention of the national media...

CORRESPONDENCE: Iodine Content of Prenatal Multivitamins in the United States

Angela M. Leung, M.D., Elizabeth N. Pearce, M.D., and Lewis E. Braverman, M.D. — Thu, 26Â FebÂ 2009 00:00:00 -05:00

To the Editor: Normal thyroid function in fetuses and breast-fed infants, which is dependent on sufficient maternal dietary intake of iodine, is crucial for normal neurocognitive development.1 Children of mothers...

EDITORIAL: Weight-Loss Diets for the Prevention and Treatment of Obesity

Martijn B. Katan, Ph.D. — Thu, 26Â FebÂ 2009 00:00:00 -05:00

No medical condition has generated as many dietary remedies as obesity. All diets have their followers, but hard data on the efficacy of the diets are scarce. In this issue...

ORIGINAL ARTICLE: Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates

Thu, 26Â FebÂ 2009 00:00:00 -05:00

Background: The possible advantage for weight loss of a diet that emphasizes protein, fat, or carbohydrates has not been established, and there are few studies that extend beyond 1 year.

Methods:...

IMAGES IN CLINICAL MEDICINE: A Smooth, Shiny Tongue

Hyo Jin Lee, M.D. and Deog Yeon Jo, M.D. — Thu, 05Â FebÂ 2009 00:00:00 -05:00

A 77-year-old woman presented with an insidious onset of fatigue and a burning sensation of the tongue on swallowing food. Six years earlier, she had undergone a total gastrectomy for...

CLINICAL THERAPEUTICS: Behavioral Management for Anorexia Nervosa

Evelyn Attia, M.D., and B. Timothy Walsh, M.D. — Thu, 29Â JanÂ 2009 00:00:00 -05:00

A 23-year-old woman with anorexia nervosa visits her internist. Her height is 5 ft 6 in. (168 cm), and her weight is 104 lb (47 kg), with a body-mass index...

ORIGINAL ARTICLE: Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women

Thu, 29Â JanÂ 2009 00:00:00 -05:00

Background: Obesity is an established and modifiable risk factor for urinary incontinence, but conclusive evidence for a beneficial effect of weight loss on urinary incontinence is lacking.

Methods: We randomly assigned...

CORRESPONDENCE: Excess Iodine from an Unexpected Source

Seth M. Arum, M.D., Xuemei He, M.D., and Lewis E. Braverman, M.D. — Thu, 22Â JanÂ 2009 00:00:00 -05:00

To the Editor: It is standard practice to induce a decrease in the body's iodine stores before treatment with radioiodine for thyroid cancer. Such patients should avoid an iodine-rich diet,12...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 3-2009 â A 9-Month-Old Boy with Seizures

Michael F. Holick, M.D., Ph.D., Ruth Lim, M.D., and Anand S. Dighe, M.D., Ph.D. — Thu, 22Â JanÂ 2009 00:00:00 -05:00

Dr. Bronwen C. Carroll (Pediatrics): A 9-month-old boy was admitted to this hospital because of a generalized seizure and a bulging fontanelle.

The patient was reportedly well until 3 days before...

CORRESPONDENCE: Glycemic Control in Patients with Insulinoma Treated with Everolimus

Matthew H. Kulke, M.D., Emily K. Bergsland, M.D., and James C. Yao, M.D. — Thu, 08Â JanÂ 2009 00:00:00 -05:00

To the Editor: Management of refractory hypoglycemia due to malignant insulinoma is challenging. Currently available treatments include dietary modification, diazoxide, and, in patients with resistant disease, the use of intravenous...

ORIGINAL ARTICLE: Glucose Control and Vascular Complications in Veterans with Type 2 Diabetes

Thu, 08Â JanÂ 2009 00:00:00 -05:00

Background: The effects of intensive glucose control on cardiovascular events in patients with long-standing type 2 diabetes mellitus remain uncertain.

Methods: We randomly assigned 1791 military veterans (mean age, 60.4 years)...

IMAGES IN CLINICAL MEDICINE: Occult Hip Fracture

Emily N. Vinson, M.D. — Thu, 25Â DecÂ 2008 00:00:00 -05:00

An 87-year-old man tripped and fell; subsequently, persistent pain developed in the left hip. A radiograph of the left hip 2 weeks after the fall revealed diffuse osteopenia with no...

EDITORIAL: Shared Genetic Risk Factors for Type 1 Diabetes and Celiac Disease

Robert M. Plenge, M.D., Ph.D. — Thu, 25Â DecÂ 2008 00:00:00 -05:00

Some families seem to be afflicted with more than their fair share of chronic illness â and sometimes more than one. Why does a particular disease develop in some members...

ORIGINAL ARTICLE: Shared and Distinct Genetic Variants in Type 1 Diabetes and Celiac Disease

Thu, 25Â DecÂ 2008 00:00:00 -05:00

Background: Two inflammatory disorders, type 1 diabetes and celiac disease, cosegregate in populations, suggesting a common genetic origin. Since both diseases are associated with the HLA class II genes on...

PERSPECTIVE: Melamine and the Global Implications of Food Contamination

Thu, 25Â DecÂ 2008 00:00:00 -05:00

Food contamination, whether accidental or intentional, has been a sad, recurrent theme throughout recorded history, going back some 8000 years and described in the Old Testament. However, a new dimension...

IMAGES IN CLINICAL MEDICINE: Ultrasound Imaging of the Thoracic Duct

Marcus Seeger, M.D. and Burkhard Bewig, M.D. — Thu, 27Â NovÂ 2008 00:00:00 -05:00

Recent advances in ultrasound imaging allow visualization of the cervical part of the thoracic duct. In Panel A and Video 1, ultrasound imaging conducted to evaluate the thyroid of a...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: The Exercise Pill â Too Good to Be True?

Laurie J. Goodyear, Ph.D. — Thu, 23Â OctÂ 2008 00:00:00 -05:00

Regular physical exercise has undisputed health benefits in the prevention â and in some cases, the treatment â of many diseases. The problem is that for the great majority of...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2008 â A 10-Year-Old Girl with Recurrent Oral Lesions and Cutaneous Bullae

James G.H. Dinulos, M.D., and Artur Zembowicz, M.D. — Thu, 16Â OctÂ 2008 00:00:00 -05:00

Dr. Melissa M. Burnett (Pediatric Dermatology): A 10.8-year-old girl was seen in the Pediatric Dermatology Clinic of this hospital because of recurrent oral ulcers and cutaneous bullae.

The patient was well...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2008 â A 10-Year-Old Girl with Recurrent Oral Lesions and Cutaneous Bullae

James G.H. Dinulos, M.D., and Artur Zembowicz, M.D. — Thu, 16Â OctÂ 2008 00:00:00 -05:00

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2008 â A 19-Year-Old Man with Weight Loss and Abdominal Pain

Thu, 18Â SepÂ 2008 00:00:00 -05:00

Dr. Jennifer Broder (Pediatrics): A 19-year-old man was admitted to this hospital because of acute abdominal pain.

He had been in his usual state of health until the evening before admission,...

ORIGINAL ARTICLE: Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

Thu, 17Â JulÂ 2008 00:00:00 -05:00

Background: Trials comparing the effectiveness and safety of weight-loss diets are frequently limited by short follow-up times and high dropout rates.

Methods: In this 2-year trial, we randomly assigned 322 moderately...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 16-2008 â A 46-Year-Old Woman with Bone Pain

Marie B. Demay, M.D., Daniel I. Rosenthal, M.D., and Vikram Deshpande, M.D. — Thu, 22Â MayÂ 2008 00:00:00 -05:00

A 46-year-old woman was seen in the orthopedic oncology clinic of this hospital because of pain in the right hip and leg. Several months earlier, pain had developed in her...

CLINICAL PROBLEM-SOLVING: Back to Basics

Ilan Gabriely, M.D., James P. Leu, M.D., and Uriel S. Barzel, M.D. — Thu, 01Â MayÂ 2008 00:00:00 -05:00

A 41-year-old woman was brought by her husband to the emergency department with a history of 72 hours of epigastric pain, nausea, repeated vomiting, and altered mental status. Her blood...

CLINICAL PRACTICE: Nonsurgical Management of Obesity in Adults

Robert H. Eckel, M.D. — Thu, 01Â MayÂ 2008 00:00:00 -05:00

A 44-year-old woman desires weight reduction. Her history is notable for hypertension, snoring, daytime somnolence, and osteoarthritis. Her father was obese and had type 2 diabetes. On physical examination, her...

ORIGINAL ARTICLE: Gene Identification for the cblD Defect of Vitamin B Metabolism

Thu, 03Â AprÂ 2008 00:00:00 -05:00

Background: Vitamin B12 (cobalamin) is an essential cofactor in several metabolic pathways. Intracellular conversion of cobalamin to its two coenzymes, adenosylcobalamin in mitochondria and methylcobalamin in the cytoplasm, is necessary...

IMAGES IN CLINICAL MEDICINE: Renal Failure from Vitamin C after Transplantation

Brian J. Nankivell, M.D., Ph.D. and Karumathil M. Murali, M.D. — Thu, 24Â JanÂ 2008 00:00:00 -05:00

A 31-year-old woman with bilateral nephrectomy due to bleeding angiomyolipomas from tuberous sclerosis received a kidney transplant with good early graft function. Irreversible, oliguric renal allograft failure soon developed from...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 23-2007 â A 9-Year-Old Boy with Bone Pain, Rash, and Gingival Hypertrophy

Thu, 26Â JulÂ 2007 00:00:00 -05:00

Dr. Laura Chapman (Pediatrics): A 9-year-old boy with autism was admitted to this hospital because of pain in the hip, refusal to walk, and the recent onset of a rash...

REVIEW ARTICLE: Vitamin D Deficiency

Michael F. Holick, M.D., Ph.D. — Thu, 19Â JulÂ 2007 00:00:00 -05:00

Once foods were fortified with vitamin d and rickets appeared to have been conquered, many health care professionals thought the major health problems resulting from vitamin D deficiency had been...

ORIGINAL ARTICLE: Reduction in Neural-Tube Defects after Folic Acid Fortification in Canada

Thu, 12Â JulÂ 2007 00:00:00 -05:00

Background: In 1998, folic acid fortification of a large variety of cereal products became mandatory in Canada, a country where the prevalence of neural-tube defects was historically higher in the...

PERSPECTIVE: New York to Trans Fats: You're Out!

Thu, 17Â MayÂ 2007 00:00:00 -05:00

Ferrara CafÃ© in Manhattan's Little Italy is a century-old bakery steeped in tradition, but executive pastry chef Dennis Canciello has recently been tinkering with the recipes of two of the...

ORIGINAL ARTICLE: Effect of Torcetrapib on Carotid Atherosclerosis in Familial Hypercholesterolemia

Thu, 19Â AprÂ 2007 00:00:00 -05:00

Background: Torcetrapib, an inhibitor of cholesteryl ester transfer protein, may reduce atherosclerotic vascular disease by increasing levels of high-density lipoprotein (HDL) cholesterol.

Methods: A total of 850 patients with heterozygous familial...

ORIGINAL ARTICLE: Vitamins and Perinatal Outcomes among HIV-Negative Women in Tanzania

Thu, 05Â AprÂ 2007 00:00:00 -05:00

Background: Prematurity and low birth weight are associated with high perinatal and infant mortality, especially in developing countries. Maternal micronutrient deficiencies may contribute to these adverse outcomes.

Methods: In a double-blind...

EDITORIAL: CETP Inhibitors to Increase HDL Cholesterol Levels

Alan R. Tall, M.B., B.S. — Thu, 29Â MarÂ 2007 00:00:00 -05:00

Plasma levels of high-density lipoprotein (HDL) cholesterol are inversely related to the incidence of coronary heart disease and stroke. The lowering of low-density lipoprotein (LDL) cholesterol with statin therapy reduces...

ORIGINAL ARTICLE: Effect of Torcetrapib on the Progression of Coronary Atherosclerosis

Thu, 29Â MarÂ 2007 00:00:00 -05:00

Background: Levels of high-density lipoprotein (HDL) cholesterol are inversely related to cardiovascular risk. Torcetrapib, a cholesteryl ester transfer protein (CETP) inhibitor, increases HDL cholesterol levels, but the functional effects associated...

