Original Article

Incidental Findings on Brain MRI in the General Population

by MW Vernooij et al, NEJM, November 1 2007, Vol 357 (18), 1821-8

Magnetic resonance imaging of the brain has improved considerably over the past decade, allowing the detection of unexpected brain abnormalities such as brain tumors and aneurysms.  The authors studied 2000 patients of the general population to determine the prevalence of these abnormalities.  They document a surprising prevalence of incidental brain findings, suggesting a valuable role of neuroimaging in preventative treatment.

Clinical Therapeutics

Electroconvulsive Therapy for Depression

by SH Lisanby, NEJM, November 8 2007, Vol 357 (19), 1939-45

Electroconvulsive therapy (ECT) applies electricity to the scalp to induce seizure activity as a treatment for depression.  In this NEJM feature, a case vignette of a woman with a history of depression is presented, followed by extensive discussion of depression and characterization of ECT as a valid treatment alternative.  The author then gives her own clinical recommendation for the patient.

Perspective

In Defense of Pharmacoepidemiology — Embracing the Yin and Yang of Drug Research

by J Avorn, NEJM, November 29 2007, Vol 357 (22), 2219-21

Pharmaceutical companies often study drug effects on an epidemiological scale, observing large numbers of patients in settings of routine care. Pharmacoepidemiology can offer insights not given by the randomized, controlled trial, the traditional means of assessing drugs.  Although several notorious examples of misleading epidemiological studies mar the practice of observational study, the author defends pharmacoepidemiology as a budding, promising tool for drug evaluation.

Pathways in Medicine

Pediatrics

by Serene Chen

Imagine tending to patients who do not know how to describe their symptoms well, who are dependent on other people for decisions, whose bodily systems work differently from the majority of the population, who are prone to injuring themselves, who are ever changing...And imagine caring for them for decades at a time. This is the job of a pediatrician. Think you have what it takes? Dr. Sean Palfrey from the Boston Medical Center describes his specialty.

» More "Pathways in Medicine" Articles

Free Standing Perspective

Unlinking Poverty and Poor Health

by Eva Luo

How much can you do in fifteen minutes of contact with a patient? Some physicians feel that the answer is "much less than ideal," when it comes to treating patients afflicted not just by immediate illnesses, but by a grander issue--poverty. Next Gen presents some of the challenges and frustrations related medicine in light of greater social contexts; and features an organization, Project HEALTH, that has started to tackle the problem, to involve students, and to infuse a sense of optimism.

» More "Free Standing Perspective" Articles

Free Standing Perspective

Health Information in Developing Countries

by Allen Cheng

While accessing health information in the United States may be a simple task, it is profoundly difficult for many clinics in resource-poor settings. In this article, we describe health programs that face obstacles in the absence of an information infrastructure. We also discuss the performance of innovative programs to bring new information technology to developing countries.

» More "Free Standing Perspective" Articles

Advice to the Next Generation

• Anatomy Lab: What to expect in your first year (new!)
• Other than "helping people," what are some other aspects of a doctor's job?

» Other Questions and Answers

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