There has been substantial controversy over the treatment of patients with candidemia. Descriptions of transient candidemia caused by venous catheters¹ led initially to the conclusion that some episodes might not require treatment. Recent data have, ...

Although the use of percutaneous transluminal coronary angioplasty has increased dramatically,¹ restenosis remains an important limitation of the procedure. Several pathophysiologic characteristics suggest similarities between the processes of restenosis ...

The mortality rate among patients with acute renal failure remains high, ranging from 42 to 75 percent, despite numerous advances in the diagnosis and treatment of this disorder¹–⁴. Several concurrent conditions, such as coma or dependence on a respirator,...

Whipple's disease is a systemic infection characterized most commonly by fever, weight loss, diarrhea, polyarthritis, and adenopathy¹,². Attempts to culture the causative organism have been unsuccessful, but microscopical examination of infected tissue, ...

Figure 1. Cholesteatoma.

A cholesteatoma medial to an intact translucent tympanic membrane is shown in the left ear of a five-year-old girl. This abnormality was found by an audiologist during screening at school. The tympanic membrane was illuminated ...

In 1972, topical tretinoin (Retin-A, Ortho Pharmaceutical) was approved for the treatment of acne. Today this remains the only medical indication for its use approved by the Food and Drug Administration (FDA). In 1988 a highly publicized study reported ...

In today's prescription-drug marketplace a host of similar products compete for essentially the same population of patients. Between 1989 and 1993, for example, the Center for Drug Evaluation and Research of the Food and Drug Administration (FDA) approved ...

The ability of tricyclic antidepressant drugs to inhibit the prejunctional reuptake of norepinephrine and serotonin may be responsible for their antidepressant effect. The ability of these drugs to block muscarinergic, H₁-histaminergic, and α₁-adrenergic ...

Presentation of Case

A 57-year-old man was admitted to the hospital because of evidence of gram-negative bacteremia, with peripheral edema and erythema of the leg with bullae.

The patient had been well until six weeks earlier, when edema of the lower ...

The future viability of academic medical centers is threatened. These institutions have flourished since the 1960s, even managing to survive the shift toward prospective payment over the past decade, but many are now in danger of becoming seriously ...

Finding the optimal treatment for patients with candidemia has been a major source of frustration for physicians during the past decade. It is a tremendous challenge, since the infection is often an obstacle to successful therapy, and the cost in terms of ...

Acute renal failure is an important cause of morbidity and mortality. The annual incidence of severe acute renal failure in the United Kingdom is about 180 per million,¹ but substantial renal impairment may occur in up to 5 percent of patients undergoing ...

Many academic medical centers are developing complex organizations of physicians and large health networks that provide managed care to large groups of people. Leaders of these centers believe that these organizations and networks will provide the ...

To the Editor: The report on the neuropathological findings in the brain of Karen Ann Quinlan (May 26 issue)¹ proposes a role for the thalamus in the persistent vegetative state. However, we are concerned about the methods used and the interpretation of ...

To the Editor: The duration of survival cited for persons in a persistent vegetative state in the two-part review by the Multi-Society Task Force on PVS (May 26 and June 2 issues)¹ may not reflect the actual chances of a patient's surviving with good ...

To the Editor: In an otherwise cogent editorial (May 26 issue)¹ about public-policy alternatives for handling patients in a persistent vegetative state, Dr. Angell makes one inaccurate observation. We agree with her that calling such patients dead would ...

To the Editor: In the analysis of the Baby K case (May 26 issue),¹ Annas suggests that resolution of disputes between patients at the end of their lives and physicians can be made simply by distinguishing between legal and medical issues. However, thus ...

The objective of the editor of Difficult Concepts in Cardiology was to present issues of current interest in cardiology in a manner that is applicable, personal, and “fun to read.” The book has achieved these goals. The 18 chapters by contributors from ...

At last, a textbook that approaches the ideal for practitioners and teachers of electrocardiography. It takes its place among a large number of books ranging from the supersimplistic, with rigid paradigms that will fail in practice, to quite satisfactory ...

The specialty of clinical electrophysiology has evolved over the past two decades from an esoteric, predominantly investigative subspecialty to one that offers important therapeutic interventions for a variety of cardiac arrhythmias. As a consequence, ...

Clinicians have focused their attention on cardiovascular problems in the elderly since 1937, when Sir Thomas Lewis devoted a section of his Diseases of the Heart, Described for Practitioners and Student (London: Macmillan) to special problems in elderly ...

Cardiovascular Pharmacology and Therapeutics is a clinically pertinent, well-coordinated, and comprehensive reference work for any current library in cardiology.

The editors have directed their attention to fundamental concepts of cardiovascular drugs and ...

Interventional cardiovascular medicine has expanded rapidly during the past 17 years. No longer considered merely the technical counterpart of conventional cardiology, the field has evolved into a discipline that has coronary angioplasty as its primary ...

Vascular Diseases is an excellent, state-of-the-art discussion of the pathophysiology, diagnosis, and treatment of vascular disease. The contributing authors represent many of the leaders in vascular surgery and vascular imaging, the latter being an area ...

Many of the nation's academic medical centers face an uncertain future because of developments that threaten the traditional ways in which they have carried out their multiple missions. When Democratic congressional leaders recently declared comprehensive ...