ORIGINAL ARTICLE: Inhibition of Microsomal Triglyceride Transfer Protein in Familial Hypercholesterolemia

Thu, 11Â JanÂ 2007 00:00:00 -05:00

Background: Patients with homozygous familial hypercholesterolemia have markedly elevated cholesterol levels, which respond poorly to drug therapy, and a very high risk of premature cardiovascular disease. Inhibition of the microsomal...

ORIGINAL ARTICLE: Low-Carbohydrate-Diet Score and the Risk of Coronary Heart Disease in Women

Thu, 09Â NovÂ 2006 00:00:00 -05:00

Background: Low-carbohydrate diets have been advocated for weight loss and to prevent obesity, but the long-term safety of these diets has not been determined.

Methods: We evaluated data on 82,802 women...

ORIGINAL ARTICLE: A Self-Regulation Program for Maintenance of Weight Loss

Thu, 12Â OctÂ 2006 00:00:00 -05:00

Background: Since many successful dieters regain the weight they lose, programs that teach maintenance skills are needed. We developed a maintenance program based on self-regulation theory and tested the efficacy...

ORIGINAL ARTICLE: Body-Mass Index and Mortality in Korean Men and Women

Thu, 24Â AugÂ 2006 00:00:00 -05:00

Background: Obesity is associated with diverse health risks, but the role of body weight as a risk factor for death remains controversial.

Methods: We examined the association between body weight and...

ORIGINAL ARTICLE: Overweight, Obesity, and Mortality in a Large Prospective Cohort of Persons 50 to 71 Years Old

Thu, 24Â AugÂ 2006 00:00:00 -05:00

Background: Obesity, defined by a body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) of 30.0 or more, is associated with an increased...

PERSPECTIVE: Overweight and Mortality among Baby Boomers â Now We're Getting Personal

Thu, 24Â AugÂ 2006 00:00:00 -05:00

I am a baby boomer, and my body-mass index (BMI) is 27.3. I am also an epidemiologist, so for both personal and professional reasons, I have closely followed the sometimes...

EDITORIAL: Iodine Nutrition â More Is Better

Robert D. Utiger, M.D. — Thu, 29Â JunÂ 2006 00:00:00 -05:00

In normal adults, the daily production rate of the two biologically active thyroid hormones, tetraiodothyronine (which is better known as thyroxine and has four iodine atoms) and triiodothyronine (which has...

EDITORIAL: Vitamin B, Folic Acid, and the Prevention of Dementia

Robert Clarke, M.D. — Thu, 29Â JunÂ 2006 00:00:00 -05:00

Finding treatments for the prevention of dementia is an important challenge for medical research.1 Dementia currently affects about 4.5 million persons in the United States, and many more have cognitive...

ORIGINAL ARTICLE: Effect of Iodine Intake on Thyroid Diseases in China

Thu, 29Â JunÂ 2006 00:00:00 -05:00

Background: Iodine is an essential component of thyroid hormones; either low or high intake may lead to thyroid disease. We observed an increase in the prevalence of overt hypothyroidism, subclinical...

ORIGINAL ARTICLE: A Controlled Trial of Homocysteine Lowering and Cognitive Performance

Thu, 29Â JunÂ 2006 00:00:00 -05:00

Background: The results of observational studies suggest that plasma homocysteine concentrations are inversely related to cognitive function in older people. Our objective was to test the hypothesis that lowering the...

PERSPECTIVE: Food Marketing and Childhood Obesity â A Matter of Policy

Thu, 15Â JunÂ 2006 00:00:00 -05:00

Everyone knows that American children are becoming fatter, but not everyone agrees on the cause. Many of today's children routinely consume more calories than they expend in physical activity, but...

EDITORIAL: Antioxidants and the Prevention of Preeclampsia â Unresolved Issues

Arun Jeyabalan, M.D., and Steve N. Caritis, M.D. — Thu, 27Â AprÂ 2006 00:00:00 -05:00

Preeclampsia is a pregnancy-specific, multisystem disorder that can have considerable adverse effects on the mother and the fetus. In developing countries, preeclampsia is a major cause of death among pregnant...

ORIGINAL ARTICLE: Vitamins C and E and the Risks of Preeclampsia and Perinatal Complications

Thu, 27Â AprÂ 2006 00:00:00 -05:00

Background: Supplementation with antioxidant vitamins has been proposed to reduce the risk of preeclampsia and perinatal complications, but the effects of this intervention are uncertain.

Methods: We conducted a multicenter, randomized...

EDITORIAL: Homocysteine Trials â Clear Outcomes for Complex Reasons

Joseph Loscalzo, M.D., Ph.D. — Thu, 13Â AprÂ 2006 00:00:00 -05:00

In 1969, McCully first proposed that homocysteine causes atherosclerosis.1 His hypothesis was based on the finding of atherosclerotic plaque at autopsies of young people with homocystinuria. This hypothesis was later...

IMAGES IN CLINICAL MEDICINE: Pellagra-like Dermatitis

Neda Ashourian, M.D. and Nico Mousdicas, M.D. — Thu, 13Â AprÂ 2006 00:00:00 -05:00

Three months after undergoing Roux-en-Y bariatric surgery, a 32-year-old woman presented with glossitis, angular cheilitis, and an erythematous, desquamative dermatitis with a distribution indicative of photosensitivity causing a burning sensation...

REVIEW ARTICLE: Trans Fatty Acids and Cardiovascular Disease

Thu, 13Â AprÂ 2006 00:00:00 -05:00

Trans fats, unsaturated fatty acids with at least one double bond in the trans configuration (Figure 1), are formed during the partial hydrogenation of vegetable oils, a process that converts...

ORIGINAL ARTICLE: Homocysteine Lowering and Cardiovascular Events after Acute Myocardial Infarction

Thu, 13Â AprÂ 2006 00:00:00 -05:00

Background: Homocysteine is a risk factor for cardiovascular disease. We evaluated the efficacy of homocysteine-lowering treatment with B vitamins for secondary prevention in patients who had had an acute myocardial...

ORIGINAL ARTICLE: Homocysteine Lowering with Folic Acid and B Vitamins in Vascular Disease

The Heart Outcomes Prevention Evaluation (HOPE) 2 Investigators — Thu, 13Â AprÂ 2006 00:00:00 -05:00

Background: In observational studies, lower homocysteine levels are associated with lower rates of coronary heart disease and stroke. Folic acid and vitamins B6 and B12 lower homocysteine levels. We assessed...

PERSPECTIVE: Crisis in Niger â Outpatient Care for Severe Acute Malnutrition

Thu, 19Â JanÂ 2006 00:00:00 -05:00

In July 2005, an international aid agency was preparing to distribute supplementary food rations at a therapeutic feeding center near Maradi, Niger. Fearing that few people would show up, aid...

CLINICAL PRACTICE: Low HDL Cholesterol Levels

M. Dominique Ashen, Ph.D., C.R.N.P., and Roger S. Blumenthal, M.D. — Thu, 22Â SepÂ 2005 00:00:00 -05:00

A 41-year-old man with dyslipidemia, hypertension, and a history of myocardial infarction four years previously comes to establish care. He is physically inactive and consumes a diet high in saturated...

PERSPECTIVE: Studying Herbal Remedies

Wallace Sampson, M.D. — Thu, 28Â JulÂ 2005 00:00:00 -05:00

How plausible are claims that echinacea, or purple coneflower, a perennial that is native to North America, is an effective treatment for viral respiratory disease? Tracing the evolution of views...

CLINICAL PRACTICE: Overweight Children and Adolescents

William H. Dietz, M.D., Ph.D., and Thomas N. Robinson, M.D., M.P.H. — Thu, 19Â MayÂ 2005 00:00:00 -05:00

A seven-year-old girl is 130 cm tall (51 in., the 90th percentile for girls of the same age) and weighs 34.6 kg (76 lb, above the 95th percentile), with a...

IMAGES IN CLINICAL MEDICINE: Wernicke's Encephalopathy

Brian Kaineg, M.D. and Patricia A. Hudgins, M.D. — Thu, 12Â MayÂ 2005 00:00:00 -05:00

A 21-year-old woman with schizoaffective disorder and a four-month history of diffuse abdominal pain, nausea, vomiting, and weight loss of more than 13 kg was admitted to the hospital because...

ORIGINAL ARTICLE: Hyponatremia among Runners in the Boston Marathon

Thu, 14Â AprÂ 2005 00:00:00 -05:00

Background: Hyponatremia has emerged as an important cause of race-related death and life-threatening illness among marathon runners. We studied a cohort of marathon runners to estimate the incidence of hyponatremia...

PERSPECTIVE: Marathon Maladies

Benjamin D. Levine, M.D., and Paul D. Thompson, M.D. — Thu, 14Â AprÂ 2005 00:00:00 -05:00

Patriots' Day, a Massachusetts holiday commemorating the Revolutionary War Battles of Lexington and Concord, is also the date of the annual Boston Marathon, a 42-km footrace. It was first run...

PERSPECTIVE: A Nutrition Paradox â Underweight and Obesity in Developing Countries

Benjamin Caballero, M.D., Ph.D. — Thu, 14Â AprÂ 2005 00:00:00 -05:00

A few years ago, I was visiting a primary care clinic in the slums of SÃ£o Paulo. The waiting room was full of mothers with thin, stunted young children, exhibiting...

IMAGES IN CLINICAL MEDICINE: Acquired Acrodermatitis Enteropathica

Linda C. Wang, M.D., J.D. and Shail Busbey, M.D. — Thu, 17Â MarÂ 2005 00:00:00 -05:00

A 41-year-old woman with a history of alcohol abuse, hypertension, and type 1 diabetes mellitus complicated by retinopathy, nephropathy, and end-stage renal disease presented with a five-month history of alopecia...

CLINICAL PRACTICE: Unhealthy Alcohol Use

Richard Saitz, M.D., M.P.H. — Thu, 10Â FebÂ 2005 00:00:00 -05:00

A 32-year-old man has a three-month history of difficulty sleeping. On questioning, he mentions that he drinks four to six glasses of wine three to four times per week. How...

CLINICAL PROBLEM-SOLVING: Special Cure

Thu, 04Â NovÂ 2004 00:00:00 -05:00

A 42-year-old white man presented with a history of eight months of pain in his low back, hips, ankles, and feet. He had begun experiencing progressively severe pain during a...

IMAGES IN CLINICAL MEDICINE: A Medical Mystery â Hyperpigmentation

Scott C. Wickless, D.O. and Tor A. Shwayder, M.D. — Thu, 07Â OctÂ 2004 00:00:00 -05:00

A 16-year-old boy presented with a two-year history of hyperpigmentation of the skin; his sclera were unaffected. He is shown with his mother for comparison. What is the diagnosis?...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 30-2004 â A 37-Year-Old Woman with Paresthesias of the Arms and Legs

Peter W. Marks, M.D., Ph.D., and Lawrence R. Zukerberg, M.D. — Thu, 23Â SepÂ 2004 00:00:00 -05:00

A 37-year-old woman was seen in the clinic because of numbness in the arms and legs.

Four months earlier, she had noticed tingling and numbness in the fingertips, without weakness, three...

PERSPECTIVE: Body Fat, Leptin, and Hypothalamic Amenorrhea

Rexford S. Ahima, M.D., Ph.D. — Thu, 02Â SepÂ 2004 00:00:00 -05:00

Hypothalamic amenorrhea can be defined as the cessation of menstruation due to a dysfunction of hypothalamic signals to the pituitary gland, resulting in a failure of ovulation. Typically, young women...

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 25-2004 â A 49-Year-Old Woman with Severe Obesity, Diabetes, and Hypertension

Thu, 12Â AugÂ 2004 00:00:00 -05:00

A 49-year-old woman was evaluated at this hospital for the management of obesity. She had been overweight since childhood; at the age of 10 years she weighed 45.4 kg, at...

