The risk of having an infant with a birth defect varies among women. This heterogeneity is expressed in the relatively high risk of having a second infant with the same defect as the first infant. For example, among women who have one infant with a cleft ...

It has been established that the risk of breast cancer is decreased in women who have their first child at an early age,¹ but there is no consensus about the effect of subsequent pregnancies. Some authors suggest that bearing two or more children has an ...

Fibroadenomas are benign breast tumors composed of epithelial and stromal components¹. Women can present with these lesions at any age, but the tumors are most commonly diagnosed when the patients are in their 20s -- an age when breast cancer is extremely ...

Throughout the world, pertussis remains a major cause of morbidity and mortality among infants; it is estimated to account for more than 600,000 deaths annually¹. Whole-cell pertussis vaccines have been effective in controlling the disease but have not ...

In September 1991, the New Jersey Department of Health received two case reports of Plasmodium vivax malaria presumed to have been locally acquired in New Jersey. Both patients reported no known exposure to malaria, including travel to areas of endemic ...

Figure 1. Loffler's Endocarditis.

A transverse slice of the heart from a 65-year-old man with Loffler's endocarditis shows large mural thrombi (T) surrounding the thickened endocardium in both ventricles. Loffler's endocarditis is characterized by ...

Pulmonary-function tests provide objective, quantifiable measures of lung function. They are used to evaluate and monitor diseases that affect heart and lung function, to monitor the effects of environmental, occupational, and drug exposures, to assess ...

Sotalol hydrochloride is a potent noncardioselective β-adrenergic-blocking agent devoid of intrinsic sympathomimetic and membrane-stabilizing actions¹–⁶. Unlike other β-adrenergic-blocking drugs, sotalol (4-(2-isopropylamino-1-hydroxyethyl) ...

Forty years after the discovery of the double helical structure of DNA, it is still remarkable that this deceptively simple molecule specifies virtually everything about the form and function of all cells and all organisms. The way DNA stores its code of ...

Stage

A 68-year-old man was evaluated for a two-year history of hypercalcemia, constipation, generalized weakness, and slowing of intellectual function. He had a 20-year history of recurrent nephrolithiasis. He had been treated for a peptic ulcer at the ...

When I was a first-year medical student at New York University in 1950, neither the biochemistry curriculum nor the 650-page textbook we used mentioned DNA or genes. For the entire year, I studied carbohydrates, fats, and proteins; the composition of milk ...

Birth defects are the leading cause of infant mortality, and they account for much of the disability in children in the United States and most developed countries¹,². To reduce infant mortality we must find the causes of birth defects and implement ...

Although gene therapy and immunotherapy hold great promise for the future, cancer treatment now centers around surgical resection, radiation therapy, and chemotherapy. The therapeutic basis of surgical resection is obvious, but the same cannot be said for ...

To the Editor: In a well-designed study Cook et al. (Feb. 10 issue)¹ purport to identify risk factors for gastrointestinal bleeding in critically ill patients. “Critically ill patients” is not rigorously defined, but one may infer from the study design ...

To the Editor: Jensen et al. (Feb. 10 issue)¹ showed that recurrent bleeding of duodenal ulcers can be prevented to a large extent by instituting maintenance therapy with histamine H-receptor blockers. Since the authors excluded all patients who were ...

To the Editor: Steiner et al., in their report on operative mortality among patients undergoing cholecystectomy (Feb. 10 issue),¹ blame the absence of a significant reduction in total mortality after the adoption of the laparoscopic technique on the ...

To the Editor: The article by Soper et al. (Feb. 10 issue)¹ reviews the development of laparoscopy with respect to general surgery. However, the authors omit a group of surgeons who were the forerunners of today's laparoscopic surgeons. Gynecologists ...

To the Editor: Drs. First and Palfrey (Feb. 17 issue)¹ emphasize the importance of assessing language and cognitive skills -- the two developmental areas most predictive of overall outcome and success in school -- but they are in error in stating that ...

To the Editor: The method reported by Quintero et al. (Feb. 17 issue)¹ of umbilical-cord ligation of an acardiac twin by fetoscopy is clearly superior to hysterotomy² and to ultrasound-guided procedures reported so far. The intraarterial placement of ...

To the Editor: The neuropsychiatric side effects of the antimalarial drug mefloquine are well documented¹,². They include anxiety, depression, hallucinations, acute psychosis, and seizures. The incidence of these side effects is 1 in 13,000 with ...

To the Editor: During the Persian Gulf war, military personnel were exposed to toxic fumes from burning oil in Kuwait. We report the case of a 23-year-old man who presented with a one-month history of worsening fatigue and shortness of breath on ...

To the Editor: Dipyridamole, a widely used vasodilatory drug, enhances renal tubular reabsorption of phosphate by decreasing adenosine uptake by tubular cells.¹ In rats, dipyridamole prevents phosphate excretion induced by cyclic AMP and decreases the ...

To the Editor: Dunkle et al. (Nov. 28, 1991, issue)¹ reported that treatment with acyclovir reduces the duration and severity of chickenpox in normal children when therapy is begun during the first 24 hours after the appearance of rash. The effect of ...

The audience for this book is medical sociologists, policy makers and planners concerned with health work-force issues, and those who would encourage the professional development of women. The studies in this book not only contribute to empirical ...

It has never been easy being female on this planet. An editorial in the The New York Times (Feb. 14, 1994), inspired by the most recent human-rights report by the State Department on the condition of women worldwide, reminds us that “no one social, ...

Within the past several years, the surgical management of diseases of the breast has become increasingly a shared enterprise involving both general or oncologic surgeons and reconstructive surgeons. This new atlas exemplifies the benefits of such ...

This comprehensive and encyclopedic textbook will guide the reader through the pitfalls in diagnosing clinical ophthalmologic disorders. Rather than merely list the differential diagnosis of a specific clinical finding, the authors describe in detail the ...

In his preface to this series, one of the editors writes that many students probably are attracted to ophthalmology because of the erroneous notion that one should be able to master all available knowledge about an organ as small and anatomically well ...

In the ongoing struggle in the private marketplace to attract new patients to managed care, health plans continue to score impressive gains over fee-for-service physicians and indemnity insurers. In the political marketplace, however, the American Medical ...