What the management of fever should be in an infant less than two months of age has been strongly debated in the pediatric literature¹–¹⁰. As many as 15 percent of such infants may have serious bacterial illness, and their clinical examination may be ...

The rate of mortality due to ischemic heart disease increases progressively with age. In the United States, about 80 percent of deaths from ischemic heart disease occur among patients over the age of 65¹.

The findings of recent large multicenter trials of ...

Baroreflexes buffer changes in arterial pressure so that excessive fluctuations of blood pressure are avoided¹–⁷. Baroreceptors in each carotid sinus send information about distention of the vessel wall by the glossopharyngeal nerves to the brain stem⁸. ...

Patients with diabetic nephropathy have a progressive decline in glomerular function, and the treatment of hypertension in these patients slows the rate of loss of renal function¹–⁵. Angiotensin-converting-enzyme inhibitors have been used in several ...

Severe thrombocytopenia in an otherwise healthy neonate is an uncommon but important clinical finding¹–³. Some infants with this condition have major bleeding, including intracranial hemorrhage, that may leave them with lifelong residual defects. ...

Figure 1. Pseudothrombocytopenia.

An electronic counting machine estimated the platelet count in a routine blood sample, anticoagulated with EDTA, at 44,000 per cubic millimeter. A peripheral-blood smear (Wright's stain, x800) from the same blood sample (...

Ophthalmopathy is a potentially disfiguring and sight-threatening component of Graves' disease. It is clinically evident in 25 to 50 percent of patients with Graves' hyperthyroidism and occurs occasionally in patients with Hashimoto's thyroiditis and in ...

Migraine is an episodic headache that is unilateral or bilateral, pulsating in quality, moderate to severe in intensity, and exacerbated by physical activity. Associated symptoms include nausea or vomiting, photophobia, and phonophobia. The disorder is ...

Presentation of Case

A 23-year-old man with asthma was admitted to the hospital because of an increased cough with pulmonary infiltrates.

There was a history of mild asthma since childhood, which was managed occasionally with short courses of prednisone. ...

Fever in infants in the first three months of life is not infrequent. Although fever is usually self-limited, serious infections may be present, the most important of which are bacteremia and bacterial meningitis. Defining fever in infants is a complex ...

In this issue of the Journal, Robertson et al.¹ admirably characterize a poorly understood and rarely recognized syndrome, baroreflex failure. The hallmark of this syndrome is marked lability of blood pressure, with systolic and diastolic hypertension and ...

Nephropathy, characterized by proteinuria and a decreasing glomerular filtration rate, develops in about 35 percent of patients with insulin-dependent diabetes mellitus¹. The risk of death for patients with nephropathy is nine times that of diabetic ...

To the Editor: In their reports of the transplantation of fetal tissue in advanced Parkinson's disease (Nov. 26, 1992, issue), Spencer et al.¹ and Freed et al.² did not compare their results with those for adrenal transplantation. A detailed comparison ...

To the Editor: In reviewing the use of benzodiazepines in anxiety disorders (May 13 issue),¹ Shader and Greenblatt are surprisingly sanguine about the safety of these drugs. I take issue with several of their points.

First, the authors state, “Abusers of ...

To the Editor: In their review of hormonal contraception (May 27 issue), Baird and Glasier state, “After differences in sexual activity and the use of barrier methods of contraception (which have a protective effect) have been accounted for, there ...

To the Editor: The 14- to 16-fold increase in the risk of pancreatic cancer among patients with chronic pancreatitis, noted by Lowenfels et al. (May 20 issue),¹ is striking. However, if the true risk were increased this much, one must wonder why earlier ...

To the Editor: In their report (May 20 issue), Bulengo-Ransby et al. concluded that topical tretinoin therapy lightened postinflammatory hyperpigmentation; it also lightened normal skin in black persons to a minimal degree.¹ The authors have demonstrated ...

To the Editor: In their report (May 13 issue) on visceral infection caused by Leishmania tropica in veterans of Operation Desert Storm,¹ Magill et al. provide good laboratory evidence of infection. But were the infections actually acquired as a result of ...

To the Editor: Ortega et al. (May 6 issue)¹ report the identification of organisms from the genus cyclospora that have remarkable similarities to cryptosporidia with regard to the diarrheal disease they produce in humans. In their Table 1, the authors ...

To the Editor: Damage induced by light has been a topic of great concern among ophthalmologists and visual scientists¹. It has been described clinically in conjunction with gazing directly into the sun² and with exposure to ophthalmic instrumentation, ...

To the Editor: We reported previously (April 30, 1992, issue)¹ that 71 percent of 42 milk samples purchased in five Eastern states in 1991 did not contain 80 to 120 percent of the amount of vitamin D claimed on the label. These results confirmed an ...

Coverage of suicides in the news media has been linked with a subsequent increase in suicides,¹,² but there has been some controversy about these studies³. Recently, Dr. Jack Kevorkian and others who advocate assisted suicide for the terminally ill have ...

With reform in the air, The Healer's Tale is a timely and thoughtful inquiry into the tremendous changes that have transformed medicine in the past half-century. Whereas the traditional role of the physician, once a diagnosis had been arrived at, was to ...

Despite our current preoccupation with dinosaurs, we have not lost our fascination with the mummies of ancient Egypt. Books, articles, cartoons, films, and museum displays continue to bring us the stories and remains of pharaohs, princesses, and priests, ...

This massive book is the product of the Cambridge History and Geography of Human Disease Project, begun in 1985 under the direction of Kenneth F. Kiple. It is intended to replace August Hirsch's monumental but long-outdated Handbook of Geographical and ...

Arthropods transmit devastating infections that affect millions of humans. There is hardly a person alive who has not suffered from arthropod bites, stings, or parasitism. Nevertheless, these organisms are not well known to most medical personnel. The ...

In the introduction to this book the editor states that its purpose “is to summarize the progress to date in understanding the natural history and epizootiology of Lyme disease. It is my hope that synthesis of this information will provide a useful ...

What an unfortunate title for an excellent monograph. This multiauthored book provides broad coverage of all aspects of the study of vaccines against hepatitis B virus (HBV). Only 4 of the 20 chapters relate to the use of these vaccines in clinical ...