CLINICAL PROBLEM-SOLVING: A Bitter Tale

Lori S. Newman, M.D., Ph.D., Mark W. Feinberg, M.D., and Howard E. LeWine, M.D. — Thu, 05Â AugÂ 2004 00:00:00 -05:00

A 53-year-old woman presented to an outpatient urgent care clinic with persistent nausea and vomiting. On the previous evening, she had had an acute onset of nausea that was followed...

IMAGES IN CLINICAL MEDICINE: The Chemosis of Trichinosis

Leonardo M. Astudillo, M.D. and Philippe M. Arlet, M.D. — Thu, 29Â JulÂ 2004 00:00:00 -05:00

A 45-year-old man was admitted to the hospital because of a fever (temperature, 40Â°C), myalgia, and headache. He did not have diarrhea. On examination, he had bilateral proptosis with chemosis...

EDITORIAL: Multivitamins, Nutrition, and Antiretroviral Therapy for HIV Disease in Africa

Barbara Marston, M.D., and Kevin M. De Cock, M.D. — Thu, 01Â JulÂ 2004 00:00:00 -05:00

Readers could be forgiven for being confused by the literature on micronutrients and the pathogenesis of human immunodeficiency virus (HIV) disease. Micronutrients play important roles in maintaining immune function and...

ORIGINAL ARTICLE: A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality

Thu, 01Â JulÂ 2004 00:00:00 -05:00

Background: Results from observational studies suggest that micronutrient status is a determinant of the progression of human immunodeficiency virus (HIV) disease.

Methods: We enrolled 1078 pregnant women infected with HIV in...

EDITORIAL: Prevention of Cardiovascular Events after Percutaneous Coronary Intervention

Howard C. Herrmann, M.D. — Thu, 24Â JunÂ 2004 00:00:00 -05:00

Cardiologists agree that the best and safest percutaneous coronary intervention is the one that never becomes necessary. In this regard, new therapies that prevent restenosis and retard or reverse atherosclerosis...

ORIGINAL ARTICLE: Folate Therapy and In-Stent Restenosis after Coronary Stenting

Thu, 24Â JunÂ 2004 00:00:00 -05:00

Background: Vitamin therapy to lower homocysteine levels has recently been recommended for the prevention of restenosis after coronary angioplasty. We tested the effect of a combination of folic acid, vitamin...

EDITORIAL: Homocysteine and Osteoporotic Fractures â Culprit or Bystander?

Lawrence G. Raisz, M.D. — Thu, 13Â MayÂ 2004 00:00:00 -05:00

Osteoporotic fractures are a major health problem in the industrialized nations, a problem that is likely to become even greater throughout the world as the population ages. One way to...

SOUNDING BOARD: The Role of Irradiation in Food Safety

Michael T. Osterholm, Ph.D., M.P.H., and Andrew P. Norgan — Thu, 29Â AprÂ 2004 00:00:00 -05:00

An estimated 76 million cases of foodborne disease, resulting in more than 325,000 hospitalizations and 5000 deaths, occur in the United States annually.1 Important sources of foodborne pathogens include contaminated...

PERSPECTIVE: Irradiation of Food â Helping to Ensure Food Safety

Donald W. Thayer, Ph.D. — Thu, 29Â AprÂ 2004 00:00:00 -05:00

In this issue of the Journal, Osterholm and Norgan (pages 1898â1901) present a convincing argument that physicians and other health care professionals, as health advocates, should also be advocates for...

EDITORIAL: Intensive Statin Therapy â A Sea Change in Cardiovascular Prevention

Eric J. Topol, M.D. — Thu, 08Â AprÂ 2004 00:00:00 -05:00

In the management of atherosclerotic vascular disease, statin drugs have already surpassed all other classes of medicines in reducing the incidence of the major adverse outcomes of death, heart attack,...

ORIGINAL ARTICLE: Effects of an Inhibitor of Cholesteryl Ester Transfer Protein on HDL Cholesterol

Thu, 08Â AprÂ 2004 00:00:00 -05:00

Background: Decreased high-density lipoprotein (HDL) cholesterol levels constitute a major risk factor for coronary heart disease; however, there are no therapies that substantially raise HDL cholesterol levels. Inhibition of cholesteryl...

ORIGINAL ARTICLE: Intensive versus Moderate Lipid Lowering with Statins after Acute Coronary Syndromes

Thu, 08Â AprÂ 2004 00:00:00 -05:00

Background: Lipid-lowering therapy with statins reduces the risk of cardiovascular events, but the optimal level of low-density lipoprotein (LDL) cholesterol is unclear.

Methods: We enrolled 4162 patients who had been hospitalized...

IMAGES IN CLINICAL MEDICINE: Oculo-Orogenital Syndrome â A Deficiency of Vitamins B and B

AndrÃ© Friedli, M.D. and Jean-Hilaire Saurat, M.D. — Thu, 11Â MarÂ 2004 00:00:00 -05:00

A 48-year-old man presented with a six-month history of irritated mouth angles, irritated genital skin, and red, burning eyes. On physical examination, he had blepharoconjunctivitis (Panel A), angular stomatitis (Panel...

ORIGINAL ARTICLE: Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men

Thu, 11Â MarÂ 2004 00:00:00 -05:00

Background: Various purine-rich foods and high protein intake have long been thought to be risk factors for gout. Similarly, the possibility that the consumption of dairy products has a role...

PERSPECTIVE: Uric Acid and Diet â Insights into the Epidemic of Cardiovascular Disease

Richard J. Johnson, M.D., and Bruce A. Rideout, D.V.M., Ph.D. — Thu, 11Â MarÂ 2004 00:00:00 -05:00

Gout, a disease that has been known since antiquity, is an acute, often recurrent arthritis mediated by the crystallization of uric acid within the joints and typically associated with hyperuricemia....

ORIGINAL ARTICLE: Relation of Serial Changes in Childhood Body-Mass Index to Impaired Glucose Tolerance in Young Adulthood

Thu, 26Â FebÂ 2004 00:00:00 -05:00

Background: The risk of type 2 diabetes mellitus is increased in people who have low birth weights and who subsequently become obese as adults. Whether their obesity originates in childhood...

PERSPECTIVE: Overweight in Childhood and Adolescence

William H. Dietz, M.D., Ph.D. — Thu, 26Â FebÂ 2004 00:00:00 -05:00

The prevalence of overweight doubled among children 6 to 11 years of age and tripled among those 12 to 17 years of age between the second National Health and Nutrition...

EDITORIAL: Fatty Acid Metabolism in Cystic Fibrosis

Birgitta Strandvik, M.D., Ph.D. — Thu, 05Â FebÂ 2004 00:00:00 -05:00

In 1989, when the gene locus for cystic fibrosis was identified, expectations were great for rapid progress in understanding and effectively treating the disease. It was generally believed that cystic...

PERSPECTIVE: Folic Acid and the Prevention of Neural-Tube Defects

Nicholas J. Wald, D.Sc., F.R.C.P. — Thu, 08Â JanÂ 2004 00:00:00 -05:00

In 1991, a randomized trial funded by the Medical Research Council demonstrated that folic acid supplementation before pregnancy and during its early stages markedly reduced the risk of neural-tube defects...

PERSPECTIVE: From Asthma to Atherosclerosis â 5-Lipoxygenase, Leukotrienes, and Inflammation

Raffaele De Caterina, M.D., Ph.D., and Antonella Zampolli, Ph.D. — Thu, 01Â JanÂ 2004 00:00:00 -05:00

Eicosanoids are lipid mediators of inflammation; they include a variety of compounds (prostaglandins, thromboxanes, leukotrienes, hydroxy- and epoxy-fatty acids, lipoxins, and isoprostanes) that are derived from the ubiquitous 20-carbon atom...

ORIGINAL ARTICLE: Arachidonate 5-Lipoxygenase Promoter Genotype, Dietary Arachidonic Acid, and Atherosclerosis

Thu, 01Â JanÂ 2004 00:00:00 -05:00

Background: Leukotrienes are inflammatory mediators generated from arachidonic acid (polyunsaturated nâ6 fatty acid) by the enzyme 5-lipoxygenase. Since atherosclerosis involves arterial inflammation, we hypothesized that a polymorphism in the 5-lipoxygenase...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Putting the Brakes on Insulin Signaling

Alan R. Saltiel, Ph.D. — Thu, 25Â DecÂ 2003 00:00:00 -05:00

The dramatic increase in the incidence of type 2 diabetes mellitus and obesity in the Western world signals the beginning of an epidemic that is expected to become a major...

ORIGINAL ARTICLE: The Effect of Oral Sucrose on Exercise Tolerance in Patients with McArdle's Disease

John Vissing, M.D., Ph.D., and Ronald G. Haller, M.D. — Thu, 25Â DecÂ 2003 00:00:00 -05:00

Background: Energy metabolism in muscles relies predominantly on the breakdown of glycogen early in exercise. In patients with McArdle's disease, blocked glycogenolysis in muscles results in low exercise tolerance and...

PERSPECTIVE: Sweet Success â A Treatment for McArdle's Disease

Anthony A. Amato, M.D. — Thu, 25Â DecÂ 2003 00:00:00 -05:00

Carbohydrates are often stored as glycogen in the body. Pathways for the synthesis and breakdown of glycogen (see Figure) permit the maintenance of a steady blood glucose level and provide...

REVIEW ARTICLE: Irritable Bowel Syndrome

Howard R. Mertz, M.D. — Thu, 27Â NovÂ 2003 00:00:00 -05:00

Irritable bowel syndrome, a common disorder in which bowel habits are altered in association with abdominal pain or discomfort, has a prevalence of 12 percent among adults in the United...

REVIEW ARTICLE: Chronic Constipation

Anthony Lembo, M.D., and Michael Camilleri, M.D. — Thu, 02Â OctÂ 2003 00:00:00 -05:00

Constipation is a common symptom affecting between 2 percent12 and 27 percent3 of the population in Western countries. In the United States, it results in more than 2.5 million visits...

ORIGINAL ARTICLE: Inhibition of Food Intake in Obese Subjects by Peptide YY

Thu, 04Â SepÂ 2003 00:00:00 -05:00

Background: The gut hormone fragment peptide YY3â36 (PYY) reduces appetite and food intake when infused into subjects of normal weight. In common with the adipocyte hormone leptin, PYY reduces food...

PERSPECTIVE: Prescription-Drug Coverage for Medicare Beneficiaries

John K. Iglehart — Thu, 04Â SepÂ 2003 00:00:00 -05:00

The Congressional Budget Office has estimated that all spending for prescription drugs by and on behalf of Medicare's eligible population will total $1.8 trillion during the period from 2004 through...

IMAGES IN CLINICAL MEDICINE: Phytosterolemia and Xanthomatosis

Anton F. Stalenhoef,, M.D., Ph.D. — Thu, 03Â JulÂ 2003 00:00:00 -05:00

A 17-year-old girl presented with multiple xanthomas of the hands (Panel A) and the Achilles tendons, as well as a family history of vascular disease. Familial hypercholesterolemia was suspected, but...

PERSPECTIVE: Severe Methylenetetrahydrofolate Reductase Deficiency, Methionine Synthase, and Nitrous Oxide â A Cautionary Tale

Richard W. Erbe, M.D., and Robbert J. Salis, M.D. — Thu, 03Â JulÂ 2003 00:00:00 -05:00

In this issue of the Journal, Selzer et al. (pages 45â50) describe the unexpected neurologic deterioration and death of an infant boy who had been anesthetized twice within a short...

ORIGINAL ARTICLE: Adherence to a Mediterranean Diet and Survival in a Greek Population

Thu, 26Â JunÂ 2003 00:00:00 -05:00

Background: Adherence to a Mediterranean diet may improve longevity, but relevant data are limited.

Methods: We conducted a population-based, prospective investigation involving 22,043 adults in Greece who completed an extensive, validated,...

PERSPECTIVE: The Mediterranean Diet and Mortality â Olive Oil and Beyond

Frank B. Hu, M.D., Ph.D. — Thu, 26Â JunÂ 2003 00:00:00 -05:00

The concept of the Mediterranean diet originated from the Seven Countries Study initiated by Ancel Keys in the 1950s. The study showed that, despite a high fat intake, the population...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Celiac Disease â The Villain Unmasked?

