Maternal-infant transmission is the primary means by which young children become infected with human immunodeficiency virus type 1 (HIV)¹,². From 15 to 40 percent of infants born to infected mothers become infected in utero, during labor and delivery, or ...

Human immunodeficiency virus (HIV) infection of adults and children results in severe dysfunction of B cells and T cells¹–⁴. Whereas in adults opportunistic infections are the most common manifestations of HIV-related immune impairment, children ...

Non-insulin-dependent diabetes mellitus (NIDDM) is likely to develop in persons with impaired glucose tolerance. The proportion of study subjects in whom the condition progresses to diabetes depends on their characteristics, the length of follow-up, and ...

Idiopathic IgA nephropathy is the most common glomerular disease in the world. Renal failure develops in 20 to 40 percent of patients 5 to 25 years after diagnosis¹–⁵. The pathogenesis of the disease is poorly understood,⁶ and there is no effective ...

Figure 1. Microsurgical Fertilization and Blastomere Removal for Genetic Analysis.

The oocyte and embryo are each immobilized at the tip of a holding pipette by the application of a gentle vacuum to the surrounding zona pellucida (zp). Intracytoplasmic ...

Despite efforts to decrease sexual activity and increase the use of effective contraceptive practices, 10 percent of adolescent girls in the United States become pregnant each year¹. Among those who give birth, 16 to 30 percent are pregnant again within a ...

Idiopathic thrombocytopenic purpura (ITP), also referred to as primary immune thrombocytopenic purpura, is defined by a low platelet count, normal bone marrow, and the absence of other causes of thrombocytopenia. This review focuses on ITP and its ...

The traditional method of identifying a pathogen by culturing it is a key element in forging the causal link between a particular disease and a specific microorganism. However, many kinds of infectious agents, including mycobacteria, fungi, and viruses, ...

Stage

A previously healthy 47-year-old man presented to the emergency room after the sudden onset of cough, shortness of breath, and tightness in his chest while climbing stairs.

Response

The first thing that occurs to me is that this man may be having ...

Over the past 15 years, human immunodeficiency virus (HIV) infection has become a major cause of illness and death in young children. Each year approximately 7000 HIV-infected women give birth in the United States; 1000 to 2000 of their infants are ...

In February 1994 the Data and Safety Monitoring Board of the National Institute of Allergy and Infectious Diseases recommended the interruption of a clinical trial designed to determine whether the administration of zidovudine to pregnant women infected ...

In 1992 the direct costs of diabetes mellitus and its complications in the United States were estimated at a staggering $45 billion,¹ more than the total annual cost of the British National Health Service. Preventing this disease and especially its ...

A quarter of a century ago, Jean Berger, using recently developed immunofluorescence methods, discovered diffuse mesangial deposits of IgA on light microscopy of kidneys with focal, glomerular lesions.¹ IgA nephropathy is now the most common form of ...

In the United States approximately one of every eight young women between 15 and 19 years of age becomes pregnant, a rate that has not changed for the past 15 years.¹ The remarkable constancy of this discouraging figure masks two offsetting trends; ...

To the Editor: As rheumatologists who have examined and evaluated a combined total of more than 3000 symptomatic women with silicone breast implants, we feel compelled to point out the shortcomings of the study by Gabriel et al. (June 16 issue).¹ This ...

To the Editor: We believe that some important aspects of the immunogenetics and the pathogenesis of systemic lupus erythematosus (SLE) are missing in the review article by Mills on SLE (June 30 issue).¹ Mills states that many clinical manifestations of ...

To the Editor: Siscovick et al. (June 30 issue)¹ report that higher doses of thiazide diuretics were associated with an increased risk of cardiac arrest. They state that they corrected for the differences between the case and control patients, but this ...

To the Editor: We read the Brief Report by Saba et al. (June 23 issue)¹ on the treatment of bleeding in hereditary hemorrhagic telangiectasia with aminocaproic acid with a mixture of hope and concern. Although Saba and colleagues had success with ...

To the Editor: In their discussion of exercise training for physical frailty in very elderly people (June 23 issue),¹ Fiatarone et al. compare resistance training with endurance training, stating that “endurance training has generally resulted in ...

To the Editor: Your thoughtful and scholarly editorial (June 23 issue)¹ awarding a grade of C to computer-assisted diagnosis steers an admirable middle course between wild enthusiasm (expressed by some of our colleagues in computer-related fields) and ...

To the Editor: If Dr. Casscells's letter (June 23 issue)¹ is representative of how physicians think about handguns in this country, then I am shocked by the lack of common sense in our profession. Do we really believe that criminals buy their ammunition ...

Society and physicians in the United States remain unable to accept death and thus unable to deal with the physical, psychological, and spiritual approach of death. The hour of death itself “is commonly tranquil,” but “the serenity is usually bought at a ...

Michael Lerner has undertaken to present a road map of the maze of therapeutic options presented to patients with cancer by doctors, family members, neighbors, friends, and the media in contemporary America. The book is for patients, and thus should be ...

Few general physicians caring for adults under 45 years of age realize that in a given year their patient population includes as many survivors of childhood cancer as patients who will be newly diagnosed with breast or lung cancer. Schwartz et al. remind ...

Uncontrolled pain is understandably a predominant concern of patients with cancer. The difficulties in its management make it a major challenge to clinicians as well. This excellent and comprehensive book admirably addresses and illuminates the decisions ...

Although cutaneous malignant melanoma accounts for only 3 percent of all neoplasms, its incidence has risen more rapidly than that of any other cancer, with an 83 percent increase between 1973 and 1987. If this trend continues, it is estimated that the ...

The collaboration of two experts from the University of Kentucky, one in pathology (Deborah E. Powell) and the other in diagnostic radiology (Carol B. Stelling), makes this book an eminently practical and useful addition to the library of books on breast ...