Adenomatous polyps have been identified with increasing frequency in recent years as a result of the introduction of screening with tests of stool for occult blood and flexible-instrument sigmoidoscopy and wider use of colonoscopy, colonoscopic ...

Quality of life is widely perceived to be an important end point in therapeutic assessment. Quality-of-life end points that are related to health are increasingly being used to adjust measures of effectiveness for clinical decision making and resource ...

The initial treatment for hypertension has changed as drugs with pharmacologic properties permitting single-drug therapy have become available. In their 1988 report, the Joint National Committee on Detection, Evaluation, and Treatment of High Blood ...

It is estimated that 1 million people in the United States are spending more than $100 million a year on black-market anabolic steroids¹–³. Habitual use of anabolic steroids to enhance muscle size for cosmetic reasons and to improve strength and endurance ...

Figure 1. Pinworms.

Female pinworms (Enterobius vermicularis) are shown leaving the anus of a five-year-old child who presented with crying, restlessness, and abdominal pain at 11 p.m. Female worms leave the rectum during the night and deposit eggs on the ...

The U.S. Health Care Financing Administration created a firestorm in mid-1991 when it announced its proposed Medicare fee schedule for physicians' services. The Medicare fee schedule, based on the resource-based relative-value scale,¹,² represents a ...

Rural areas of the United States continue to suffer from a shortage of primary care physicians¹,². Because family physicians provide the vast majority of primary care in rural areas,³ increasing the number of family doctors in nonmetropolitan areas ...

The United States is in the process of rediscovering primary care. Primary care is being promoted as an antidote to excessive health care costs and inadequate access to health services. However, primary care physicians in the United States are perceived ...

Stage

An 87-year-old independent and active woman with no known heart or pulmonary disease went to see her physician because she had shortness of breath.

Response

The two most common causes of shortness of breath in this age group are pulmonary disease ...

Presentation of Case

A 74-year-old woman was admitted to the hospital because of progressive renal failure.

The patient had had a subendocardial infarct and congestive heart failure 14 months before admission. Nine months before entry she was treated as ...

In the 20 years since the creation of the National High Blood Pressure Education Program, remarkable progress has been made in detecting and treating hypertension in the United States¹. The number of patients with hypertension who are aware of their ...

Never before have so many Americans been so aware of our health care system's two most glaring defects -- its inability to restrain runaway medical expenditures and its failure to provide basic health care for all citizens. Strangely neglected in the ...

To the Editor: The companion articles by Quill et al. and Brody (Nov. 5 issue)¹,² were well thought out and presented compelling arguments for the validity of assisted suicide or active euthanasia on rare occasions. The concern I have focuses on the ...

To the Editor: Dr. Pfeffer and the investigators of the Survival and Ventricular Enlargement (SAVE) study recently (Sept. 3 issue)¹ presented the results of a carefully designed clinical trial suggesting that long-term treatment with the angiotensin-...

To the Editor: Polish et al. (March 12, 1992, issue)¹ present data to indicate that an outbreak of acute hepatitis B virus infection at the Fresno Veterans Affairs Hospital in Fresno, California, was due to improper use of the Autolet device (Owen ...

To the Editor: Our laboratory recently completed a nutritional study involving 104 college students in which fasting blood glucose levels were obtained with a spring-loaded finger-stick device. The Glucolet Automatic Lancing Device (Figure 1), marketed ...

To the Editor: Could Miles et al. (Oct. 8 issue)¹ elaborate on the rationale in the Minnesota plan for taxing the providers of services, as opposed to either the population at large or the recipients of the services? I question the legality and ...

To the Editor: In the current debate on health care, the performance of health maintenance organizations (HMOs) is often touted as showing how rising health care costs can be controlled while quality of care is ensured. As a practicing physician in ...

The Clinical Problem-Solving article “Too Old for What?” elsewhere in this issue¹ describes an 87-year-old woman with severe aortic stenosis, three-vessel coronary artery disease, depressed left ventricular function, and moderately severe heart failure. ...

Once upon a time there was a doctor who awakened one morning with a splitting headache. As he groggily approached his shaving mirror in the dim light, he thought he was hallucinating and vowed to consume no more midnight snacks of smoked oysters and ...

The consultative practice of the specialist in pediatric infectious diseases has changed dramatically within the past decade. Currently, as many as 50 percent of all infectious-disease consultations are sought because of an infection in an ...

The idea for this book grew out of a report, TORCH Screening Reassessed, by a Public Health Laboratory Working Party in England. The report concluded that simply sending a blood sample with a request for screening for toxoplasma, rubella, cytomegalovirus, ...

The editors point out in their introduction that no comprehensive textbook dealing with cardiorespiratory control in infants and children exists. This is no longer true, since this work fills the void quite nicely. Beckerman et al. have assembled 47 ...

This book is unique among the currently available textbooks of pediatric pulmonary disease in that its purpose is to bridge the gap between classic physiology and the exciting insights now being revealed by cellular and molecular biology. Chernick and ...

If the weight of a textbook bears any relation to the degree of expansion of a new specialty, then this new arrival from Paris, at a weight of 1.5 kg, signals a modest expansion in comparison with other books -- the 5.3-kg Pediatric Gastrointestinal ...

Hung and his colleagues have designed their textbook as a practical guide to the physiologic evaluation, diagnosis, and treatment of endocrine disorders in infants, children, and adolescents. It is written for pediatric house officers and practicing ...