Ross McManus, Ph.D., and Dermot Kelleher, M.D. — Thu, 19Â JunÂ 2003 00:00:00 -05:00

Celiac disease (also known as celiac sprue and gluten-sensitive enteropathy) is a common autoimmune condition triggered by ingesting one of several related proteins found in wheat, barley, and rye: the...

EDITORIAL: Celiac Disease â How to Handle a Clinical Chameleon

Alessio Fasano, M.D. — Thu, 19Â JunÂ 2003 00:00:00 -05:00

Celiac disease is an immune-mediated enteropathy triggered by the ingestion of gluten-containing grains (including wheat, rye, and barley) in genetically susceptible persons. The disease is associated with HLA-DQ2 in 90...

ORIGINAL ARTICLE: Prevalence of Celiac Disease among Children in Finland

Thu, 19Â JunÂ 2003 00:00:00 -05:00

Background: Wheat, rye, and barley proteins induce celiac disease, an autoimmune type of gastrointestinal disorder, in genetically susceptible persons. Because the disease may be underdiagnosed, we estimated the prevalence of...

EDITORIAL: Interpreting Incomplete Data in Studies of Diet and Weight Loss

James H. Ware, Ph.D. — Thu, 22Â MayÂ 2003 00:00:00 -05:00

The prevalence of obesity among Americans 20 to 74 years of age increased from 15 percent during the period between 1976 and 1980 to 27 percent in 19991 and continues...

ORIGINAL ARTICLE: A Randomized Trial of a Low-Carbohydrate Diet for Obesity

Thu, 22Â MayÂ 2003 00:00:00 -05:00

Background: Despite the popularity of the low-carbohydrate, high-protein, high-fat (Atkins) diet, no randomized, controlled trials have evaluated its efficacy.

Methods: We conducted a one-year, multicenter, controlled trial involving 63 obese men...

ORIGINAL ARTICLE: A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity

Thu, 22Â MayÂ 2003 00:00:00 -05:00

Background: The effects of a carbohydrate-restricted diet on weight loss and risk factors for atherosclerosis have been incompletely assessed.

Methods: We randomly assigned 132 severely obese subjects (including 77 blacks and...

PERSPECTIVE: Diet, Obesity, and Cardiovascular Risk

Robert O. Bonow, M.D., and Robert H. Eckel, M.D. — Thu, 22Â MayÂ 2003 00:00:00 -05:00

The growing prevalence of obesity and type 2 diabetes in the United States has attracted the attention and concern of the medical profession, the media, policymakers, and the American public....

EDITORIAL: Defective Melanocortin 4 Receptors in Hyperphagia and Morbid Obesity

James F. List, M.D., Ph.D., and Joel F. Habener, M.D. — Thu, 20Â MarÂ 2003 00:00:00 -05:00

There has been a dramatic increase in the worldwide prevalence of obesity, a disorder with complex genetic traits that is influenced by environmental factors and that predisposes affected persons to...

ORIGINAL ARTICLE: Binge Eating as a Major Phenotype of Melanocortin 4 Receptor Gene Mutations

Thu, 20Â MarÂ 2003 00:00:00 -05:00

Background: Obesity, a multifactorial disease caused by the interaction of genetic factors with the environment, is largely polygenic. A few mutations in these genes, such as in the leptin receptor...

ORIGINAL ARTICLE: Clinical Spectrum of Obesity and Mutations in the Melanocortin 4 Receptor Gene

Thu, 20Â MarÂ 2003 00:00:00 -05:00

Background: Melanocortin 4 receptor (MC4R) deficiency is the commonest monogenic form of obesity. However, the clinical spectrum and mode of inheritance have not been defined, pathophysiological mechanisms leading to obesity...

ORIGINAL ARTICLE: Effect of Anti-IgE Therapy in Patients with Peanut Allergy

Thu, 13Â MarÂ 2003 00:00:00 -05:00

Background: Peanut-induced anaphylaxis is an IgE-mediated condition that is estimated to affect 1.5 million people and cause 50 to 100 deaths per year in the United States. TNX-901 is a...

PERSPECTIVE: Studying Peanut Anaphylaxis

Beverly Merz — Thu, 13Â MarÂ 2003 00:00:00 -05:00

In this issue of the Journal, Leung et al. (pages 986â993) report results with a new drug to reduce the risk of anaphylactic reactions to food. In a multicenter, phase...

EDITORIAL: Two Approaches to Peanut Allergy

Henry Metzger, M.D. — Thu, 13Â MarÂ 2003 00:00:00 -05:00

About 80 years ago, Carl Prausnitz injected into his abdominal skin a small amount of serum from his colleague, Heinz KÃ¼stner. When Prausnitz subsequently ate some cooked fish to which...

ORIGINAL ARTICLE: Factors Associated with Progression of Carcinoid Heart Disease

Thu, 13Â MarÂ 2003 00:00:00 -05:00

Background: By releasing vasoactive substances into the circulation, carcinoid tumors can cause right-sided valvular heart disease. Factors associated with the progression of carcinoid heart disease are poorly understood. We conducted...

PERSPECTIVE: Inappropriate Advertising of Dietary Supplements

Jeffrey M. Drazen, M.D. — Thu, 27Â FebÂ 2003 00:00:00 -05:00

Information about health is worthwhile only if it is accurate and fairly communicated. Recently, a number of advertisements on the Internet have contained statements about dietary supplements that could lead...

EDITORIAL: Reducing Cardiovascular Risk in Type 2 Diabetes

Caren G. Solomon, M.D. — Thu, 30Â JanÂ 2003 00:00:00 -05:00

Mortality from cardiovascular disease is increased by a factor of two to three in persons with diabetes as compared with the general population.1 Cardiovascular disease develops earlier in the presence...

ORIGINAL ARTICLE: Multifactorial Intervention and Cardiovascular Disease in Patients with Type 2 Diabetes

Thu, 30Â JanÂ 2003 00:00:00 -05:00

Background: Cardiovascular morbidity is a major burden in patients with type 2 diabetes. In the Steno-2 Study, we compared the effect of a targeted, intensified, multifactorial intervention with that of...

EDITORIAL: Hypervitaminosis A and Fractures

Paul Lips, M.D., Ph.D. — Thu, 23Â JanÂ 2003 00:00:00 -05:00

The toxicity of certain foods that contain high amounts of vitamin A has been recognized for centuries. The 1597 diary of Gerrit de Veer, which he wrote while taking refuge...

ORIGINAL ARTICLE: Serum Retinol Levels and the Risk of Fracture

Thu, 23Â JanÂ 2003 00:00:00 -05:00

Background: Although studies in animals and epidemiologic studies have indicated that a high vitamin A intake is associated with increased bone fragility, no biologic marker of vitamin A status has...

EDITORIAL: To Drink or Not to Drink?

Ira J. Goldberg, M.D. — Thu, 09Â JanÂ 2003 00:00:00 -05:00

A number of epidemiologic studies have found an association of alcohol intake with a reduced risk of cardiovascular disease. These observations have been purported to explain the so-called French paradox:...

ORIGINAL ARTICLE: Roles of Drinking Pattern and Type of Alcohol Consumed in Coronary Heart Disease in Men

Thu, 09Â JanÂ 2003 00:00:00 -05:00

Background: Although moderate drinking confers a decreased risk of myocardial infarction, the roles of the drinking pattern and type of beverage remain unclear.

Methods: We studied the association of alcohol consumption...

ORIGINAL ARTICLE: Tetrahydrobiopterin as an Alternative Treatment for Mild Phenylketonuria

Thu, 26Â DecÂ 2002 00:00:00 -05:00

Background: Hyperphenylalaninemia is a common inherited metabolic disease that is due to phenylalanine hydroxylase deficiency, and at least half the affected patients have mild clinical phenotypes. Treatment with a low-phenylalanine...

PERSPECTIVE: Tetrahydrobiopterin and Dietary Restriction in Mild Phenylketonuria

Thu, 26Â DecÂ 2002 00:00:00 -05:00

Inherited disorders of intermediary metabolism are the prototypes for the treatment of genetic disorders. In each condition, accumulation of a metabolite results from a genetically determined abnormality in a metabolic...

IMAGES IN CLINICAL MEDICINE: Something Fishy Going on in the Heart

James de la Torre and Julius Bishop — Thu, 28Â NovÂ 2002 00:00:00 -05:00

Figure 1. An important component of the second-year pathology course at medical school is becoming familiar with the microscopical manifestations of pathologic processes. While examining tissue from a patient with...

ORIGINAL ARTICLE: Mercury and the Risk of Coronary Heart Disease in Men

Thu, 28Â NovÂ 2002 00:00:00 -05:00

Background: A high dietary intake of mercury from consumption of fish has been hypothesized to increase the risk of coronary heart disease.

Methods: Using a nested caseâcontrol design, we investigated the...

ORIGINAL ARTICLE: Mercury, Fish Oils, and the Risk of Myocardial Infarction

Thu, 28Â NovÂ 2002 00:00:00 -05:00

Background: It has been suggested that mercury, a highly reactive heavy metal with no known physiologic activity, increases the risk of cardiovascular disease. Because fish intake is a major source...

PERSPECTIVE: Mercury and Health

Thu, 28Â NovÂ 2002 00:00:00 -05:00

Mercury, particularly methylmercury, is an established worldwide environmental pollutant with known toxicity in humans. The toxic effects of methylmercury in fish were first brought to light after several episodes of...

ORIGINAL ARTICLE: Decline in Physical Activity in Black Girls and White Girls during Adolescence

Thu, 05Â SepÂ 2002 00:00:00 -05:00

Background: Physical activity declines during adolescence, but the underlying reasons remain unknown.

Methods: We prospectively followed 1213 black girls and 1166 white girls enrolled in the National Heart, Lung, and Blood...

PERSPECTIVE: Physical Inactivity among Young People

Thu, 05Â SepÂ 2002 00:00:00 -05:00

It is widely recognized that the increasing proportion of overweight children and adolescents in the United States is a serious public health issue. Fifteen percent of young Americans are overweight...

ORIGINAL ARTICLE: Obesity and the Risk of Heart Failure

Thu, 01Â AugÂ 2002 00:00:00 -05:00

Background: Extreme obesity is recognized to be a risk factor for heart failure. It is unclear whether overweight and lesser degrees of obesity also pose a risk.

Methods: We investigated the...

EDITORIAL: The Stomach Speaks â Ghrelin and Weight Regulation

Thu, 23Â MayÂ 2002 00:00:00 -05:00

Recent years have witnessed explosive growth in knowledge of the physiologic factors regulating appetite and body weight.1 Among these are neural, metabolic, and endocrine signals from the periphery that reflect...

ORIGINAL ARTICLE: Plasma Ghrelin Levels after Diet-Induced Weight Loss or Gastric Bypass Surgery

Thu, 23Â MayÂ 2002 00:00:00 -05:00

Background: Weight loss causes changes in appetite and energy expenditure that promote weight regain. Ghrelin is a hormone that increases food intake in rodents and humans. If circulating ghrelin participates...

ORIGINAL ARTICLE: Blood Levels of Long-Chain nâ3 Fatty Acids and the Risk of Sudden Death

Thu, 11Â AprÂ 2002 00:00:00 -05:00

Background: Experimental data suggest that long-chain nâ3 polyunsaturated fatty acids found in fish have antiarrhythmic properties, and a randomized trial suggested that dietary supplements of nâ3 fatty acids may reduce...

PERSPECTIVE: Fish â Food to Calm the Heart

Thu, 11Â AprÂ 2002 00:00:00 -05:00

In the Book of Genesis, fish appeared in the waters on the fifth day of creation, after dry land and water separated. This may be the first reference to a...

IMAGES IN CLINICAL MEDICINE: Hypercarotenemia

Antonino Mazzone, M.D. and Antonio Dal Canton, M.D. — Thu, 14Â MarÂ 2002 00:00:00 -05:00

Figure 1. A 23-year-old woman who was admitted for jaundice was found to have yellow-orange discoloration of her skin (her hand is shown on the right, and the hand of...

REVIEW ARTICLE: Obesity

Susan Z. Yanovski, M.D., and Jack A. Yanovski, M.D., Ph.D. — Thu, 21Â FebÂ 2002 00:00:00 -05:00

Overweight and obesity are the most common nutritional disorders in the United States, affecting the majority of adults in the country. Given a normal body-mass index (defined as the weight...

