APPROXIMATELY 7.3 million Americans work at night, either on permanent shifts or on schedules requiring a rotation of day, evening, and night work.¹ These workers forgo nocturnal sleep and then attempt to sleep during daylight hours. Yet, as Benedict ...

IN recent years improvements in the methods of clinical trials and the use of accurate objective tests to detect venous thromboembolism^{1 2 3 4 5 6} have made it possible to perform a series of randomized trials to evaluate various treatments for venous ...

POSTMENOPAUSAL osteoporosis is characterized by an absolute decrease in the amount of bone, leading to fractures after minimal trauma, most frequently of the vertebrae, the proximal femur, and the distal forearm. Since the progression of bone loss is due ...

ALZHEIMER'S disease is a devastating and common neurologic disorder, and the search for symptomatic therapy has proceeded at an accelerated pace since the finding a decade ago of reduced cholinergic markers in the neocortex and hippocampus of patients.¹ ...

CLINICIANS are occasionally confronted with the finding of an elevated serum or plasma potassium level in an otherwise healthy person. Such an abnormality may herald the presence of occult mineralocorticoid deficiency or a defect in renal tubular ...

HUNTINGTON'S disease is an autosomal dominant disease characterized by slowly progressive personality changes, dementia, and movement disorders.^{1 , 2} The average age at onset is 30 to 40 years, and the disease lasts for an average of 15 to 20 years. ...

IN 1947, a technician who had rheumatoid arthritis and who worked in the laboratory of Dr. Harry Rose at Columbia University discovered that her own serum agglutinated excessively. Dr. Rose suggested that this serologic reaction might have been caused by ...

Presentation of Case

A 58-year-old man was admitted to the hospital because of hematochezia.

The patient was in a stable state of health until the early morning of the day of entry, when he awoke with the urge to defecate and passed a dark-red liquid ...

Night work, which is voluntarily accepted by millions of workers in industrialized countries, is a major health hazard, involving an increased risk of cardiovascular illness, gastrointestinal disorders, infertility, and insomnia. The medical consequences ...

From the early 1940s until the mid-1970s, circumcision of newborn boys was accepted in the United States as a simple procedure that promoted hygiene and prevented genital disease. Educated middle-class parents almost always had their newborn sons ...

Routine neonatal circumcision is the subject of much debate in the United States. The practice has attracted passionate advocates and critics. The analysis presented here examines the available medical evidence relating to routine neonatal circumcision in ...

DEATHS

Aufranc — Otto Elmo Aufranc, M.D, of Wellesley Hills, died on March 7 at the age of 80.

Dr. Aufranc received his degree from Harvard Medical School in 1934. He was a member of the American Medical Association, the American Academy of Orthopaedic ...

To the Editor: Levinson and colleagues present a fascinating study of women in academic medicine (Nov. 30 issue).* In their survey they found that 71.5 percent of the respondents were married and 63 percent had children; the vast majority of these women ...

To the Editor: I am writing because of my disappointment with the article "Outcomes of Extremely-Low-Birth-Weight Infants between 1982 and 1988," by Hack and Fanaroff (Dec. 14 issue).*

Since the recent great increase in neonatal intensive care activity, ...

To the Editor: Kritz-Silverstein et al. (Nov. 2 issue)¹ have made a valuable contribution to the literature on the effects of pregnancy on the risk of diabetes mellitus. The results that they present, however, are not entirely consistent with their ...

To the Editor: In their articles on suicide attempts among persons with panic disorders, Weissman et al.¹ and Reich² (Nov. 2 issue) note that "20 percent of the subjects with panic disorder had attempted suicide at some time in their lives," as compared ...

To the Editor: The review of intestinal electrolyte transport and diarrheal disease by Field et al. (Sept. 28 issue)¹ contains a number of statements about the structure, mechanism, and role of Shiga toxin in shigellosis that are incorrect.

The molecular ...

To the Editor: I wish to report an unusual case of human immunodeficiency virus (HIV)-related myelopathy. The patient is a 45-year-old homosexual man who presented with transverse myelitis at the T-12 level in August 1986. At that time (and since), his ...

To the Editor: In a review of oncogenes, growth factors, and signal transduction (Nov. 16 issue),¹ a table categorizing known oncogenes and associated neoplasms erroneously classifies the erb A gene as a cytoplasmic hormone receptor. It has been ...

To the Editor: Kane and Manoukian (Nov. 16 issue)* raise interesting questions about the reimbursement of cost-increasing forms of technology. They propose the establishment of temporary diagnosis-related groups (DRGs) so that the costs of new forms of ...

To the Editor: Through language, metaphors create powerful associations that often bypass consciousness to influence everyday concepts and thoughts. Among the rich and varied metaphors in medical tradition are many comparisons to religion. Third-year ...

To the Editor: The number of complaints about the poor quality of indoor air in office buildings has increased tremendously since the 1970s. Although the poor conditions were initially attributed to inadequate ventilation, other changes in building ...

Is there such a thing as psychoimmunity? What are the determinants of psychological health? How do children who are considered at risk manage to cope successfully? These are some of the fascinating and challenging questions raised in this book. The ...

Here, the editor and his coauthors have developed a general pediatric textbook that can take its place beside the four or five other leading American textbooks. This polished effort has grown from a synopsis of pediatrics to full size through a number of ...

These two books are complementary. They are intended to provide parents with a reference on childbirth education written by a person who is not a member of the medical community. It is obvious that a great deal of effort was devoted to the preparation of ...

Here is a book that accomplishes its mission — "to bring together in an accessible outline format that which is immediately required for the care of the acutely ill child." This manual provides a concise, straightforward approach to the urgent and ...

Raffensperger has taken over the editorship of the fifth edition of this textbook and has done an excellent job keeping the book well focused and properly edited.

The book has several outstanding strengths. First, it is very readable for a comprehensive ...

In 1908 James MacKenzie, in his classic Diseases of the Heart, devoted one page to congenital diseases. The therapy was simple:

If the heart maintains the circulation, no treatment is required. In more serious cases, beyond attending to the child's ...

Biomedical Science

Advances in Mutagenesis Research 1. Edited by G. Obe. 217 pp., illustrated. New York, Springer-Verlag, 1990. $79.50.

Animal Cell Culture. (Methods in Molecular Biology. Vol. 5.) Edited by Jeffrey W. Pollard and John M. Walker. 713 pp., ...

McMASTER UNIVERSITY

The "9th Annual McMaster Workshop on 'How to Teach the Critical Appraisal of Clinical Evidence,'" will be held in Hamilton, Ont., May 13–18.

Contact Judy Gerencser (HSC-3H8G), McMaster Univ., Dept. of Clinical Epidemiology and ...

These guidelines are in accordance with the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals." (The complete document is available in the June 12, 1982, issue of the British Medical Journal and the June 1982 issue of the Annals of ...