When our European-Australian Collaborative Group study was initiated, zidovudine had been shown to provide clinical benefit in patients with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex, including reductions in mortality and in ...

Microvascular complications develop in many patients with insulin-dependent diabetes mellitus, and the effect of intensified insulin treatment on these complications has not been established. Some prospective, randomized studies have indicated that lower ...

In 1969 Gardner¹ reported that fluid collected from cysts of a specimen of polycystic kidney obtained at nephrectomy had lower concentrations of sodium and chloride and higher concentrations of potassium and protons than did plasma. This evidence that ...

Although the incidence of acute lymphoblastic leukemia recurring in the central nervous system in children has decreased markedly since the introduction of effective therapy directed at the central nervous system, more than half the patients who have such ...

Figure 1. Necrobiosis Lipoidica Diabeticorum.

The photograph shows the anterior surface of the lower leg of a 20-year-old woman who had a 10-year history of poorly controlled diabetes mellitus. The lesion measures 9 by 5 cm and has characteristic atrophic,...

Health care costs in the United States exceed 14 percent of the gross domestic product, far more than in any other nation. Overall costs were $838 billion in 1992, or over $3,000 per person¹. Well over 30 million Americans are uninsured, partly because of ...

Access to health care is currently a subject of considerable concern in the United States. Approximately 34 million Americans lack health insurance,¹ and many of them may delay or forgo necessary medical care because of its cost². People without health ...

Autosomal dominant polycystic kidney disease is one of the most common hereditary disorders, being 10 times more common than sickle cell disease, 15 times more common than cystic fibrosis, and 20 times more common than Huntington's disease. In addition, ...

Presentation of Case

A 59-year-old woman was admitted to the hospital because of left-sided abdominal pain.

She had been well until two hours after dinner on the evening before entry, when she experienced the onset of intermittent crampy abdominal pain ...

In 1985, zidovudine was found to have in vitro activity against the human immunodeficiency virus (HIV). The first large clinical trial, initiated in February 1986 in patients with advanced HIV disease, was stopped by the safety monitoring board after ...

In this issue of the Journal, Fries et al.¹ offer an attractive alternative to health care cost-control proposals such as managed competition, global budgets, rationing, and the like. On behalf of the Health Project Consortium, they propose that wider use ...

Three years ago we noted that the literature on physicians' refusal to provide requested treatment was sparse¹. Since that time the issue has fueled an intense, two-pronged debate -- on futility and on the limits of patient autonomy. The debate over ...

To the Editor: The report by Sabate et al. (March 4 issue)¹ describing a reduction of serum cholesterol levels in normal men after they consumed walnuts has a simple explanation. Three ounces of nuts will supply about 400 kcal daily. The subjects must ...

To the Editor: Dr. Mazzaferri (Feb. 25 issue)¹ recommends the use of radionuclide scanning when fine-needle aspiration biopsy yields indeterminate results in the evaluation of a solitary thyroid nodule. This is done to identify hot nodules that can then ...

To the Editor: In their review of drug therapy for Hodgkin's disease (Feb. 25 issue),¹ DeVita and Hubbard cite two trials conducted to compare chemotherapy alone with radiotherapy alone as treatment for stage I or II Hodgkin's disease²,³. They stated ...

To the Editor: Kernan et al. (March 4 issue)¹ report that patients who received marrow mismatched for one HLA antigen, as opposed to none, had delayed engraftment and an increased risk of a relapse of leukemia. However, there was no difference in the ...

To the Editor: Liver transplantation has been performed in a few children with inborn errors of metabolism that do not cause liver failure but may be responsible for severe disease of extrahepatic organs (e.g., Crigler-Najjar syndrome type I). Liver ...

To the Editor: Since June 1990, we have performed liver transplantations involving living related donors in 61 children with end-stage liver disease¹–⁵. A questionnaire regarding the postoperative quality of life was mailed to 34 parental donors (11 ...

To the Editor: The clinical evaluation of treatments for disorders of globin-chain synthesis¹–⁴ has entered an exciting new era. Decisions about the design and application of future trials will dramatically influence the rapidity of the advance against ...

To the Editor: In recent years, there has been a decline in the incidence of reported ocular injuries in the sport most frequently associated with them -- hockey.¹ Injuries to spectators' eyes have received much less attention.

We treated three patients ...

Ilizarov's Russian method of bone regeneration for limb lengthening and reconstruction has swept across the West and forever altered the face of orthopedic surgery. This formidable book is Ilizarov's magnus opus, the culmination of a lifetime's work for ...

Fifty-three years elapsed between the first and eighth editions of Campbell's Operative Orthopaedics. The first edition of 1939 had one volume. The present edition has five. The book began as a classic and remains one today. Although it emanates from the ...

I spent several weeks reviewing chapters and looking up specific topics in this encyclopedia of orthopedic trauma. First and foremost, I was impressed by its currency and completeness. All the authors have made a substantial effort to place their topics ...

Dr. Henry L. Jaffe, for many years the leading light of American orthopedic pathology, conducted an annual course in the field. The tissue blocks and illustrations that provided the basis for the course were presented to Dr. Marcove on Jaffe's retirement ...

Unique and fascinating: these are the two words that best describe this book of essays. In this unique and fascinating addition to the literature on sports and exercise science, the editors have given us a chance to peek at the history of a rapidly ...

Knee surgery has evolved over the past decade into a major part of orthopedic surgical practice. Currently, the definitive postgraduate textbook is that by John Insall (Surgery of the Knee. New York: Churchill Livingstone, 1984), which has not since been ...

The management of rheumatoid arthritis is imperfect and requires a firm understanding of both the medical and the surgical aspects of the disease. Surgery for Rheumatoid Arthritis attempts to describe the various surgical options, most of which have been ...

America's hospitals are a central element of its health care system, employing 3.5 million people and constituting the single largest category of national health spending (44 percent, or $305 billion, in 1991). No other country has such a heterogeneous ...