ORIGINAL ARTICLE: Comparison of Two Diets for the Prevention of Recurrent Stones in Idiopathic Hypercalciuria

Thu, 10Â JanÂ 2002 00:00:00 -05:00

Background: A low-calcium diet is recommended to prevent recurrent stones in patients with idiopathic hypercalciuria, yet long-term data on the efficacy of a low-calcium diet are lacking. Recently, the efficacy...

PERSPECTIVE: Diet and Kidney Stones

Thu, 10Â JanÂ 2002 00:00:00 -05:00

Kidney and bladder stones cause excruciating pain, tend to recur, and are distressingly common. Roughly 10 percent of persons in the United States will have at least one stone in...

EDITORIAL: Recurrent Hypercalciuric Nephrolithiasis â Does Diet Help?

Thu, 10Â JanÂ 2002 00:00:00 -05:00

Kidney stones have a lifetime incidence of up to 13 percent in North America.1 In the United States, this disorder was responsible for an estimated 1.32 million visits to physicians...

CLINICAL PRACTICE: What Vitamins Should I Be Taking, Doctor?

Walter C. Willett, M.D., Dr.P.H., and Meir J. Stampfer, M.D., Dr.P.H. — Thu, 20Â DecÂ 2001 00:00:00 -05:00

A healthy 54-year-old, nonsmoking, omnivorous woman presenting for a routine examination asks about vitamin supplements. She expresses confusion about conflicting reports and recommendations. She currently uses no supplements....

IMAGES IN CLINICAL MEDICINE: Scurvy

Julian Leggett, M.R.C.P. and Rory Convery, M.R.C.P. — Thu, 20Â DecÂ 2001 00:00:00 -05:00

Figure 1. A 43-year-old man was admitted with a three-week history of general malaise, dysphagia, chronic cough, nausea, and a feeling of fullness after eating. He had undergone a Whipple...

ORIGINAL ARTICLE: Diet, Lifestyle, and the Risk of Type 2 Diabetes Mellitus in Women

Thu, 13Â SepÂ 2001 00:00:00 -05:00

Background: Previous studies have examined individual dietary and lifestyle factors in relation to type 2 diabetes, but the combined effects of these factors are largely unknown.

Methods: We followed 84,941 female...

ORIGINAL ARTICLE: Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance

Thu, 03Â MayÂ 2001 00:00:00 -05:00

Background: Type 2 diabetes mellitus is increasingly common, primarily because of increases in the prevalence of a sedentary lifestyle and obesity. Whether type 2 diabetes can be prevented by interventions...

EDITORIAL: Alarming Facts about the Health and Nutrition of Children in Tibet

Thu, 01Â FebÂ 2001 00:00:00 -05:00

Many people view Tibet as an exotic region where people live in rugged circumstances yet perpetuate values that are noble and mysterious. The study reported by Harris et al. in...

ORIGINAL ARTICLE: Nutritional and Health Status of Tibetan Children Living at High Altitudes

Thu, 01Â FebÂ 2001 00:00:00 -05:00

Background: Children living at high altitudes often have delayed growth, but whether growth retardation is related to altitude or to other factors is not known.

Methods: A multicultural health care team...

EDITORIAL: Beating High Blood Pressure with Low-Sodium DASH

Thu, 04Â JanÂ 2001 00:00:00 -05:00

The 1997 Dietary Approaches to Stop Hypertension (DASH) trial1 marked an important advance in the study of lifestyle factors as they relate to health and disease. Its findings were immediately...

ORIGINAL ARTICLE: Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet

Thu, 04Â JanÂ 2001 00:00:00 -05:00

Background: The effect of dietary composition on blood pressure is a subject of public health importance. We studied the effect of different levels of dietary sodium, in conjunction with the...

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Inhibition of Food Intake by Inhibitors of Fatty Acid Synthase

Thu, 21Â DecÂ 2000 00:00:00 -05:00

According to a recent report from the World Health Organization, it can be estimated that worldwide about 250 million adults â 7 percent of the population â are obese, defined...

ORIGINAL ARTICLE: Caffeine Intake and the Risk of First-Trimester Spontaneous Abortion

Thu, 21Â DecÂ 2000 00:00:00 -05:00

Background: Some epidemiologic studies have suggested that the ingestion of caffeine increases the risk of spontaneous abortion, but the results have been inconsistent.

Methods: We performed a population-based, caseâcontrol study of...

ORIGINAL ARTICLE: Adverse Cardiovascular and Central Nervous System Events Associated with Dietary Supplements Containing Ephedra Alkaloids

Christine A. Haller, M.D., and Neal L. Benowitz, M.D. — Thu, 21Â DecÂ 2000 00:00:00 -05:00

Background: Dietary supplements that contain ephedra alkaloids (sometimes called ma huang) are widely promoted and used in the United States as a means of losing weight and increasing energy. In...

ORIGINAL ARTICLE: Trends in the Incidence of Coronary Heart Disease and Changes in Diet and Lifestyle in Women

Thu, 24Â AugÂ 2000 00:00:00 -05:00

Background: Previous studies have found concurrent declines in blood pressure, serum cholesterol levels, and the incidence of and mortality from coronary disease. However, the effects of changes in diet and...

ORIGINAL ARTICLE: Primary Prevention of Coronary Heart Disease in Women through Diet and Lifestyle

Thu, 06Â JulÂ 2000 00:00:00 -05:00

Background: Many lifestyle-related risk factors for coronary heart disease have been identified, but little is known about their effect on the risk of disease when they are considered together.

Methods: We...

EDITORIAL: Cancer and Herbs

Thu, 08Â JunÂ 2000 00:00:00 -05:00

Bestselling books perpetuate the myth that natural products such as herbs and other âdietary supplementsâ tend to be safer than conventional medicines.1 Once relegated to health food stores, these products...

ORIGINAL ARTICLE: Urothelial Carcinoma Associated with the Use of a Chinese Herb ()

Thu, 08Â JunÂ 2000 00:00:00 -05:00

Background: Chinese-herb nephropathy is a progressive form of renal fibrosis that develops in some patients who take weight-reducing pills containing Chinese herbs. Because of a manufacturing error, one of the...

SOUNDING BOARD: Fortification of Foods with Folic Acid â How Much is Enough?

Thu, 11Â MayÂ 2000 00:00:00 -05:00

In the early 1990s two randomized clinical trials showed that folic acid, or multivitamins containing folic acid, could substantially reduce a woman's risk of bearing a child with a neural-tube...

ORIGINAL ARTICLE: Beneficial Effects of High Dietary Fiber Intake in Patients with Type 2 Diabetes Mellitus

Thu, 11Â MayÂ 2000 00:00:00 -05:00

Background: The effect of increasing the intake of dietary fiber on glycemic control in patients with type 2 diabetes mellitus is controversial.

Methods: In a randomized, crossover study, we assigned 13...

ORIGINAL ARTICLE: An Outbreak of Febrile Gastroenteritis Associated with Corn Contaminated by

Thu, 27Â AprÂ 2000 00:00:00 -05:00

Background: On May 21, 1997, numerous cases of febrile gastrointestinal illness were reported among the students and staff of two primary schools in northern Italy, all of whom had eaten...

EDITORIAL: Diet, Colorectal Adenomas, and Colorectal Cancer

Thu, 20Â AprÂ 2000 00:00:00 -05:00

Because colorectal cancers usually arise from adenomatous polyps, it is believed that preventing the growth of adenomas in the colon and rectum or removing any that appear will prevent colorectal...

ORIGINAL ARTICLE: Lack of Effect of a High-Fiber Cereal Supplement on the Recurrence of Colorectal Adenomas

Thu, 20Â AprÂ 2000 00:00:00 -05:00

Background: The risks of colorectal cancer and adenoma, the precursor lesion, are believed to be influenced by dietary factors. Epidemiologic evidence that cereal fiber protects against colorectal cancer is equivocal....

ORIGINAL ARTICLE: Lack of Effect of a Low-Fat, High-Fiber Diet on the Recurrence of Colorectal Adenomas

Thu, 20Â AprÂ 2000 00:00:00 -05:00

Background: We tested the hypothesis that dietary intervention can inhibit the development of recurrent colorectal adenomas, which are precursors of most large-bowel cancers.

Methods: We randomly assigned 2079 men and women...

SPECIAL ARTICLE: A Prospective Study of Holiday Weight Gain

Thu, 23Â MarÂ 2000 00:00:00 -05:00

Background: It is commonly asserted that the average American gains 5 lb (2.3 kg) or more over the holiday period between Thanksgiving and New Year's Day, yet few data support...

IMAGES IN CLINICAL MEDICINE: Ischemic Retinopathy Caused by Severe Megaloblastic Anemia

Kenneth Li, M.B., Ch.B. and Gerald McKay, M.B., Ch.B. — Thu, 23Â MarÂ 2000 00:00:00 -05:00

Figure 1. A 36-year-old woman who had been a vegan for many years presented with a one-week history of decreased visual acuity. She had had megaloblastic anemia six years earlier...

EDITORIAL: Dieting and Exercise in Overweight, Lactating Women

Thu, 17Â FebÂ 2000 00:00:00 -05:00

In this issue of the Journal, Lovelady et al.1 report the results of a 10-week intervention trial in which 40 overweight, lactating women were randomly assigned either to a diet-and-exercise...

ORIGINAL ARTICLE: The Effect of Weight Loss in Overweight, Lactating Women on the Growth of Their Infants

Thu, 17Â FebÂ 2000 00:00:00 -05:00

Background: The retention of weight gained during pregnancy may contribute to obesity. Lactation should promote weight loss, but weight loss is highly variable among lactating women. The risks associated with...

EDITORIAL: The Search for a Better Oral Rehydration Solution for Cholera

Thu, 03Â FebÂ 2000 00:00:00 -05:00

Oral rehydration therapy was developed in the 1960s. During the past three decades it has been used widely and successfully in the treatment of cholera and other diarrheal diseases. The...

ORIGINAL ARTICLE: Amylase-Resistant Starch plus Oral Rehydration Solution for Cholera

Thu, 03Â FebÂ 2000 00:00:00 -05:00

Background: Although standard glucose-based oral rehydration therapy corrects the dehydration caused by cholera, it does not reduce the diarrhea. Short-chain fatty acids, which are produced in the colon from nonabsorbed...

ORIGINAL ARTICLE: Vitamin E Supplementation and Cardiovascular Events in High-Risk Patients

The Heart Outcomes Prevention Evaluation Study Investigators — Thu, 20Â JanÂ 2000 00:00:00 -05:00

Background: Observational and experimental studies suggest that the amount of vitamin E ingested in food and in supplements is associated with a lower risk of coronary heart disease and atherosclerosis.

Methods:...

EDITORIAL: Caffeine â Filtering the Facts

Thu, 25Â NovÂ 1999 00:00:00 -05:00

The article by Klebanoff and colleagues1 in this issue of the Journal adds to the growing body of literature examining the association of caffeine intake with adverse pregnancy outcomes and...

ORIGINAL ARTICLE: Maternal Serum Paraxanthine, a Caffeine Metabolite, and the Risk of Spontaneous Abortion

Thu, 25Â NovÂ 1999 00:00:00 -05:00

Background: Whether the consumption of caffeine during pregnancy increases the risk of spontaneous abortion is controversial. Prior studies have determined caffeine consumption by questionnaire. We used a biologic marker, serum...

EDITORIAL: Alcohol for Stroke Prevention?

Thu, 18Â NovÂ 1999 00:00:00 -05:00

Cerebrovascular disease accounts for a substantial worldwide burden of death and disability. In addition to well-established risk factors such as hypertension, myocardial infarction, diabetes mellitus, and smoking,1 an increasing body...

ORIGINAL ARTICLE: Light-to-Moderate Alcohol Consumption and the Risk of Stroke among U.S. Male Physicians

Thu, 18Â NovÂ 1999 00:00:00 -05:00

Background: Several studies have shown U- or J-shaped relations between alcohol consumption and the risk of stroke. We evaluated the effect of light-to-moderate alcohol intake on the risk of stroke,...

