For more than 50 years, physicians have been taught that the erythrocyte sedimentation rate is low in patients with congestive heart failure.¹ This belief, however, stems primarily from observations published in a single report by Paul Wood in 1936.² He ...

AT one time, asthma was considered to be a mild disease, a "slight ailment that promotes longevity" in Osler's words.¹ Although deaths from asthma are uncommon, the rates of mortality from asthma appear to be increasing in England,²-⁴ New Zealand,⁵,⁶ the ...

PHOSPHOFRUCTOKINASE catalyzes the rate-limiting reaction in glycolysis, the phosphorylation of fructose-6-phosphate to fructose-1,6-diphosphate. An inherited deficiency of the muscle form of phosphofructokinase (muscle phosphofructokinase deficiency, or ...

FABRY'S DISEASE is an X-linked recessive disorder resulting from deficient activity of the lysosomal hydrolase α-galactosidase A.¹-³ The enzymatic defect leads to the progressive accumulation of neutral glycosphingolipids with terminal α-galactosyl ...

OVER the past decade there has been a steady increase in the number of malpractice claims brought against health care providers¹,² and in the monetary damages awarded to plaintiffs.³-⁵ This increase has precipitated numerous state programs designed to ...

IN recent years, concern about the increasing cost of malpractice-insurance premiums has led to numerous tort reforms. At the same time, and largely independently of tort reform, interest in initiatives affecting the quality of care has grown. Curiously, ...

THE introduction of fluoroquinolone antimicrobial agents (Fig. 1) into clinical use is an important recent advance.¹-³ These drugs, also called quinolones, include norfloxacin, ciprofloxacin, ofloxacin, enoxacin, and pefloxacin. Of these, norfloxacin, ...

A 27-year-old woman was admitted to the hospital because of Hodgkin's disease and a right adrenal mass.

The patient was well until 2 1/2 months earlier, when she began to experience fatigue and a low-grade fever, with the temperature ranging as high as ...

OF all of the medical emergencies that confront practicing physicians, asthma is the one most often dealt with in accordance with the adage "familiarity breeds contempt." Because asthma is such a common disease and is so readily reversed with treatment, ...

ALL living cells consume energy to perform work, but skeletal muscle does its work in a most conspicuous way, in bodily activities such as walking, running, jumping, and lifting. How muscle actually transforms chemical energy into mechanical energy was ...

To the Editor: Dr. Janerich and his colleagues (Sept. 6 issue)¹ report a significantly increased risk of lung cancer (odds ratio, 2.07; 95 percent confidence interval, 1.16 to 3.68) in men and women who had never smoked but were exposed to smoke for 25 ...

To the Editor: The follow-up study by Needleman et al. (Jan. 11, issue)¹ purports to demonstrate enduring cognitive and neurobehavioral effects of relatively low levels of exposure to lead in children previously studied in 1975 through 1978.² What it may ...

To the Editor: In the study by Anderson et al. (Sept. 6 issue)* I notice that the esophagoscopy performed in all the children was done with rigid esophagoscopes. In this day of fiberoptic esophagoscopy I am puzzled about why the study was conducted with ...

To the Editor: Parvovirus B19 causes several well-characterized syndromes, ranging from classic erythema infectiosum, primarily in children, to aplastic crises in patients with problems of red-cell production or immunodeficiencies, and to arthropathies, ...

To the Editor: Eyman et al. (Aug. 30 issue)¹ are to be commended for their analysis of the life expectancy of persons with multiple disabilities. This study will be enormously useful in providing prognostic information to families and planning care for ...

To the Editor: Fluoxetine (Prozac) is a commonly prescribed antidepressant. Recent concern has emerged regarding its ability to induce suicidal ideation.¹ We report on two patients in whom suicidal ideation and fluoxetine treatment were strongly ...

To the Editor: Fuchs and Garber's illuminating view of the new technology assessment (Sept. 6 issue)* clearly demonstrates the principles involved therein and, although expressing proper concern for the value of life (largely a personal and sometimes a ...

Few problems are more perplexing to modern medicine than how care might be rationed. These two books illustrate just how difficult it is to devise a defensible approach to this problem. In the first book, Who Lives? Who Dies?, Kilner takes on the daunting ...

This book is a collection of papers and presentations on hypnosis and psychotherapy, published in acknowledgment of Milton Erickson's advocacy of brief, focused therapy. It contains a wealth of detailed information about the theory and practice of brief ...

Here is a report from a committee of the Institute of Medicine's division of Mental Health and Behavioral Medicine. In 1986, responding to increasing recognition of the importance of the availability of treatment and rehabilitation services for alcoholism,...

To the uninitiated, neurology is a difficult and often arcane field. Every medical student who has had some experience with neurologic diseases during training has probably wished for a book that covered the field broadly enough to be useful in the study ...

This is a good book, a book with a point of view and a distinct voice. Laying out the available information on epilepsy is in itself a large task, but to add to it some degree of understanding is unusual. Medical books on large subjects like epilepsy are ...

Each of these books fills a specialized niche; their niches, however, are quite distinct.

The first, that edited by Sandler and Collins, is based on a private symposium. Each chapter reflects a presentation and some of the discussion that followed. Each ...

In the 12 years since it was first published, the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals" (the Vancouver style), developed by the International Committee of Medical Journal Editors, has been widely accepted by both authors ...