CHEMOTHERAPEUTIC agents are used frequently in the treatment of children and adolescents with cancer. Many of these agents are mutagenic, with the potential to cause injury to germ-cell chromosomes. The possible results of this injury include an increase ...

NON-INSULIN-DEPENDENT diabetes mellitus (NIDDM), which affects 10 to 12 million Americans over the age of 20 years,^{1 2 3} is a complex disorder characterized by increased resistance to insulin and impaired secretion of insulin⁴ and associated with an ...

FACTOR XI (plasma thromboplastin antecedent, or PTA) is a plasma glycoprotein (molecular weight, 140,000) that participates in the early phase of the intrinsic pathway of the blood-coagulation cascade. It circulates in plasma in a precursor form and is ...

LYME disease, a tick-borne spirochetal infection, J typically begins with a characteristic skin lesion, erythema migrans, and is often followed by systemic manifestations involving the heart, nervous system, or joints.¹ The illness was recognized as a ...

THE combination of fever and neutropenia is a life-threatening complication of chemotherapy in patients with cancer. Before modern management, mortality rates approached 80 percent, particularly in association with gram-negative bacteremia.^{1 , 2} Current ...

CUTANEOUS melanoma has become a common form of cancer.¹ Decades of steady increases in the incidence and mortality rates of cutaneous malignant melanoma have sparked global interest in the nature of this cancer.^{2 3 4 5 6} Recent research has advanced our ...

Presentation of Case

A 56-year-old woman was admitted to the hospital because of recurrent intermittent fever after renal transplantation.

There was a history of interstitial nephritis that led to chronic renal failure six years earlier. Extracorporeal ...

Although the pathogenesis of non-insulin-dependent diabetes mellitus (NIDDM) is not fully understood, it is clear that at least three factors are important: a genetic predisposition to the disease; a decrease in the action of insulin in insulin-sensitive ...

The conventional wisdom among health policy makers now holds (as it did 20 years ago) that major federal reform in our health system is just a matter of time. This view originates in the extraordinary economic, social, and ethical tensions created by a ...

Conventional methods of drug promotion — such as print advertising, direct marketing by salespeople, and the distribution of written materials at meetings — have increasingly been supplemented by nontraditional approaches that rely heavily on the ...

To the Editor: Leaf and Ryan (Nov. 15 issue)¹ plead for greater efforts to prevent coronary artery disease, arguing that the present situation represents a financial drain on society and that prevention is a medical imperative. They focus their ...

To the Editor: The conclusion of Molfino et al. (Jan. 31 issue)¹ that the respiratory arrests studied resulted from undertreatment is not justified by their data, for they state that the actual treatment in these patients was unknown. In fact, patients ...

To the Editor: Dr. O'Hollaren et al. (Feb. 7 issue)¹ report the inhalation of alternaria allergens as a risk factor for sudden, severe respiratory arrest in young patients with asthma. The seasonal occurrence of episodes (from June to November) together ...

To the Editor: Although epidemiologic studies show that the accumulation of aluminum in patients with end-stage renal disease, due to the use of contaminated dialysate fluid, causes low-turnover osteomalacia,¹ the potential toxicity of lower levels of ...

To the Editor: No effective treatment for chronic myelomonocytic leukemia is currently available.¹ The usual indications for the use of various chemotherapeutic agents are extramedullary manifestations and leukocytosis, with accompanying anemia and ...

To the Editor: The recent special article by Brennan et al. on adverse events and professional negligence in hospitalized patients (Feb. 7 issue)* provides ammunition for both sides in the long-running controversy about the occurrence of medical ...

To the Editor: In this age of molecular biology it is commendable that the Journal has published studies demonstrating the potential of simple measures to save the lives of millions of children at little cost: vitamin A supplementation for children in ...

To the Editor: Structural changes in the brain associated with normal aging have not yet been delineated. For example, it is still controversial whether neurons are lost during normal aging.¹ In an autopsy study, I found that the size of the corpus ...

In October 1988 another of the many recent books by physicians was published, chronicling the travails, joys, and realities of medicine — M.D.: Doctors Talk about Themselves, by John Pekkanen.¹ What was arresting about the book was not so much its content ...

The receipt of these books is acknowledged, and this listing must be regarded as sufficient return for the courtesy of the sender. Books that appear to be of particular interest will be reviewed as space permits.

Addresses of most overseas publishers ...

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.

HARVARD SCHOOL OF PUBLIC HEALTH

The following courses will be offered in ...

A consensus is taking shape that favors a substantial expansion of the authority and resources with which the Food and Drug Administration can carry out its increasingly complex regulatory mission. There is an emerging recognition among important sources ...