Persistent patent ductus arteriosus is routinely closed by means of surgical ligation, division, or clip-placement procedures,¹,² all of which require thoracotomy and have a variety of potential complications³,⁴. For patients beyond the neonatal period, ...

Respiratory syncytial virus is an important respiratory pathogen of infancy and early childhood¹–⁴. The greatest morbidity and mortality occur among children at high risk for respiratory syncytial virus infection who are less than two years old⁵–⁷; these ...

Pheochromocytomas are a feature of two disorders with an autosomal dominant pattern of inheritance -- multiple endocrine neoplasia type 2 (MEN-2) and von Hippel-Lindau disease. Persons carrying the MEN-2 mutation are predisposed to have C-cell hyperplasia ...

More women die of epithelial ovarian cancer than of all other gynecologic cancers combined. According to the International Federation of Gynecology and Obstetrics, the incidence of epithelial ovarian cancer is 15 per 100,000 women¹. These cancers are ...

Environmental tobacco smoke has been classified by the Environmental Protection Agency (EPA) as a human carcinogen. A recent report¹ concluded: “Passive smoking is causally associated with lung cancer in adults, and environmental tobacco smoke, by the ...

The deoxyadenosine analogue 2-chlorodeoxyadenosine is an effective and relatively nontoxic treatment for hairy-cell leukemia¹ and other B-cell neoplasms, including chronic lymphocytic leukemia (CLL)²,³. In a recent study of 90 patients with CLL, including ...

Figure 1. Neurofibromatosis Type 1.

Severe neurofibromatosis type 1 is shown in a 45-year-old woman who was admitted for a severe exacerbation of asthma. Inguinal freckling (known as Crowe's sign), cafe au lait macules (straight arrows), and neurofibromas ...

Epithelial cancer of the ovary is the fifth most common malignant condition among women in the United States, with an annual incidence of 22,000 new cases¹. This disease predominantly affects postmenopausal women in their sixth decade, accounting for ...

Presentation of Case

A 75-year-old right-handed man was referred to the Movement Disorders Unit of this hospital because of right-sided rigidity, dysphagia, dysarthria, and an impaired gait.

The patient's health had been stable until two years earlier, ...

On September 22 President Clinton described his American Health Security Act of 1993 to the nation in a long-awaited speech before the joint houses of Congress. The speech marked the end of seven months of intense activity by Hillary Rodham Clinton's task ...

The lungs of the fetus do not have a role in gas exchange, since that function is served by the placenta. The fetal pulmonary vascular resistance is maintained at high levels to limit blood flow to the lungs, and the ductus arteriosus provides a conduit ...

Respiratory infections in infants and children, and their complications, are responsible for enormous morbidity throughout the world and, particularly in the developing world, for substantial mortality. Of the numerous known microbial causes, respiratory ...

The Clinton proposal for health care reform is based on managed competition, as are the alternatives offered by Republicans in the Senate and by a bipartisan group in the House of Representatives. So the odds are good that managed competition will be part ...

To the Editor: In the study by Fisher et al. (June 3 issue)¹ of lumpectomy compared with lumpectomy and radiation therapy for the treatment of intraductal breast cancer, more than 20 institutions enrolled 818 women, and the diagnosis of breast cancer was ...

To the Editor: In their analysis of the effect of vitamin E supplementation on the risk of breast cancer, Hunter et al. (July 22 issue)¹ appear not to have taken into account the cardioprotective effect of vitamin E supplementation found by Stampfer et ...

To the Editor: As one of the dissenting members of the Human Fetal Tissue Transplantation Research Panel, I believe that Kassirer and Angell (Nov. 26, 1992, issue)¹ too easily dismissed our concern that transplantation therapy using tissue from induced ...

To the Editor: Chilmonczyk et al. (June 10 issue)¹ demonstrated a dose-response relation between exacerbations of asthma in children and exposure to environmental tobacco smoke, and validated parental reports of exposure by measuring urine cotinine ...

To the Editor: Domino et al. (Aug. 5 issue)¹ suggest that nicotine obtained from the consumption of vegetables could complicate the interpretation of studies of exposure to environmental tobacco smoke based on the detection of nicotine or its metabolite ...

To the Editor: Coopman et al. (June 10 issue)¹ found that cutaneous diseases, including drug reactions, are extremely common in patients with human immunodeficiency virus (HIV) infection, and that their incidence increases as immune function ...

To the Editor: In their article describing autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria, Hide et al. (June 3 issue)¹ state that the majority of patients with severe, chronic urticaria have an ...

To the Editor: In April 1988 a 50-year-old woman was referred to the Mayo Clinic to determine the cause of her chronic urticaria. She had had a cholecystectomy in 1984. In 1986 persistent right upper abdominal pain and urticaria developed. All test ...

To the Editor: As Mexicans, we would like to offer another perspective on the recent article on traveler's diarrhea by DuPont and Ericsson (June 24 issue).¹ Though it is true that Moctezuma (not Montezuma) can strike travelers with a vengeance, travel to ...

On June 5, 1993, the front page of the Birmingham (Alabama) News reported the tragic case of a local woman who died in childbirth. A healthy single woman in her mid-20s, Sheila McFarland suddenly began to hemorrhage after the birth of her first child. Her ...

Ruth Dixon-Mueller's book develops a clear agenda, incorporating principles of women's rights and reproductive health into a logical, feminist population policy that is based on evolutionary trends. Although the book may not be surcharged with passion, it ...

Childbearing during the teenage years is usually viewed as an undesirable event. It may affect the mother adversely, shortening her time in school and leaving her dependent on her family or social systems for financial and emotional support. The children ...

Physicians are under increasing pressure from patients and the popular press to address occupational and environmental health hazards, particularly in obstetrics. In many, or even most, instances there are insufficient scientific data to allow firm ...

This book covers the management of the psychological symptoms of the premenstrual syndrome (PMS), but neglects the equally distressing physical symptoms. Management is approached on an ad hoc basis that does not take into consideration the chronicity of ...

According to the preface, this book is based on the proceedings of a postgraduate course given in June 1990 that was sponsored by the Faulkner Center for Reproductive Medicine in Boston. Despite the obvious time lag, it contains a great deal of useful and ...

Congress in committee is Congress at work, as Woodrow Wilson once observed. That rule certainly applies now, as legislators, primed by President Bill Clinton and Hillary Rodham Clinton and pressured by a large array of private interests, intensify their ...

Book Review of Age-Related Macular Degeneration: Principles and Practice Book Review, N Engl J Med 1993:329;69.. The sentence that begins on line 14 of the second paragraph should have read, “The chapter on fluorescein angiography is too technical even ...

Motor Dysfunction of the Small Bowel and Colon in Patients with the Carcinoid Syndrome and Diarrhea Original Article, N Engl J Med 1993:329;1073-1078.. In Table 4, on page 1077, the entry “Percentage of fasting volume” (which appears twice in the stub ...