IT is well established that cigarette smoking is a major contributor to the risk of myocardial infarction in both men and women and that the cessation of smoking is followed by a decline in the risk.^{1 2 3 4 5 6 7 8 9 10 11 12 13} Studies of the effects of ...

LICENSED enzyme immunoassay kits for screening the blood of volunteer blood donors for antibody to the human immunodeficiency virus type 1 (HIV-1) have been available since March 1985.¹ The blood from donors who have been found to be repeatedly reactive ...

NON-INSULIN-DEPENDENT diabetes mellitus (NIDDM) is characterized by defects in insulin secretion and in tissue sensitivity to insulin. Muscle is generally believed to represent the principal site of insulin resistance in NIDDM. Once taken up by the muscle,...

THE level of high-density lipoprotein (HDL) cholesterol has been shown in large prospective studies to be inversely associated with the risk of coronary heart disease.^{1 , 2} In humans, HDL cholesterol is composed of two principal fractions, HDL₂ and HDL₃; ...

MEDICINE is changing rapidly and at an increasing rate. When today's students are in midcareer, medical practice will be far different. Medical educators must find ways to help young doctors prepare for the medicine of the future. This article explores ...

INSOMNIA is the most common sleep problem. Like other common conditions, it results from many causes and varies widely in severity and duration from patient to patient. The recent widow, the ruminative worrier, the sleepless patient with chronic ...

LYME borreliosis (or Lyme disease) is a systemic disorder caused by the spirochete Borrelia burgdorferi, a newly discovered species of borrelia.^{1 , 2} The disease usually begins with a characteristic skin lesion; neurologic, cardiac, and joint involvement ...

Presentation of Case

A 53-year-old woman was admitted to the clinic because of extensive cutaneous swelling, thickening, and pain, with peripheral eosinophilia.

The patient was in a stable state of health until five months earlier, when swelling developed ...

Reduced insulin-mediated glucose uptake, or insulin resistance, is a metabolic defect characteristic of virtually all patients with non-insulin-dependent diabetes mellitus (NIDDM). The cause of insulin resistance remains unknown, but in the past decade, ...

The 1965 law establishing Medicare was a catalyst for change in the conditions of medical practice in the United States. This article reviews the law's effects, other changes occurring in the same period, and their consequences. It suggests why the morale ...

DEATHS

Bachmann — Richard Bachmann, M.D., formerly of Springfield, died on November 7 at the age of 94.

Dr. Bachmann received his degree from Medizinische Fakultät der Ludwig Maximiliams Universität in Munich, Germany, in 1920. He was a member of the ...

To the Editor: The article by Gould et al. (July 27 issue)* examined the patient to obtain information about the doctor. Such an inquiry needs to focus elsewhere.

The decision to use cesarean section for delivery is a matter of judgment on the part of ...

To the Editor: Maternal tolerance of the fetus implies immunologic changes during pregnancy. To investigate whether such changes include a partial immunologic activation, we undertook a preliminary study to determine interleukin-2 levels in serum during ...

To the Editor: A recent increase in the prevalence of syphilis and congenital syphilis has been noted in the United States, reaching epidemic proportions in some areas.¹ Controlling this epidemic depends on the identification and treatment of infected ...

To the Editor: The Venereal Disease Research Laboratory (VDRL) and other nontreponemal tests for syphilis measure the levels of antibody directed against a cardiolipin—lecithin antigen. False positive reactions can occur in patients with immunoglobulin ...

To the Editor: Epstein et al. (Aug. 3 issue)* state their belief that the chief mechanism for sudden coronary death in patients without earlier warning symptoms of ischemia is an acute occluding thrombus of a coronary artery complicating a mild, non-flow ...

To the Editor: In an otherwise excellent discussion and review of idiopathic portal hypertension (July 27 issue),* the discussant states that the wedged hepatic-vein pressure would be elevated. Sinusoidal and postsinusoidal mechanisms of portal ...

To the Editor: There is a discrepancy between the conclusions of Sampson et al. (July 27 issue)¹ regarding the relation of their findings to atopic dermatitis (eczema) and the conclusions drawn from the same paper by Metcalfe in the accompanying ...

To the Editor: The title of the letter on the date of the first use of ether in surgery (July 27 issue)¹ and the reply to it were not completely correct. Dr. Crawford W. Long² is credited with the first surgical use of sulfuric ether, in Jefferson, ...

This book is a revision of Treatment of DSM-III Psychiatric Disorders, published in 1983. The new edition accomplishes two purposes: it brings the earlier book up to date and correlates its content with the diagnostic system adopted in 1987 (Diagnostic ...

This comprehensive work on a controversial subject attempts to bring together what is known about male homosexuality, to raise questions about what is generally accepted by psychoanalysts, and to propose some new theoretical formulations. The book's ...

This widely heralded book seeks to elevate the study of nonbiological factors (life events) as they affect medical and mental illness. Scholars discontented with the limitations of aging rating scales, checklists, questionnaires, self-reports, and the ...

Both these textbooks are intended for physicians and their teams in the treatment of patients outside the hospital. The practical importance and specialized features of outpatient treatment are now generally acknowledged. The widespread availability of ...

Aggression and violence between men and women are increasingly recognized as concerns that need to be addressed in a civilized society. The feminist movement has done much to focus the attention of the scientific community on the ubiquity and urgency of ...

Nursing

Cardiac Nursing. Second edition. Edited by Sandra L. Underhill, Susan L. Woods, Erika S. Sivarajan Froelicher, and C. Jean Halpenny. 1109 pp., illustrated. Philadelphia, J.B. Lippincott, 1989. $75.

The Nurse Intrapreneur: Opportunities and ...

CLEVELAND CLINIC EDUCATIONAL FOUNDATION

The following courses will be offered in Cleveland, unless otherwise noted: "13th Midwest Glaucoma Symposium" (March 2 and 3); "Echo Doppler Symposium" (Coral Gables, Fla., March 2–5); "Advances in Urology" (March 8–...

Bone Marrow Transplantation after the Chernobyl Nuclear Accident (July 27, 1989; 321:205–12). On page 208, in Table 2, the column headed "Cell Dose" should have read "×10−8/kg," not "×10−5/kg" as printed.

Clinical Pharmacology of 3′-Azido-2′,3′-Dideoxythymidine (Zidovudine) and Related Dideoxynucleosides (September 14, 1989; 321:726–38). In Table 3 on page 734, in the Comments section for ddA/ddI, the word disasphasias should have been dysesthesias. We ...

Hepatitis B Virus Infection among Children Born in the United States to Southeast Asian Refugees (November 9, 1989; 321:1301–5). On page 1303, in the second line of the title to Table 3, "Mothers with Infectious Disease" should have read "Mothers without ...