REVIEW ARTICLE: Neural-Tube Defects

Thu, 11Â NovÂ 1999 00:00:00 -05:00

Each year spina bifida and anencephaly, the two most common forms of neural-tube defects, occur in 1 in 1000 pregnancies in the United States1 and an estimated 300,000 or more...

ORIGINAL ARTICLE: Prevention of Neural-Tube Defects with Folic Acid in China

Thu, 11Â NovÂ 1999 00:00:00 -05:00

Background: Periconceptional use of multivitamins containing folic acid can reduce a woman's risk of having a baby with a neural-tube defect.

Methods: As part of a public health campaign conducted from...

EDITORIAL: Rickets Today â Children Still Need Milk and Sunshine

Thu, 19Â AugÂ 1999 00:00:00 -05:00

Rickets has been a childhood scourge for centuries. Before the Industrial Revolution in England it was a disease of the affluent, because their style of clothing and the fact that...

ORIGINAL ARTICLE: A Comparison of Calcium, Vitamin D, or Both for Nutritional Rickets in Nigerian Children

Thu, 19Â AugÂ 1999 00:00:00 -05:00

Background: Nutritional rickets remains prevalent in many tropical countries despite the fact that such countries have ample sunlight. Some postulate that a deficiency of dietary calcium, rather than vitamin D,...

REVIEW ARTICLE: Guidelines for Healthy Weight

Thu, 05Â AugÂ 1999 00:00:00 -05:00

Excess body fat is a cause of cardiovascular diseases, several important cancers, and numerous other medical conditions1 and is a growing problem in many countries. In the United States, for...

SOUNDING BOARD: Trans Fatty Acids and Coronary Heart Disease

Thu, 24Â JunÂ 1999 00:00:00 -05:00

Trans unsaturated fatty acids are produced commercially in large quantities by heating vegetable oils in the presence of metal catalysts and hydrogen to form shortening and margarine.1 They are so...

ORIGINAL ARTICLE: Vitamin A Supplementation for Extremely-Low-Birth-Weight Infants

Thu, 24Â JunÂ 1999 00:00:00 -05:00

Background: Vitamin A supplementation may reduce the risk of chronic lung disease and sepsis in extremely-low-birth-weight infants. The results of our pilot study suggested that a dose of 5000 IU...

ORIGINAL ARTICLE: Effects of Different Forms of Dietary Hydrogenated Fats on Serum Lipoprotein Cholesterol Levels

Thu, 24Â JunÂ 1999 00:00:00 -05:00

Background: Metabolic studies suggest that fatty acids containing at least one double bond in the trans configuration, which are found in hydrogenated fat, have a detrimental effect on serum lipoprotein...

REVIEW ARTICLE: Treatments for Wasting in Patients with the Acquired Immunodeficiency Syndrome

Colleen Corcoran, N.P., and Steven Grinspoon, M.D. — Thu, 03Â JunÂ 1999 00:00:00 -05:00

Wasting was an early identifying characteristic of human immunodeficiency virus (HIV) infection, originally termed âslim diseaseâ in Africa.1 As defined by the Centers for Disease Control and Prevention (CDC), wasting...

EDITORIAL: The Consequences for Food Safety of the Use of Fluoroquinolones in Food Animals

Thu, 20Â MayÂ 1999 00:00:00 -05:00

In June 1998, the World Health Organization convened a meeting to discuss the use of quinolones in animals used for food and its potential effect on human health. Participants included...

ORIGINAL ARTICLE: The Effect of Folic Acid Fortification on Plasma Folate and Total Homocysteine Concentrations

Thu, 13Â MayÂ 1999 00:00:00 -05:00

Background: In 1996, the Food and Drug Administration issued a regulation requiring all enriched grain products to be fortified with folic acid to reduce the risk of neural-tube defects in...

EDITORIAL: Prevention of Bladder Cancer

Thu, 06Â MayÂ 1999 00:00:00 -05:00

Strategies to prevent the most prevalent cancers in the West are remarkably straightforward in principle. To prevent lung cancer, quit smoking; to prevent breast cancer, maintain your ideal body weight...

ORIGINAL ARTICLE: Fluid Intake and the Risk of Bladder Cancer in Men

Thu, 06Â MayÂ 1999 00:00:00 -05:00

Background: Studies in animals have shown that the frequency of urination is inversely associated with the level of potential carcinogens in the urothelium. In humans, an increase in total fluid...

REVIEW ARTICLE: Eating Disorders

Thu, 08Â AprÂ 1999 00:00:00 -05:00

Eating disorders affect an estimated 5 million Americans every year. These illnesses â anorexia nervosa, bulimia nervosa, binge-eating disorder, and their variants â are characterized by a serious disturbance in...

ORIGINAL ARTICLE: A Multistate, Foodborne Outbreak of Hepatitis A

Thu, 25Â FebÂ 1999 00:00:00 -05:00

Background: We investigated a large, foodborne outbreak of hepatitis A that occurred in February and March 1997 in Michigan and then extended the investigation to determine whether it was related...

EDITORIAL: Fiber and Colorectal Cancer â Where to Now?

Thu, 21Â JanÂ 1999 00:00:00 -05:00

The idea that unrefined foods have an important influence on health goes back at least to Hippocrates. Writing in 1585, Stubs asked pointedly: âDoe we not see the poore man...

ORIGINAL ARTICLE: Dietary Fiber and the Risk of Colorectal Cancer and Adenoma in Women

Thu, 21Â JanÂ 1999 00:00:00 -05:00

Background: A high intake of dietary fiber has been thought to reduce the risk of colorectal cancer and adenoma.

Methods: We conducted a prospective study of 88,757 women, who were 34...

ORIGINAL ARTICLE: Calcium Supplements for the Prevention of Colorectal Adenomas

Thu, 14Â JanÂ 1999 00:00:00 -05:00

Background: and Methods: Laboratory, clinical, and epidemiologic evidence suggests that calcium may help prevent colorectal adenomas. We conducted a randomized, double-blind trial of the effect of supplementation with calcium carbonate...

REVIEW ARTICLE: CreutzfeldtâJakob Disease and Related Transmissible Spongiform Encephalopathies

Richard T. Johnson, M.D., and Clarence J. Gibbs, Jr., Ph.D. — Thu, 31Â DecÂ 1998 00:00:00 -05:00

Until 30 years ago, CreutzfeldtâJakob disease was an obscure form of dementia unknown to most physicians. The name is now familiar to the medical community as the major transmissible spongiform...

EDITORIAL: KashinâBeck Disease â Expanding the Spectrum of Iodine-Deficiency Disorders

Thu, 15Â OctÂ 1998 00:00:00 -05:00

Selenium, as selenocysteine, is an integral component of two important enzymes â glutathione peroxidase and iodothyronine deiodinase â that are present in many tissues, including the thyroid gland. Glutathione peroxidase...

ORIGINAL ARTICLE: KashinâBeck Osteoarthropathy in Rural Tibet in Relation to Selenium and Iodine Status

Thu, 15Â OctÂ 1998 00:00:00 -05:00

Background: and Methods: KashinâBeck disease is a degenerative osteoarticular disorder that is endemic to certain areas of Tibet, where selenium deficiency is also endemic. Because selenium is involved in thyroid...

EDITORIAL: Alternative Medicine â The Risks of Untested and Unregulated Remedies

Thu, 17Â SepÂ 1998 00:00:00 -05:00

What is there about alternative medicine that sets it apart from ordinary medicine? The term refers to a remarkably heterogeneous group of theories and practices â as disparate as homeopathy,...

REVIEW ARTICLE: Protection of AcidâBase Balance by pH Regulation of Acid Production

Virginia L. Hood, M.B., B.S., M.P.H., and Richard L. Tannen, M.D. — Thu, 17Â SepÂ 1998 00:00:00 -05:00

Under normal physiologic conditions, acidâbase balance is maintained by renal excretion of hydrogen ions generated during the metabolism of dietary protein and other metabolic processes. In normal subjects, these so-called...

ORIGINAL ARTICLE: Contamination of Botanical Dietary Supplements by

Thu, 17Â SepÂ 1998 00:00:00 -05:00

For many years, the Food and Drug Administration (FDA) regulated botanical dietary-supplement ingredients, in most circumstances, under the provisions for food additives of the Federal Food, Drug, and Cosmetic Act...

ORIGINAL ARTICLE: Clinical and Biologic Activity of an Estrogenic Herbal Combination (PC-SPES) in Prostate Cancer

Thu, 17Â SepÂ 1998 00:00:00 -05:00

Background: Herbal mixtures are popular alternatives to demonstrated therapies. PC-SPES, a commercially available combination of eight herbs, is used as a nonestrogenic treatment for cancer of the prostate. Since other...

REVIEW ARTICLE: Hypokalemia

F. John Gennari, M.D. — Thu, 13Â AugÂ 1998 00:00:00 -05:00

A low serum potassium concentration is perhaps the most common electrolyte abnormality encountered in clinical practice. When defined as a value of less than 3.6 mmol of potassium per liter,...

ORIGINAL ARTICLE: Effects of Diet and Exercise in Men and Postmenopausal Women with Low Levels of HDL Cholesterol and High Levels of LDL Cholesterol

Thu, 02Â JulÂ 1998 00:00:00 -05:00

Background: Guidelines established by the National Cholesterol Education Program (NCEP) promote exercise and weight loss for the treatment of abnormal lipoprotein levels. Little is known, however, about the effects of...

EDITORIAL: When Should Heart Disease Prevention Begin?

Thu, 04Â JunÂ 1998 00:00:00 -05:00

Early in the next century, cardiovascular disease will probably be the number-one killer worldwide.1 Despite important successes in the past 30 years, unfavorable trends in some coronary risk factors may...

ORIGINAL ARTICLE: Delayed Cerebellar Disease and Death after Accidental Exposure to Dimethylmercury

Thu, 04Â JunÂ 1998 00:00:00 -05:00

Ingestion of fish or grain contaminated with methylmercury resulted in epidemics of severe neurotoxicity and death in Japan in the 1950s and 1960s1 and in Iraq in 1972.2 The World...

EDITORIAL: Eat Right Take a Multivitamin

Thu, 09Â AprÂ 1998 00:00:00 -05:00

Since the mid-1970s, 25 percent of American adults have regularly consumed a multivitamin containing 400 Î¼g of folic acid. The current evidence suggests that people who take such supplements and...

REVIEW ARTICLE: Homocysteine and Atherothrombosis

George N. Welch, M.D., and Joseph Loscalzo, M.D., Ph.D. — Thu, 09Â AprÂ 1998 00:00:00 -05:00

In 1969, McCully made the clinical observation linking elevated plasma homocyst(e)ine concentrations with vascular disease.1 He reported autopsy evidence of extensive arterial thrombosis and atherosclerosis in two children with elevated...

SPECIAL ARTICLE: Aging, Health Risks, and Cumulative Disability

Thu, 09Â AprÂ 1998 00:00:00 -05:00

Background: Persons with lower health risks tend to live longer than those with higher health risks, but there has been concern that greater longevity may bring with it greater disability....

ORIGINAL ARTICLE: Reduction of Plasma Homocyst(e)ine Levels by Breakfast Cereal Fortified with Folic Acid in Patients with Coronary Heart Disease

Thu, 09Â AprÂ 1998 00:00:00 -05:00

Background: The Food and Drug Administration (FDA) has recommended that cereal-grain products be fortified with folic acid to prevent congenital neural-tube defects. Since folic acid supplementation reduces levels of plasma...

EDITORIAL: The Need for More Vitamin D

Thu, 19Â MarÂ 1998 00:00:00 -05:00

Vitamin D is an essential precursor of 1,25-dihydroxyvitamin D, the steroid hormone required not only for bone development and growth in children and maintenance of bone in adults, but also...

EDITORIAL: Losing Weight â An Ill-Fated New Year's Resolution

Thu, 01Â JanÂ 1998 00:00:00 -05:00

Today, at the start of the new year, millions of Americans will resolve to lose weight, but by tomorrow, or next week, or maybe next month, most of them will...

