Several cross-sectional investigations have found associations between mortality rates and particulate air pollution in U.S. metropolitan areas¹–³. A recent study reported associations between infant mortality and particulate air pollution in the Czech ...

Nearly a decade ago there was a dramatic increase in the number of patients with asthma who were admitted to emergency rooms on specific days in Barcelona, Spain. These outbreaks were characterized by a point-source distribution of cases around the harbor ...

Optic neuritis is frequently the first manifestation of multiple sclerosis¹. Even when optic neuritis occurs without other clinical signs of multiple sclerosis (“isolated optic neuritis”), magnetic resonance imaging (MRI) of the brain often demonstrates ...

In treating patients with cancer, the dose intensity of chemotherapeutic drugs, defined as the dose of drug per unit of time, may be a determinant of their response¹. Because non-Hodgkin's lymphoma with aggressive histologic features is a chemotherapy-...

Acyclovir has been widely used over the past decade as an effective and safe drug for the treatment of infections with herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2)¹. Resistance to acyclovir was initially noted only in studies of HSV infection in ...

Figure 1. Vulvar Herpes Simplex Infection.

Characteristic histologic changes are seen in herpes simplex virus infection of the vulva. Panel A shows necrosis of the epidermis and dermis, with acute inflammation and nuclear debris on the left, viable ...

Patients with different types of health insurance but similar medical problems may receive quite different treatment after their admission to a hospital. As compared with privately insured patients, patients who are uninsured or are covered by Medicaid ...

Chemotherapy regimens for the treatment of cancer are unfortunately better known for their toxicity than for their efficacy. Although some of the toxic effects may be life-threatening, patients are often most fearful of the nausea and emesis caused by ...

Presentation of Case

A 21-year-old woman was admitted to the hospital for lung transplantation because of lifelong respiratory difficulties.

The patient had been born after an uncomplicated pregnancy lasting 37 weeks, weighing 2.9 kg. At two hours of age ...

On December 5, 1952, a severe temperature inversion occurred over London, leading to a substantial accumulation of air pollutants emitted by the combustion of fossil fuels. This phenomenon was associated with an abrupt increase in the mortality rate, ...

Despite years of research, multiple sclerosis remains one of the most difficult neurologic disorders to understand and treat. Acute optic neuritis is a common manifestation of multiple sclerosis, either a first manifestation or one appearing during the ...

Despite the controversies surrounding almost every aspect of health care reform in the United States, analysts are virtually unanimous in complaining that our residency programs are turning out too few generalists, too many specialists, and too many ...

In times of fundamental social change, institutions face both mortal threats and unparalleled opportunities. Such is now the case with the unique class of health care organizations known as academic medical centers.

For the purposes of this discussion, we ...

To the Editor: We support the general direction in which the Food and Drug Administration (FDA) is moving regarding the inclusion of fertile women in clinical trials, as outlined by Merkatz et al. (July 22 issue).¹ The previous policy prohibiting women ...

To the Editor: In her editorial (July 22 issue),¹ Dr. Angell charges that women have been discriminated against in three key areas; yet, my observations and the evidence she presents do not support the charges.

First, Dr. Angell notes, “diseases that ...

To the Editor: Akashi et al. (July 15 issue)¹ reported seroconversion to human herpesvirus 6 (HHV-6) positivity in a patient with an infectious mononucleosis-like syndrome, and Cone et al. (July 15 issue)² detected high levels of HHV-6 genome in the ...

To the Editor: We wish to highlight a shortcoming of the study by Packer et al. (July 1 issue)¹ regarding the withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-converting-enzyme (ACE) inhibitors. The authors state ...

To the Editor: Thibault, in the Clinical Problem-Solving case “One More Hypothesis” (July 1 issue),¹ interprets a white-cell count of 26,900 with a differential count of 91 percent neutrophils, 6 percent lymphocytes, 2 percent monocytes, and 1 percent ...

To the Editor: As we previously reported (November 5, 1992, issue),¹ interferon alfa, when added to a four-drug, doxorubicin-based chemotherapy regimen, is an effective antitumor agent in patients with clinically aggressive low-grade or intermediate-...

To the Editor: Inhaled steroids are commonly used in the treatment of chronic asthma, partly because of their diminished systemic side effects as compared with systemic steroids¹. Irrespective of the route of administration, however, steroid use has been ...

To the Editor: Buckey et al. (June 24 issue)¹ promulgate a common misconception about the effects of gravity on astronauts in orbit. The term “zero gravity” is used to describe the environment inside the space shuttle. Gravity, however, is not zero ...

It is appropriate to bear in mind Fothergill's 1887 admonition that “so long as a disease carries a man's name it shows we know little about it.” Nothing can be truer than this contention when it comes to nephritis, which originally carried the ...

This is the third book on hypertension in blacks published in the past eight years. It reflects a growing recognition that the pathogenesis of hypertension in blacks may well differ from that in whites in ways that could account for its greater prevalence ...

In the light of recent interest in alternative therapies, Loudell Snow's book on traditional African American medicine is timely and important. Snow describes these traditional practices and shows how and why they remain meaningful to their adherents. She ...

Doctors Talking with Patients/Patients Talking with Doctors is a treasure-trove of information about patient-doctor communication. Roter and Hall point out that talking is the fabric of medical care. By talking with patients, physicians figure out what is ...

Medical science is a source of both sadness and joy in our society. People express gratitude for technological advances -- and in the same breath worry about the cost and consequences of their use. Such ambivalence is one of the reasons for the recent ...