In 1987, the Expert Panel of the National Cholesterol Education Program (NCEP) issued guidelines for the treatment of adults with hypercholesterolemia¹. The first step in the treatment of patients with sustained elevation of levels of low-density ...

Despite decades of interest and numerous clinical and epidemiologic investigations, the status of the plasma triglyceride level as a risk factor for coronary heart disease remains unsettled¹–³. In many prospective studies the triglyceride level has been a ...

Chronic immune thrombocytopenic purpura is an autoimmune disorder in which autoantibodies against platelet membrane proteins, most commonly the glycoprotein IIb/IIIa and Ib/IX complexes, cause platelet destruction by the reticuloendothelial system¹,². ...

Recent attempts to assess the public health burden attributable to sleep disorders¹,² have underscored the need for epidemiologic data on sleep-disordered breathing. The condition is characterized by repeated pauses in breathing during sleep, which lead ...

Figure 1. Primary Biliary Cirrhosis.

Stage I lesions in primary biliary cirrhosis are seen in these slides, with typical destruction of small bile ducts by lymphocytes. In Panel A and Panel B, a small bile duct is surrounded and infiltrated by ...

Over the past two decades a vast new armamentarium of diagnostic techniques has revolutionized the practice of medicine. The entire human body can now be imaged in exquisite anatomical detail. Computed tomography (CT), magnetic resonance imaging (MRI), ...

The movement of ions across cardiac cell membranes generates the electrical potentials that activate the heart. Today's molecular biology is providing breathtaking new insights into the regulation of this electrical activity, which is the basis of ...

In the United States, the immunization of adults does not receive the same priority as the immunization of children, although deaths from vaccine-preventable diseases occur predominantly in adults. About 50,000 to 70,000 adults die each year from ...

Presentation of Case

A 53-year-old woman died after several years of a dementing illness with intermittent grand-mal seizures and abnormal movements of the extremities.

The patient had been well until the age of 47 years, when she became depressed after ...

I have never seen a time in the past four decades when so much attention has been paid to medicine. Not a day goes by without a story on television, in the newspapers, or in popular magazines about medical care or its organization. Hardly a story begins ...

The principal aims of health system reform are to provide access to care for uninsured Americans and to control health care costs. Accomplishing these goals will require a lean package of health benefits that will be provided to all Americans. We must ...

The National Commission on Sleep Disorders Research was established by Congress in 1988 “to conduct a comprehensive study of sleep disorders and to develop a long-range plan for the use and organization of national resources to deal effectively with sleep ...

To the Editor: The study by Mitchell and Sunshine (Nov. 19 issue)¹ contains serious technical flaws. Fundamental principles of experimental design dictate that a study must control adequately for confounding factors. The study by Mitchell and Sunshine, ...

To the Editor: Snoring may decrease daytime alertness in the absence of repetitive or sustained hypoxia¹.

Acute total sleep deprivation can worsen sleep-disordered breathing in patients with obstructive sleep apnea syndrome². No data are available on the ...

To the Editor: Wei is to be commended for her scholarly review of the effect of age on the cardiovascular system (Dec. 10 issue)¹. However, her recommendations for treating systolic dysfunction do not reflect the results of several studies documenting ...

To the Editor: We question the validity of the conclusion of Donahue et al. (Aug. 6 issue)¹ that testing for non-A, non-B hepatitis surrogate markers caused a reduction in the incidence of post-transfusion hepatitis C virus (HCV) infection. Their data ...

To the Editor: We recently encountered the uncommon situation of a false positive test for human immunodeficiency virus type 1 (HIV-1) during the pretransplantation evaluation of a 32-year-old Haitian woman with systemic lupus erythematosus and end-stage ...

To the Editor: Patients infected with HIV have increased susceptibility to infection with Streptococcus pneumoniae. A 28-year-old man with hemophilia A was recently admitted to our hospital with a two-day history of malaise, sweats, and pain in the right ...

The following statement was approved by the International Committee of Medical Journal Editors* at its January 1993 meeting in London.

The public's interest in news of medical research has led the popular media to compete vigorously to get information ...

The basic premise for writing this book is a good one. Since the evidence is now so strong that several of the dyslipidemias are related to the development of atherosclerosis, which is known to be a reversible disorder, and since these dyslipidemias are ...

This book is intended for doctors who would like to set up or have just established lipid clinics in either general or hospital practice. Written by only two authors, it presents a unified approach. The book is extremely well illustrated with many graphs, ...

The first and last chapters of Coronary Heart Disease Prevention, by the book's editor, use a systems model to emphasize the importance of nonmedical influences on coronary heart disease. These chapters serve as lonely bookends for the middle chapters, ...

There is concern among some clinicians that dependence on modern imaging techniques has led to a decline in the skills used to detect heart disorders by physical examination. A recent study at a highly respected medical center revealed that third-year ...

Although the first three editions of Dr. Nadas' textbook were entitled Pediatric Cardiology, the book was familiarly referred to as Nadas', and it is fitting that Dr. Fyler has officially entitled this book Nadas' Pediatric Cardiology. In the 35 years ...

An explosively growing scientific literature makes it ever more difficult for any reader to master the wealth of data in most fields of study. This holds particularly true for cardiac surgery, in which seemingly every aspect of current surgical practice ...

Modern-day open-heart surgery -- the quintessence of high-technology surgical therapy -- often boggles the minds of patients, referring physicians, and even practitioners of cardiac surgery. We have arrived at this apogee of technology as the result of an ...

Transesophageal Echocardiography is an excellent introduction for the novice, yet will be useful to experienced echocardiographers as well. Specialists in anesthesiology, cardiac surgery, and radiology contribute to the book by reflecting on their 10-year ...