The World Health Organization has defined the sick building syndrome as an excess of workrelated irritations of the skin and mucous membranes and other symptoms, including headache, fatigue, and difficulty concentrating, reported by workers in modern ...

Cardiovascular disease remains the leading cause of death in the United States, with more than 1.5 million myocardial infarctions and one fourth of all deaths attributed to coronary artery disease each year¹. Invasive coronary angiography is currently the ...

Among disorders of the urinary tract, kidney stones are a major cause of morbidity. Approximately 12 percent of the U.S. population will have a kidney stone at some time,¹,² and the incidence is rising not only in the United States¹,² but also in Sweden³ ...

Electroconvulsive therapy is widely used to treat certain psychiatric disorders, particularly major depression¹,². For the past 30 years, its practitioners have thought that a generalized seizure of adequate duration is necessary and sufficient for ...

Neuroblastoma is one of the most common malignant tumors among children, yet the prognosis of patients with advanced disease is still very poor. The tumor originates from the sympathoadrenal lineage of the neural crest¹. The ability to differentiate both ...

Figure 1. CT Scan Demonstrating Air in the Right Ventricle.

To increase the rate of infusion of an intravenous contrast agent, air was forced into a patient's intravenous bottle. Shortly afterward, the patient became dyspneic, diaphoretic, and hypotensive,...

Hysterectomy is second only to cesarean section as the most frequently performed major operation in the United States¹. Data from the National Hospital Discharge Survey (NHDS) indicate that approximately 590,000 hysterectomies are performed annually¹. ...

In 1959, not long after surfactant had been identified as critical to maintaining lung inflation at low transpulmonary pressures,¹,² Avery and Mead³ reported that saline extracts from the lungs of preterm infants with respiratory distress syndrome lacked ...

Presentation of Case

A 44-year-old man was admitted to the hospital because of a nonproductive cough and dyspnea.

The patient had been well until 25 months earlier, when hematochezia, diarrhea, and urgency of stool passage developed. Sigmoidoscopic ...

Complaints from office workers about building-related symptoms began to flood public health agencies during the late 1970s, in the wake of the energy crisis. The eye, nose, and throat irritation, headache, and difficulty concentrating that occurred in ...

Hardly a day goes by now without at least one story in a major newspaper about the importance of controlling soaring health care costs. The issue is not just the magnitude of health care spending or the rate of increase. There is also increasing ...

Kidney stones occur frequently. As many as 10 percent of men and 3 percent of women have a stone during their adult lives¹. About 80 percent of all stones are composed of calcium oxalate, alone or with a nucleus of calcium phosphate (apatite)¹. The first ...

Electroconvulsive therapy is more firmly established than ever as an important method of treating certain severe forms of depression. Less than a decade ago, a review article in the Journal was considered necessary to provide a perspective on ...

To the Editor: It is becoming increasingly common for physicians to invest in free-standing health care businesses to which they refer their patients but at which they do not practice. These arrangements, known as joint ventures, include a wide variety ...

To the Editor: Armand Trousseau died in 1867. Therefore, he was incapable of making observations in 1868 or lecturing in 1872, as suggested by Prandoni et al.¹ and Silverstein and Nachman² (Oct. 15 issue). These investigators cited an English translation ...

To the Editor: A review of the data on the effectiveness of psychosocial support in reducing complications in “highrisk” pregnancies, as presented by Villar et al. (Oct. 29 issue),¹ reveals a consistent decrease in the frequency of intrauterine growth ...

To the Editor: The conclusions drawn by Brown et al. (Aug. 20 issue)¹ illustrate one of the dangers of limited investigations in Africa and the pitfalls of inadequately controlled studies. The lack of microbiologic studies of the women studied in Zaire ...

To the Editor: Grinspoon and Bilezikian state (Nov. 5 issue)¹ that “There is no evidence that pentamidine administered by aerosol alters pancreatic function.” At least three cases of pancreatitis,²,³ one of hypoglycemia,⁴ and two of diabetes mellitus⁵,⁶ ...

To the Editor: The Clinton administration promises to make managed care the cornerstone of our new health policy. Because all these systems place the burden of managing on the primary care physician, it is important for the public and health planners to ...

To the Editor: A 30-year-old man presented with burning, severe swelling, and blistering of his left hand. Two days earlier he had prepared a large quantity of margaritas, which entailed squeezing 5 dozen limes, after which he had sunbathed for the ...

Over the past decade, the medical community has created many programs for the delivery of integrated care for homeless persons. The literature on the medical problems of homeless people has not kept pace with that on the social, economic, and political ...

La Fond and Durham, respectively an attorney and a social scientist, have written widely on issues related to mental health law and policy in the United States. This book focuses on these matters as they have changed direction during the past 30 years and ...

This edition of the classic textbook begun by Milton J. Rosenau in 1913 consists of 75 informative, self-contained chapters in diverse areas of public health and preventive medicine. Each chapter has been prepared by contributors (165 in all) who are ...

Jain Malkin's book is a catalogue of the best of the best health care environments. Her aim is to improve the quality of the health care environment by offering the state-of-the-art design image to the health care administrator, physician, hospital staff, ...

According to the introduction, this book is aimed at the informed nonspecialist who has to deal with questions of indoor air pollution. We certainly qualify as nonspecialists in the field, and we have judged the book by its clarity in explaining this ...

Medicaid, a health insurance safety net that shortchanges providers and bedevils its federal and state stewards because of its soaring expenditures, is nevertheless the financial lifeline of 28.3 million people who rely on it to pay for their medical and ...