ORIGINAL ARTICLE: Absence of Toxicity of Oats in Patients with Dermatitis Herpetiformis

Thu, 25Â DecÂ 1997 00:00:00 -05:00

Background: People with gluten sensitivity should avoid foods containing wheat, rye, and barley, but there has been debate about whether they should avoid oats. Although patients with celiac disease have...

EDITORIAL: Hazards and Benefits of Alcohol

Thu, 11Â DecÂ 1997 00:00:00 -05:00

Alcohol occupies a unique place in many human societies; it is a widely used drug, tolerated physiologically and socially, with a place in religious ceremony, in ritual, in spontaneous celebration,...

ORIGINAL ARTICLE: Alcohol Consumption and Mortality among Middle-Aged and Elderly U.S. Adults

Thu, 11Â DecÂ 1997 00:00:00 -05:00

Background: Alcohol consumption has both adverse and beneficial effects on survival. We examined the balance of these in a large prospective study of mortality among U.S. adults.

Methods: Of 490,000 men...

EDITORIAL: Hardened Fats, Hardened Arteries?

Thu, 20Â NovÂ 1997 00:00:00 -05:00

The value of hardened (trans) unsaturated fats in our food supply is probably best exemplified by the glazed doughnut. At room temperature, a glazed doughnut can be easily eaten with...

ORIGINAL ARTICLE: Dietary Fat Intake and the Risk of Coronary Heart Disease in Women

Thu, 20Â NovÂ 1997 00:00:00 -05:00

Background: The relation between dietary intake of specific types of fat, particularly trans unsaturated fat, and the risk of coronary disease remains unclear. We therefore studied this relation in women...

REVIEW ARTICLE: Caloric Intake and Aging

Richard Weindruch, Ph.D., and Rajindar S. Sohal, Ph.D. — Thu, 02Â OctÂ 1997 00:00:00 -05:00

In postindustrial societies, overeating, inactivity, and obesity have emerged as new challenges in public health.12 Considerable effort is now being devoted to determining the pathophysiologic consequences of overeating. Several lines...

ORIGINAL ARTICLE: Nutritional Benefits of Neonatal Screening for Cystic Fibrosis

Thu, 02Â OctÂ 1997 00:00:00 -05:00

Background: Many patients with cystic fibrosis are malnourished at the time of diagnosis. Whether newborn screening and early treatment may prevent the development of a nutritional deficiency is not known.

Methods:...

EDITORIAL: Obesity in Adulthood â The Importance of Childhood and Parental Obesity

Thu, 25Â SepÂ 1997 00:00:00 -05:00

Obesity is a common condition with delayed and usually late-onset consequences. Since the prevalence of obesity is high and still growing, it is important to understand who is at risk...

ORIGINAL ARTICLE: Predicting Obesity in Young Adulthood from Childhood and Parental Obesity

Thu, 25Â SepÂ 1997 00:00:00 -05:00

Background: Childhood obesity increases the risk of obesity in adulthood, but how parental obesity affects the chances of a child's becoming an obese adult is unknown. We investigated the risk...

EDITORIAL: Diet and the Prevention of Osteoporotic Fractures

Thu, 04Â SepÂ 1997 00:00:00 -05:00

One of the striking demographic features of all countries in the late 20th century is the increasing longevity of both men and women. Unfortunately, this extension of life expectancy has...

ORIGINAL ARTICLE: Effect of Calcium and Vitamin D Supplementation on Bone Density in Men and Women 65 Years of Age or Older

Thu, 04Â SepÂ 1997 00:00:00 -05:00

Background: Inadequate dietary intake of calcium and vitamin D may contribute to the high prevalence of osteoporosis among older persons.

Methods: We studied the effects of three years of dietary supplementation...

ORIGINAL ARTICLE: Fatal Pulmonary Hypertension Associated with Short-Term Use of Fenfluramine and Phentermine

Thu, 28Â AugÂ 1997 00:00:00 -05:00

The dangers inherent in marked obesity have prompted physicians to advocate more aggressive strategies for weight reduction. One current strategy is the prescription of fenfluramine,12 either alone or in combination...

ORIGINAL ARTICLE: Fatal Pulmonary Hypertension Associated with Short-Term Use of Fenfluramine and Phentermine

Thu, 28Â AugÂ 1997 00:00:00 -05:00

ORIGINAL ARTICLE: Invasive Infections Due to a Fish Pathogen,

Thu, 28Â AugÂ 1997 00:00:00 -05:00

Background: Streptococcus iniae is a pathogen in fish, capable of causing invasive disease and outbreaks in aquaculture farms. During the winter of 1995â1996 in the greater Toronto area there was...

ORIGINAL ARTICLE: Invasive Infections Due to a Fish Pathogen,

Thu, 28Â AugÂ 1997 00:00:00 -05:00

ORIGINAL ARTICLE: Cumulative Effects of High Cholesterol Levels, High Blood Pressure, and Cigarette Smoking on Carotid Stenosis

Thu, 21Â AugÂ 1997 00:00:00 -05:00

Background: Single measurements of cardiovascular risk factors may not accurately reflect a person's past exposure to those risk factors. We therefore studied the long-term associations of cardiovascular risk factors such...

ORIGINAL ARTICLE: Probucol and Multivitamins in the Prevention of Restenosis after Coronary Angioplasty

Thu, 07Â AugÂ 1997 00:00:00 -05:00

Background: Oxidizing metabolites generated at the site of coronary angioplasty can induce chain reactions that may lead to restenosis. Antioxidants may counter oxidative stress and modify neointimal formation and vascular...

EDITORIAL: Eating Disorders and Diabetic Complications

Thu, 26Â JunÂ 1997 00:00:00 -05:00

Poor metabolic control in adolescents with insulin-dependent diabetes mellitus (IDDM) is sometimes accepted as inevitable but likely to resolve when the patient's hormones, metabolism, and psyche finally come to terms...

ORIGINAL ARTICLE: Disordered Eating Behavior and Microvascular Complications in Young Women with Insulin-Dependent Diabetes Mellitus

Thu, 26Â JunÂ 1997 00:00:00 -05:00

Background: Insulin-dependent diabetes mellitus (IDDM) and eating disorders are relatively common among young women in North America. Their coexistence could lead to poor metabolic control and an increased risk of...

REVIEW ARTICLE: Neuroendocrine Responses to Starvation and Weight Loss

Michael W. Schwartz, M.D., and Randy J. Seeley, Ph.D. — Thu, 19Â JunÂ 1997 00:00:00 -05:00

The inability to consume enough calories to meet energy requirements is a common threat to survival. To meet this danger, animals retard their fuel depletion by lowering their metabolic rate...

ORIGINAL ARTICLE: A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure

Thu, 17Â AprÂ 1997 00:00:00 -05:00

Background: It is known that obesity, sodium intake, and alcohol consumption influence blood pressure. In this clinical trial, Dietary Approaches to Stop Hypertension, we assessed the effects of dietary patterns...

ORIGINAL ARTICLE: Fish Consumption and the 30-Year Risk of Fatal Myocardial Infarction

Thu, 10Â AprÂ 1997 00:00:00 -05:00

Background: Epidemiologic data on the possible benefit of eating fish to reduce the risk of coronary heart disease have been inconsistent. We used data from the Chicago Western Electric Study...

REVIEW ARTICLE: Nutritional Support

Wiley W. Souba, M.D., Sc.D. — Thu, 02Â JanÂ 1997 00:00:00 -05:00

The indications for providing nutrients by the enteral or intravenous route (nutritional support) are not well defined, and the efficacy of nutritional support in many circumstances is unproved. Nonetheless, nutritional...

ORIGINAL ARTICLE: The Effect of the Ingestion of Ethanol on Obstruction of the Left Ventricular Outflow Tract in Hypertrophic Cardiomyopathy

Thu, 26Â SepÂ 1996 00:00:00 -05:00

Background: Ethanol causes vasodilatation, which might have an adverse effect, due to increased obstruction of the left ventricular outflow tract, in patients with hypertrophic obstructive cardiomyopathy. We assessed the hemodynamic...

EDITORIAL: Improving Our Diet â Still a Long Way to Go

Thu, 05Â SepÂ 1996 00:00:00 -05:00

Apart from occasional failures of our sanitation and food-protection systems, common sense tells us that common foods or nutrients as such cannot be lethal and, furthermore, that the effect of...

SPECIAL ARTICLE: A Comparison of Dietary Trends among Racial and Socioeconomic Groups in the United States

Barry M. Popkin, Ph.D., Anna Maria Siega-Riz, Ph.D., and Pamela S. Haines, Ph.D. — Thu, 05Â SepÂ 1996 00:00:00 -05:00

Background: There may be dietary differences among racial and socioeconomic groups in the United States.

Methods: Using data from a representative sample of adults, we compared dietary trends among blacks and...

ORIGINAL ARTICLE: Appetite-Suppressant Drugs and the Risk of Primary Pulmonary Hypertension

Thu, 29Â AugÂ 1996 00:00:00 -05:00

Background: Recently in France, primary pulmonary hypertension developed in a cluster of patients exposed to derivatives of fenfluramine in appetite suppressants (anorexic agents), which are used for weight control. We...

SPECIAL ARTICLE: Effect of Economic Reforms on Child Growth in Urban and Rural Areas of China

Tiefu Shen, M.D., Ph.D., Jean-Pierre Habicht, M.D., Ph.D., and Ying Chang, M.D. — Thu, 08Â AugÂ 1996 00:00:00 -05:00

Background: Beginning in 1978, China implemented economic reforms to transform the economy to a free-market system. We compared the effect of the reforms on the growth of children in urban...

SOUNDING BOARD: Physical and Emotional Problems of Elite Female Gymnasts

Thu, 25Â JulÂ 1996 00:00:00 -05:00

Within the past five years, two U.S. female gymnasts at the Olympic level, Christy Henrich and Julissa Gomez, died from medical problems related to their sport. Christy died from complications...

EDITORIAL: Keeping Crohn's Disease Quiet

Thu, 13Â JunÂ 1996 00:00:00 -05:00

Fifteen years ago, after the National Cooperative Crohn's Disease Study (NCCDS)1 had found that patients in remission who were given placebo fared better than those given corticosteroids, azathioprine, or a...

ORIGINAL ARTICLE: Effect of an Enteric-Coated Fish-Oil Preparation on Relapses in Crohn's Disease

Thu, 13Â JunÂ 1996 00:00:00 -05:00

Background: Patients with Crohn's disease may have periods of remission, interrupted by relapses. Because fish oil has antiinflammatory actions, it could reduce the frequency of relapses, but it is often...

EDITORIAL: How Safe is Our Food? â Lessons from an Outbreak of Salmonellosis

Thu, 16Â MayÂ 1996 00:00:00 -05:00

The microbiologic hazards of food present an issue of increasing concern.12 In the not-so-distant past, most food was produced and consumed locally. In the 20th century, however, the production and...

ORIGINAL ARTICLE: A National Outbreak of Infections from Ice Cream

Thu, 16Â MayÂ 1996 00:00:00 -05:00

Background: In September 1994, the Minnesota Department of Health detected an increase in the number of reports of Salmonella enteritidis infections. After a caseâcontrol study implicated a nationally distributed brand...

EDITORIAL: Antioxidant Vitamins, Cancer, and Cardiovascular Disease

Thu, 02Â MayÂ 1996 00:00:00 -05:00

In 1850, an article on the origin of epidemic yellow fever and malaria appeared in the Boston Medical and Surgical Journal.1 The anonymous author referred to earlier reports that âthose...

ORIGINAL ARTICLE: Dietary Antioxidant Vitamins and Death from Coronary Heart Disease in Postmenopausal Women

Thu, 02Â MayÂ 1996 00:00:00 -05:00

Background: The role of dietary antioxidant vitamins in preventing coronary heart disease has aroused considerable interest because of the knowledge that oxidative modification of low-density lipoprotein may promote atherosclerosis.

Methods: We...

ORIGINAL ARTICLE: Effects of a Combination of Beta Carotene and Vitamin A on Lung Cancer and Cardiovascular Disease

Thu, 02Â MayÂ 1996 00:00:00 -05:00

Background: Lung cancer and cardiovascular disease are major causes of death in the United States. It has been proposed that carotenoids and retinoids are agents that may prevent these disorders.

