Concern about deaths from asthma is increasing¹–³. Most of the deaths are avoidable if patients are adequately treated³,⁴. However, adequate treatment requires clarification of the mechanisms by which fatal or near-fatal attacks develop and identification ...

Of the many clinical manifestations of Marfan's syndrome,¹ dilatation of the aorta is the most worrisome. Aortic dissection and regurgitation, first described 50 years ago,²,³ continue to account for a shortening of life expectancy by about one third in ...

Primary biliary cirrhosis is a chronic cholestatic liver disease that progresses slowly toward a terminal phase characterized by hyperbilirubinemia, signs of decompensated cirrhosis, ascites, and variceal bleeding. The survival of patients with end-stage ...

The importance of host factors in the susceptibility to mycobacterial infection has been suspected for over a century¹. Patients with T-cell deficiencies, such as the acquired immunodeficiency syndrome² and idiopathic CD4+ T-lymphocytopenia,³–⁶ and ...

Human herpesvirus-6 (HHV-6) is the causative agent of exanthem subitum¹ and febrile illnesses² in children. More recently, HHV-6 has been shown to infect the recipients of bone marrow transplants and has been implicated in interstitial pneumonitis³,⁴ and ...

Figure 1. Dissection of the Ascending Thoracic Aorta.

A dissecting aneurysm of the ascending segment of the thoracic aorta was diagnosed by two-dimensional transesophageal echocardiography. The horizontal imaging plane is approximately 3 cm above the ...

Exercise-induced asthma is a condition in which vigorous physical activity triggers acute airway narrowing in people with heightened airway reactivity. A more accurate description would be exercise-induced bronchospasm. Long usage, however, has left the ...

Three major classes of drugs are used in the treatment of patients with rheumatoid arthritis: nonsteroidal antiinflammatory drugs, corticosteroids, and drugs that are thought to modify fundamental pathologic processes responsible for the chronic ...

Presentation of Case

A 47-year-old woman was admitted to the hospital because of intermittent abdominal pain, vomiting, and weight loss.

The patient had been well until six years earlier, when she began to experience intermittent bouts of crampy ...

Despite astounding advances in our understanding and treatment of asthma, patients still die. Indeed, mortality from asthma in several countries, including the United States, continues to rise, unlike mortality from other common treatable conditions¹. The ...

Marfan's syndrome is classically defined as an autosomal dominant disorder of connective tissue with variable manifestations involving primarily the cardiovascular, ocular, and musculoskeletal systems. The most important feature that reduces life ...

Primary biliary cirrhosis, a progressive cholestatic liver disease that primarily affects middle-aged women, has been called a “model autoimmune disease”¹. The numerous abnormalities of the humoral and cellular immune systems include elevated serum levels ...

To the Editor: The Special Article by Phillips and Schneider (Dec. 23 issue)¹ addresses what they define as sexual harassment of female doctors by patients. Sexual harassment is usually defined as the creation of a hostile atmosphere or abuse of a ...

To the Editor: . . . Beware of a patient with obvious carpal tunnel syndrome who has any symptoms in the little finger or ulnar half of the ring finger: ulnar-nerve testing by electromyography or testing of nerve-conduction velocity seems of little value ...

To the Editor: In the review of irritable bowel syndrome by Lynn and Friedman (Dec. 23 issue),¹ much is made of the pathophysiology of the symptoms and somatization, but little is made of environmental causes such as food intolerance. The literature now ...

To the Editor: The recent study by Cohen et al. (Dec. 23 issue)¹ demonstrates a common misconception about randomization in clinical trials. Assignment of patients to one of two treatment groups by means of medical-record numbers does not constitute true ...

To the Editor: The article by Sagie et al. (Dec. 23 issue)¹ states that “borderline systolic hypertension and the risk of cardiovascular disease are causally related.” I wonder whether the cart and horse have been reversed with regard to causality.

It is ...

To the Editor: The recent report by Dalakas et al. (Dec. 30 issue)¹ on the treatment of dermatomyositis with intravenous immune globulin states, “In five patients who had a major improvement after the third infusion, we performed another open-muscle ...

To the Editor: In their report on herpetic geometric glossitis, Grossman et al. (Dec. 16 issue)¹ described linear fissures on the dorsum of the tongue as a characteristic of herpes simplex virus (HSV) type 1 infection in immunocompromised patients. ...

To the Editor: Ray et al. (Dec. 30 issue)¹ are to be complimented on their arguments in favor of changing the way we evaluate drugs after they have been approved for clinical use. As clinical pharmacologists, we strongly endorse their proposals for more ...

To the Editor: We report the occurrence of Candida albicans fungemia in a 70-year-old woman that was associated with an intrauterine contraceptive device that had been in place for 28 years.

The woman had a six-month history of non-insulin-dependent ...

Worsening of asthma at night has been recognized since the earliest descriptions of the disease, but the mechanisms underlying this phenomenon have still not been fully explained. Nocturnal exacerbation is a very common feature of asthma. It may affect a ...

The patients dealt with in this interesting book are particularly problematic and are often forgotten in discussions of both asthma and allergy. They are pregnant or suffer from asthma and allergic disorders in early infancy. It is argued in the preface ...

Sinusitis is a term that physicians and patients often use, though they have grave difficulty in defining it precisely. Nevertheless, we know it is a common disorder with manifestations that vary from acute illness after a viral upper respiratory tract ...

The skepticism that once prevailed when the topic of autoimmunity came up in a discussion, or when a “so-called” autoimmune disease entered the differential diagnosis, is difficult to appreciate today. The dogma of the time -- an era that began around ...