Huntington's disease usually presents in adult life with mood and personality changes, clumsiness, and chorea. The disease is inexorably progressive, with cognitive decline and worsening of the movement disorder, ending in death approximately 18 years ...

The increased awareness of the potentially adverse cognitive and behavioral effects of antiepileptic drugs and the social stigma implicit in their use have generated much interest in attempts to discontinue treatment in selected patients with epilepsy. In ...

Ten to 30 percent of patients with chest pain sufficiently similar to angina to justify cardiac catheterization are found to have normal coronary angiograms¹–⁶. Despite a good prognosis and the beneficial effect of reassurance for many patients, most ...

Patients with chronic unexplained diarrhea present a diagnostic and therapeutic challenge. Many disorders can cause chronic diarrhea, but despite extensive evaluation the cause may remain unknown. Surreptitious abuse of laxatives¹ and ingestion of drugs ...

Figure 1. Acute Myocardial Infarction and Coronary Spasm.

A 41-year-old woman with a history of hypertension and cigarette smoking was admitted to the emergency department with chest pain. Electrocardiography revealed changes consistent with acute ...

During the 1960s and 1970s, the United States made progress toward ensuring access to health care services for all children through various public programs affecting the financing and delivery of medical care. More recently, however, these gains in access ...

The number of visits by Medicaid recipients to hospital emergency departments increased by 34 percent between 1985 and 1990, according to a recent survey¹. Many of these people sought treatment for relatively minor health problems¹. Emergency department ...

The vessel wall is an active, integrated organ composed of endothelial, smooth-muscle, and fibroblast cells coupled to each other in a complex autocrine-paracrine set of interactions. The vasculature is capable of sensing changes within its milieu, ...

Presentation of Case

A girl five years and eight months old was admitted to the hospital because of a nodular lesion in the upper lobe of the left lung, recent bouts of fever, and a cough associated with pulmonary infiltrates.

The child had been born ...

In 1985 the Journal published a paper from the multicenter National Surgical Adjuvant Breast and Bowel Project (NSABP) showing that lumpectomy was as effective as mastectomy in the treatment of early breast cancer¹. A follow-up paper in 1989 confirmed the ...

Huntington's disease is an inherited neurodegenerative disease of midlife onset that produces a characteristic, progressive movement disorder with accompanying psychiatric changes. The symptoms result from the selective loss of neurons, most notably in ...

Some critics of current efforts to reform the American health care system claim that every American already has a catastrophic health insurance policy: the emergency room of the nearest hospital. With universal coverage thus in place, they ask, “What ...

Between the 1960s and the early 1990s, the evolution of subspecialty divisions in academic departments of internal medicine was characterized by an impressive blend of research, clinical and technological development, and educational growth. The ...

The structure of academic departments of medicine reflects the changes in science and clinical practice that evolved with the development of new knowledge and forms of technology. Before World War II, departments were small and the clinical interests of ...

To the Editor: On behalf of the National Surgical Adjuvant Breast and Bowel Project (NSABP), we wish to call your attention to misconduct by one of its investigators, Dr. Roger Poisson, at St. Luc Hospital in Montreal. Instances of falsification and ...

The idea of an articulate nonphysician addressing the multifaceted topic of temporal-lobe epilepsy is an interesting one, since physicians are not always the best able to communicate concepts to the lay public. This book is designed to provide insights by ...

Close your eyes and imagine a way to finish reading this review. For most of us, the loss of useful vision would make the practice of our profession an impossibility. We often take our sight for granted until we are faced with its loss. Second Sight is a ...

More than 175,000 people in the United States are living with a traumatic spinal cord injury -- that is, one not caused by disease. They are typically male and well educated (the majority attended college). At the time of the injury they were young (half ...

This book is the first in a series entitled 100 Maxims in Neurology, which is intended to provide clinically useful information, much of which is often not available in standard textbooks, to the practitioner. The series editor, Roger Porter, M.D., ...

This book of 15 chapters is part of a series of neurology textbooks published as Butterworth-Heinemann International Medical Reviews. Whisnant, the editor, is an internationally recognized expert on cerebrovascular disease. Dr. Whisnant, his colleagues at ...

With the recent publication of several well-designed, prospective, randomized, multicenter studies demonstrating the benefit of carotid endarterectomy for symptomatic high-grade carotid-artery disease, this book is both timely and thought-provoking. The ...

Eight-Year Results of a Randomized Clinical Trial Comparing Total Mastectomy and Lumpectomy with or without Irradiation in the Treatment of Breast Cancer (N Engl J Med 1989:320;822-880:). On page 824, in the legend for Figure 2, the phrase “with or ...