VOLUNTARY self-exclusion from blood donation by persons at risk for human immunodeficiency virus type 1 (HIV-1) infection and the implementation of routine screening for HIV-1 antibodies have substantially reduced the risk of HIV-1 transmission through ...

FETAL deaths at ≥20 weeks of gestation now constitute a major proportion of perinatal deaths in the United States, and in some states the fetal death rate is reported to equal or exceed the neonatal death rate.¹ For this reason, increased attention is ...

PERIODIC, self-limited episodes of excruciating musculoskeletal pain punctuate the lives of patients with sickle cell disease. Often referred to as "crises," these episodes are the principal cause of morbidity among these patients. Although Western ...

BALLOON aortic valvuloplasty was initially developed as an alternative to aortic-valve replacement for elderly patients with symptomatic aortic stenosis for whom the risks of aortic-valve replacement were felt to be high.^{1 , 2} Early reports documented the ...

RESPIRATORY syncytial virus is the most important respiratory pathogen causing lower respiratory tract infection in infants and young children. Ribavirin (1-β-D-ribofuranosyl-1,2,4-triazole-3-carboxamide) is a synthetic nucleoside with inhibitory activity ...

THE pace of political and social change in South Africa has quickened dramatically since my previous review¹ of medicine and health care, and there has been a resurgence of hope that at last real progress may be made toward a legitimate society capable of ...

GOLORECTAL cancer is a leading cause of death from cancer in the United States, with approximately 140,000 new cases and 60,000 deaths per year.¹ A 50-year-old person has about a 5 percent risk of having colorectal cancer by the age of 80 and a 2.5 ...

Presentation of Case

A 75-year-old man was admitted to the hospital because of an impaired mental status, myoclonic jerks, and a tonic—clonic seizure.

The patient was right-handed. There was a history of adult-onset diabetes mellitus that was managed with ...

Alpha-fetoprotein is a glycoprotein with a molecular weight of about 70,000 that is synthesized first by the embryonic yolk sac and later by the fetal gastrointestinal tract and liver. This major fetal protein reaches its highest concentration in fetal ...

Three and a half decades ago Morris et al.¹ recovered from a chimpanzee with a cold a virus that had infected the entire colony and its handler. In subsequent years this contagious chimpanzee coryza agent earned a new name, respiratory syncytial virus. It ...

Arnold S. Relman, M.D., retired this week after 14 years as Editor-in-Chief of the New England Journal of Medicine. As he departs, the Journal is recognized as the leading general-interest medical journal and is widely acknowledged to be at the forefront ...

To the Editor: Like Lady Macbeth, the Gerber Products Company is determined to pluck the "nipple from [the] boneless gums"¹ of infants by their cynical and sophisticated advertising techniques. Let us explain. In 1989, despite the protestations of the ...

To the Editor: Medium-chain acyl-coenzyme A dehydrogenase (MCAD) deficiency is a newly characterized disorder of fatty acid oxidation that presents in the first two years of life as either sudden death at home or, if seen in a hospital, as Reye's ...

To the Editor: The endorsement by Bergsagel et al. (Jan. 3 issue)¹ of inexpensive oral androgen as opposed to expensive erythropoietin as a hematostimulant in multiple myeloma is unfortunate, primarily because the oral route fails to avoid the first-pass ...

To the Editor: The article on lymphangioleiomyomatosis (LAM) by Taylor et al. (Nov. 1 issue)* was a very useful addition to the limited literature on the disease. I take issue with one of their recommendations, however. Despite their own finding that ...

To the Editor: The interesting study by Silber et al. (Dec. 27 issue)¹ focused on the use of epididymal sperm from patients with congenital absence of the vas deferens to fertilize the human oocyte in vitro. However, the possibility of a mild form of ...

To the Editor: After the publication of data from the Centers for Disease Control showing an increase of only 9 percent in newly diagnosed cases of the acquired immunodeficiency syndrome (AIDS) during 1989,¹ some predicted an early end to the epidemic of ...

To the Editor: In his Sounding Board article (Oct. 25 issue),¹ Wennberg makes the argument that patients' preferences need to be better gauged and incorporated into patient care plans. He has hit on an emerging controversy in clinical medicine.² We have ...

To the Editor: I regret to write that the study by Moore and Priebe (Feb. 21 issue)¹ has a distressing variety of misinterpretations and errors. They state that data on board-certified physicians was obtained from the physician "Masterfile" of the ...

To the Editor: It happens every day in the language of medicine that we use someone's name to describe an instrument, a sign, or a test. Consider the following case report. A 47-year-old, previously healthy man presented with Killip and Kimball class 4 ...

This book is a gem that will be informative and educational for a broad audience of health professionals. The editor shares much new knowledge on the subject with his readers.

A new emphasis on the importance of impaired glucose tolerance is discussed at ...

Fundamental to this unique book is the recognition that the manifestations of diabetes mellitus are sufficiently diffuse to involve virtually all the patient's organs and all the patient's doctors, generalists and specialists. It attempts to address each ...

The detection of treatment of malignant tumors by phototherapy remains an interestingly underexplored field, considering that the tools involved have been known for much of the 20th century. Phototherapy in essence relies on the uptake of sensitizing dyes ...

"Practical" is the watchword for this third edition of Principles of Ambulatory Medicine. The book is eminently useful and usable. The most practical improvement over the second edition is the reduction in size; the second edition's 3-inch thickness has ...

These two additions to the dermatologie bookshelf should both appeal to the nondermatologist, although for different reasons. The new Lange medical book, Dermatology, has all the attributes of its successful forebears. It is inexpensive and amazingly ...

This pricey volume has been expanded dramatically since the 1980 edition. That edition, the second, was entitled Cardiac Pacing and included a minimum of basic and clinical electrophysiology. Since that time there has been an explosion in the basic-...

In 1912 James Herrick first described coronary thrombosis as the inciting event in an acute myocardial infarction. Since that time, the field of cardiology has seen major changes. Disorders related to coronary artery disease now occupy the majority of a ...

Notices submitted for publication should contain a mailing address and phone number of a contact person or department. We regret we are unable to publish all Notices received.

PRION DISEASES IN HUMANS AND ANIMALS

The program will take place in London, ...

Case Records of the Massachusetts General Hospital (Case 6–1990) (February 8, 1990; 322:388–97). On page 392, the text that begins 12 lines from the bottom of the right-hand column should have read, "nocardia is an unlikely culprit because of the absence ...

Hospital Cost Containment in the 1980s — Hard Lessons Learned and Prospects for the 1990s (April 11, 1991; 324:1037–42). The article should have stated that grant support was provided by the Commonwealth Fund.

Linkage of a Gene Causing Familial Amyotrophic Lateral Sclerosis to Chromo some 21 and Evidence of Genetic-Locus Heterogeneity (May 16, 1991; 324: 1381–4). On page 1382, in the left-hand column, the 12th line of the second paragraph under the subheading "...

These guidelines are in accordance with the "Uniform Requirements for Manuscripts Submitted to Biomedical Journals." (The complete document appears in the February 9, 1991, issue of the British Medical Journal and the February 7, 1991, issue of the New ...