THE current risk of transfusion-associated non-A, non-B hepatitis is unknown, but it is undoubtedly lower than the estimates of 5 to 18 percent that were given in prospective studies conducted in the 1970s and early 1980s.^{1 2 3} Research conducted during ...

CALCIFICATION of the mitral annulus is a noninflammatory chronic degenerative process of the fibrous support structure of the mitral valve.^{1 2 3 4} Mitral annular calcification (MAC) occurs more commonly in women and the elderly.⁵ It has also been reported ...

THERE are few reports in the medical literature of fatal or near-fatal anaphylactic reactions caused by food. There is no code for the diagnosis of food-induced anaphylaxis in the International Classification of Diseases, so it has been difficult to ...

RECENT reports that tretinoin (all-trans-retinoic acid) induced the maturation of leukemic cells in vivo and in vitro and yielded high rates of complete remission in patients with acute promyelocytic leukemia illustrate a form of therapy that induces the ...

MUNCHAUSEN'S syndrome, originally described in 1951,¹ is the term applied to persons who seek medical care by feigning illness in the absence of any organic medical or surgical disease. Some persons with the syndrome pretend to have disorders known to ...

Staging

Staging refers to the grouping of patients according to the extent of their disease. Breast cancer is staged initially on a clinical basis, according to the results of the physical examination and laboratory and radiologic evaluations, and ...

THE effect of cocaine use by pregnant women on their fetuses and then newborn infants is a topic of major public health importance. Cocaine has profound effects on the central and peripheral nervous systems of adults and can cause major alterations in ...

A 33-year-old naval pilot was admitted to Yale–New Haven Hospital in early 1992 because he had been coughing up blood and passing bloody urine for two days. He gave a history of Goodpasture's syndrome manifested by hemoptysis and hematuria, which had ...

Presentation of Case

A 72-year-old man was admitted to the hospital because of a painful mass in the thigh.

Three years earlier the patient became aware of swelling in the posterior portion of the right thigh. During the two months before entry the mass ...

Four key measures help keep the use of blood safe. First, all who prescribe blood should try to limit the frequency of homologous transfusion by responding only to patients' physiologic needs and by using alternatives such as autologous transfusion and ...

Food allergy occurs in up to 8 percent of children,¹ but anaphylaxis occurs in only a few. There are no reliable data on the incidence, prevalence, or mortality rates for food-induced anaphylaxis in either children or adults. Fatalities receive transient ...

The growth of cancer cells is characterized by the blocking of normal differentiation. Nonetheless, the cytotoxic effects of standard anticancer chemotherapy are directed not only at the malignant cells but also at normal tissues. A more rational approach ...

Over 90 percent of health maintenance organizations (HMOs) use primary care physicians as gatekeepers,¹ whose role is to authorize access to specialty, emergency, and hospital care and to diagnostic tests. Gatekeeping has come to imply the medically ...

To the Editor: In the March 19 issue, Boice et al.¹ present data to indicate that radiotherapy for breast cancer contributes little to the already high risk of a second cancer in the opposite breast. They note, however, that the risk was significantly ...

To the Editor: The results of the study of non—small-cell lung cancer by Schaake-Koning et al. (Feb. 20 issue)¹ are in line with previously published results^{2 , 3} demonstrating a clear survival benefit of chemotherapy combined with radiotherapy over ...

To the Editor: In reference to the report of Sidransky et al. (March 12 issue)¹, I would accept the view that the most likely explanation of their findings is monoclonality of the multiple tumors tested. However, the limited clinical histories provided ...

To the Editor: The case–control study by Selby et al. (March 5 issue)* on the effect of screening sigmoidoscopy on mortality from rectosigmoid carcinoma was interesting to me because of my previous skepticism about the benefits of the procedure, given ...

To the Editor: Landis et al. (Jan. 9 issue)¹ have provided additional support for the concept and practice of partner notification — specifically, the provider-referral approach used in cases of human immunodeficiency virus (HIV) infection. Our ...

To the Editor: Barnett et al. (June 4 issue)¹ suggested that physicians consider the use of pneumococcal vaccine for persons planning to visit Spain this summer and fall, because of the high frequency of penicillin-resistant strains of Streptococcus ...

To the Editor: Patients with functional asplenia are prone to life-threatening infections with gram-positive bacteria.¹ The usual causes of functional asplenia are splenic irradiation,¹ sickle cell anemia,² and graft-versus-host disease after bone marrow ...

To the Editor: We herewith report successful laparoscopic splenectomy.

Two women with idiopathic thrombocytopenic purpura, one 55 years of age and the other 26 years of age, were referred to us for splenectomy. After we explained the available options to ...

To the Editor: Having recently moved to the United States from Canada, I was very interested in the article by Iglehart (April 2 issue)* on the American health care system. In Canada, where the chief financial constraint is the available global budget ...

To the Editor: In performing research for a book on factitious disorders, I came across some surprising material concerning a case of factitious Munchausen's syndrome published in the Journal. In a 1980 letter, Drs. Gurwith and Langston¹ described a man ...

A great deal of attention has been given lately to a reexamination of the assassination of President John Kennedy. We must remember, however, that this tragic event was not the most recent act of violence against an American president. On March 30, 1981, ...

Here is a book about surgeons written by an anthropologist, an ethnologist. She presents this as a scientific book for the layperson, reporting in relatively simple language a study of surgeons, such as might be carried out in analyzing the habits of a ...

Few surgical textbooks survive for more than a decade. Bailey and Love's Short Practice of Surgery turns 60 this year and is going strong under the editorship of Charles V. Mann and R.C.G. Russell. It is read worldwide and used in facilities as diverse as ...

In each field of medicine there are classic textbooks that are almost synonymous with the specialty. Sabiston's Textbook of Surgery, now in its 14th edition, is certainly one. The editor and publisher have continued the rich tradition of quality that has ...

Effective replacements for diseased heart valves were introduced into clinical practice in 1964. Yet today's surgeon, who expects to be able to take one of these devices from the shelf and have it work reliably, often has relatively little knowledge of ...

CONTINUING MEDICAL EDUCATION AND TRAINING IN EUROPE: THE FUTURE

The conference will be held in London, Oct. 1 and 2.

Contact Dr. M.W.N. Nicholls, Fellowship of Postgrad. Med., 6 St. Andrew's Pl., London NW1 4LB, United Kingdom; or call (44) 71 935–5556.

...

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 ...