Methods:...

ORIGINAL ARTICLE: Lack of Effect of Long-Term Supplementation with Beta Carotene on the Incidence of Malignant Neoplasms and Cardiovascular Disease

Thu, 02Â MayÂ 1996 00:00:00 -05:00

Background: Observational studies suggest that people who consume more fruits and vegetables containing beta carotene have somewhat lower risks of cancer and cardiovascular disease, and earlier basic research suggested plausible...

SOUNDING BOARD: Olestra and the FDA

Thu, 11Â AprÂ 1996 00:00:00 -05:00

Olestra, a polyester of sucrose and six or more triglycerides, was approved by the Food and Drug Administration (FDA) on January 24 as a nondigestible substitute for fat in snack...

ORIGINAL ARTICLE: Identification of a Brazil-Nut Allergen in Transgenic Soybeans

Thu, 14Â MarÂ 1996 00:00:00 -05:00

Background: The nutritional quality of soybeans (Glycine max) is compromised by a relative deficiency of methionine in the protein fraction of the seeds. To improve the nutritional quality, methionine-rich 2S...

ORIGINAL ARTICLE: Cohort Studies of Fat Intake and the Risk of Breast Cancer â A Pooled Analysis

Thu, 08Â FebÂ 1996 00:00:00 -05:00

Background: Experiments in animals, international correlation comparisons, and caseâcontrol studies support an association between dietary fat intake and the incidence of breast cancer. Most cohort studies do not corroborate the...

NEJM â Collection Updates for Diet/Nutrition

OTHER POINTS OF VIEW: Taxing âSin Foodsâ â Obesity Prevention and Public Health Policy

CLINICAL IMPLICATIONS OF BASIC RESEARCH: A Look at the Low-Carbohydrate Diet

HEALTH POLICY REPORT: The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages

PERSPECTIVE: American Roulette â Contaminated Dietary Supplements

CLINICAL THERAPEUTICS: Parenteral Nutrition in the Critically Ill Patient

CORRESPONDENCE: What Went In When Trans Went Out?

HEALTH LAW, ETHICS, AND HUMAN RIGHTS: New York City's War on Fat

CORRESPONDENCE: Vitamin D Deficiency in Critically Ill Patients

PERSPECTIVE: Ounces of Prevention â The Public Policy Case for Taxes on Sugared Beverages

CORRESPONDENCE: Melamine and Nephrolithiasis in Children in Taiwan

CORRESPONDENCE: Ultrasonographic Evaluation of Melamine-Exposed Children in Hong Kong

EDITORIAL: Melamine, Powdered Milk, and Nephrolithiasis in Chinese Infants

ORIGINAL ARTICLE: Melamine-Contaminated Powdered Formula and Urolithiasis in Young Children

PERSPECTIVE: Coming to Grips with Foodborne Infection â Peanut Butter, Peppers, and Nationwide Salmonella Outbreaks

CORRESPONDENCE: Iodine Content of Prenatal Multivitamins in the United States

EDITORIAL: Weight-Loss Diets for the Prevention and Treatment of Obesity

ORIGINAL ARTICLE: Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates

IMAGES IN CLINICAL MEDICINE: A Smooth, Shiny Tongue

CLINICAL THERAPEUTICS: Behavioral Management for Anorexia Nervosa

ORIGINAL ARTICLE: Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women

CORRESPONDENCE: Excess Iodine from an Unexpected Source

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 3-2009 â A 9-Month-Old Boy with Seizures

CORRESPONDENCE: Glycemic Control in Patients with Insulinoma Treated with Everolimus

ORIGINAL ARTICLE: Glucose Control and Vascular Complications in Veterans with Type 2 Diabetes

IMAGES IN CLINICAL MEDICINE: Occult Hip Fracture

EDITORIAL: Shared Genetic Risk Factors for Type 1 Diabetes and Celiac Disease

ORIGINAL ARTICLE: Shared and Distinct Genetic Variants in Type 1 Diabetes and Celiac Disease

PERSPECTIVE: Melamine and the Global Implications of Food Contamination

IMAGES IN CLINICAL MEDICINE: Ultrasound Imaging of the Thoracic Duct

CLINICAL IMPLICATIONS OF BASIC RESEARCH: The Exercise Pill â Too Good to Be True?

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2008 â A 10-Year-Old Girl with Recurrent Oral Lesions and Cutaneous Bullae

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2008 â A 10-Year-Old Girl with Recurrent Oral Lesions and Cutaneous Bullae

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2008 â A 19-Year-Old Man with Weight Loss and Abdominal Pain

ORIGINAL ARTICLE: Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 16-2008 â A 46-Year-Old Woman with Bone Pain

CLINICAL PROBLEM-SOLVING: Back to Basics

CLINICAL PRACTICE: Nonsurgical Management of Obesity in Adults

ORIGINAL ARTICLE: Gene Identification for the cblD Defect of Vitamin B Metabolism

IMAGES IN CLINICAL MEDICINE: Renal Failure from Vitamin C after Transplantation

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 23-2007 â A 9-Year-Old Boy with Bone Pain, Rash, and Gingival Hypertrophy

REVIEW ARTICLE: Vitamin D Deficiency

ORIGINAL ARTICLE: Reduction in Neural-Tube Defects after Folic Acid Fortification in Canada

PERSPECTIVE: New York to Trans Fats: You're Out!

ORIGINAL ARTICLE: Effect of Torcetrapib on Carotid Atherosclerosis in Familial Hypercholesterolemia

ORIGINAL ARTICLE: Vitamins and Perinatal Outcomes among HIV-Negative Women in Tanzania

EDITORIAL: CETP Inhibitors to Increase HDL Cholesterol Levels

ORIGINAL ARTICLE: Effect of Torcetrapib on the Progression of Coronary Atherosclerosis

ORIGINAL ARTICLE: Inhibition of Microsomal Triglyceride Transfer Protein in Familial Hypercholesterolemia

ORIGINAL ARTICLE: Low-Carbohydrate-Diet Score and the Risk of Coronary Heart Disease in Women

ORIGINAL ARTICLE: A Self-Regulation Program for Maintenance of Weight Loss

ORIGINAL ARTICLE: Body-Mass Index and Mortality in Korean Men and Women

ORIGINAL ARTICLE: Overweight, Obesity, and Mortality in a Large Prospective Cohort of Persons 50 to 71 Years Old

PERSPECTIVE: Overweight and Mortality among Baby Boomers â Now We're Getting Personal

EDITORIAL: Iodine Nutrition â More Is Better

EDITORIAL: Vitamin B, Folic Acid, and the Prevention of Dementia

ORIGINAL ARTICLE: Effect of Iodine Intake on Thyroid Diseases in China

ORIGINAL ARTICLE: A Controlled Trial of Homocysteine Lowering and Cognitive Performance

PERSPECTIVE: Food Marketing and Childhood Obesity â A Matter of Policy

EDITORIAL: Antioxidants and the Prevention of Preeclampsia â Unresolved Issues

ORIGINAL ARTICLE: Vitamins C and E and the Risks of Preeclampsia and Perinatal Complications

EDITORIAL: Homocysteine Trials â Clear Outcomes for Complex Reasons

IMAGES IN CLINICAL MEDICINE: Pellagra-like Dermatitis

REVIEW ARTICLE: Trans Fatty Acids and Cardiovascular Disease

ORIGINAL ARTICLE: Homocysteine Lowering and Cardiovascular Events after Acute Myocardial Infarction

ORIGINAL ARTICLE: Homocysteine Lowering with Folic Acid and B Vitamins in Vascular Disease

PERSPECTIVE: Crisis in Niger â Outpatient Care for Severe Acute Malnutrition

CLINICAL PRACTICE: Low HDL Cholesterol Levels

PERSPECTIVE: Studying Herbal Remedies

CLINICAL PRACTICE: Overweight Children and Adolescents

IMAGES IN CLINICAL MEDICINE: Wernicke's Encephalopathy

ORIGINAL ARTICLE: Hyponatremia among Runners in the Boston Marathon

PERSPECTIVE: Marathon Maladies

PERSPECTIVE: A Nutrition Paradox â Underweight and Obesity in Developing Countries

IMAGES IN CLINICAL MEDICINE: Acquired Acrodermatitis Enteropathica

CLINICAL PRACTICE: Unhealthy Alcohol Use

CLINICAL PROBLEM-SOLVING: Special Cure

IMAGES IN CLINICAL MEDICINE: A Medical Mystery â Hyperpigmentation

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 30-2004 â A 37-Year-Old Woman with Paresthesias of the Arms and Legs

PERSPECTIVE: Body Fat, Leptin, and Hypothalamic Amenorrhea

NEJM â Collection Updates for Diet/Nutrition

OTHER POINTS OF VIEW: Taxing âSin Foodsâ â Obesity Prevention and Public Health Policy

PERSPECTIVE: American Roulette â Contaminated Dietary Supplements

PERSPECTIVE: Ounces of Prevention â The Public Policy Case for Taxes on Sugared Beverages

PERSPECTIVE: Coming to Grips with Foodborne Infection â Peanut Butter, Peppers, and Nationwide Salmonella Outbreaks

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 3-2009 â A 9-Month-Old Boy with Seizures

CLINICAL IMPLICATIONS OF BASIC RESEARCH: The Exercise Pill â Too Good to Be True?

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2008 â A 10-Year-Old Girl with Recurrent Oral Lesions and Cutaneous Bullae

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 32-2008 â A 10-Year-Old Girl with Recurrent Oral Lesions and Cutaneous Bullae

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 29-2008 â A 19-Year-Old Man with Weight Loss and Abdominal Pain

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 16-2008 â A 46-Year-Old Woman with Bone Pain

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 23-2007 â A 9-Year-Old Boy with Bone Pain, Rash, and Gingival Hypertrophy

PERSPECTIVE: Overweight and Mortality among Baby Boomers â Now We're Getting Personal

EDITORIAL: Iodine Nutrition â More Is Better

PERSPECTIVE: Food Marketing and Childhood Obesity â A Matter of Policy

EDITORIAL: Antioxidants and the Prevention of Preeclampsia â Unresolved Issues

EDITORIAL: Homocysteine Trials â Clear Outcomes for Complex Reasons

PERSPECTIVE: Crisis in Niger â Outpatient Care for Severe Acute Malnutrition

PERSPECTIVE: A Nutrition Paradox â Underweight and Obesity in Developing Countries

IMAGES IN CLINICAL MEDICINE: A Medical Mystery â Hyperpigmentation

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 30-2004 â A 37-Year-Old Woman with Paresthesias of the Arms and Legs

CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL: Case 25-2004 â A 49-Year-Old Woman with Severe Obesity, Diabetes, and Hypertension

EDITORIAL: Homocysteine and Osteoporotic Fractures â Culprit or Bystander?

PERSPECTIVE: Irradiation of Food â Helping to Ensure Food Safety

EDITORIAL: Intensive Statin Therapy â A Sea Change in Cardiovascular Prevention

IMAGES IN CLINICAL MEDICINE: Oculo-Orogenital Syndrome â A Deficiency of Vitamins B and B

PERSPECTIVE: Uric Acid and Diet â Insights into the Epidemic of Cardiovascular Disease

PERSPECTIVE: From Asthma to Atherosclerosis â 5-Lipoxygenase, Leukotrienes, and Inflammation

PERSPECTIVE: Sweet Success â A Treatment for McArdle's Disease

PERSPECTIVE: Severe Methylenetetrahydrofolate Reductase Deficiency, Methionine Synthase, and Nitrous Oxide â A Cautionary Tale

PERSPECTIVE: The Mediterranean Diet and Mortality â Olive Oil and Beyond

CLINICAL IMPLICATIONS OF BASIC RESEARCH: Celiac Disease â The Villain Unmasked?

EDITORIAL: Celiac Disease â How to Handle a Clinical Chameleon

EDITORIAL: The Stomach Speaks â Ghrelin and Weight Regulation

ORIGINAL ARTICLE: Blood Levels of Long-Chain nâ3 Fatty Acids and the Risk of Sudden Death

PERSPECTIVE: Fish â Food to Calm the Heart