The role of long-term vasodilator therapy in the care of asymptomatic patients with severe aortic regurgitation is of considerable interest. Aortic regurgitation results in an increase in left ventricular volume and thus in afterload; the left ventricle ...

Maternal infection with Toxoplasma gondii acquired during pregnancy may result in congenital infection and serious sequelae in the neonatal period or years after birth¹. Prenatal diagnosis of congenital toxoplasmosis is based on ultrasonography,² ...

In a previous two-year study of patients with generally mild asthma, we found that treatment with an inhaled corticosteroid, budesonide (1200 μg per day), resulted in rapid improvement in symptoms and lung function, whereas similar changes were not ...

The response of the plasma cholesterol concentration to cholesterol feeding is heterogeneous. In most people, plasma total and low-density lipoprotein (LDL) cholesterol increases when they are fed a diet high in cholesterol, but in some people there is ...

Figure 1. Brain Herniation in Toxoplasmosis.

A computed tomographic scan of the head (Panel A) shows subfalcial brain herniation in an outpatient who was seropositive for the human immunodeficiency virus and who had subtle changes in cognitive function ...

In many civilizations, certain surgical procedures have profound cultural and social meanings. Male circumcision, for example, has deep importance as a symbol of religious and ethnic identity and has played a major part in the political and social history ...

Peptic ulcer is the most common cause of acute hemorrhage in the upper gastrointestinal tract, accounting for about 50 percent of cases¹–¹⁴. There are approximately 150,000 hospitalizations per year in the United States for evaluation and treatment of ...

Presentation of Case

A 38-year-old man was admitted to the hospital because of progressive hoarseness.

The patient had been in stable health until six months earlier, when hoarseness developed and gradually worsened, especially during the two months ...

Major advances in the recognition, evaluation, and surgical treatment of valvular heart disease during the past two decades have yielded striking improvements in quality of life and long-term survival for patients with this disorder. These advances are ...

Asthma affects nearly 1 in 15 people in the United States and Europe. Although the cause or causes of asthma remain unknown, its pathophysiology has been well enough characterized to allow the development of two major classes of drugs for treatment -- ...

Even in countries where female genital mutilation is an age-old tradition, the belief that it should be eliminated is growing. For example, women who have themselves been mutilated are working at the grassroots level to eliminate female genital mutilation ...

To the Editor: Wood et al. (May 5 issue)¹ report the results of a randomized study of different doses and levels of dose intensity (dose per unit of time) of adjuvant chemotherapy in women with stage II, node-positive breast cancer. The study is an ...

To the Editor: Parsonnet and colleagues (May 5 issue)¹ reported an association between previous Helicobacter pylori infection and gastric lymphoma. Although H. pylori infects more than 50 percent of the people in the world, gastric lymphomas are very ...

To the Editor: Elevated levels of fetal hemoglobin may diminish the severity of the β-hemoglobinopathies sickle cell disease and β-thalassemia. In β-thalassemia, this effect is related to a reduction in the overall imbalance in the ratio of α-globin and ...

To the Editor: In their comparison of the educational costs and incomes of physicians and other professionals (May 5 issue), Weeks et al. found that dental specialists and attorneys working in law firms did better than specialist physicians.¹ I suspect ...

To the Editor: Tendinitis and tendon rupture are unusual and unexpected side effects of drugs¹,². An 85-year-old man had been treated for polymyalgia rheumatica with prednisone. His condition improved in the next three months, and the dose of prednisone ...

A few months ago in the Journal, Lester Grinspoon and James Bakalar argued that our drug policies “require a war of annihilation against a wrongly chosen enemy” (“The War on Drugs -- A Peace Proposal.” 1994;330:357-60). Confronting Drug Policy, a ...

On December 7, 1993, the Surgeon General of the United States, Joycelyn Elders, fired a shot heard around the world when she publicly stated that the legalization of drugs should be explored. Although Dr. Elders's statement gained considerable media ...

Dual Diagnosis is a welcome book for all of us who have suffered the frustration of dealing with patients who have both a psychiatric disorder and a substance-abuse disorder. This book represents the collective efforts of a “treatment resource team” ...

Professors Rabin and Sugarman have edited a timely book on smoking policy. It is fitting that the funding for the research and writing of the book grew out of one of the most important events in the history of tobacco control -- the passage in 1988 of ...

Smoking is the greatest preventable cause of mortality and morbidity in the United States. Yet most medical libraries have a limited number of works, if any, on the treatment of smoking. This deficiency has been due, in part, to the absence of a well-...