Patients with coronary artery disease who have persistent symptoms and a diminished quality of life while receiving medical therapy are generally considered for revascularization. Coronary-artery bypass grafting (CABG) and percutaneous transluminal ...

Although percutaneous transluminal coronary angioplasty (PTCA) is frequently performed in patients with multivessel coronary artery disease, its value as compared with coronary-artery bypass grafting (CABG) has not been established. In contrast, bypass ...

The introduction of continuous positive airway pressure in 1971¹ improved the treatment of neonatal respiratory distress syndrome. With the early application of continuous positive airway pressure delivered nasally or by a face mask, the progression of ...

The actions of adrenal and gonadal steroids, thyroid hormone, and vitamin D are mediated by receptors encoded by a family of related genes. Mutations of glucocorticoid, androgen, thyroid hormone, and vitamin D receptors leading to syndromes of hormone ...

Figure 1. Fifth Disease.

Typical ”slapped cheek” rash is apparent in a two-year-old child with fifth disease (erythema infectiosum), caused by parvovirus B19 infection. The common lacelike erythema of the trunk is also present but not clearly in focus. ...

In the debate over health care reform, opponents argue that increased government involvement inevitably limits the use of costly forms of medical technology, even when the procedures provide the most appropriate treatment. To contribute empirical data on ...

Health care reform in the United States has focused attention on universal single-payer health insurance systems, such as the one in Canada¹,². Millions of Americans lack health insurance,³ and health care expenditures in the United States have increased ...

Conception is followed by a series of hormonal and metabolic changes that involve most maternal endocrine systems. With regard to thyroid metabolism, these include an increase in serum thyroxine-binding globulin and thyroid hormone concentrations, ...

Presentation of Case

A 55-year-old man was admitted to the hospital because of a tender left paraspinal mass.

The patient had been well until eight months earlier, when he began to experience pain and tenderness near the left costovertebral angle. The ...

Since coronary-artery bypass grafting was introduced by Favaloro in 1969,¹ its results have improved steadily even though the procedure has been performed increasingly in patients whose operative risk is relatively high because of advanced age, impaired ...

Most biologic arrangements seem so obvious, and so well adapted to their uses, that we tend to forget that things might have been worked out quite differently. Impious as it may be, it is worth thinking about evolutionary alternatives -- if only to deepen ...

Two articles in this issue of the Journal address how the United States rations medical care as compared with other countries. The specter of medical rationing -- the deliberate withholding of potentially beneficial care -- is usually invoked in health ...

Few diseases are as debilitating and inevitably lethal as amyotrophic lateral sclerosis (ALS). The disease typically strikes adults in midlife, causing paralysis and death within five years. The cause of most cases remains unknown, and the disease is ...

To the Editor: The studies by Small et al. and Alland et al. (June 16 issue)¹,² substantially advance our understanding of the recent resurgence of tuberculosis in urban areas of the United States.³ However, both groups present odds ratios that appear to ...

To the Editor: To find linkage between the angiotensinogen gene and essential hypertension in one underpowered study¹ and its subgroups requires good fortune; to present a second with still less power demands fortitude.² The demonstration of linkage ...

To the Editor: The report by Schunkert et al. (June 9 issue)¹ was intriguing, but it did not elaborate on why the effect of the DD genotype of the angiotensin-converting-enzyme (ACE) gene on the development of left ventricular hypertrophy was stronger in ...

To the Editor: The hepatopulmonary syndrome, which is characterized by hypoxemia due to intrapulmonary shunting or a ventilation-perfusion mismatch (or both), develops in some patients with liver cirrhosis. Patients with this syndrome have no apparent ...

To the Editor: In a recent letter (June 9 issue),¹ Dr. Chatterton asks how information from an epidemiologic article on the risks of lung cancer after exposure to radon by Pershagen et al. (Jan. 20 issue)² can be of value to him in his practice. The ...

To the Editor: As hospital stays are shortened and the population ages, more care must be provided at home. Physicians must be prepared to supervise home care as well as to provide it. Given the continuing evolution of vertically integrated health care ...

To the Editor: Dr. Angell editorializes (June 16 issue)¹ on her concern about the presentation of medical evidence in the courtroom, particularly in relation to the controversy swirling around breast implants. I also hope that the courts will develop ...

In late 1985, Dr. Abraham Verghese, freshly licensed infectious-disease specialist, arrived in Johnson City, Tennessee, to begin his practice. The number of AIDS cases was beginning to rise in the urban centers of the East and West Coasts. Dr. Verghese's ...

Michael King, an academic clinician at the Royal Free Hospital in London, has written this book for the Psychiatry and Medicine series, which focuses on the interface between medicine and psychiatry. The series integrates aspects of the two disciplines, ...

The Encyclopedia of Virology is a three-volume set encompassing the contributions of 270 leading international scientists, researchers, and clinicians in the field of virology. The entries cover the biologic, molecular, and medical aspects of animal, ...

Psoriasis is one of the more common problems of the skin and is treated by primary care physicians as well as by dermatologists. It is also one of the more difficult dermatologic problems to manage, especially severe cases. This book was written to guide ...

Headache is the subject of more than 50 books in print, ranging from self-help paperbacks to textbooks covering the entire spectrum of scientific literature on all the major subtypes of headache. Headache: Diagnosis and Treatment is yet another book on ...