Children born to women with human immunodeficiency virus (HIV) infection have a 20 to 30 percent risk of infection with HIV¹. Because early intervention with antiretroviral therapy can substantially decrease the risk of opportunistic infections and may ...

The early morning hours after awakening (approximately 6 to 11 a.m.) are associated with a higher-than-expected incidence of cardiovascular events, such as myocardial infarction and ischemic stroke¹–³. The relation between sleep and these events is not ...

The rate of recurrence of duodenal ulcer is low when patients receive a treatment designed to eradicate Helicobacter pylori. In several studies, patients treated with bismuth subcitrate (a bismuth compound not available for medical use in the United ...

Cardiovascular disease is the leading cause of death in middle-aged American men¹. In 1988, more than 41,000 U.S. residents died of cardiovascular disease before the age of 50. Atherosclerosis, however, begins at a much earlier age. Fatty streaks are ...

Many patients are waiting for heart transplantation, and some of them will die before surgery because of the lack of donor organs¹. The increased demand for cardiac transplantation in the face of a relatively fixed supply of donor hearts has meant that ...

Figure 1. Cholesterol and Lipid Deposits.

A specimen from the wall of the ascending aorta was excised from a 55-year-old patient at the time of aortocoronary bypass grafting. In a Sudan-stained cryosection viewed under polarized light, cholesterol (open ...

Sexual harassment in the workplace has received increasing attention over the past two years in the national lay press and within medicine. The allegations of sexual harassment made by attorney Anita Hill at the confirmation hearings for Supreme Court ...

The human immunodeficiency virus (HIV) is probably the most intensively studied virus in the history of biomedical research. A large number of distinct isolates have been cloned and sequenced, and the genes of the virus and several of the protein products ...

Stage

A 40-year-old Haitian woman who had never smoked had respiratory distress at work and was taken to the emergency department by ambulance.

Response

The first things that come to mind are the usual causes of respiratory distress, such as pneumonia, ...

Presentation of Case

An 81-year-old man was admitted to the hospital because of pain and subcutaneous emphysema in the right upper extremity.

The patient was in a stable state of health until one day earlier, when he was admitted to another hospital ...

There are several reasons for the growth of interest in the effect of sleep on the cardiovascular system. Because about one third of human life is spent sleeping, a description of the cardiovascular changes accompanying sleep is necessary for a thorough ...

Research on the pathogenesis and treatment of peptic ulcer disease is yielding surprising discoveries that will change the medical approach to ulcer therapy. Among the most surprising is the fact that peptic ulcer disease is often a curable infectious ...

The modest study by Komaromy et al.¹ in this issue of the Journal usefully reminds the medical world that not only verbal discrimination² but also more blatant forms of sexual harassment are remarkably prevalent even in our prestigious profession. ...

To the Editor: The paper by Carmelli et al. (Sept. 17 issue)¹ describing genetic influences on smoking among male subjects in the National Academy of Sciences-National Research Council Twin Registry shows the value of studies of twins in elucidating ...

To the Editor: Glasier et al. (Oct. 8 issue)¹ report that mifepristone (RU 486) was an “effective postcoital contraceptive agent.” In their accompanying editorial, Grimes and Cook² suggest that the drug could reduce the number of unwanted pregnancies and ...

To the Editor: Zec et al. (June 25 issue)¹ describe a suspected adverse drug reaction (with seizures and acute renal failure) to povidone-iodine used for mediastinal irrigation and suggest that an elevated serum iodine level was responsible. They cite ...

To the Editor: Single lesions that are enhanced during computed tomography (CT) with a contrast agent are frequently found in patients with partial seizures. Reports from the Indian subcontinent suggested that these lesions were tuberculomas¹; however, ...

To the Editor: In their study comparing the outcomes of electrophysiologically guided antiarrhythmic therapy with those of empirical beta-blocker therapy in patients presenting with sustained ventricular arrhythmias, Steinbeck et al. (Oct. 1 issue)¹ fail ...

To the Editor: We recently encountered an unusual complication associated with the deployment of an automobile air bag.

A 22-year-old woman was in a car traveling 10 to 15 mph that collided with a stopped car. The woman's car sustained relatively minor ...

To the Editor: As part of a comprehensive evaluation of the risk of Creutzfeldt-Jakob disease in recipients of native human growth hormone (GH), we inoculated nonhuman primates with samples of all 76 lots of GH retained on file at the National Hormone ...

To the Editor: We wish to report a case of trauma from a voracious shredder.

Our office manager was recently engaged in shredding several documents when his tie fell into the GBE Shredmaster 10365, which violently ingested it to within inches of his ...

These two provocative books look at women, men, and their roles and relations in our health care system. The message in both cases is that the practice of medicine and our thinking about medicine and ethics need revision from a feminist perspective. ...

As the academic and professional worlds sit up and listen to the feminist voice, many are asking themselves: What is feminism? And what does it offer? Feminism, including feminism in medical ethics, could be the collective voice of a relatively oppressed ...

To the Ends of the Earth is an encyclopedic history of migration, courage, and frustration in which Bonner recounts the attempts of women to obtain a medical education in Europe and the United States since the late 1840s. While the author, an academic ...

Controversy persists about the importance of the Flexner report of 1910 in the reform of our medical-education system. Was it a revolutionary force or merely a catalyst for changes already in progress? Some undesirable changes in medical education, such ...

What does it mean to be a good physician? Nigel Cameron, a theologian at Trinity Evangelical Divinity School in the United Kingdom, attempts to answer this complex but timely moral question by examining the relevance of the Hippocratic oath. Although many ...

Dear Lara,

Here's a book I'd like you to read -- in between completing your applications to medical school. It consists of an exchange of letters between C. Everett Koop (“Dear Chick”), the former surgeon general, and Timothy Johnson (“Dear Tim”), the ...

What happens when the federal government is virtually the only payer for a medical service that is privately provided? The best example of this is Medicare's End Stage Renal Disease Program. For 20 years, the government has essentially frozen the level of ...