CONCERN has mounted that cost-containment policies implemented during the 1980s may be compromising the quality of care and the health of vulnerable populations, such as poor and chronically ill elderly people, although few studies have examined this ...

prospective trial to test whether abnormal coronary vasoconstriction, detected by hyperventilation testing before angioplasty, increases the likelihood of re-Stenosis. A test that could accurately identify patients at high risk for re-Stenosis might ...

THE removal of normal renal tissue in animals leads to focal sclerosis in the glomeruli of the remaining kidney and to progressive renal failure,^{1 , 2} an injury that may be due to intraglomerular hypertension and chronic glomerular hyperfiltration.³ There ...

LUPUS anticoagulants and anticardiolipin antibodies belong to a heterogeneous group of antibodies directed against negatively charged phospholipids. Although antiphospholipid antibodies are frequently found in otherwise healthy persons, they have been ...

ASTHMA is often associated, especially in childhood, with atopy manifested by positive skin tests, a clinical history of allergen-induced wheezing episodes, or concomitant eczema or allergic rhinitis.¹ However, some children and many adults with asthma ...

WE report an unusual form of cutaneous T-cell lymphoma characterized by subcutaneous tumors that regress spontaneously, fever, progressive leukopenia, high levels of interferon gamma in the serum, and an increased natural-killer-cell activity of ...

MOLLARET'S meningitis is a rare disease characterized by recurrent, self-limited episodes of aseptic meningitis.¹ Signs and symptoms of meningeal irritation appear acutely, in association with fever and pleocytosis of mononuclear cells. These episodes ...

Presentation of Case

First admission. A 76-year-old man was admitted to the hospital because of recurrent gastrointestinal bleeding.

There was a history of an ostium secundum atrial septal defect that was repaired five years before admission, with ...

One of the intriguing mysteries of biologic design is why there is such redundancy in the function of the kidneys. If a single kidney is removed (as it is from a living renal-transplant donor), the remaining kidney promptly grows larger and increases its ...

Medical cost containment has been compared to squeezing a balloon — constraining one end causes the other end to bulge. The relentless rise in national health care expenditures — estimated to consume over $700 billion and more than 12 percent of our gross ...

The debate about the role of physicians in euthanasia and assisted suicide is long-standing, ethically complex, and unlikely to be resolved easily or soon. It was rekindled by the death in June 1990 of Janet Adkins, a 54-year-old woman with probable ...

To the Editor: The difficulty of randomizing conventional cancer treatments has led Cassileth et al. (April 25 issue)¹ to adopt a convoluted study design that cannot, even if the major defects in its statistical analysis are rectified, provide reliable ...

To the Editor: Kendig and his coinvestigators should be commended for their well-done comparison of surfactant given as prophylaxis and as rescue therapy in very premature neonates (March 28 issue).¹ I disagree, however, with the editorial comment of ...

To the Editor: In considering the relation of an elevated renin-sodium profile with a higher risk of myocardial infarction, Alderman et al. (April 18 issue)¹ assume that it is causative rather than correlative. Although it is true, as they point out, ...

To the Editor: Hyperkalemia is a frequent and important clinical event that often necessitates therapeutic intervention. Pseudohyperkalemia should be high on the list of differential diagnoses, and fist clenching has been described in the Journal as an ...

To the Editor: Sonies and Dalakas (April 25 issue)¹ describe swallowing abnormalities due to weakness of the bulbar muscles of the tongue, mouth, and throat that increase the risk of choking for some of the 125,000 patients with the post-polio syndrome. ...

To the Editor: In 1987, Maeda et al. reported a case of human ehrlichiosis diagnosed by the serologic response to Ehrlichia canis and ultrastructural identification of clusters of small bacteria in cytoplasmic vacuoles of peripheral-blood leukocytes.¹ ...

To the Editor: In their letter of May 9, Clayman et al.* report the first laparoscopic nephrectomy. They state that a minimally invasive approach was justifiable because the patient was elderly. Their procedure had an operative time of seven hours and ...

This small book is one of the exceptional series of research publications that was begun in 1920 by the Association for Research in Nervous and Mental Disease. Despite its title, it presents little information that actually addresses the relation among ...

The stated aim of this book is to educate psychiatrists and other clinical practitioners in the use of pharmacologic and related biologic methods of treating psychiatric disorders. It succeeds well in this aim. Recognizing the contentions and controversy ...

A number of years ago, while a resident at Cornell University, I had the privilege of presenting a case from my clinic to Dr. Norman Geschwind, a visiting professor. The patient, a religious family man who worked at the hospital, had partial complex ...

Here is an impressive monograph by a panel of authors who have presented an informative discussion of disorders that are often difficult to define and poorly understood, even by the psychiatric community. Although this book presents a sophisticated ...

This book was edited by Matthews, who took over the job of editing McAlpine's classic work on multiple sclerosis in 1985. Matthews himself wrote the section on clinical aspects, which constitutes nearly half the book. The decision to use only three other ...

Both my thumbs are up — way up. Although the contents are not remarkable and the book discusses the familiar basic statistical tests (without explaining many advanced methods), the approach to these topics is remarkable. Most statistics textbooks bore ...

As soon as this book arrived for review, it disappeared from my office, never to return. Whoever borrowed it kept it, and once the replacement copy finally arrived, it was easy to see why. Dr. Shott has written perhaps the most accessible and useful ...

Radiology

Easily Missed Fractures and Corner Signs in Radiology. By Hans O. Riddervold. 400 pp., illustrated. Mt. Kisco, N.Y., Futura, 1991. $150.

Geriatric Radiology. Edited by Manuel Viamonte. 228 pp., illustrated. Baltimore, Williams and Wilkins, 1991. ...

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ALBERT EINSTEIN COLLEGE OF MEDICINE & MONTEFIORE MEDICAL CENTER

The following ...