Dideoxynucleosides similar in activity to zidovudine were tested in early-phase clinical trials soon after zidovudine was approved¹–⁵. It was hoped that early evaluation and release of these agents would increase the armamentarium of treatments for ...

Coronary artery disease is commonly associated with peripheral vascular disease and is a leading cause of morbidity and mortality after vascular surgery¹–⁴. For the preoperative assessment of cardiac risk, several tests have been proposed, including ...

Myocardial infarction is the most common cause of morbidity and mortality in patients who have had noncardiac surgery¹. The mortality among patients with perioperative infarction ranges from 36 to 70 percent²,³. However, it can be difficult to detect ...

The sideroblastic anemias are a heterogeneous group of inherited and acquired disorders characterized by anemia of variable severity, hypochromic and microcytic erythrocytes in the blood, and ring sideroblasts (erythroblasts with large, perinuclear, ...

Figure 1. Osborn Waves of Hypothermia.

12-lead electrocardiogram and rhythm strip were obtained in a 40-year-old alcoholic man with a core body temperature of 29 °C (84 °F) because of accidental exposure to the cold (Panel A). The tracing shows a ...

Insanity has afflicted humanity throughout history¹. At the turn of this century, identification of the syphilitic insanities set the stage for Kraepelin to recognize the distinctive symptom patterns of the manic-depressive psychoses and dementia praecox²...

Hairy-cell Leukemia, or leukemic reticuloendotheliosis, is an uncommon chronic lymphoproliferative disorder first described by Bouroncle et al. in 1958¹. Its defining features are mononuclear cells with prominent cytoplasmic projections (Figure 1) that ...

Presentation of Case

A 37-year-old woman with treated Hodgkin's disease in remission was admitted to the hospital because of a question of idiopathic thrombocytopenic purpura.

The patient had been well until seven years earlier, when she was seen at ...

For many clinicians providing care for patients infected with the human immunodeficiency virus (HIV), their mood with regard to the use of antiretroviral therapy reflects the opening of Samuel Beckett's Waiting for Godot: “Nothing to be done.” The results ...

About 10 percent of the U.S. population undergoes noncardiac surgery each year. Although the risk of a perioperative myocardial infarction with major surgery is only 1 to 2 percent in patients over the age of 40 years,¹,² the risk is higher in those who ...

In a normal adult, 2 × 10¹¹ worn-out red cells die every day. In replacing them with an equal number of fresh erythrocytes, the bone marrow synthesizes 4 × 10¹⁴ molecules of hemoglobin per second. These hemoglobin molecules consist of two equal partners: ...

To the Editor: In their review of ectopic pregnancy (Oct. 14 issue),¹ Carson and Buster propose an algorithm for early diagnosis based on progesterone measurement. In many areas of the country, including our own, progesterone measurement is not available ...

To the Editor: Pregnancy and the first postnatal year are considered a period with a low risk of suicidal behavior¹,². The risk of suicide among women at this stage of life was one sixth that in a matched population of nonpregnant women. Possible reasons ...

To the Editor: In his excellent, comprehensive review of hearing loss (Oct. 7 issue),¹ Dr. Nadol referred specifically to genetic-linkage analyses in Usher's syndrome and Waardenburg's syndrome, but made no mention of the precise genetic basis of Alport'...

To the Editor: The study by Felson and colleagues (Oct. 14 issue)¹ is liable to be interpreted as showing a decline in the protective effect of estrogen, perhaps related to “catch up” bone loss. One of the chief problems with this cross-sectional study ...

To the Editor: Newburger et al. (Oct. 7 issue)¹ report a higher incidence of clinical and electroencephalographic seizure activity in infants subjected to profound hypothermia and circulatory arrest than in those subjected to profound hypothermia and low-...

To the Editor: In her editorial on neurologic complications of cardiac surgery (Oct. 7 issue),¹ Dr. Swain outlines the causes of injury to the central nervous system and the various techniques used to prevent it. However, she fails to mention the ...

To the Editor: Penicillium marneffei is a dimorphic fungus that can infect either immunocompromised or healthy people. The infection is most likely to be seen in Asians,¹,² particularly in the setting of AIDS³,⁴. The diagnosis may be difficult, since the ...

To the Editor: Intoxication with verapamil is a serious and often fatal condition, complicated by severe hypotension and cardiac-conduction abnormalities¹–⁴. The current therapeutic approach involves intravenous atropine, catecholamines, ventilation, and ...

To the Editor: As fourth-year medical students at the University of Pennsylvania School of Medicine, we led discussions of ethical issues with third-year medical students. These discussions included consideration of the ethical issues that the students ...

To the Editor: We have several comments on the Image in Clinical Medicine entitled “Some Features of Fanconi's Anemia” (Oct. 14 issue)¹. It is gratifying that efforts are being made to increase physicians' awareness of the clinical features of this ...

In recent decades William Carlos Williams, physician-poet, has straddled disciplines in university settings. Literature students compare his Pulitzer Prize-winning works with writings by his modernist colleagues Wallace Stevens, T.S. Eliot, and Ezra ...

It is well known that German academic medicine was an important model for those who wished to improve American medical education in the years just before and after the turn of this century. What is less often appreciated is that it was the German ...

Near the beginning of the 17th century, a weary herbalist characterized the boundless array of botanicals that he was required to master as a “sea of simples.” That immense body of botanical and medical knowledge, first collected by the ancients and then ...

The medical sequelae of cocaine use, including addiction, now challenge health professionals in nearly every major specialty. There is a growing consensus that much can be done in the primary care setting to facilitate public health efforts to reduce the ...

This book was written on the basis of the premises that “neurologists would welcome a book on drug abuse” and “that most biomedical aspects of drug abuse are in fact neurological.” Although it may not be politically astute for a psychiatrist to comment on ...

Myths die hard, especially when fueled by a steady diet of facile truisms used to calm society's fear of uncertainty. Moreover, myth bashing is politically incorrect and a risky business for anyone who disturbs entrenched beliefs or exposes exaggerated ...

The United States is moving forward with health care reform in an unplanned fashion that reflects its belief in entrepreneurial capitalism. Steps are being taken in two areas toward an era in which doctors, hospitals, and other health care providers will ...