Insulin-dependent diabetes mellitus (IDDM) is accompanied by long-term microvascular, neurologic, and macrovascular complications. Although the daily management of IDDM is burdensome and the specter of metabolic decompensation ever-present, long-term ...

Combination chemotherapy has transformed aggressive non-Hodgkin's lymphoma from a fatal disease into one that is often curable. However, many patients still die of their disease, underscoring the need for more accurate methods of prospectively identifying ...

Encephalitis caused by Toxoplasma gondii is the most frequent cause of focal central nervous system infection complicating the acquired immunodeficiency syndrome (AIDS)¹. If untreated, toxoplasmic encephalitis is uniformly fatal. In the United States, it ...

At present, more than 150,000 Americans with end-stage renal disease benefit from dialysis treatment under Medicare's disease-targeted entitlement program¹. Without the widespread availability of dialysis and kidney transplantation, many lives would have ...

Figure 1. Superior Vena Cava Syndrome.

The photograph shows massive engorgement of collateral subcutaneous veins of the chest and abdomen in a 58-year-old man with partial obstruction of the superior vena cava caused by small-cell lung cancer. The patient ...

Overweight is an increasingly prevalent nutritional disorder among children and adolescents in the United States¹–³. Numerous health risks have been associated with adolescent overweight, including hypertension, respiratory disease, several orthopedic ...

Acute pain and swelling in a joint always require immediate evaluation. Although there are many other less-threatening causes of monoarthritis, inadequately treated infectious arthritis carries a risk of prolonged morbidity and even mortality. If ...

Parkinson's disease (idiopathic parkinsonism or paralysis agitans) is characterized clinically by progressive tremor, bradykinesia, and rigidity and pathologically by degeneration of the dopaminergic nigrostriatal pathway, decreases in the striatal ...

Presentation of Case

An 83-year-old woman was admitted to the hospital because of severe upper-back pain, hypertension, and anuria.

There was a history of hypertension that dated back 34 years and was treated in recent years with propranolol, atenolol, ...

The results of the Diabetes Control and Complications Trial (DCCT), published in this issue of the Journal,¹ demonstrate that intensive insulin therapy can delay the onset and slow the progression of retinopathy, nephropathy, and neuropathy in patients ...

One of the most striking facts about obesity is the powerful inverse relation between obesity and socioeconomic status in the developed world, especially among women¹. What is responsible for this association? There are at least three possibilities: ...

October 1 of this year marks the retirement from the Journal of its two longest-serving associate editors, Dr. Jane F. Desforges and Dr. Ronald A. Malt. Dr. Desforges came to the Journal in 1961. Since that time, she has worked with four editors and been ...

In 1961, when Dr. Joseph Garland met with me and his other two associate editors for our weekly review of manuscripts submitted to the Journal, the meeting took place in a small office in space shared with the Massachusetts Medical Society and the Boston ...

Medical ethicists place great weight on the intentions of clinical actions. The religious principle of “double effect,” based on a distinction between intentions and consequences, is an ethical cornerstone in the medical treatment of the terminally ill¹,²...

To the Editor: Nabulsi et al. (April 15 issue)¹ present convincing data that postmenopausal hormone-replacement therapy, whether with estrogen alone or with estrogen and progestin, greatly decreases the risk of cardiovascular disease. In their editorial, ...

To the Editor: Zehender et al. (April 18 issue)¹ reported important observations about the prognostic value of electrocardiographic evidence of right ventricular infarction in patients with an acute inferior myocardial infarction. The authors, however, ...

To the Editor: Materson and colleagues (April 1 issue)¹ compared the effects of six different antihypertensive agents in patients with mild-to-moderate hypertension. Their findings contrast with the results of a similar study comparing five single agents ...

To the Editor: Several articles and an editorial in the February 11 issue of the Journal draw the conclusion that idiopathic CD4+ T-lymphocytopenia is extremely rare¹–⁵. However, transient CD4+ T-lymphocytopenia as a consequence of a low total white-cell ...

To the Editor: Dr. Figueroa et al. (April 29 issue)¹ demonstrated that combination chemotherapy is beneficial to some patients in whom immune thrombocytopenic purpura is refractory to corticosteroids and splenectomy. Since all 10 patients had had ...

To the Editor: In their review of the immunization of adults (April 29 issue),¹ Gardner and Schaffner omit from consideration routine use of a booster dose of a vaccine containing diphtheria toxoid, tetanus toxoid, and antigens to Bordetella pertussis. ...

To the Editor: In his article on public and professional expectations about physicians' autonomy, Dr. Mirvis (May 6 issue)¹ makes no distinction between medical services purchased by the government with tax dollars and services purchased by private ...

The editor of this comprehensive textbook has attempted to put together a single reference work of epileptology with a “broad but detailed overview,” and she has succeeded in this effort. The book comprises six major parts: basic mechanisms of ...

In this book Dr. Sapolsky, an associate professor of biology at Stanford University and of neuroscience at Stanford University School of Medicine, details his thesis, based on work in rats, that glucocorticoids such as hydrocortisone (cortisol) and ...

This book is a fitting tribute to the “decade of the brain.” It maintains a strong clinical focus and emphasizes state-of-the-art issues in several important areas of clinical neuroscience. The editor introduces each chapter with succinct commentary, ...

Dr. Rubin has brought together 28 authors, many of them national and international authorities in the fields of surgery, research, rehabilitation, and therapy for disorders affecting the seventh nerve. The Paralyzed Face expands and updates Reanimation of ...

Most treatises on stroke begin with a familiar refrain: stroke is the third leading cause of death in the United States, affects about 500,000 patients each year, and costs over $10 billion annually. This is the stuff that multiple-choice examinations are ...

Imaging of the Spine and Spinal Cord is an excellent contribution to the literature. It covers all aspects of spinal imaging, including computed tomography (CT), CT myelography, magnetic resonance imaging (MRI), ultrasonography, and angiography. Normal ...

Teaching hospitals, which developed in response to changes in medical education in the early 20th century, have three missions that are critical to the maintenance of clinical excellence: graduate medical education, clinical and basic research, and the ...