WE have previously reported the initial results of a randomized trial begun in 1975 that compared mechanical with porcine prostheses for heartvalve replacement. After a median follow-up of 5.6 years, there were no significant differences in the rates of ...

CRYPTOCOCCAL disease accounts for 8 to 13 percent of hospital admissions for the acquired immunodeficiency syndrome (AIDS) in the United States, and it is likely to increase in importance as survival of patients with advanced human immunodeficiency virus (...

THE majority of patients with asthma have mild symptoms that can be controlled with beta-2 agonists, cromolyn, theophylline, inhaled corticosteroids, or a combination of these agents. Systemic corticosteroids are often required during acute exacerbations. ...

A DENOMAS that arise from the gonadotroph cells of the pituitary gland account for a substantial percentage of pituitary macroadenomas in men, but they are rarely recognized in women. When gonadotroph adenomas were first described in men less than 20 ...

In recent decades the nursing home population in the United States has increased substantially. A little over a half million people were residing in nursing homes or personal care facilities in 1964.¹ By 1985, after considerable growth in the elderly ...

Sooner or later bacteria develop resistance to virtually any antimicrobial agent. Resistance has many consequences. The patient infected with a drug-resistant as opposed to a drug-sensitive organism is more likely to require hospitalization and have a ...

Presentation of Case

A 61-year-old woman was admitted to the hospital because of recurrent abdominal pain and fever.

The patient was a native of Cambodia, who moved to the Philippine Islands three years before admission and immigrated to the United States ...

The first successful totally artificial device to replace a cardiac valve was implanted in the aortic-valve position by Dr. Dwight Harken in March 1960 at the Peter Bent Brigham Hospital in Boston.¹ Shortly thereafter, Dr. Nina Braunwald, at the National ...

Pituitary adenomas are more common than most people realize. They have been found at autopsy in from 1 to 25 percent of persons who were not suspected of having pituitary disease.¹ About 40 percent of such silent tumors contain prolactin. The remainder ...

The article by Kemper and Murtaugh¹ in this issue of the Journal employs a familiar algorithm to suggest the dire consequences of the aging of a society. Generally, the age- and sex-specific rates of elderly people today are multiplied by projections of ...

To the Editor: The carefully designed and analyzed study of outcomes of pregnancy among female resident physicians by Dr. Klebanoff and colleagues at the National Institute of Child Health and Human Development (Oct. 11 issue)¹ provides important data ...

To the Editor: Sullivan et al. (Sept. 13 issue)¹ report that the administration of intravenous immunoglobulin to patients undergoing bone marrow transplantation had beneficial effects with respect to the amelioration of graft-versus-host disease, ...

To the Editor: Recombinant interferon alfa is the drug of choice today for routine treatment of patients with metastatic renal-cell carcinoma who are candidates for systemic therapy.¹ Most responses to interferon have been observed in lung and lymph-node ...

To the Editor: Toxoplasmosis is a serious and common infection in patients with the acquired immunodeficiency syndrome (AIDS), and the cerebral form occurs in 10 to 40 percent of patients infected with the human immunodeficiency virus, especially in ...

To the Editor: Human herpesvirus Type 6 (herpesvirus 6) has been isolated from peripheral-blood mononuclear cells of the liver¹ and kidney² of transplant recipients. However, the clinical importance of infection with this virus after organ ...

To the Editor: Omeprazole is a potent new peptic-acid—secretion inhibitor that acts by inhibiting membrane H+/K+-transporting ATPase¹; its mechanism is therefore different from that of H2 antagonists, such as ranitidine and cimetidine, which are known —...

To the Editor: In 1988 Congress passed the Clinical Laboratory Improvement Amendments, charging the Health Care Financing Administration with implementation.¹ As health care providers, we are all concerned with the precision and accuracy of the tests on ...

To the Editor: In trying to use the standard mental-status examination in their work with patients, medical students and nonpsychiatric physicians are often daunted by the fact that, as one recent author put it, "The Mental Status Examination is a ...

The past half-dozen years have witnessed a revolution in the structure of textbooks in the basic medical sciences. Many classic textbooks of biochemistry have vanished, replaced by books emphasizing multicolored, eye-catching graphics that enable the ...

I have become perhaps unduly sensitive to the efforts of many who have achieved the M.D. degree (or who are aiming for it) to capitalize on their "doctor" role by writing lurid and exaggerated accounts for the book trade. I refer to the medical student ...

Here is a complete textbook on temporary cardiac pacing, a relatively simple technique. The majority of the book is written by one of the authors and often provides only a limited perspective, occasionally anecdotal.

The book starts out with the basics: ...

Here is a book designed to provide an initial exposure to electrocardiography for physicians in training and a review of basic electrocardiography for the general physician. To these ends, it offers a succinct introduction to the principles of ...

The quest for complete understanding of the biology of low-density lipoprotein (LDL) cholesterol has been a stimulating and important journey for the scientific community in the past two decades. Research on LDL has been driven by the relation between ...

The changing concept of lymphoid disorders resembles in many ways the situation described by mathematicians as chaos. Our comfortable perception of the stability of DNA has been shattered by knowledge of the rearrangements of lymphoid genes for antigen ...

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RESEARCH POLICIES AND QUALITY ASSURANCE

The symposium will be held in Rome, ...