PRURITUS is one of the most disturbing symptoms in patients with end-stage renal disease, and it occurs in up to 86 percent of patients undergoing maintenance hemodialysis.^{1 2 3 4 5} The pathogenesis of uremic pruritus is poorly understood. Possible ...

THE classic treatment for acute deep-vein thrombosis is initial therapy with continuous intravenous heparin,^{1 2 3 4 5} followed by long-term oral anticoagulant therapy.^{6 7 8 9} The use of accurate objective tests to detect venous thromboembolism^{10 11 12 13 ...}

ETHANOL accounts for 5.6 percent of the energy in the average American diet.¹ Among consumers of ethanol, ethanol accounts for up to 10 percent of total energy intake, and in alcoholic persons ethanol may supply more than 50 percent of dietary energy.^{2 3 ...}

EPIDEMIOLOGIC studies have shown that 70 to 80 percent of adults are seropositive for the human polyomaviruses BK and JC. ^{1 , 2} BK virus, originally discovered in the urine of a renal-transplant recipient,³ is thought to be a cause of hemorrhagic cystitis ...

RECURRENT, severe hypoglycemia in the absence of exogenous insulin administration is uncommon. Reported causes include islet-cell adenomas or carcinomas, surreptitious use of insulin or sulfonylurea medications, stimulatory insulin-receptor antibodies, ...

PNEUMOCYSTIS CARINII is a well-known pulmonary pathogen that has been increasingly identified in extrapulmonary sites in patients with the acquired immunodeficiency syndrome (AIDS).^{1 2 3 4 5 6 7} We describe a case of pneumocystis osteomyelitis that ...

FECAL incontinence is personally and socially incapacitating. The stigma is so considerable that many affected patients are unwilling to admit they have fecal incontinence, and physicians are often reluctant even to inquire about it. Fecal incontinence ...

Presentation or Case

A 23-year-old woman was admitted to the hospital because of the acute onset of abdominal pain.

The patient was in excellent health until the morning of admission, when she was awakened from sleep in the early hours by a severe, ...

ITCHING is the dominant symptom of skin disease and a frequent manifestation of systemic disease. It causes more distress than even pain, because it is frequently intractable. Numerous analgesic drugs relieve pain effectively, but there are no specific ...

SINCE heparin and the vitamin K antagonists became available for clinical use more than 40 years ago, the number of other drugs that have been introduced to prevent or treat thrombotic states is surprisingly small. Activators of plasminogen are exceptions;...

FASTING hypoglycemia is a serious condition with the potential to cause substantial morbidity and even death. Because it has numerous causes, the approach to patients who have low plasma glucose levels during fasting may be confusing. This confusion can ...

EVIDENCE is accumulating of substantial deterioration in the health status of people living in the former Soviet Union and Eastern Europe.^{1 , 2} The public health system has degenerated in recent decades. Support for preventive services has been largely ...

To the Editor: Dr. Spital's article (Oct. 24 issue) * on the very real shortage of available organs was one-sided, emphasizing the problem from the perspective of the recipient. He was quite accurate that "many families derive great comfort from donating,...

To the Editor: In their discussion of the mechanisms responsible for the immunosuppressive properties of pretransplantation blood transfusions, van Twuyver et al. (Oct. 24 issue)¹ misinterpret our previously reported findings that HLA Class II disparity ...

To the Editor: As outlined by Sachs (Oct. 24 issue),¹ specific allogeneic tolerance to donor tissues can be induced by the transfer of donor lymphohemopoietic cells,² establishing a state of mixed chimerism. A major problem, however, is that patients ...

To the Editor: The report by Frymoyer et al. (Sept. 5 issue)¹ was of great interest to us, because we have studied 23 patients, 20 of them from five families in which up to three generations are involved, and all the patients appear to have the same ...

To the Editor: Recently, the trade name for omeprazole was changed from Losec to Prilosec after several physicians noted incidents in which prescriptions written for Losec were instead dispensed with Lasix.^{1 2 3} We report a similar confusion between a ...

To the Editor: Anyone can now possess thin thighs in 30 days or less, according to current television and magazine advertising. The advertisements assert that shapely thighs can be achieved "in just minutes a day" with the use of specialized exercise ...

To the Editor: As a scholar of 19th-century American literature, I have published an article about the relation of physical disease to an understanding of Melville's life and work.¹ Therefore, I was particularly interested in Dr. Udvarhelyi's review (...

Alas, poor Ahab's mission Monomaniacal as his soul Was a preposterous proposition When taken as a whole.

Avast, for him no hearse or coffin Yet, now, his body must gravely roll Because it is not very often Medical journals take such a toll.

Across the ...

Rosner and Markowitz have written a thought-provoking, densely referenced, uncompromising history that examines silicosis as a paradigm of "the politics of occupational disease in twentieth-century America." Like all good history, it challenges our basic ...

The clinical entity of multiple chemical sensitivity has aroused vigorous and at times acrimonious debate. Clinical ecologists, along with some allergists and occupational physicians, assert that they evaluate and treat patients who suffer a variety of ...

This comprehensive new textbook of neurology distinguishes itself from other textbooks by its section on neurology in other regions of the world, its relatively extensive coverage of pediatric topics, and its strong sections on neuro-ophthalmology, ...

Impaired memory is a common symptom. Clinicians consulted by patients with such a complaint need some familiarity both with the spectrum of memory disorders seen in medical practice and with the psychological processes thought to constitute normal memory. ...

Contemporary neurosurgery is an expanding and exciting discipline. Among its procedures are operations on the brain and spinal cord, including spinal fusions, skull-base procedures, brachial-plexus and peripheral-nerve repair and reconstruction, carotid-...

The field of emergency medicine demands technical skill with a number of procedures, any of which may be required on a moment's notice. These measures may be lifesaving, and the availability of backup consultation varies widely with the practice setting ...

The latest edition of Shackelford's Surgery is a prodigious compilation of practically everything that can be conveyed with the written word about abdominal surgery as well as surgery of the thoracic and cervical esophagus. It is organized according to ...

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AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS

The "1st Annual Meeting and ...