Randomized clinical trials have established that adjuvant chemotherapy increases the survival of patients with breast cancer¹–³. As a result of these studies, large numbers of women with breast cancer now receive adjuvant chemotherapy. However, it is not ...

Several molecular markers have been associated with a poor prognosis in patients with breast cancer, and it is widely assumed that the presence of these markers is an indication for adjuvant therapy. Many physicians and patients believe that it is better ...

Primary non-Hodgkin's lymphoma of the stomach is an uncommon cancer, accounting for only 10 percent of lymphomas and 3 percent of gastric neoplasms¹. According to U.S. tumor-registry data from 1985, there were only 7.1 cases of gastric non-Hodgkin's ...

Nonmelanoma skin cancer is the most common cancer among whites in the United States, with approximately one-half million new cases a year¹. Nonmelanoma skin cancer includes, by definition, both basal-cell and squamous-cell carcinomas. However, lesions of ...

Approximately 52,300 new cases of carcinoma of the bladder were diagnosed in the United States in 1993¹. These carcinomas struck primarily older men, who often presented with hematuria or increased frequency of urination. Patients whose cancers are ...

Figure 1. Chemotherapy-Induced Acral Erythema.

Acral cyanosis can be seen in a 61-year-old woman with non-Hodgkin's lymphoma. The lesions developed while the patient had severe neutropenia during a course of therapy consisting of methotrexate with ...

Two arguments pervade discussions of physician-payment reform in the United States. The first is familiar -- that physicians' income is unfairly distributed and that there are particular disparities between generalists and specialists¹–⁴. The second is ...

The past 10 years have witnessed major changes in our understanding of the pathophysiologic mechanisms underlying vascular occlusion¹,² and considerable progress in the clinical assessment of aspirin and other antiplatelet agents³–⁵. The purpose of this ...

Stage

A 27-year-old woman had severe hypertension and hirsutism during the last trimester of a normal pregnancy. In the six months after the delivery of her child, she noticed increasing skin pigmentation and continued weight gain, and insulin-requiring ...

Presentation of Case

A 37-year-old woman was admitted to the hospital because of chronic interstitial lung disease and a history of spontaneous pneumothorax.

The patient had been in good health until 4 1/2 years earlier, when she had chest pain and was ...

Randomized clinical trials have shown that chemotherapy, tamoxifen, and ovarian ablation can each reduce the frequency of relapses and prolong survival among patients with operable breast cancer and ipsilateral axillary-lymph-node metastases¹. As a result,...

In 1983, Warren and Marshall discovered a spiral urease-producing organism in the human stomach, later classified as Helicobacter pylori¹. H. pylori has been shown to be strongly associated with peptic ulcer disease, and antibiotic therapy to eradicate ...

Physicians' incomes are variously decried as contributing to high health care costs in the United States and championed as reasonable compensation for hard work, sobering responsibilities, and long years of training. The public perception is that many ...

To the Editor: Fitzgibbon et al. (Dec. 16 issue)¹ report a case of transmission of human immunodeficiency virus type 1 (HIV-1) from one child to another in the home setting. Although extensive molecular analyses yielded convincing evidence that the HIV-1 ...

To the Editor: Despite evidence of HIV in the saliva of HIV-positive persons, oral transmission of the virus appears to be a rare event. Researchers have isolated infectious virus from only a small percentage of saliva samples from HIV-infected patients, ...

To the Editor: Nightingale et al. (Sept. 16 issue)¹ reported no cases of uveitis among 292 patients taking 300 mg of rifabutin per day as prophylaxis against Mycobacterium avium complex infection, and there was no mention of uveitis in the guidelines on ...

To the Editor: The results of two double-blind, randomized, placebo-controlled trials published in the Journal (Sept. 16 issue)¹ have shown that prophylactic treatment with rifabutin (300 mg per day) significantly reduces the incidence of Mycobacterium ...

To the Editor: Samuel et al. (Dec. 16 issue)¹ report the results of a major retrospective multicenter study of liver transplantation in European patients with hepatitis B virus (HBV) infection. Of great clinical importance is the observed reduction in ...

To the Editor: William M. Lee's masterly review of acute liver failure indicts trichloroethylene as a direct liver toxin (Dec. 16 issue)¹. This allegation is inconsistent with the fact that trichloroethylene was used for years as an anesthetic and was ...

To the Editor: The clinicians involved in Case 49-1993 (Dec. 9 issue),¹ which describes a patient with chronic pulmonary disease that started in infancy, do a disservice to pediatricians in not remembering that common things are common. The patient had ...

To the Editor: The Sounding Board by Cohen (Dec. 9 issue)¹ nicely summarized the 1993 academic consensus “proposal to regulate graduate medical education.” The number of residency positions would be reduced. The number of generalists (general internists, ...

To the Editor: The letter by Fariza and Castellote (Nov. 11 issue)¹ on light damage by indirect ophthalmoscopy contains photographs illustrating an acute change in both maculas of a patient with high myopia after retinal examination. I take issue with ...

Dear Sir,

I collect Marvel Masterpieces. So do some of my friends and my brothers. I found 5 out of 100 cards that were smoking!! Some of them were villains and some were heros. Here are their names Blaze, Gambit, Kingpain, Nick Fury, and Red Skull.

...

The past few decades have witnessed revolutionary developments in the management of ischemic heart disease. Technical advances in coronary revascularization and myocardial protection, clinical refinement of thrombolytic therapy, and the introduction of ...

This book, edited by three respected experts, fills the need for a suitable reference for its intended audience of anesthesiologists, cardiothoracic surgeons, perfusionists, and all other physicians and health care personnel involved in the immediate ...

This small but relatively comprehensive book summarizes the relation between viruses and the cardiovascular system. It is ambitious in scope and includes chapters on virology, epidemiology, pathology, animal models, the clinical spectrum of human ...

Myocardial infarction due to coronary artery disease remains the leading cause of death in the Western world. Its mechanical complications are usually what kill people. This review of the pathology, diagnosis, and medical and surgical management of these ...

For whom is this book intended? It would not be very toothsome for a family doctor or an internist, but a pediatrician would savor Victoria Fedder's clear, useful discussion of the sudden infant death syndrome. A practicing cardiologist might acquire a ...

This is an excellent book for scientists, researchers, microbiologists, and infectious-disease experts interested in the molecular biology, virology, epidemiology, and clinical manifestations of the herpesviruses. This important group of human viruses is ...