THE acquired immunodeficiency syndrome (AIDS) is characterized by severe opportunistic infections, certain types of cancers, and degeneration of the central nervous system. The causative agent of the underlying immunodeficiency is a human retrovirus ...

THE antiarrhythmic agent propafenone, a sodium-channel blocker with some structural similarity to propranolol,¹ is effective in the management of atrial and ventricular arrhythmias. Propafenone has been available in Germany since the mid-1970s and has ...

PLATELETS from patients with diabetes and from diabetic rats have been reported to synthesize more thromboxane than normal platelets in response to a variety of agonists that induce deacylation of arachidonate from membrane phospholipids.¹ Di Minno et al.^...

SEVERAL diseases in humans result from the ability of mussels, clams, oysters, and other mollusks to concentrate pathogens present in water and pass them on to consumers. Among the mollusk-associated intoxications and infectious diseases, only paralytic ...

IN November and December 1987, an outbreak of illness characterized by gastrointestinal and neurologic symptoms was associated with the consumption of mussels from Prince Edward Island.^{1 , 2} The mussel toxin was purified by high-performance liquid ...

A PATIENT with Philadelphia chromosome-positive chronic myelocytic leukemia in a phase of accelerated growth received a bone marrow transplant from her HLA-identical brother, whose cells were not reactive in the mixed leukocyte culture. Although routine ...

SURGICAL personnel who are exposed to blood risk infection with the hepatitis B virus (HBV) and the human immunodeficiency virus (HIV). The recommendations from the Centers for Disease Control for the prevention of infection with blood-borne pathogens ...

Presentation of Case

First admission. A 63-year-old man was admitted to the hospital because of recurrent diarrhea.

The patient stated that he became malnourished as a prisoner of war during World War II, with a decrease in his weight from 90 to 74 kg ...

Recognition of the myriad immunologic defects associated with human immunodeficiency virus (HIV) infection has stimulated the development of novel approaches to its treatment. To date, the most effective treatments have been antiviral agents directed ...

A compelling picture of the growing confrontation between physicians in private practice and third-party payers is provided by the correspondence in this issue¹ on Dr. Gerald Grumet's recent essay, "Health Care Rationing through Inconvenience."² The ...

We are engaged in a great struggle to reform the American health care system, a system addicted to increasing costs and decreasing equity. The first tactic of someone suffering from addictive behavior is twofold: to try to remove the bad habit with the ...

A widely held view is that medical costs are a problem verging on a crisis. Perhaps on the principle that drastic problems require drastic solutions, for the first time powerful voices have been raised in favor of explicit rationing as a solution — ...

To the Editor: Dr. Grumet's Sounding Board article on health care rationing (Aug. 31 issue)* put into concise language how Massachusetts physicians feel about Blue Shield of Massachusetts. The section on "Emerging Trends and Dangers" might also have ...

To the Editor: When the results of case–control studies differ dramatically from the results of large cohort studies, it is important to keep in mind the fundamental differences in methods that affect the reliability of their inferences. In the case–...

To the Editor: In the article by Schaad et al. (Jan. 18 issue),¹ it is stated that there were no statistically significant differences between the two treatment groups in terms of the base-line characteristics shown in Table 1. Looking at the table, I ...

To the Editor: Hornbein et al. (Dec. 21 issue) ¹ state that increased oxygen delivery to muscle during exercise is responsible for the finding that "persons with a high hypoxic ventilatory response, who appear more impaired after exposure to extremely ...

To the Editor: Adding dye to enterai feedings to aid in the detection of tracheobronchial aspiration has been suggested.^{1 , 2} Although the addition of green food dye can facilitate the confirmation of occult aspiration, in one of our patients it caused ...

To the Editor: For any patient or family, the diagnosis of cancer is a terrible shock. Discussions of treatment emphasize the discomforts and the probability of relapse. Too often there is not enough emphasis on the positive side, including the ...

To the Editor: The role of physicians in educating the public about the acquired immunodeficiency syndrome (AIDS) and infection with the human immunodeficiency virus (HIV) has received relatively little attention. The patient's perspective on physicians ...

To the Editor: The study by Lomas and colleagues (Nov. 9 issue) ¹ indicates that practice guidelines had little effect on cesarean-section rates in Ontario. From this one study Lomas et al. conclude that although such guidelines may modify physicians' ...

To the Editor: In a recent letter to the Editor (March 8 issue)¹ on primary care in underserved areas and medical education, Garland stated that the general trend in medicine has been toward specialization and away from primary care. Although we agree ...

Through the sweat and sun

Crowded corridors notwithstanding

He came with a walking stick

Seventy-nine years swaying in a frail frame

Eyes glowing deep from their pits

Well-spoken words and no slurring.

White cloth showing only black patches of dirt

...

During the past 10 years, neonatal intensive care has been extended to progressively smaller and less mature infants, specifically those weighing less than 1000 g and those born at less than 28 weeks' gestation. Only recently, however, has attention been ...

It has been eight years since the first edition of this textbook appeared. Its second edition clearly reflects the explosion in knowledge and research in pediatric gastroenterology and nutrition and their application to the neonate and older infant. The ...

Advances in developmental pulmonary physiology in the 15 years since the publication of the first edition of this book have enhanced our understanding of the interplay of structure and function, of molecular biology and fluid mechanics, in the developing ...

In the decade since the fourth edition of what has been the definitive American textbook on pediatric anesthesia almost since its first printing in 1959, the first editor, Robert Smith, has retired. Responsibility has passed to his former associate, ...

Publications on radiology have too often been expensive, multi-volume textbooks, perilous to carry and outdated by the time they are sold. These two small books covering specific topics and presenting both recent literature and current practice are most ...

Our fascination with persons who have developmental abnormalities has been ascribed to the fact that they are mirrors in which we see ourselves. This collection of papers makes that point at every level, from the genetic to the behavioral. It is possible ...

Biomedical Science

Atlas of Human Limb Joints. Second edition. By Jacques Guyot. 258 pp., illustrated. New York, Springer-Verlag, 1990. $169.

Central Cholinergic Synaptic Transmission. Edited by Michael Frotscher and Ulrich Misgeld. 323 pp., illustrated. ...

MARY IMOGENE BASSETT HOSPITAL

The following Conferences will take place in Cooperstown, N.Y.: "Neurology" (July 11) and "3rd Annual Pediatric Refresher Course" (Aug. 24–26).

Contact Charlotte L. Hoag, Office of Medical Educ., Mary Imogene Bassett Hosp., 1 ...