SINCE the number of therapeutic options in sickle cell anemia is limited, red-cell transfusions have been used to treat certain complications of this disease.^{1 2 3 4 5 6 7 8 9 10 11 12} For example, the morbidity and mortality of cerebrovascular accidents,^...

SEPTICEMIA is frequently associated with disturbances of hemostatic balance. Disseminated intravascular coagulation, with widespread depositions of fibrin in the microvasculature, is commonly found in septic shock and is closely linked to the development ...

IN the United States low back pain, often of a chronic nature, results in expenditures of $13 billion a year for medical care.^{1 2 3 4} A number of simultaneous treatments are usually advocated for patients with chronic pain, but few of these treatments ...

A DRAMATIC reduction in mortality from cardiovascular disease over the past 30 years has been well documented^{1 2 3 4 5}; over that period, age-adjusted mortality from cardiovascular disease has fallen by 40 percent in the United States.^{6 , 7} The causes of ...

ORNITHINE carbamoyltransferase is a mitochondrial-matrix enzyme encoded on the X chromosome and expressed in the liver and small intestine. It catalyzes the synthesis of citrulline from carbamoyl phosphate and ornithine. A deficiency of this enzyme ...

ORNITHINE carbamoyltransferase deficiency is an X-linked disorder of urea synthesis. Its clinical manifestations — lethargy, vomiting, coma, and cerebral edema — are related to hyperammonemia and hyperglutaminemia. Other laboratory findings include low ...

THE epidemic caused by the human immunodeficiency virus (HIV) is having widespread effects on the national blood supply. Patients, blood donors, and the public at large are apprehensive about the safety of the blood supply, possible acquisition of HIV ...

Presentation of Case

An 84-year-old man was admitted to the hospital because of chronic aortic dissection, weakness, and lethargy.

He was in a stable state of health until two months earlier, when substernal pain developed while he was walking, with ...

I have two patients in the hospital today. Both have sickle cell disease, and questions about the hazards of transfusion therapy have been raised in both their cases. Two articles in this issue of the Journal explore such questions but do not provide the ...

In this issue of the Journal, Arn et al.¹ describe a new clinical entity: ammonia intoxication in otherwise healthy women, particularly in the postpartum period. The entity results from a defect at the X-chromosome locus for the liver-specific urea-cycle ...

To the Editor: The tuberculosis-control program in Arkansas nursing homes and the data generated by Dr. Stead and his colleagues (Feb. 15 issue)¹ continue to be impressive. I was surprised, however, by the one-sided nature of the discussion, which did ...

To the Editor: Over the past decade, data have accumulated suggesting that an increased incidence of left-handedness is found in groups that have been subjected to prenatal and perinatal stress.^{1 , 2} The sources of birth stress that increase the risk of ...

To the Editor: The article by Tandon et al. (Feb. 1 issue)¹ is an important addition to the growing literature on cathepsins in cancer. However, it is unfortunate that the authors failed to note parallels in the association between cathepsins B and L, as ...

To the Editor: A variety of physical and psychological sequelae have been reported among athletes using high doses of androgenic steroids to enhance their performance.^{1 2 3} We have recently evaluated two athletes with a history of Gilles de la Tourette's ...

To the Editor: Since the release of Losec (omeprazole) by Merck Sharp and Dohme some months ago, we have noted two incidents in which patients received furosemide instead of omeprazole.

In the first incident, an inpatient with renal failure and erosive ...

To the Editor: Iglehart's Health Policy Report in the December 21 issue¹ was basically accurate from the viewpoint of a physician who has practiced in both the United States and Canada. There is, however, an error in the second paragraph, which states ...

To the Editor: Dr. Linton's perspective on the Canadian health care system (Jan. 18 issue)¹ includes a number of valid and compelling observations. He points out Canada's success in controlling costs while maintaining the delivery of high-quality, ...

To the Editor: The term "cost-effective care" is frequently employed in the discussion of economy in the practice of medicine. The setting in which it is used is not always clearly defined. When it is applied to the treatment of a specific medical ...

This report should be required reading for policy makers concerned with the treatment of drug abuse. It is not exciting, but it is factual. Teams of data collectors — guided by expert statisticians, advised by committees of experts, armed with computers, ...

Anyone who works with substance abusers has to be impressed by the high prevalence of cocaine use and its medical, psychological, and social consequences. According to the National Household Survey of Drug Abuse of 1985, 22 million Americans had tried ...

The acquired immunodeficiency syndrome (AIDS) is a terrifying, relentless disease that is simultaneously acute, chronic, infectious, progressive, disabling, and ultimately fatal. Soon the number of newly diagnosed cases of AIDS is expected to reach 100,...

This book is a must for anyone interested in the acquired immunodeficiency syndrome (AIDS) — indeed, anyone concerned with the ethics of medical care and public health. The perspective of this collection of essays is that of the humanities: the concern is ...

This book makes a crucial and timely contribution to the understanding of the nature and scale of the problem of the homeless in the United States. It starts with case examples that illustrate the human dimensions of this problem and then provides ...

This book is divided into four major sections. The first section describes the foundations of suicide and consists of three models to explain suicidal behavior: a psychological model, a biologic model, and a social relations model. Sheidman sets up these ...

Public Health and Environmental and Occupational Medicine

Adams & Maegraith: Clinical tropical diseases. Ninth edition. By Brian Maegraith, with S.G. Browne, H.M. Gilles, D.H. Smith, and R.D.G. Theakston. 505 pp., illustrated. Boston, Blackwell Scientific,...

CALL FOR ABSTRACTS

Abstracts are now being accepted for the "American Aging Association (AGE) 20th Annual Meeting," to be held in New York, Oct. 3–6. Deadline for receipt is June 29.

Contact AGE, 600 S. 42nd St., Omaha, NE 68198–4635; or call (402) 559–...

Responding to the rapidly changing nature of the delivery and financing of medical care, the federal government has enacted a new law that prohibits (as of 1992) physicians who own, invest in, or have certain compensation arrangements with clinical ...

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 ...