Atrial fibrillation is a well-known manifestation of hyperthyroidism. Among older people, in whom atrial fibrillation is common,¹–⁴ hyperthyroidism is relatively uncommon, however⁵–⁷. Thus, although hyperthyroidism is a risk factor for atrial fibrillation,...

Current regimens of intensive chemotherapy produce remissions in almost all children with acute lymphoblastic leukemia. Additional treatment with consolidation and maintenance chemotherapy cures up to 70 percent of these children, but in about 25 percent ...

Mutations of the p53 gene are the most common genetic defect in human tumors¹. The p53 gene functions as a tumor-suppressor gene and more specifically as a cell-cycle regulator². Levels of p53 protein increase in response to damage to DNA, arresting the ...

Figure 1. Coronary Arteriovenous Fistula on Coronary Angiography.

A large coronary arteriovenous fistula can be seen originating in the left coronary artery, coursing over the lateral and posterior walls of the left ventricle, and eventually emptying into ...

Most proposals to increase access to primary care in the United States emphasize increasing the proportion of generalist physicians¹–⁵. Another approach is to increase the number of other practitioners -- specifically, physician assistants, nurse ...

Although the rate of acute severe adverse cutaneous reactions to medications is low, these reactions can affect anyone who takes medications and can result in death or disability¹. Even a small number of cases associated with a particular drug may alter ...

Progressive fibrosis in the kidney, liver, lung, heart, bone marrow, and skin is both a major cause of suffering and death and an important contributor to the cost of health care. All of this is likely to change in the future. Advances in cell and ...

Presentation of Case

A 77-year-old woman was admitted to the hospital because of pain in the head and legs, fever, and sweats.

The patient had been well until four weeks earlier, when she began to experience pain in the neck that extended over the lower ...

Since the introduction 10 years ago of assays for serum thyrotropin that are sensitive enough to distinguish between normal and low concentrations, the measurement of serum thyrotropin has become the single best test of thyroid function. The reason is ...

Public spending for prenatal care in the United States has been justified in recent years primarily by the cost-savings argument. Prenatal care, it is argued, can prevent the costs and medical complications associated with low birth weight; it is public ...

To the Editor: Saper and Breder provide a comprehensive review of the neurologic basis of fever (June 30 issue).¹ Thermoregulation involves a complex interaction of autonomic, endocrine, and behavioral responses governed largely by the hypothalamus. ...

To the Editor: Lie et al. (July 7 issue)¹ report that if a woman's first child had a birth defect, the risk of her second child's being affected was increased, but that this excess risk in the second child was lower if the woman moved after the birth of ...

To the Editor: The suggestion by Cheung et al. (June 30 issue)¹ that an acetaminophen overdose in an alcoholic should be treated with acetylcysteine regardless of the serum acetaminophen concentration is unfounded and contrary to the available evidence. ...

To the Editor: Sebastian and colleagues (June 23 issue)¹ report that the administration of potassium bicarbonate reduced net acid and calcium excretion and had beneficial effects on measures of bone turnover in postmenopausal women. They suggest that the ...

To the Editor: In Crapo's review of pulmonary-function testing (July 7 issue),¹ I was surprised by the statement, “Some subgroups (e.g., cigarette smokers and people exposed to known agents of lung injury, such as asbestos or diisocyanates) are at higher ...

To the Editor: I have a large geriatric-internal medicine practice. I have enthusiastically adopted the use of the salmeterol inhaler (twice a day) for my patients as a way to improve compliance. In the past three months, two elderly patients with ...

To the Editor: Kinzler and Vogelstein (July 7 issue)¹ eloquently discuss the clinical implications of basic research on the p53 tumor-suppressor gene. In key statements, they suggest that p53 mutations may provide a genetic basis for drug resistance and ...

To the Editor: I want to draw your attention to the viability of the human immunodeficiency virus (HIV) in cadavers and the implications of the presence of live HIV during embalming procedures in anatomy departments and during the dissection of embalmed ...

It is 7 a.m. I am sitting in a heroically proportioned lecture hall trying to focus my eyes. On a table in front of me, slightly blurred, sits what was advertised as a continental breakfast: lukewarm coffee in a styrofoam cup and a Danish, which is “...

Americans enjoy big novels, biographies, and textbooks. Now they have a big book on psychiatric epidemiology. The title may represent a limitation, since with the present tendency for psychiatry to cuddle up to the neurosciences it would be more au ...

Research news on nutrition, eating behavior, and body weight is currently capturing headlines in the medical literature and the popular press. This multiauthored book provides a timely, comprehensive overview of current research on bulimia nervosa, for ...

This resource book brings us up to date on the facts about premenstrual dysphoria while showing how these facts are embedded in a sociocultural context that is fraught with psychological meaning and mythology and much in need of continued study and ...

Medicine is far more than an empirical activity, and physicians are not mere technocrats. The underlying philosophies of how we regard nature and ourselves determine the very character of medicine. Thus, the vast differences between medicines in China and ...

This is an easily read book that makes embryology easy to understand. However, I think it is geared more to the general public than to the medical profession. The book deals with the embryologic processes leading to congenital abnormalities. There are ...

Except when caused by noxious gases or fumes, bronchiolar diseases have long been viewed as diseases of childhood that are caused mainly by microbes. Recently, bronchiolar diseases have been recognized as clinically important diseases affecting all age ...

More on the GUSTO trial Correspondence, N Engl J Med 1994:331;277-278.. On page 277, in the second footnote at the bottom of the right-hand column, the wrong number (0512X) was given for the NAPS document. A new number, 05145, has been assigned, and the ...