Essential hypertension represents the upper quintile of the blood-pressure distribution in the general population and is a major risk factor for morbidity and mortality from cardiovascular causes¹. The causes of essential hypertension, which accounts for ...

Left ventricular hypertrophy, a major independent risk factor for morbidity and mortality from cardiovascular disease,¹–⁴ is widely thought to be a consequence of left ventricular pressure overload⁵,⁶. However, the degree of such hypertrophy in patients ...

The life expectancy of patients with sickle cell disease has improved considerably since 1960, when Sir John Dacie described sickle cell disease as “essentially a disease of childhood.” “Indeed,” he wrote, “the mortality is high and relatively few ...

In tumor-induced osteomalacia, a rare syndrome characterized by hypophosphatemia, hyperphosphaturia, low plasma 1,25-dihydroxyvitamin D concentrations, and osteomalacia,¹–⁵ all biochemical and pathological abnormalities disappear when the tumor is ...

Figure 1. Cutaneous Lesions of Disseminated Candidiasis.

Erythematous papules with pale centers are present on the arm of a 13-year-old boy with neutropenia and Ewing's sarcoma. Blood cultures grew Candida parapsilosis and C. lusitania. The lesions were ...

Hypopituitarism may be either partial or complete and may result from either pituitary or hypothalamic disease. Its clinical manifestations vary, depending on the extent and severity of the pituitary hormone deficiency. Thus, a patient may present in ...

The H₁-receptor antagonists are among the most widely used medications in the world. We review here the molecular basis of their action and their clinical pharmacology, efficacy in allergic disorders, and adverse effects. Although we will discuss the ...

Presentation of Case

A 37-year-old man was admitted to the hospital because of a pancreatic-duct lesion and several bouts of acute pancreatitis.

The patient had been in excellent health until 2 1/2 years earlier, when acute pancreatitis developed, with ...

What mark dost see that I can trust?

--Euripides, Electra

Physicians and their patients have long known that the development of the most common chronic diseases is influenced by genetic factors. Hypertension, asthma, ischemic heart disease, diabetes, and ...

Phosphate plays a critical part in the regulation of cell metabolism, and phosphate homeostasis is closely regulated in normal humans. Indeed, like serum calcium, serum phosphate is maintained within a narrow range of values, and people with abnormal ...

To the Editor: In their interesting report, Newcomb et al. (Jan. 13 issue)¹ do not speculate about why the reduced risk of breast cancer associated with lactation was limited to premenopausal women. Changes in breast-feeding practices in the United ...

To the Editor: Pershagen et al. (Jan. 20 issue)¹ were thorough in their measurements of radon exposure, but the incidence of smoking that they reported may have been seriously underestimated. If so, the relative risk of lung cancer associated with radon ...

To the Editor: Tint et al. (Jan. 13 issue)¹ reported a biochemical defect in cholesterol biosynthesis that gives rise to a well-recognized dysmorphic syndrome, the Smith-Lemli-Opitz syndrome. Plasma from affected children contains a high concentration of ...

To the Editor: Periconceptional supplementation with multivitamins including folic acid or with folic acid alone can reduce both the first occurrence and the recurrence of neural-tube defects¹–³. We examined the effect of such supplementation on multiple ...

To the Editor: We were intrigued by Case 2-1994 (Jan. 13 issue),¹ which describes constrictive pericarditis and mitral regurgitation associated with a myxomatous mitral valve. Tricuspid annuloplasty was required when severe tricuspid regurgitation was ...

To the Editor: During further analysis of the data used in our study of single-drug therapy for hypertension in men (April 1, 1993, issue),¹ we discovered two errors in the computer program; these errors affected the results that we reported in Figures 2 ...

To the Editor: The article by McCormack (Jan. 13 issue)¹ makes no mention of the importance of routine screening for syphilis and the human immunodeficiency virus (HIV) in patients with pelvic inflammatory disease. Only two of the four treatment regimens ...

To the Editor: Primary hyperoxaluria with l-glyceric aciduria (primary hyperoxaluria type 2) is caused by a deficiency of d-glycerate dehydrogenase,¹ which catalyzes the conversion of hydroxypyruvate to d-glycerate. Because this enzyme also has ...

To the Editor: The superb photographs of a diaper soaked with urine containing a high porphyrin level (Jan. 13 issue)¹ warrant additional clarification so as not to mislead readers¹. No specific diagnosis beyond porphyria is given, and it should be ...

To the Editor: Incorrect use of metered-dose inhalers continues to be a problem in clinical practice. Although misuse is commonly related to poor coordination between actuation and inhalation, failure to inhale slowly, or inadequate holding of breath, ...

This two-volume work is an unparalleled, comprehensive bible for orthopedic surgeons. Its 112 contributors make up the “dream team” of sports medicine. The first 400-odd pages cover the important areas of musculoskeletal basic science, statistics on ...

This monograph on traumatic sports injuries to the soft tissues serves as a source for primary care physicians, in particular those who care for athletes at all levels. By narrowing their focus to the soft tissues, the authors avoid repetition of material ...

Shephard has followed up his very successful Endurance Fitness (2nd ed. Toronto: University of Toronto Press, 1977) with a thought-provoking, heavily referenced, academic summary of exercise and health. This book is destined to be as well received as his ...

Over the past 25 years there has been an explosion of new techniques and procedures in plastic and reconstructive surgery. This progress is due to an improved understanding of the blood supply to the tissues of the body, and it has allowed the rapid and ...

This book provides up-to-date information on the treatment of pediatric spinal disorders, discussed in the context of a clear description of the specific disease, anomaly, or injury of the spine and the natural history of these entities. It provides good ...

This book is divided into three sections: one on neck ache, the second on shoulder pain, and the third a single chapter that reviews the differential diagnosis of neck and shoulder pain. The concepts are presented with remarkable clarity and precision. ...

Book Review of Less Time to Do More: Psychotherapy on the Short-Term Inpatient Unit Book Review, N Engl J Med 1994:330;1245.. The publisher of the book should have been listed as the American Psychiatric Press, in Washington D.C. We regret the error.