FOR several decades, clinical trials have addressed the question of whether treatment of hyperlipidemia reduces the associated risk of cardiovascular events.^{1 2 3 4 5 6 7 8 9 10 11 12 13} A substantial body of evidence now supports the idea that ...

THE identification of newborns at risk for congenital syphilis depends on the results of serologic tests performed during pregnancy and at the time of delivery. It is generally accepted that if both mother and baby are seronegative, the infant is free of ...

RETINITIS pigmentosa is the name applied to a group of hereditary retinal degenerations that affect between 50,000 and 100,000 people in the United States. The incidence at birth is about 1 in 3500.^{1 , 2} Patients characteristically report the occurrence ...

TESTING of voluntary donors of whole blood and paid donors of plasma for antibody to HIV-1 (anti-HIV-1) has markedly reduced but not eliminated the risk of transmission of HIV-1 infection by transfusion of blood products. Several studies have now ...

THE combination of donor education and self-exclusion with serologic testing has proved very effective in reducing the incidence of infection with human immunodeficiency virus type 1 (HIV-1) as a result of transmission by transfusion.^{1 , 2} There is a ...

HYPERCALCEMIA accompanied by elevated serum concentrations of parathyroid hormone (PTH) is the cardinal feature of primary hyperparathyroidism. The excessive production of PTH is due most often to a parathyroid adenoma, less often to parathyroid ...

THE endocrine glands are components of feedback loops whose function is to control the concentration of substances in the circulation.¹ These substances may be hormonal (e.g., thyroxine) or nonhormonal (e.g., glucose). Disorders of endocrine loops may ...

Presentation of Case

A 68-year-old man was admitted to the hospital because of recurrent hemoptysis.

There was a history of hemoptysis 30 years earlier, followed by resection of a hamartoma of the right upper lobe. Twenty-five years before admission an x-...

The study of therapeutic interventions to bring about the regression of atherosclerosis has been a major part of atherosclerosis research. Until recently, however, this objective had been realized only in experimental animal models. In the early part of ...

"Almost certainly preventable, the occurrence of a case of congenital syphilis can usually be attributed to ignorance or neglect."¹ This statement, made by Platou in his exhaustive description of the treatment of congenital syphilis with penicillin in ...

Clinical trials of a new treatment are undertaken in three phases. Phase I trials are designed to test the safety of the new treatment, phase II to test its efficacy, and phase III to compare it with standard treatment in a large number of patients ...

Statisticians and clinicians involved in the design and conduct of trials of new treatments for the acquired immunodeficiency syndrome (AIDS) have realized that some traditional approaches to the clinical-trials process may be unnecessarily rigid and ...

To the Editor: The study by Sigurdsson et al. (April 12 issue)¹ is an important one. There are, however, two factors that may confound interpretation of their data and its reproducibility. The first concerns tumor heterogeneity. Studies of other tissues (...

To the Editor: Renal-transplant recipients have a marked increase of viral warts, premalignant actinic keratoses, and skin cancers.^{1 , 2} Both cutaneous and cervical squamous-cell carcinomas are associated with human papillomavirus.^{3 4 5} We compared ...

To the Editor: Considering that there is now a consensus on the central role of tumor necrosis factor in the pathogenesis of septic shock, the study by van der Poll et al. (June 7 issue),¹ in which normal subjects were administered tumor necrosis factor, ...

To the Editor: Wiesner et al. are to be congratulated for their innovative study on the use of cyclosporine in early primary biliary cirrhosis (May 17 issue).* However, it is important to point out that although the authors claim that this was a double-...

To the Editor: In their article (June 7 issue),¹ Hauser et al. provide convincing evidence that measurement of urinary orotidine excretion after the administration of allopurinol is a simple and reliable test for the identification of women who are ...

To the Editor: Artifacts from the diet and medication can sometimes interfere with the detection of hereditary metabolic disorders. Examples of frequently encountered artifacts are metabolites of valproate, which can mask certain organic acid disorders, ...

To the Editor: "What does shared decision making imply for a physician's responsibilities when an apparently competent patient's choice appears to be irrational?" In posing this question, Brock and Wartman¹ address an important yet too little studied ...

To the Editor: As a research scientist and clinician employed by the Food and Drug Administration, I review many clinical-trial protocols. The results of some of these trials subsequently appear in the medical literature. On occasion, the published ...

To the Editor: It is a truism that physicians cannot just treat the patient but also must concern themselves with the patient's environment. Many important medical successes have been related to controlling the environment. The concept of sterility in ...

To the Editor: The effect of the human immunodeficiency virus (HIV) epidemic on medical-residency training programs is the subject of increasing concern, expressed both informally and in the medical literature.^{1 , 2} Recent cases of HIV infection and the ...

The last time I saw him,

encephalopath, addict to ethanol,

his soft accent had been replaced

by a dirge of ventilator valves

opening and closing in chorus.

His hair was a greasy mat

and his sheepish, guilty, half-hidden grin

had fallen open, a mouth ...

This book is a sequel to Noninvasive Diagnostic Techniques in Vascular Disease, the third edition of which was published in 1985 (Eugene F. Bernstein, ed. St. Louis: C.V. Mosby). The editor renamed this volume to emphasize its primary focus: summarizing ...

This small, inexpehsive book on the history of vascular surgery clearly represents a labor of love. With the plethora of articles and monographs that have recently been published on the major figures in the history of vascular surgery, a work such as this ...

In his introduction to this book, the editor states: "Some of the chapters may seem sketchy in comparison to others; however, they were deemed worthy of inclusion because they represent new concepts or work in evolution." Dr. Veith has been well served by ...

Here is a review of the care of burn patients from the scene of the accident through hospitalization to the time of discharge. It is an attempt to review the pathophysiologic changes that occur after a burn injury, as well as the medical, surgical, and ...

This new textbook is a strong and welcome addition to the ophthalmic literature. Eighteen well-recognized specialties have contributed to this book, which is completely up to date and is as thorough as possible.

Every aspect of ocular surgery is ...

This will be a most welcome addition to your medical library and one that you will use continually. Gold and Weingeist have successfully edited succinct yet comprehensive essays on ocular involvement in systemic diseases.

A group of 320 contributors, ...

The stated goal of this book is to present a balanced view of all disorders of the prostate. It consists of 49 relatively short chapters written by international experts on the topics, with pertinent rather than exhaustive lists of references. It is meant ...

One must be wary of practical approaches to medical treatment, which, like the management diagrams and paradigms so frequently employed in books on these approaches, can lull one into a false sense of security when facing a patient with a problem. While ...

CALL FOR ABSTRACTS

Abstracts are now being accepted for the "9th World Congress on Medical Law," to be held in Ghent, Belgium, Aug. 18–22. Deadline for receipt is Nov. 30.

Contact Dr. R. Dierkens, Apotheekstraat 5, B-9000 Ghent, Belgium; or call (32)91 25–...

The Efficacy of Inosine Pranobex in Preventing the Acquired Immunodeficiency Syndrome in Patients with Human Immunodeficiency Virus Infection (June 21, 1990; 322:1757–63). The name "isoprinosinc" appeared with a lower-case initial letter, suggesting that ...

Transfusion-Associated Graft-versus-Host Disease (August 2, 1990; 323:315–21). On page 316, the left-hand column, the sentence that begins six lines from the bottom should have read, "A recently reported survey of 340 Japanese hospitals documented '...