PATIENTS who take nonsteroidal antiinflammatory drugs (NSAIDs) have an increased risk of mucosal damage in the upper gastrointestinal tract.¹ The development of new lesions weeks after the initiation of treatment with NSAIDs has been confirmed in a ...

THE hemolytic uremic syndrome is an important cause of acute and often of end-stage renal failure in children.¹ The disease is characterized by glomerular fibrin deposition. An intrinsic glomerular fibrinolytic mechanism mediated by tissue plasminogen ...

STUDIES of blood flow in tissues and organs in patients with diabetes mellitus have revealed a typical pattern of change.^{1 , 2} There is an early increase in flow that is partly attenuated by improved glycemic control. With increasing duration of disease, ...

EACH year symptomatic localization-related (partial) epilepsy with partial or secondarily generalized tonic—clonic seizures develops in 70,000 to 130,000 adults.¹ If such seizures are not controlled, major compromises in the quality of life result. ...

ALTHOUGH the diagnosis of atrioventricular nodal reentrant tachycardia is made on the basis of electrophysiologic criteria, the symptoms and results of physical examination in patients with this arrhythmia may differ from those in patients with other ...

The two ulcerations visible on the scalp of a 41-year-old man with human immunodeficiency virus (HIV) infection had become progressively larger over a two-month period. Herpes simplex virus was cultured from a biopsy specimen, and multinucleated giant ...

HYPERTENSION is one of the most common medical conditions in the United States, with a prevalence of about 22 percent among adults 18 to 74 years of age, according to the second National Health and Nutrition Examination Survey.¹ The results of at least 15 ...

REPORTS of the clinical efficacy of acyclovir, a selective and specific inhibitor of herpesvirus replication, appeared in the literature a decade ago. Acyclovir has become the most widely prescribed and clinically effective antiviral drug available, and ...

Presentation of Case

A 31-year-old man was admitted to the hospital because of the acquired immunodeficiency syndrome (AIDS) and a recent onset of intermittent fever, diarrhea, and progressive weakness.

The patient was well until 20 months earlier, when ...

This election year, for the first time, nearly everyone seems to be talking about the need to reform our health care system. And nearly everyone agrees on what the problem is: We have increasingly costly care, of uneven quality, provided to an ever ...

The genesis of the debate over the nation's health care system lies in a paradox: on the one hand, more dollars are being spent on health care in the United States than in any other country; on the other hand, some 15 percent of our citizens do not have ...

The American health care system has the potential to provide every citizen with the best care in the world. Yet the system as currently financed and organized is plagued by two problems: health care costs are increasing at unsustainable rates, and ...

The standard I use to evaluate the candidates' positions on health care reform is the Jackson Hole Group initiative, a comprehensive proposal to remedy many sources of market failure and inequity in our present system, to foster an effective, ...

American youngsters are taught in their civics courses that "smart" American voters stand ready to be confronted with tough choices, to ponder them carefully, and to express their own choices at the ballot box.

Real-life politicians rarely meet such ...

To the Editor:... In every field of medicine, it is the physician's responsibility to give the patient as much medical information as possible, to enable the patient to make decisions about his or her care. No woman sees a physician to find out whether ...

To the Editor: Graham et al. (April 16 issue)¹ show that patients who received zidovudine and prophylaxis against Pneumocystis carinii pneumonia before the acquired immunodeficiency syndrome (AIDS) developed survived longer than those who received ...

To the Editor: In any clinical trial, it is important that the two randomized groups be comparable and managed similarly. Unfortunately, in the study by van der Meché et al. (April 23 issue),¹ there are numerous differences favoring the immune globulin ...

To the Editor: Hull et al. (April 9 issue)¹ demonstrated convincingly that low-molecular-weight heparin is at least as effective as intravenous unfractionated heparin in the treatment of proximal-vein thrombosis. They also found fewer major bleeding ...

To the Editor: In his comprehensive review of the management of acute hypercalcemia, Bilezikian (April 30 issue)¹ stated that etidronate therapy lowered serum calcium concentrations to normal in 60 to 100 percent of patients. Later, in describing our ...

To the Editor: Physicians should refuse a manufacturer's payment for prescribing a drug. There is an obvious conflict of interest and increased risk to the patient when a physician is paid to prescribe a drug. Financial inducements should not compromise ...

To the Editor: The term "gladiator" conjures up Technicolor images of actors clad in period attire, dispatching rivals before a crowd of enthusiastic spectators. With a similar image in mind, Selling et al.¹ first used the term "herpes gladiatorum" in ...

It may be coincidental that Oregon's request to restructure its Medicaid program was rejected by the Bush administration in August, with encouragement to resubmit it with revisions addressing legally mandated benefits for the disabled, for reevaluation ...

Nearly 20 years after Congress created an entitlement to Medicare for all patients covered by Social Security who had end-stage renal disease (ESRD), it instructed the Institute of Medicine to study the effects of this legislation on access to care, ...

As the book jacket says, Marketplace Medicine is sure to arouse controversy. The author is a Fulbright scholar. He is also an investigative reporter, and he writes in that style. Health professionals, patients, business students, investors, and ...

Poor health habits contribute to the high cost of personal health services. As various policy approaches for curbing the high rate of inflation in health care costs are evaluated, it is pertinent to consider what the role of individual responsibility in ...

Ten years ago, a birth in Bloomington, Indiana, made headlines and triggered an unprecedented entry of government into the details of patient care. In this book, the editors have assembled 12 essays that reflect on the effects of the "Baby Doe" law and ...

There has been renewed interest, fueled in large part by the intensity of cost-containment efforts, in the assessment and assurance of the quality of medical care. Assessing Quality of Health Care: Perspectives for Clinicians, edited by Richard P. Wenzel, ...

Biomedical Science

The Amygdala: Neurobiological aspects of emotion, memory, and mental dysfunction. Edited by John P. Aggleton. 615 pp., illustrated. New York, Wiley-Liss, 1992. $125. ISBN 0–471–56129–0.

Baroreceptor Reflexes: Integrative functions and ...

INSTITUTE OF OBSTETRICS AND GYNAECOLOGY

The following will be held in London: "Support for Families of Women and Children with HIV" (Oct. 14); "Adaptation to Extrauterine Life" (Nov. 13); "The Death of a Child" (Nov. 25); and "Neonatal Course for Senior ...