Higher levels of physical activity¹–¹¹ and cardiorespiratory fitness¹¹–¹⁷ have been found to be associated with a decreased incidence of and mortality from coronary heart disease. However, only a few previous studies⁷,⁹,¹¹,¹²,¹⁴,¹⁶ have simultaneously ...

Although age-specific incidence rates for hip fracture in black women are about half those in white women,¹,² the rates in black women are still considerable. Moreover, the impact of hip fracture is particularly devastating, because the rates of mortality ...

Chronic idiopathic thrombocytopenic purpura results from the removal of autoantibody-coated platelets from the circulation by splenic and hepatic macrophages¹–⁵. The disorder may be a complication of systemic lupus erythematosus⁶ or B-cell lymphomas,⁷ but ...

The risk of cerebral infarction is multifactorial and includes genetic, anatomical, and environmental considerations. If a major vessel such as a carotid artery is occluded, flow may still be possible through primary or secondary collateral vessels. ...

Figure 1. Cerebral Infarction.

Computed tomographic scans were obtained in a 77-year-old man with sudden onset of dense left-sided hemiparesis. Noncontrast scans performed 2 1/2 hours after the onset of symptoms (Panel A and Panel B) show early changes in ...

Prognosis for Recovery

There are two dimensions of recovery from a persistent vegetative state: recovery of consciousness and recovery of function. Recovery of consciousness can be verified by reliable evidence of awareness of self and the environment, ...

Polarized epithelial cells transport ions, water, and macromolecules from one biologic compartment to another. These processes include absorption by enterocytes and renal tubular cells; secretion by hepatocytes, endocrine cells, and exocrine cells; and ...

We have set a high standard of evidence for the evaluation of preventive services to be widely used. Cost is one reason. Since everyone is a candidate for preventive services, the aggregate cost is high. Professional ethics is another reason. By seeking ...

Stage

A 61-year-old man with seropositive rheumatoid arthritis consulted his rheumatologist because of a three-week history of pain in the right hip.

Response

My first concern would be to find out whether the hip pain is related to the rheumatoid ...

Presentation of Case

A 57-year-old man was referred to the hospital because of extensive bilateral air-space disease and a lung-biopsy specimen that showed alveolar filling, interpreted as pulmonary alveolar proteinosis.

The patient had been in excellent ...

Given the public's interest in the possibility of preventing illness or forestalling death by taking vitamins, it probably was inevitable that the paper entitled “The Effect of Vitamin E and Beta Carotene on the Incidence of Lung Cancer and Other Cancers ...

Idiopathic thrombocytopenic purpura is a common problem in hematologic practice. The acute form of the disease, which affects mainly children, is almost always self-limited. The physician's role in these cases is to tide the patient over the attack, ...

Our ability to translate our expanding genetic knowledge into usable information for individual men and women is at best uncertain. Today many adults are offered genetic counseling to help them make reproductive decisions, either before they attempt to ...

To the Editor: In regard to the article by Sharfstein and Sharfstein (Jan. 6 issue)¹ on campaign contributions by the American Medical Political Action Committee (AMPAC): contributions from political action committees and public health funds are two ...

To the Editor: Kouchoukos and colleagues describe their experience with a pulmonary-root autograft to replace the aortic root in young patients with aortic-valve disease (Jan. 6 issue)¹. The rationale for this operation, technical considerations and ...

To the Editor: Atkinson and colleagues (Dec. 16 issue)¹ report a lack of B-cell and T-cell immunity to bovine serum albumin (BSA) in children with insulin-dependent diabetes mellitus (IDDM). Their results are in contrast with several epidemiologic, ...

To the Editor: Although Dr. Hoyer has written a comprehensive review of the medical aspects of hemophilia (Jan. 6 issue),¹ the review does not address the effect on patients of blood products contaminated with the human immunodeficiency virus (HIV). The ...

To the Editor: In their Clinical Problem-Solving article (Jan. 6 issue),¹ Oren and Matzner describe a 44-year-old man who apparently had Epstein-Barr virus (EBV) hepatitis, pure red-cell aplasia, and infectious endocarditis due to Haemophilus ...

To the Editor: Reports of improper reuse of syringes for injection have prompted a reemphasis of recommendations by the Centers for Disease Control and Prevention (CDC) that syringes used for injection not be reused unless sterilized properly and that a ...

To the Editor: Although I support the Women's Health Initiative, I also believe that the risks of participation in the study should be communicated clearly to members of the public and their health care providers. This study will examine the effects of ...

To the Editor: Nitric oxide is a central mediator in septic shock because of its ability to relax smooth-muscle cells in arterial walls¹. High levels of nitrate, one of the metabolites of nitric oxide, can be found in the serum of hypotensive patients ...

To the Editor: A 21-year-old man presented to our hospital with a one-day history of brown urine, nocturia, urinary frequency, and mild suprapubic pain. Three days earlier, while participating in a prison hazing ritual, he was challenged to maneuver 10 ...

With health care reform rising to the top of our nation's political agenda, the burgeoning costs of the nonclinical aspects of patient care are finally coming under scrutiny¹. Most of the focus is properly being directed toward paperwork, malpractice, and ...

This slender book, with its all-encompassing title, is full of surprises. It is a scholarly work, carefully documenting the social, political, and economic forces that have shaped the dramatic changes in the care of children in the United States from ...

Children with chronic illness or disability constitute almost a fourth of our total population of children. Of the 20 to 35 million children in the United States with chronic health conditions, 10 to 15 percent have problems severe enough to interfere ...

This book is close to art: not because it is a labor of love or because the amount of labor involved is massive -- both of which are true -- but because the labor has been intelligent and disciplined. As a result, several virtues have been achieved.

One ...

The identification of Helicobacter pylori as a gastric pathogen has revolutionized gastroenterology. Now widely recognized as the main cause of gastritis and peptic ulcers, the role of H. pylori numbers among the most important bacterial discoveries of ...

Transfusion medicine has undergone many changes over the century since its inception in the laboratory of Karl Landsteiner, and so have textbooks on the subject. Discoveries of numerous red-cell antigens and associated antibodies made blood-group serology ...

The architects of health care reform are putting pressure on physicians to evaluate and alter their traditional approach to diagnosis. The emphasis is on doing less in an attempt to redress the overuse perceived in the current system. Some of the excess ...

Variation in the Prothrombin-Time Ratio during Oral Anticoagulation Correspondence, N Engl J Med 1994:330;509-510.. In the letter from Schuff-Werner, Schutz, and Gonska, the last sentence of the second paragraph should have read, “In the case of reagent A,...

The Clinical and Genetic Spectrum of the Holt-Oram Syndrome (Heart-Hand Syndrome) Original Article, N Engl J Med 1994:330;885-891.. On page 891, the authors of reference 5 should have been listed as Elek C, Vitez M, Czeizel AE. We regret the error.