During the postpartum period many women are eager to lose weight. Exercise is often considered safer than dieting and is beneficial since it maintains lean body tissue and improves cardiovascular fitness. However, a high level of physical activity may ...

Over the past decade, cocaine abuse has become widespread, with over 30 million Americans estimated to have used it¹. As its use has escalated, cocaine-associated catastrophic cardiac events, such as acute myocardial infarction and sudden death, have been ...

Twenty percent of women have polycystic ovaries,¹,² which when associated with menstrual irregularity, anovulation, hirsutism, and acne, constitute the polycystic ovary syndrome (PCOS)²–⁴. There is no single biochemical marker of PCOS, although elevated ...

Hypothyroidism in neonates and very young infants is usually caused by thyroid dysgenesis associated with an absent, ectopic, or hypoplastic gland¹. It can be detected by neonatal screening, even if it is not clinically evident at that time. Although this ...

Twin reversed-arterial-perfusion sequence is a serious complication of monozygotic multiple gestations, affecting 1 percent of monozygotic twins, or 1 in 35,000 births¹. It has been hypothesized that in the presence of artery-to-artery and vein-to-vein ...

Figure 1. Multiple Myeloma.

Dysplastic plasma cells are visible in the bone marrow of a patient with multiple myeloma. Many of the nuclei contain nucleoli. A binucleated plasma cell can be seen in the center of the field (Wright-Giemsa stain).

During the current debate on health care reform, access to state-of-the-art care for serious illness has been stressed as an essential part of universal health care. The American medical-research establishment has been praised as a major strength of the ...

Despite the 10 percent prevalence of developmental delay,¹ the early identification of such problems remains difficult. Although severe disorders can be recognized in infancy, it is unusual to diagnose speech impairments, hyperactivity, or emotional ...

Multiple myeloma accounts for 10 percent of hematologic cancers and kills approximately 10,000 Americans each year. The disease is more common in older persons, and blacks are affected twice as frequently as whites. The cause of multiple myeloma is ...

Presentation of Case

A 55-year-old man was admitted to the hospital because of a persistent urinary tract infection.

The patient had had an extensive anterior myocardial infarct 11 years earlier accompanied by ventricular tachycardia, and another ...

The United States is unique among nations in having private companies run its health insurance system, handle claims, and make determinations about coverage. Over the past 20 years, American physicians have increasingly felt the effects of competition ...

My main office is different from that of most physicians: I am assistant medical director for a very large insurance company. We administer self-insured accounts, as well as conventional, minimal-premium, and experience-rated health care policies. With ...

To the Editor: Despite the best of intentions, seemingly impartial members of an academic medical section frequently have a vested interest in the ongoing use and widespread medical acceptance of technical procedures and intellectual paradigms emanating ...

To the Editor: I take issue with the statement by Kassirer and Angell (Aug. 19 issue)¹ that “financial conflicts of interest are a matter of choice.” This implies that biomedical research worthy of publication takes place only in academic institutions ...

To the Editor: After an intensive marketing campaign by Genentech, the report by the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) investigators (Sept. 2 issue)¹ has finally appeared. In view ...

To the Editor: The recent report by Meade et al. (Aug. 26 issue)¹ relating plasma renin activity to ischemic heart disease in primarily normotensive subjects is consistent with and extends our previous investigation² in which a high renin-sodium profile ...

To the Editor: In a recent paper (Aug. 19 issue), Turpie et al. report a beneficial effect of adding aspirin to warfarin treatment for heart-valve recipients¹. We question the interpretation of this study.

The risk of major embolism among patients who ...

To the Editor: The international normalized ratio (INR) is a value calculated to help determine the intensity of anticoagulation therapy based on the results of prothrombin-time tests performed by laboratories using different reagents with different ...

To the Editor: Cocaine abuse has been associated with myocardial injury, infarction, and dysfunction caused by a number of mechanisms, including coronary vasospasm, thrombotic coronary occlusion, and marked systemic hypertension¹. We report a case of ...

To the Editor: I wish to take issue with a comment in the Clinical Problem-Solving article that appeared in the September 2 issue.¹ The case described was one of fulminating meningococcal septicemia. The discussant commented that the fellow travelers on ...

Adolescent pregnancy continues to be an issue of concern to the American public and to professionals in the fields of health, education, and social welfare. The public's need for knowledge is met primarily by newspaper and magazine articles and television ...

The answers that physicians and other health care workers are most likely to be seeking in a book on contraception are predictable. What is the current view of the relation between hormonal contraception and cancer? Do progestins differ in their effects ...

Dr. Stewart is associate professor of psychiatry and obstetrics and gynecology and codirector of the Program in Women's Mental Health at the University of Toronto, and Dr. Stotland is associate professor of clinical psychiatry and obstetrics and ...

Because of the emphasis on coronary artery disease in men, the incidence and severity of this disorder in women has often been minimized or ignored. The introduction to Cardiovascular Health and Disease in Women states that “Recognition of women's health ...

The Effects of Tissue Plasminogen Activator, Streptokinase, or Both on Coronary-Artery Patency, Ventricular Function, and Survival after Acute Myocardial Infarction Original Article, N Engl J Med 1993:329;1615-1622.. In the appendix on page 1621, Centre ...

Case Records of the Massachusetts General Hospital (Case 47-1993) Case Records of the Massachusetts General Hospital, N Engl J Med 1993:329;1639-1647.. On page 1639, in Table 1, the white-cell count should have been listed as 9800 per cubic millimeter; ...