PERCUTANEOUS balloon mitral valvuloplasty was originally introduced as an alternative to surgical mitral commissurotomy or valve replacement for the treatment of mitral stenosis.^{1 , 2} Previous studies have demonstrated marked immediate improvement in ...

INTERFERON ALFA has been found to be an effective therapeutic agent in patients with low-grade non-Hodgkin's lymphoma. Early studies using both crude natural and recombinant forms of this interferon demonstrated an effective antitumor response rate of 33 ...

THERE has been considerable improvement in outcome among patients with diffuse large-cell and diffuse mixed lymphomas as a result of new regimens of combination chemotherapy.¹ Such regimens result in complete remission in 40 to 80 percent of patients and ...

OVERWEIGHT in adults is associated with cardiovascular disease, hypertension, gallbladder disease, diabetes mellitus, atherosclerosis, gout, arthritis, and certain cancers.^{1 , 2} In adolescents, overweight is less closely related to the later appearance of ...

THE secretion of melatonin from the pineal gland is linked to the light–dark cycle, being greater at night in all species, including humans, and it is pulsatile.¹ In humans the peak nocturnal plasma melatonin concentration declines progressively with age, ...

HUMAN immunodeficiency virus (HIV) infection and the acquired immunodeficiency syndrome (AIDS) that results from it may involve, directly or indirectly, virtually every organ system. The endocrine system is not spared. Recent reports of endocrine and ...

A 52-year-old man with a history of mild hypertension and nephrolithiasis presented with progressive dyspnea, productive cough, and fever for three days.

The first thing that comes to mind is pneumonia. An upper respiratory tract infection does not ...

Presentation of Case

A 60-year-old man was admitted to the hospital because of chronic diarrhea and increasing weakness.

The patient was in stable health until eight months earlier, when diarrhea developed while he was working in Mexico. A test for ...

The secretion of melatonin is stimulated by darkness. Darkness also characterizes our understanding of the physiology of melatonin in humans. (The name derives from the hormone's ability to lighten the skin of amphibians, a property it is not recognized ...

The paper by Must and colleagues in this issue of the Journal ¹ uses data from the Third Harvard Growth Study, conducted between 1922 and 1935, to evaluate the effects of weight in adolescence on future health risks. A major strength of the paper lies in ...

One of medicine's most important purposes is to allow hopelessly ill persons to die with as much comfort, control, and dignity as possible. The philosophy and techniques of comfort care provide a humane alternative to more traditional, curative medical ...

Is it ever morally appropriate for physicians to assist a patient's dying, either by providing the means or by directly causing death? What should be the stance of the law toward physician-assisted death?

We have usually tried to resolve these questions ...

To the Editor: Much has been made of disclosures in the media that celebrities have the acquired immunodeficiency syndrome (AIDS) or are infected with the human immunodeficiency virus (HIV). Although there can be no question that unauthorized disclosure ...

To the Editor: The title of the report by Doebbeling et al. (July 9 issue)¹ is somewhat misleading. Although the chlorhexidine gluconate preparation is a hand-washing agent, the intended use of alcohol formulations is not hand-washing but hand ...

To the Editor: The Occupational Safety and Health Administration (OSHA) is implementing a program for the control of blood-borne pathogens as possible sources of infection in the offices of physicians throughout the United States. These regulations have ...

To the Editor: There is no more reason a priori to reduce the use of psychoactive drugs in nursing homes than there is to reduce the use of analgesics or anticonvulsants in such settings. Rather, our goal should be to match the right agent to the right ...

To the Editor: Dr. Volpe's excellent review (Aug. 6 issue)¹ of the mechanisms by which exposure to cocaine in utero may produce teratogenic and destructive effects in the developing fetus focused on the damage that may be done to the nervous system. ...

To the Editor: The finding by Staessen et al. (July 16 issue)¹ that low blood lead and zinc protoporphyrin concentrations are associated with renal insufficiency in a large population confirms that lead is nephrotoxic. This report once again identifies ...

To the Editor: In the recent Clinical Problem-Solving article, "Failure to Resolve a Diagnostic Inconsistency" (July 2 issue),¹ we are presented with a 56-year-old obese woman who arrives at the emergency room with arterial embolus, hypoxemia, and chest ...

To the Editor: We wish to report a case of Pasteurella multocida salpingitis.

A 37-year-old woman, gravida 2, para 1, with one spontaneous abortion, presented with a two-day history of crampy, intermittent right-lower-quadrant pain radiating to the back ...

To the Editor: Fludarabine, the 2-fluoro,5′-phosphate derivative of vidarabine, is a rare cause of acute tumor lysis syndrome in chronic lymphocytic leukemia.¹ This complication has been reported to occur only after the initial treatment cycle of ...

To the Editor: With great flair, neurologists of yesteryear would roll the multipinned Wartenberg wheel up one patient's leg and down another's, occasionally measuring a sensory level, usually trailing little footprints of wheals and, often, droplets of ...

The advent of the syndrome of multiple-system organ failure as a major clinical entity is a paradoxical consequence of technological improvements in the care of critically ill patients. Advances in surgical techniques, mechanical ventilation, ...

In the United States, the percentage of the population 65 years of age and older has increased from 8 percent in 1950 to 12 percent in 1984, and it is projected to increase to 21 percent by 2030. The fastest-growing segment is the group over the age of ...

There is no question that as the population of the United States continues to age, there is a need for information on diseases that affect the elderly. This book addresses various aspects of how advancing age may modify the clinical presentation and ...

Less than a decade since the publication of the previous edition, the third edition of Asthma now appears with much new information, particularly about airway inflammation and reactivity, new drugs, new drug formulations, and improved delivery systems. ...

We so often ask whether we really need a new book that covers subjects already represented in a number of others. It is therefore refreshing to read Gosney's monograph on pulmonary endocrine pathology, the first of its kind. Since this subject is normally ...

This excellent monograph is yet another first-rate addition to the medical encyclopedia devoted to lung biology in health and disease. It addresses an important issue in the modern approach to the pathogenesis of lung diseases in human subjects — namely, ...

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 ...